Search results for: respiratory failure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2915

Search results for: respiratory failure

575 Scaling up Small and Sick Newborn Care Through the Establishment of the First Human Milk Bank in Nepal

Authors: Prajwal Paudel, Shreeprasad Adhikari, Shailendra Bir Karmacharya, Kalpana Upadhyaya

Abstract:

Background: Human milk banks have been recommended by the World Health Organization (WHO) for newborn and child nourishment in the provision of optimum nutrition as an alternative to breastfeeding in circumstances when direct breastfeeding is inaccessible. The vulnerable group of babies, mainly preterm, low birth weight, and sick newborns, are at a greater risk of mortality and possibly benefit from the safe use of donated human milk through milk banks. In this study, we aimed to shed light on the process involved during the setting up of the nation’s first milk bank and its vitality in small and sick newborn nutrition and care. Methods: The study was conducted in Paropakar Maternity and Women’s Hospital, where the first human milk (HMB) was established. The establishment involved a stepwise process of need assessment meeting, formation of the HMB committee, learning visit to HMB in India, studying the strengths and weaknesses of promoting breastfeeding and HMB system integration, procurement, installation, and setting up the infrastructure, and developing technical competency, launching of the HMB. After the initiation of HMB services, information regarding the recruited donor mothers and the volume of milk pasteurized and consumed by the needy recipient babies were recorded. Descriptive statistics with frequencies and percentages were used to describe the utilization of HMB services. Results: During the study period, a total of 506113 ml of milk was collected, while 49930 ml of milk was pasteurized. Of the pasteurized milk, 381248 ml of milk was dispensed. The total volume of milk received was from a total of 883 after proper routine screening tests. Similarly, the total number of babies who received the donated human milk (DHM) was 912 with different neonatal conditions. Among the babies who received DHM, 527(57.7%) were born via CS, and 385 (42.21%) were delivered normally. In the birth weight category,9 (1%) of the babies were less than 1000 grams, 75 (8.2%) were less than 1500 grams, 405 (44.4%) were between 1500 to less than 2500 grams whereas, 423 (46.4%) of the babies who received DHM were normal weight babies. Among the sick newborns, perinatal asphyxia accounted for 166 (18.2%), preterm with other complications 372 (40.7%), preterm 23 (2.02%), respiratory distress 140 (15.35%), neonatal jaundice 150 (16.44%), sepsis 94 (10.30%), meconium aspiration syndrome 9(1%), seizure disorder 28 (3.07%), congenital anomalies 13 (1.42%) and others 33(3. 61%). The neonatal mortality rate dropped to 6.2/1000 live births from 7.5/1000 live births in the first year of establishment as compared to the previous year. Conclusion: The establishment of the first HMB in Nepal involved a comprehensive approach to integrate a new system with the existing newborn care in the provision of safe DHM. Premature babies with complication, babies born via CS, perinatal asphyxia and babies with sepsis consumed the greater proportion of DHM. Rigorous research is warranted to assess the impact of DHM in small and sick newborn who otherwise would be fed formula milk.

Keywords: human milk bank, sick-newborn, mortality, neonatal nutrition

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574 Design and Development of Engine Valve Train Wear Test Rig for the Assessment of Valve Train Tribochemistry

Authors: V. Manjunath, C. V. Chandrashekara

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Ecosystem authority calls for the use of lubricants with less effect on the nature in terms of exhaust emission, while engine user demands more mileage per liter of fuel without any compromise on engine durability. From this viewpoint, engine manufacturers require the optimum combination of materials and lubricant additive package to minimize friction and wear in the engine components like piston, crankshaft and valve train etc. The demands are placed for requirements to operate at higher speeds, loads, temperature and for extended replacement intervals of engine oil. Besides, it is necessary to accurately predict the lubricant life or the replacement interval to prevent lubrication and valve-train components failure. Experimental tribology evaluation of new engine oils requires large amount of time and energy. Hence low cost bench test is necessary for industries and original equipment manufacturing companies (OEM) to study the performance of lubricants. The present work outlines the procedure for the design and development of a valve train wear rig (MCR) to simulate the ASTMD-6891 and to develop new engine test for Indian automobile sector to evaluate lubricants for Indian automobile market. In order to improve the lubrication between cam and follower of internal combustion engine, the influence of materials or oils viscosity and additives on the friction and wear characteristics are examined with test rig by increasing the contact load at two different revolution speed. From the experimentation following results are made obvious. Temperature, Torque, speed and wear plots are used to validate the data obtained from the newly developed multi-cam cam rig (MCR) with follower against a cast iron camshaft. Camshaft lobe wear is measured at seven different locations on cam profile. Tribofilm formed using 5W-30 oil is evaluated and correlated with the standard test results.

Keywords: ASTMD-6891, multi-cam rig (MCR), 5W-30, cam-profile

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573 Effects of Earthquake Induced Debris to Pedestrian and Community Street Network Resilience

Authors: Al-Amin, Huanjun Jiang, Anayat Ali

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Reinforced concrete frames (RC), especially Ordinary RC frames, are prone to structural failures/collapse during seismic events, leading to a large proportion of debris from the structures, which obstructs adjacent areas, including streets. These blocked areas severely impede post-earthquake resilience. This study uses computational simulation (FEM) to investigate the amount of debris generated by the seismic collapse of an ordinary reinforced concrete moment frame building and its effects on the adjacent pedestrian and road network. A three-story ordinary reinforced concrete frame building, primarily designed for gravity load and earthquake resistance, was selected for analysis. Sixteen different ground motions were applied and scaled up until the total collapse of the tested building to evaluate the failure mode under various seismic events. Four types of collapse direction were identified through the analysis, namely aligned (positive and negative) and skewed (positive and negative), with aligned collapse being more predominant than skewed cases. The amount and distribution of debris around the collapsed building were assessed to investigate the interaction between collapsed buildings and adjacent street networks. An interaction was established between a building that collapsed in an aligned direction and the adjacent pedestrian walkway and narrow street located in an unplanned old city. The FEM model was validated against an existing shaking table test. The presented results can be utilized to simulate the interdependency between the debris generated from the collapse of seismic-prone buildings and the resilience of street networks. These findings provide insights for better disaster planning and resilient infrastructure development in earthquake-prone regions.

Keywords: building collapse, earthquake-induced debris, ORC moment resisting frame, street network

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572 Intensive Care Experience of Providing Palliative Care for a Terminal Lung Cancer Patient

