Search results for: replacement rates

Authors: Saeed Ghali, Hoda El-Faramawy, Mamdouh Eissa, Michael Mishreky

Abstract:

Scale-resistant austenitic stainless steel, X45CrNiW 18-9, has been developed, and modified steels produced through partial and total nickel replacement by nitrogen. These modified steels were produced in a 10 kg induction furnace under different nitrogen pressures and were cast into ingots. The produced modified stainless steels were forged, followed by air cooling. The phases of modified stainless steels have been investigated using the Schaeffler diagram, dilatometer, and microstructure observations. Both partial and total replacement of nickel using 0.33-