Authors: Ting-I Lin

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Objective: This article explores the nursing care experience of a 51-year-old terminal lung cancer patient admitted to the intensive care unit (ICU) following an upper right lobectomy. The patient initially sought emergency treatment due to worsening cough and dyspnea, which led to the placement of an endotracheal tube following sudden deterioration. Subsequent CT scans and chest X-rays revealed a tumor in the upper right lung with metastases to the lungs, liver, bones, and adrenal glands. The patient underwent a right upper lobectomy and a wedge resection of the right middle lobe. Pathology staging: T4N3M1c and the patient was diagnosed with advanced cancer postoperatively. Method: During the care period, nursing staff continuously monitored the patient’s physiological data through observations, direct care, interviews, physical assessments, and review of the patient’s medical records. The nursing team collaborated with the critical care team and the palliative care team, using Gordon's Eleven Functional Health Patterns to conduct a comprehensive assessment. The key health problems identified included pain related to postoperative cancer resection and invasive devices, fear of death due to rapid disease progression, and altered tissue perfusion associated with hemodynamic instability. Results: Postoperatively, the patient experienced pain from the surgical wound and dyspnea due to extensive metastasis, often leading to confusion. Through the adjustment of pain medication, the patient’s discomfort was alleviated, using Morphine 8 mg in 0.9% normal saline 60 ml IV drip q6h prn, and Ultracet 37.5 mg/325 mg 1# PO q6h. Additionally, lavender essential oil inhalation and limb massage were provided for 15 minutes four times a day. The patient’s FLACC pain score decreased from 7 to below 3. After respiratory training, the endotracheal tube was successfully removed, and the patient was weaned off the ventilator. Triflow exercises were used to promote alveolar expansion, with the goal of achieving 2 balls for 10 seconds, 5 repetitions per session, 6-8 times a day. The patient’s breathing stabilized at 16-18 breaths per minute, body temperature remained between 35.8°C and 36.1°C, and the mean arterial pressure was maintained between 60-80 mmHg. Conclusion: The critical care team and the palliative care team held a family meeting to discuss not only the patient’s care but also the emotional well-being of the family. Visiting hours were increased to two times per day, one hour each time, allowing the patient and family to express love and gratitude, which strengthened their emotional connection and reduced the patient’s anxiety from severe to mild. The family expressed that they had no regrets. After the patient was transferred to the general ward, the nursing team continued to provide end-of-life care with genuine empathy, compassion, and religious support, helping both the patient and family through the final stage of life.

Keywords: multiple metastases, lung cancer, palliative care, nursing experience

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571 Nephroprotective Activity of Aqueous Methanolic Extract of Aerva Lanata (Busehri Booti) against Cisplatin Induced Nephrotoxicity in Rats

Authors: Mohd Aslam Aslam

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Chronic renal failure is a debilitating condition responsible for high morbidity and mortality. Because of its costs and the complexity of its treatment, proper care is available to very few patients in India. According to researchers, the number of adults aged 30 or older who have chronic kidney disease is projected to increase from 13.2 percent currently, to 14.4 percent in 2020 and 16.7 percent in 2030. The aerial part of Aerva lanata (Busehri booti) have been used in kidney disorders by the Unani physicians. In the present study, the effect of extract of Aerva lanata was investigated on cisplatin-induced nephrotoxicity in rats. The renal effects of this drug was evaluated by monitoring levels of blood urea nitrogen (BUN), serum creatinine, serum uric acid in blood and histopathological examination of kidney. Aerva lanata was evaluated at two different doses (1400 mg/kg and 2800 mg/kg). The effect of higher dose was more pronounced in terms of inhibition in the rise of BUN, serum creatinine and uric acid. Higher dose show greater prevention in the rise of BUN, serum creatinine, and uric acid. The histopathological examination of the kidney tissue of the rats treated with aqueous methanolic extract of Aerva lanata (Higher dose-2800 mg/kg) showed marked inhibition of glomerular congestion, tubular casts, peritubular congestion, epithelial desquamation, blood vessel congestion, interstitial edema and inflammatory cells produced by the cisplatin-induced nephrotoxicity. This finding clearly indicates the protective role of Aerva lanata at higher dose. Present investigation validates the use of Aerva lanata in kidney disorders by Unani physicians.

Keywords: Aerva lanata, Busehri booti, nephroprotective, unani medicine

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570 A Suggested Study Plan for Mining Engineering Program in Northern Border University (NBU) to Match the Requirements of the Local Mining Industry

Authors: Mohammad Aljuhani, Yasamina Aljuhani

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The Mining Engineering Department at College of Engineering in NBU is under establishment. It is essential to establish such department in NBU. This is because, it is the only university in the region. Moreover, the mining industry is very active in the northern borders region. However, there is no mining engineering department in KSA except one in King Abdulziz University, which is 1400 km from the mining industry in the northern borders. As a result, department graduates from KAU find difficulties to get suitable jobs in their specialization in spite of their few numbers graduated per year and the presence of many jobs vacancies at the local mining sector. Therefore, the objectives of this research are to identify, measure and analyze the above mentioned problem from educational point of view. One more objective is to add a contribution towards solving such vital, society affecting problem. For achieving the first task of the research, that is problem size identification and analyses, a questionnaire was designed. The questionnaire was directed towards experienced engineers, in the mining and related industries, including the ministry of petroleum and minerals, Saudi Geological Survey, and Ma’aden Company as being prospective employers for the mining sector. The questionnaire target was to evaluate the Saudi mining engineers from an industrial point of view and to detect the main reasons behind their failure to find jobs. In addition, the study focuses in the demand of mining engineers in the northern borders region. Moreover, the study plan of the suggested department is designed based on the requirements of the mining industry. The feedback received from the industry reflected major educational shortcomings. In order to overcome the revealed defects, the second objective of the research was achieved where a suggested study plan “curriculum” has been prepared to take into consideration all the points of weakness so as to improve the graduates’ quality to fit the local mining work market.

Keywords: mining engineering, labor market, qualifications, curriculum, mining industry, mining engineers

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569 Computational Modeling of Load Limits of Carbon Fibre Composite Laminates Subjected to Low-Velocity Impact Utilizing Convolution-Based Fast Fourier Data Filtering Algorithms

Authors: Farhat Imtiaz, Umar Farooq

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In this work, we developed a computational model to predict ply level failure in impacted composite laminates. Data obtained from physical testing from flat and round nose impacts of 8-, 16-, 24-ply laminates were considered. Routine inspections of the tested laminates were carried out to approximate ply by ply inflicted damage incurred. Plots consisting of load–time, load–deflection, and energy–time history were drawn to approximate the inflicted damages. Impact test generated unwanted data logged due to restrictions on testing and logging systems were also filtered. Conventional filters (built-in, statistical, and numerical) reliably predicted load thresholds for relatively thin laminates such as eight and sixteen ply panels. However, for relatively thick laminates such as twenty-four ply laminates impacted by flat nose impact generated clipped data which can just be de-noised using oscillatory algorithms. The literature search reveals that modern oscillatory data filtering and extrapolation algorithms have scarcely been utilized. This investigation reports applications of filtering and extrapolation of the clipped data utilising fast Fourier Convolution algorithm to predict load thresholds. Some of the results were related to the impact-induced damage areas identified with Ultrasonic C-scans and found to be in acceptable agreement. Based on consistent findings, utilizing of modern data filtering and extrapolation algorithms to data logged by the existing machines has efficiently enhanced data interpretations without resorting to extra resources. The algorithms could be useful for impact-induced damage approximations of similar cases.

Keywords: fibre reinforced laminates, fast Fourier algorithms, mechanical testing, data filtering and extrapolation

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568 Influenza Virus Circulation among the Population of Kazakhstan in 2012-2014

Authors: N. G. Klivleyeva, T. I. Glebova, G. V. Lukmanova, S. B. Bayseit, S. Z. Taubaeva, M. K. Kalkozhaeva

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The role of viral diseases in the general infectious disease incidence increases every year and requires special attention to the problem of interpreting the etiology of infectious agents. Influenza and acute respiratory viral infections are one of the most pressing public health issues. In the period 2012-2014, collection of 419 nasal swabs and 150 blood sera has been carried out in the patient care institutions of the various Kazakhstan regions from patients with symptoms of ARVI and pneumonia. Primary identification of biosamples for the presence of influenza viral antigens in enzyme immunoassay on nitrocellulose membrane gave positive results in 125 swabs (29.8%). Biosample screening in immunofluorescence test revealed the presence of influenza viral antigens against A/H1 in 63 samples (15.0%), A/H3 – in 70 samples (16.7%) and type B – in 9 samples (2.1%). As a result of primary infection, and successive passages in chick embryos and MDCK cell cultures, 38 HAAg were isolated from 419 samples with a clear cytopathic effect and hemagglutination titre in MDCK cell culture within 1:2-1:4, in CE - 1:8-1:256. The infectivity of isolates in chicken embryos were 3.5-6.5 lg EID50/0.2, in MDCK cell culture – 2.5-6.5 lg PFU/ml. Identification of 28 isolates was carried out in inhibition reactions of hemagglutinating activity and neuraminidase activity, showed their belonging to the influenza virus: 26 strains to A/H1N1, one - to A/H3N2, and one - to type B. Serological examination of blood sera for the presence of specific antibodies being an indirect evidence of the performed isolation and contributing to the timely interpretation of the disease etiology in the epidemics takes an important place in the comprehensive study of influenza viruses circulating among people. Serological analyzes were carried out in HAI assay using a kit consisting of 12 reference strains obtained from the WHO centre for reference and research on Influenza (CDC, Atlanta, USA) and three Kazakhstan (A/Almaty/347/09 (H1N1v), A/Almaty/462/11 (H3N2) and B/Almaty/414/10) human influenza viruses that are stored in the laboratory collection. The results of serological analysis of 150 blood sera showed that antihaemagglutinins against the A/H3N2 virus serosubtype were found in 46 samples (49.4%) out of 93 sera collected in 2012-2013. The antibody titres were within 1:160-1:320. 19 sera (20.4%) were seropositive against influenza A/H1N1 virus, the antibodies were observed in titres of 1:20-1:40. Six sera (6.4%) were positive against the influenza A/H1N1+A/H3N2 virus (mixed infection); the antibodies were recorded in titres of 1:20-1:40. Antihaemagglutinins against influenza type B virus were detected only in five sera (5.4%). The results of analysis of 57 sera collected in 2014 showed that antihaemagglutinins against A/H3N2 virus subtype were detected in 32 blood sera (56.1%) in titres of 1:160-1:640. Ten sera (17.5%) were seropositive against A/H1N1 virus; antihaemagglutinins against influenza type B virus were not detected. Therefore, virological and serological studies have shown that in Kazakhstan, as well as in the world, the influenza viruses A/H1N1, A/H3N2 and influenza B viruses were actively circulating during the epidemic seasons in 2012-2014.

Keywords: influenza, MDCK cell, serological analysis, virus

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567 Mangrove Plantation in a Reclaimed Land From the Sea

Authors: Anusree Ghosh, Nahid Morshed, Tapas Ranjan Chakraborty, Moniruzzaman Khan, Liakath Ali

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To establish the Bangabandhu Sheikh Mujib Shilpa Nagar in Mirsarai, Chattogram land was reclaimed from the river mouth of the Feni River in the Bay of Bangle. The sandy land has a salinity of 9.5 EC ds/m, and the water of the adjacent Bay was 13.2 EC ds/m during winter, i.e., it has moderate salinity. The selection of plant species for the plantation was following the local practices. Mangrove plantation in a such landscape is not common in the country, and some actions towards the plantation seem ineffective and could be accomplished differently. The aim of this paper is to analyze the trial and develop a strategy for mangrove afforestation in reclaimed land where the tidal effect does not occur year-round. Though the Keora (Sonneratia apetala) is the priority species in a typical mangrove plantation, the success rate is comparatively high for the Baen (Avcennia officinalis) and Sada Baen (Avicennia alba). The natural growth was recorded for Keora, Goran (Ceriops decandra), Lal Jhau (Tamarix dioica) and Baen. Though there was the natural growth of Durba grass (Cynodon dactylon) and Motha Gash (Cyperus rotundus), no growth of climber was reported at the early stage of the natural growth. The transplanted growth of Keora, Gewa (Excoecaria agallocha), and Baen was found not suitable for plantation. The saplings growing from the viviparous germinated bean show no germination failure. Since the plantation site remains dry for 5 months, there was irrigation from the river; though it resulted in an increase in land salinity. To increase fertility, cow dung was used, and green manuring by planting Doincha (Sesbania bispinosa) shows a very insignificant contribution. The plantation of, only one and a half years old, is now a habitat of more than 100 species. The learning from the mangrove plantation from August 2021 to February 2023 assumes that in reclaimed land where there is inundation during monsoon only and salinity is moderate, the plantation from viviparous germinated Baen is better.

Keywords: mangrove plantation, reclaimed land, climate change, habitat restoration

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566 Impact of Drainage Defect on the Railway Track Surface Deflections; A Numerical Investigation

Authors: Shadi Fathi, Moura Mehravar, Mujib Rahman

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The railwaytransportation network in the UK is over 100 years old and is known as one of the oldest mass transit systems in the world. This aged track network requires frequent closure for maintenance. One of the main reasons for closure is inadequate drainage due to the leakage in the buried drainage pipes. The leaking water can cause localised subgrade weakness, which subsequently can lead to major ground/substructure failure.Different condition assessment methods are available to assess the railway substructure. However, the existing condition assessment methods are not able to detect any local ground weakness/damageand provide details of the damage (e.g. size and location). To tackle this issue, a hybrid back-analysis technique based on artificial neural network (ANN) and genetic algorithm (GA) has been developed to predict the substructurelayers’ moduli and identify any soil weaknesses. At first, afinite element (FE) model of a railway track section under Falling Weight Deflection (FWD) testing was developed and validated against field trial. Then a drainage pipe and various scenarios of the local defect/ soil weakness around the buried pipe with various geometriesand physical properties were modelled. The impact of the soil local weaknesson the track surface deflection wasalso studied. The FE simulations results were used to generate a database for ANN training, and then a GA wasemployed as an optimisation tool to optimise and back-calculate layers’ moduli and soil weakness moduli (ANN’s input). The hybrid ANN-GA back-analysis technique is a computationally efficient method with no dependency on seed modulus values. The modelcan estimate substructures’ layer moduli and the presence of any localised foundation weakness.

Keywords: finite element (FE) model, drainage defect, falling weight deflectometer (FWD), hybrid ANN-GA

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565 Failure Analysis of Recoiler Mandrel Shaft Used for Coiling of Rolled Steel Sheet

Authors: Sachin Pawar, Suman Patra, Goutam Mukhopadhyay

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The primary function of a shaft is to transfer power. The shaft can be cast or forged and then machined to the final shape. Manufacturing of ~5 m length and 0.6 m diameter shaft is very critical. More difficult is to maintain its straightness during heat treatment and machining operations, which involve thermal and mechanical loads, respectively. During the machining operation of a such forged mandrel shaft, a deflection of 3-4mm was observed. To remove this deflection shaft was pressed at both ends which led to the development of cracks in it. To investigate the root cause of the deflection and cracking, the sample was cut from the failed shaft. Possible causes were identified with the help of a cause and effect diagram. Chemical composition analysis, microstructural analysis, and hardness measurement were done to confirm whether the shaft meets the required specifications or not. Chemical composition analysis confirmed that the material grade was 42CrMo4. Microstructural analysis revealed the presence of untempered martensite, indicating improper heat treatment. Due to this, ductility and impact toughness values were considerably lower than the specification of the mentioned grade. Residual stress measurement of one more bent shaft manufactured by a similar route was done by portable X-ray diffraction(XRD) technique. For better understanding, measurements were done at twelve different locations along the length of the shaft. The occurrence of a high amount of undesirable tensile residual stresses close to the Ultimate Tensile Strength(UTS) of the material was observed. Untempered martensitic structure, lower ductility, lower impact strength, and presence of a high amount of residual stresses all confirmed the improper tempering heat treatment of the shaft. Tempering relieves the residual stresses. Based on the findings of this study, stress-relieving heat treatment was done to remove the residual stresses and deflection in the shaft successfully.

Keywords: residual stress, mandrel shaft, untempered martensite, portable XRD

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564 Finite Element-Based Stability Analysis of Roadside Settlements Slopes from Barpak to Yamagaun through Laprak Village of Gorkha, an Epicentral Location after the 7.8Mw 2015 Barpak, Gorkha, Nepal Earthquake

Authors: N. P. Bhandary, R. C. Tiwari, R. Yatabe

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The research employs finite element method to evaluate the stability of roadside settlements slopes from Barpak to Yamagaon through Laprak village of Gorkha, Nepal after the 7.8Mw 2015 Barpak, Gorkha, Nepal earthquake. It includes three major villages of Gorkha, i.e., Barpak, Laprak and Yamagaun that were devastated by 2015 Gorkhas’ earthquake. The road head distance from the Barpak to Laprak and Laprak to Yamagaun are about 14 and 29km respectively. The epicentral distance of main shock of magnitude 7.8 and aftershock of magnitude 6.6 were respectively 7 and 11 kilometers (South-East) far from the Barpak village nearer to Laprak and Yamagaon. It is also believed that the epicenter of the main shock as said until now was not in the Barpak village, it was somewhere near to the Yamagaun village. The chaos that they had experienced during the earthquake in the Yamagaun was much more higher than the Barpak. In this context, we have carried out a detailed study to investigate the stability of Yamagaun settlements slope as a case study, where ground fissures, ground settlement, multiple cracks and toe failures are the most severe. In this regard, the stability issues of existing settlements and proposed road alignment, on the Yamagaon village slope are addressed, which is surrounded by many newly activated landslides. Looking at the importance of this issue, field survey is carried out to understand the behavior of ground fissures and multiple failure characteristics of the slopes. The results suggest that the Yamgaun slope in Profile 2-2, 3-3 and 4-4 are not safe enough for infrastructure development even in the normal soil slope conditions as per 2, 3 and 4 material models; however, the slope seems quite safe for at Profile 1-1 for all 4 material models. The result also indicates that the first three profiles are marginally safe for 2, 3 and 4 material models respectively. The Profile 4-4 is not safe enough for all 4 material models. Thus, Profile 4-4 needs a special care to make the slope stable.

Keywords: earthquake, finite element method, landslide, stability

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563 A Quantitative Model for Replacement of Medical Equipment Based on Technical and Environmental Factors

Authors: Ghadeer Mohammad Said El-Sheikh, Samer Mohamad Shalhoob

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Medical equipment operation state is a valid reflection of health care organizations' performance, where such equipment highly contributes to the quality of healthcare services on several levels in which quality improvement has become an intrinsic part of the discourse and activities of health care services. In healthcare organizations, clinical and biomedical engineering departments play an essential role in maintaining the safety and efficiency of such equipment. One of the most challenging topics when it comes to such sophisticated equipment is the lifespan of medical equipment, where many factors will impact such characteristics of medical equipment through its life cycle. So far, many attempts have been made in order to address this issue where most of the approaches are kind of arbitrary approaches and one of the criticisms of existing approaches trying to estimate and understand the lifetime of a medical equipment lies under the inquiry of what are the environmental factors that can play into such a critical characteristic of a medical equipment. In an attempt to address this shortcoming, the purpose of our study rises where in addition to the standard technical factors taken into consideration through the decision-making process by a clinical engineer in case of medical equipment failure, the dimension of environmental factors shall be added. The investigations, researches and studies applied for the purpose of supporting the decision making process by a clinical engineers and assessing the lifespan of healthcare equipment’s in the Lebanese society was highly dependent on the identification of technical criteria’s that impacts the lifespan of a medical equipment where the affecting environmental factors didn’t receive the proper attention. The objective of our study is based on the need for introducing a new well-designed plan for evaluating medical equipment depending on two dimensions. According to this approach, the equipment that should be replaced or repaired will be classified based on a systematic method taking into account two essential criteria; the standard identified technical criteria and the added environmental criteria.

Keywords: technical, environmental, healthcare, characteristic of medical equipment

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562 Relearning to Learn: Approaching Sustainability by Incorporating Inuit Vernacular and Biomimicry Architecture Principles

Authors: Hakim Herbane

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Efforts to achieve sustainability in architecture must prove their effectiveness despite various methods attempted. Biomimicry, which looks to successful natural models to promote sustainability and innovation, faces obstacles in implementing sustainability despite its restorative approach to the relationship between humans and nature. In Nunavik, Inuit communities are exploring a sustainable production system that aligns with their aspirations and meets their demands of human, technological, technical, economic, and ecological factors. Biomimicry holds promise in line with Inuit philosophy, but its failure to implement sustainability requires further investigations to remedy its deficiencies. Our literature review underscores the importance of involving the community in defining sustainability and determining the best methods for its implementation. Additionally, vernacular architecture shows valuable orientations for achieving sustainability. Moreover, reintegrating Inuit communities and their traditional architectural practices, which have successfully balanced their built environment's diverse needs and constraints, could pave the way for a sustainable Inuit-built environment in Nunavik and advance architectural biomimicry principles simultaneously. This research aims at establishing a sustainability monitoring tool for Nordic architectural process by analyzing Inuit vernacular and biomimetic architecture, in addition to the input of stakeholders involved in Inuit architecture production in Nunavik, especially Inuit. The goal is to create a practical tool (an index) to aid in designing sustainable architecture, taking into account environmental, social, and economic perspectives. Furthermore, the study seeks to authenticate strong, sustainable design principles of vernacular and biomimetic architectures. The literature review uncovered challenges and identified new opportunities. The forthcoming discourse will focus on the careful and considerate incorporation of Inuit communities’ perceptions and indigenous building practices into our methodology and the latest findings of our research.

Keywords: sustainability, biomimicry, vernacular architecture, community involvement

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561 Adhesion Enhancement of Boron Carbide Coatings on Aluminum Substrates Utilizing an Intermediate Adhesive Layer

Authors: Sharon Waichman, Shahaf Froim, Ido Zukerman, Shmuel Barzilai, Shmual Hayun, Avi Raveh

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Boron carbide is a ceramic material with superior properties such as high chemical and thermal stability, high hardness and high wear resistance. Moreover, it has a big cross section for neutron absorption and therefore can be employed in nuclear based applications. However, an efficient attachment of boron carbide to a metal such as aluminum can be very challenging, mainly because of the formation of aluminum-carbon bonds that are unstable in humid environment, the affinity of oxygen to the metal and the different thermal expansion coefficients of the two materials that may cause internal stresses and a subsequent failure of the bond. Here, we aimed to achieving a strong and a durable attachment between the boron carbide coating and the aluminum substrate. For this purpose, we applied Ti as a thin intermediate layer that provides a gradual change in the thermal expansion coefficients of the configured layers. This layer is continuous and therefore prevents the formation of aluminum-carbon bonds. Boron carbide coatings with a thickness of 1-5 µm were deposited on the aluminum substrate by pulse-DC magnetron sputtering. Prior to the deposition of the boron carbide layer, the surface was pretreated by energetic ion plasma followed by deposition of the Ti intermediate adhesive layer in a continuous process. The properties of the Ti intermediate layer were adjusted by the bias applied to the substrate. The boron carbide/aluminum bond was evaluated by various methods and complementary techniques, such as SEM/EDS, XRD, XPS, FTIR spectroscopy and Glow Discharge Spectroscopy (GDS), in order to explore the structure, composition and the properties of the layers and to study the adherence mechanism of the boron carbide/aluminum contact. Based on the interfacial bond characteristics, we propose a desirable solution for improved adhesion of boron carbide to aluminum using a highly efficient intermediate adhesive layer.

Keywords: adhesion, boron carbide coatings, ceramic/metal bond, intermediate layer, pulsed-DC magnetron sputtering

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560 Influence of Flexible Plate's Contour on Dynamic Behavior of High Speed Flexible Coupling of Combat Aircraft

Authors: Dineshsingh Thakur, S. Nagesh, J. Basha

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A lightweight High Speed Flexible Coupling (HSFC) is used to connect the Engine Gear Box (EGB) with an Accessory Gear Box (AGB) of the combat aircraft. The HSFC transmits the power at high speeds ranging from 10000 to 18000 rpm from the EGB to AGB. The HSFC is also accommodates larger misalignments resulting from thermal expansion of the aircraft engine and mounting arrangement. The HSFC has the series of metallic contoured annular thin cross-sectioned flexible plates to accommodate the misalignments. The flexible plates are accommodating the misalignment by the elastic material flexure. As the HSFC operates at higher speed, the flexural and axial resonance frequencies are to be kept away from the operating speed and proper prediction is required to prevent failure in the transmission line of a single engine fighter aircraft. To study the influence of flexible plate’s contour on the lateral critical speed (LCS) of HSFC, a mathematical model of HSFC as a elven rotor system is developed. The flexible plate being the bending member of the system, its bending stiffness which results from the contoured governs the LCS. Using transfer matrix method, Influence of various flexible plate contours on critical speed is analyzed. In the above analysis, the support bearing flexibility on critical speed prediction is also considered. Based on the study, a model is built with the optimum contour of flexible plate, for validation by experimental modal analysis. A good correlation between the theoretical prediction and model behavior is observed. From the study, it is found that the flexible plate’s contour is playing vital role in modification of system’s dynamic behavior and the present model can be extended for the development of similar type of flexible couplings for its computational simplicity and reliability.

Keywords: flexible rotor, critical speed, experimental modal analysis, high speed flexible coupling (HSFC), misalignment

Procedia PDF Downloads 214
559 Computation and Validation of the Stress Distribution around a Circular Hole in a Slab Undergoing Plastic Deformation

Authors: Sherif D. El Wakil, John Rice

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The aim of the current work was to employ the finite element method to model a slab, with a small hole across its width, undergoing plastic plane strain deformation. The computational model had, however, to be validated by comparing its results with those obtained experimentally. Since they were in good agreement, the finite element method can therefore be considered a reliable tool that can help gain better understanding of the mechanism of ductile failure in structural members having stress raisers. The finite element software used was ANSYS, and the PLANE183 element was utilized. It is a higher order 2-D, 8-node or 6-node element with quadratic displacement behavior. A bilinear stress-strain relationship was used to define the material properties, with constants similar to those of the material used in the experimental study. The model was run for several tensile loads in order to observe the progression of the plastic deformation region, and the stress concentration factor was determined in each case. The experimental study involved employing the visioplasticity technique, where a circular mesh (each circle was 0.5 mm in diameter, with 0.05 mm line thickness) was initially printed on the side of an aluminum slab having a small hole across its width. Tensile loading was then applied to produce a small increment of plastic deformation. Circles in the plastic region became ellipses, where the directions of the principal strains and stresses coincided with the major and minor axes of the ellipses. Next, we were able to determine the directions of the maximum and minimum shear stresses at the center of each ellipse, and the slip-line field was then constructed. We were then able to determine the stress at any point in the plastic deformation zone, and hence the stress concentration factor. The experimental results were found to be in good agreement with the analytical ones.

Keywords: finite element method to model a slab, slab undergoing plastic deformation, stress distribution around a circular hole, visioplasticity

Procedia PDF Downloads 318
558 Executive Deficits in Non-Clinical Hoarders

Authors: Thomas Heffernan, Nick Neave, Colin Hamilton, Gill Case

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Hoarding is the acquisition of and failure to discard possessions, leading to excessive clutter and significant psychological/emotional distress. From a cognitive-behavioural approach, excessive hoarding arises from information-processing deficits, as well as from problems with emotional attachment to possessions and beliefs about the nature of possessions. In terms of information processing, hoarders have shown deficits in executive functions, including working memory, planning, inhibitory control, and cognitive flexibility. However, this previous research is often confounded by co-morbid factors such as anxiety, depression, or obsessive-compulsive disorder. The current study adopted a cognitive-behavioural approach, specifically assessing executive deficits and working memory in a non-clinical sample of hoarders, compared with non-hoarders. In this study, a non-clinical sample of 40 hoarders and 73 non-hoarders (defined by The Savings Inventory-Revised) completed the Adult Executive Functioning Inventory, which measures working memory and inhibition, Dysexecutive Questionnaire-Revised, which measures general executive function and the Hospital Anxiety and Depression Scale, which measures mood. The participant sample was made up of unpaid young adult volunteers who were undergraduate students and who completed the questionnaires on a university campus. The results revealed that, after observing no differences between hoarders and non-hoarders on age, sex, and mood, hoarders reported significantly more deficits in inhibitory control and general executive function when compared with non-hoarders. There was no between-group difference on general working memory. This suggests that non-clinical hoarders have a specific difficulty with inhibition-control, which enables you to resist repeated, unwanted urges. This might explain the hoarder’s inability to resist urges to buy and keep items that are no longer of any practical use. These deficits may be underpinned by general executive function deficiencies.

Keywords: hoarding, memory, executive, deficits

Procedia PDF Downloads 191
557 Dielectric Response Analysis Measurement for Diagnostic Oil-Paper Insulation System on Aged Inter Bus Transformer 3x10 MVA

Authors: Eki Farlen, Akas

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Condition assessment of oil-paper-insulated power transformers, particularly of water content, is becoming increasingly important for aged transformers. As insulation ages, it can produce water, which reduces its dielectric strength, accelerates the cellulose ageing process, and causes gas bubbles to form at high temperatures. This paper mainly assesses the life condition of oil-paper insulation system of Inter Bus Transformer (IBT) 30 MVA, 150/30 kV in PT PLN-Substation Jelok that has been operating for 41 years, since 1974. Valuable information about the condition of high voltage insulation may be obtained by measuring its dielectric response. This paper describes in detail the interpretation of Dielectric Response Analysis (DIRANA) measurements and the test result compared to other insulation tests to get deep information for diagnostic, such as Tan delta test, oil characteristic test and Dissolve Gas Analysis (DGA) test. This paper mainly discusses the parameter relationship between moisture content, water content, acidity, oil conductivity and dissipation factor. The result and analysis show that IBT 30 MVA Jelok phase U and W had just been ageing due to high acidity level (>0.2 mgKOH/g) which cause high moisture in cellulose/paper (%) are in wet category about 4.7% and 5% and water content in oil (ppm) about 3.13 ppm and 3.33 ppm at temperature 20°C. High acidity level can make oxidation process and produce water in paper and particle which can decrease the value of Interfacial Tension (IFT) below 22 mN/m (poor category) for both phase U and W. Even if paper insulation of transformer are in wet condition, dissipation factor and capacitance at the same frequency (50 Hz) from both measurement DIRANA test and Tangent delta test give the same result (almost), the results are 0.69% and 0.71% (<1%), it may be acceptable and should not be investigated. The DGA results show that TDCG are in level one (1) condition and there are no found a Key Gases, it means that transformers had no failure during operation like arching, partial discharge and thermal in oil or cellulose.

Keywords: diagnostic, inter-bus transformer, oil-paper insulation, moisture, dissipation factor

Procedia PDF Downloads 278
556 Indoor Air Pollution and Reduced Lung Function in Biomass Exposed Women: A Cross Sectional Study in Pune District, India

Authors: Rasmila Kawan, Sanjay Juvekar, Sandeep Salvi, Gufran Beig, Rainer Sauerborn

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Background: Indoor air pollution especially from the use of biomass fuels, remains a potentially large global health threat. The inefficient use of such fuels in poorly ventilated conditions results in high levels of indoor air pollution, most seriously affecting women and young children. Objectives: The main aim of this study was to measure and compare the lung function of the women exposed in the biomass fuels and LPG fuels and relate it to the indoor emission measured using a structured questionnaire, spirometer and filter based low volume samplers respectively. Methodology: This cross-sectional comparative study was conducted among the women (aged > 18 years) living in rural villages of Pune district who were not diagnosed of chronic pulmonary diseases or any other respiratory diseases and using biomass fuels or LPG for cooking for a minimum period of 5 years or more. Data collection was done from April to June 2017 in dry season. Spirometer was performed using the portable, battery-operated ultrasound Easy One spirometer (Spiro bank II, NDD Medical Technologies, Zurich, Switzerland) to determine the lung function over Forced expiratory volume. The primary outcome variable was forced expiratory volume in 1 second (FEV1). Secondary outcome was chronic obstruction pulmonary disease (post bronchodilator FEV1/ Forced Vital Capacity (FVC) < 70%) as defined by the Global Initiative for Obstructive Lung Disease. Potential confounders such as age, height, weight, smoking history, occupation, educational status were considered. Results: Preliminary results showed that the lung function of the women using Biomass fuels (FEV1/FVC = 85% ± 5.13) had comparatively reduced lung function than the LPG users (FEV1/FVC = 86.40% ± 5.32). The mean PM 2.5 mass concentration in the biomass user’s kitchen was 274.34 ± 314.90 and 85.04 ± 97.82 in the LPG user’s kitchen. Black carbon amount was found higher in the biomass users (black carbon = 46.71 ± 46.59 µg/m³) than LPG users (black carbon=11.08 ± 22.97 µg/m³). Most of the houses used separate kitchen. Almost all the houses that used the clean fuel like LPG had minimum amount of the particulate matter 2.5 which might be due to the background pollution and cross ventilation from the houses using biomass fuels. Conclusions: Therefore, there is an urgent need to adopt various strategies to improve indoor air quality. There is a lacking of current state of climate active pollutants emission from different stove designs and identify major deficiencies that need to be tackled. Moreover, the advancement in research tools, measuring technique in particular, is critical for researchers in developing countries to improve their capability to study the emissions for addressing the growing climate change and public health concerns.

Keywords: black carbon, biomass fuels, indoor air pollution, lung function, particulate matter

Procedia PDF Downloads 172
555 The Impact of COVID-19 on Antibiotic Prescribing in Primary Care in England: Evaluation and Risk Prediction of the Appropriateness of Type and Repeat Prescribing

Authors: Xiaomin Zhong, Alexander Pate, Ya-Ting Yang, Ali Fahmi, Darren M. Ashcroft, Ben Goldacre, Brian Mackenna, Amir Mehrkar, Sebastian C. J. Bacon, Jon Massey, Louis Fisher, Peter Inglesby, Kieran Hand, Tjeerd van Staa, Victoria Palin

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Background: This study aimed to predict risks of potentially inappropriate antibiotic type and repeat prescribing and assess changes during COVID-19. Methods: With the approval of NHS England, we used the OpenSAFELY platform to access the TPP SystmOne electronic health record (EHR) system and selected patients prescribed antibiotics from 2019 to 2021. Multinomial logistic regression models predicted the patient’s probability of receiving an inappropriate antibiotic type or repeating the antibiotic course for each common infection. Findings: The population included 9.1 million patients with 29.2 million antibiotic prescriptions. 29.1% of prescriptions were identified as repeat prescribing. Those with same-day incident infection coded in the EHR had considerably lower rates of repeat prescribing (18.0%), and 8.6% had a potentially inappropriate type. No major changes in the rates of repeat antibiotic prescribing during COVID-19 were found. In the ten risk prediction models, good levels of calibration and moderate levels of discrimination were found. Important predictors included age, prior antibiotic prescribing, and region. Patients varied in their predicted risks. For sore throat, the range from 2.5 to 97.5th percentile was 2.7 to 23.5% (inappropriate type) and 6.0 to 27.2% (repeat prescription). For otitis externa, these numbers were 25.9 to 63.9% and 8.5 to 37.1%, respectively. Interpretation: Our study found no evidence of changes in the level of inappropriate or repeat antibiotic prescribing after the start of COVID-19. Repeat antibiotic prescribing was frequent and varied according to regional and patient characteristics. There is a need for treatment guidelines to be developed around antibiotic failure and clinicians provided with individualised patient information.

Keywords: antibiotics, infection, COVID-19 pandemic, antibiotic stewardship, primary care

Procedia PDF Downloads 118
554 A Fluid-Walled Microfluidic Device for Cell Migration Studies

Authors: Cyril Deroy, Agata Rumianek, David R. Greaves, Peter R. Cook, Edmond J. Walsh

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Various microfluidic platforms have been developed in the past couple of decades offering experimental methods for the study of cell migration; however, their implementation in the laboratory has remained limited. Some reasons cited for the lack of uptake include the technical complexity of the devices, high failure rate associated with gas-bubbles, biocompatibility concerns with the use of polydimethylsiloxane (PDMS) and equipment/time/expertise requirements for operation and manufacture. As sample handling remains challenging due to the closed format of microfluidic devices, open microfluidic systems have been developed offering versatility and simplicity of use. Rather than confining fluids by solid walls, samples can be accessed directly over the open platform, by removing at least one of the solid boundaries, such as the cover. In this paper, a method for the fabrication of open fluid-walled microfluidic circuits for cell migration studies is introduced, where only materials commonly used by the life-science community are required; tissue culture dishes and cell media. The simplicity of the method, and ability to retrieve cells of interest are two key features of the method. Both passive and active flow-devices can be created in this way. To demonstrate the versatility of the method a cell migration assay is performed, which requires fabricating circuits for establishing chemical gradients, loading cells and incubating, creating chemical gradients, real time imaging of cell migration and finally retrieval of cells. The open architecture has high fidelity as it eliminates air bubble related failures and enables the precise control of gradients. The ability to fabricate custom microfluidic designs in minutes should make this method suitable for use in a wide range of cell migration studies.

Keywords: chemotaxis, fluid walls, gradient generation, open microfluidics

Procedia PDF Downloads 148
553 Evaluation of Reinforced Concrete Beam-Column Knee Joints Performance: Numerical and Experimental Comparison

Authors: B. S. Abdelwahed, B. B. Belkassem

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Beam-column joints are a critical part in reinforced concrete RC frames designed for inelastic response to several external loads. Investigating the behaviour of the exterior RC beam-column joints has attracted many researchers in the past decades due to its critical influence on the overall behaviour of RC moment-resisting frames subjected to lateral loads. One of the most critical zones in moment-resistant frames is the knee joints because of restraints associated with providing limited anchorage length to the beam and column longitudinal reinforcement in it and consequentially causes a lot of damage in such building frames. Previous numerical simulations focussed mainly on the exterior and interior joints, for knee joint further work is still needed to investigate its behaviour and discuss its affecting parameters. Structural response for an RC knee beam-column joint is performed in this study using LS-DYNA. Three-dimensional finite element (FE) models of an RC knee beam-column joint are described and verified with experimental results available in literature; this is followed by a parametric study to investigate the influence of the concrete compressive strength, the presence of lateral beams and increasing beam reinforcement ratio. It is shown that the concrete compressive strength has a significant effect on shear capacity, load-deflection characteristics and failure modes of an RC knee beam-column joints but to a certain limit, the presence of lateral beams increased the joint confinement and reduced the rate of concrete degradation in the joint after reaching ultimate joint capacity, added to that an increase in the maximum load resistance. Increasing beam reinforcement ratio is found to improve the flexural resistance of the anchored beam bars and increase the joint maximum load resistance.

Keywords: beam reinforcement ratio, joint confinement, numerical simulation, reinforced concrete beam-column joints, structural performance

Procedia PDF Downloads 462
552 Safeguarding Product Quality through Pre-Qualification of Material Manufacturers: A Ship and Offshore Classification Society's Perspective

Authors: Sastry Y. Kandukuri, Isak Andersen

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Despite recent advances in the manufacturing sector, quality issues remain a frequent occurrence, and can result in fatal accidents, equipment downtime, and loss of life. Adequate quality is of high importance in high-risk industries such as sea-going vessels and offshore installations in which third party quality assurance and product control play an important essential role in ensuring manufacturing quality of critical components. Classification societies play a vital role in mitigating risk in these industries by making sure that all the stakeholders i.e. manufacturers, builders, and end users are provided with adequate rules and standards that effectively ensures components produced at a high level of quality based on the area of application and risk of its failure. Quality issues have also been linked to the lack of competence or negligence of stakeholders in supply value chain. However, continued actions and regulatory reforms through modernization of rules and requirements has provided additional tools for purchasers and manufacturers to confront these issues. Included among these tools are updated ‘approval of manufacturer class programs’ aimed at developing and implementing a set of standardized manufacturing quality metrics for use by the manufacturer and verified by the classification society. The establishment and collection of manufacturing and testing requirements described in these programs could provide various stakeholders – from industry to vessel owners – with greater insight into the state of quality at a given manufacturing facility, and allow stakeholders to anticipate better and address quality issues while simultaneously reducing unnecessary failures that are costly to the industry. The publication introduces, explains and discusses critical manufacturing and testing requirements set in a leading class society’s approval of manufacturer regime and its rationale and some case studies.

Keywords: classification society, manufacturing, materials processing, materials testing, quality control

Procedia PDF Downloads 354
551 Application of MALDI-MS to Differentiate SARS-CoV-2 and Non-SARS-CoV-2 Symptomatic Infections in the Early and Late Phases of the Pandemic

Authors: Dmitriy Babenko, Sergey Yegorov, Ilya Korshukov, Aidana Sultanbekova, Valentina Barkhanskaya, Tatiana Bashirova, Yerzhan Zhunusov, Yevgeniya Li, Viktoriya Parakhina, Svetlana Kolesnichenko, Yeldar Baiken, Aruzhan Pralieva, Zhibek Zhumadilova, Matthew S. Miller, Gonzalo H. Hortelano, Anar Turmuhambetova, Antonella E. Chesca, Irina Kadyrova

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Introduction: The rapidly evolving COVID-19 pandemic, along with the re-emergence of pathogens causing acute respiratory infections (ARI), has necessitated the development of novel diagnostic tools to differentiate various causes of ARI. MALDI-MS, due to its wide usage and affordability, has been proposed as a potential instrument for diagnosing SARS-CoV-2 versus non-SARS-CoV-2 ARI. The aim of this study was to investigate the potential of MALDI-MS in conjunction with a machine learning model to accurately distinguish between symptomatic infections caused by SARS-CoV-2 and non-SARS-CoV-2 during both the early and later phases of the pandemic. Furthermore, this study aimed to analyze mass spectrometry (MS) data obtained from nasal swabs of healthy individuals. Methods: We gathered mass spectra from 252 samples, comprising 108 SARS-CoV-2-positive samples obtained in 2020 (Covid 2020), 7 SARS-CoV- 2-positive samples obtained in 2023 (Covid 2023), 71 samples from symptomatic individuals without SARS-CoV-2 (Control non-Covid ARVI), and 66 samples from healthy individuals (Control healthy). All the samples were subjected to RT-PCR testing. For data analysis, we employed the caret R package to train and test seven machine-learning algorithms: C5.0, KNN, NB, RF, SVM-L, SVM-R, and XGBoost. We conducted a training process using a five-fold (outer) nested repeated (five times) ten-fold (inner) cross-validation with a randomized stratified splitting approach. Results: In this study, we utilized the Covid 2020 dataset as a case group and the non-Covid ARVI dataset as a control group to train and test various machine learning (ML) models. Among these models, XGBoost and SVM-R demonstrated the highest performance, with accuracy values of 0.97 [0.93, 0.97] and 0.95 [0.95; 0.97], specificity values of 0.86 [0.71; 0.93] and 0.86 [0.79; 0.87], and sensitivity values of 0.984 [0.984; 1.000] and 1.000 [0.968; 1.000], respectively. When examining the Covid 2023 dataset, the Naive Bayes model achieved the highest classification accuracy of 43%, while XGBoost and SVM-R achieved accuracies of 14%. For the healthy control dataset, the accuracy of the models ranged from 0.27 [0.24; 0.32] for k-nearest neighbors to 0.44 [0.41; 0.45] for the Support Vector Machine with a radial basis function kernel. Conclusion: Therefore, ML models trained on MALDI MS of nasopharyngeal swabs obtained from patients with Covid during the initial phase of the pandemic, as well as symptomatic non-Covid individuals, showed excellent classification performance, which aligns with the results of previous studies. However, when applied to swabs from healthy individuals and a limited sample of patients with Covid in the late phase of the pandemic, ML models exhibited lower classification accuracy.

Keywords: SARS-CoV-2, MALDI-TOF MS, ML models, nasopharyngeal swabs, classification

Procedia PDF Downloads 106
550 A Lung Cancer Patients with Septic Shock Nursing Experience

Authors: Syue-Wen Lin

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Objective: This article explores the nursing experience of an 84-year-old male lung cancer patient who underwent a thoracoscopic right lower lobectomy and treatment. The patient has multiple medical histories, including hypertension and diabetes. The nursing process involved cancer treatment, postoperative pain management, as well as wound care and healing. Methods: The nursing period is from February 10 to February 17, 2024. During the nursing process, pain management strategies are implemented, including morphine drugs and non-drug methods, and music therapy, essential oil massage, and extended reception time are used to make patients feel physically and mentally comfortable so as to reduce postoperative pain and encourage active participation in rehabilitation. Strict sterile wound dressing procedures and advanced wound care techniques are used to promote wound healing and prevent infection. Due to septic shock, dialysis is used to relieve worsening symptoms. Taking into account the patient's cancer status, the nursing team provides comprehensive cancer care based on the patient's physical and psychological needs. Given the complexity of the patient's condition, including advanced cancer, palliative care is also incorporated throughout the care process to relieve discomfort and provide psychological support. Results: Through comprehensive health assessment, the nursing team fully understood the patient's condition and developed a personalized care plan based on the patient's condition. The interprofessional critical care team provides respiratory therapy and lung expansion exercises to reduce muscle loss while addressing the patient's psychological status, pain management, and vital sign stabilization needs, resulting in a comprehensive approach to care. Lung expansion exercises and the use of a high-frequency chest wall oscillation vest successfully improved sputum drainage and facilitated weaning from mechanical ventilation. In addition, helping patients stabilize their vital signs and the integration of cancer care, pain management, wound care and palliative care helps the patient be fully supported throughout the recovery process, ultimately improving his quality of life. Conclusion: Lung cancer and septic shock present significant challenges to patients, and the nursing team not only provides critical care but also addresses the unique needs of patients through comprehensive infection control, cancer care, pain management, wound care, and palliative care interventions. These measures effectively improve patients' quality of life, promote recovery, and provide compassionate palliative care for terminally ill patients. Nursing staff work closely with family members to develop a comprehensive care plan to ensure that patients receive high-quality medical care as well as psychological support and a comfortable recovery environment.

Keywords: septic shock, lung cancer, palliative care, nursing experience

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549 Tribological Aspects of Advanced Roll Material in Cold Rolling of Stainless Steel

Authors: Mohammed Tahir, Jonas Lagergren

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Vancron 40, a nitrided powder metallurgical tool Steel, is used in cold work applications where the predominant failure mechanisms are adhesive wear or galling. Typical applications of Vancron 40 are among others fine blanking, cold extrusion, deep drawing and cold work rolls for cluster mills. Vancron 40 positive results for cold work rolls for cluster mills and as a tool for some severe metal forming process makes it competitive compared to other type of work rolls that require higher precision, among others in cold rolling of thin stainless steel, which required high surface finish quality. In this project, three roll materials for cold rolling of stainless steel strip was examined, Vancron 40, Narva 12B (a high-carbon, high-chromium tool steel alloyed with tungsten) and Supra 3 (a Chromium-molybdenum tungsten-vanadium alloyed high speed steel). The purpose of this project was to study the depth profiles of the ironed stainless steel strips, emergence of galling and to study the lubrication performance used by steel industries. Laboratory experiments were conducted to examine scratch of the strip, galling and surface roughness of the roll materials under severe tribological conditions. The critical sliding length for onset of galling was estimated for stainless steel with four different lubricants. Laboratory experiments result of performance evaluation of resistance capability of rolls toward adhesive wear under severe conditions for low and high reductions. Vancron 40 in combination with cold rolling lubricant gave good surface quality, prevents galling of metal surfaces and good bearing capacity.

Keywords: Vancron 40, cold rolling, adhesive wear, galling, surface finish, lubricant, stainless steel

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548 Mycophenolate Versus Methotrexate in Non-Infectious Ocular Inflammatory Disease: A Systematic Review and Meta-Analysis

Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi

Abstract:

Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.

Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis

Procedia PDF Downloads 150
547 The Effects of the Waste Plastic Modification of the Asphalt Mixture on the Permanent Deformation

Authors: Soheil Heydari, Ailar Hajimohammadi, Nasser Khalili

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The application of plastic waste for asphalt modification is a sustainable strategy to deal with the enormous plastic waste generated each year and enhance the properties of asphalt. The modification is either practiced by the dry process or the wet process. In the dry process, plastics are added straight into the asphalt mixture, and in the wet process, they are mixed and digested into bitumen. In this article, the effects of plastic inclusion in asphalt mixture, through the dry process, on the permanent deformation of the asphalt are investigated. The main waste plastics that are usually used in asphalt modification are taken into account, which is linear, low-density polyethylene, low-density polyethylene, high-density polyethylene, and polypropylene. Also, to simulate a plastic waste stream, different grades of each virgin plastic are mixed and used. For instance, four different grades of polypropylene are mixed and used as representative of polypropylene. A precisely designed mixing condition is considered to dry-mix the plastics into the mixture such that the polymer was melted and modified by the later introduced binder. In this mixing process, plastics are first added to the hot aggregates and mixed three times in different time intervals, then bitumen is introduced, and the whole mixture is mixed three times in fifteen minutes intervals. Marshall specimens were manufactured, and dynamic creep tests were conducted to evaluate the effects of modification on the permanent deformation of the asphalt mixture. Dynamic creep is a common repeated loading test conducted at different stress levels and temperatures. Loading cycles are applied to the AC specimen until failure occurs; with the amount of deformation constantly recorded, the cumulative, permanent strain is determined and reported as a function of the number of cycles. The results of this study showed that the dry inclusion of the waste plastics is very effective in enhancing the resistance against permanent deformation of the mixture. However, the mixing process must be precisely engineered to melt the plastics, and a homogenous mixture is achieved.

Keywords: permanent deformation, waste plastics, low-density polyethene, high-density polyethene, polypropylene, linear low-density polyethene, dry process

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546 Attenuation of Endotoxin Induced Hepatotoxicity by Dexamethasone, Melatonin and Pentoxifylline in White Albino Mice: A Comparative Study

Authors: Ammara Khan

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Sepsis is characterized by an overwhelming surge of cytokines and oxidative stress to one of many factors, gram-negative bacteria commonly implicated. Despite major expansion and elaboration of sepsis pathophysiology and therapeutic approach; death rate remains very high in septic patients due to multiple organ damages including hepatotoxicity.The present study was aimed to ascertain the adequacy of three different drugs delivered separately and collectively- low dose steroid-dexamethasone (3mg/kg i.p) ,antioxidant-melatonin(10 mg/kg i.p) ,and phosphodiesterases inhibitor - pentoxifylline (75 mg/kg i.p)in endotoxin-induced hepatotoxicity in mice. Endotoxin/lipopolysaccharides induced hepatotoxicity was reproduced in mice by giving lipopolysaccharide of serotype E.Coli intraperitoneally. The preventive role was questioned by giving the experimental agent half an hour prior to LPS injection whereas the therapeutic potential of the experimental agent was searched out via post-LPS delivering. The extent of liver damage was adjudged via serum alanine aminotransferases (ALT) and aspartate aminotransferase (AST) estimation along with a histopathological examination of liver tissue. Dexamethasone is given before (Group 3) and after LPS (group 4) significantly attenuated LPS generated liver injury.Pentoxifylline generated similar results and serum ALT; AST histological alteration abated considerably (p≤ 0.05) both in animals subjected to pentoxifylline pre (Group 5) and post-treatment(Group 6). Melatonin was also prosperous in aversion (Group 7) and curation (Group 8) of LPS invoked hepatotoxicity as evident by lessening of augmented ALT (≤0.01) and AST (≤0.01) along with restoration of pathological changes in liver sections (p≤0.05). Combination therapies with dexamethasone in conjunction with melatonin (Group 9), dexamethasone together with pentoxifylline (Group 10), and pentoxifylline along with melatonin (Group 11) after LPS administration tapered LPS evoked hepatic dysfunction statistically considerably. In conclusion, both melatonin and pentoxifylline set up promising results in endotoxin-induced hepatotoxicity and can be used therapeutic adjuncts to conventional treatment strategies in sepsis-induced liver failure.

Keywords: endotoxin/lipopolysacchride, dexamethasone, hepatotoxicity, melatonin, pentoxifylline

Procedia PDF Downloads 279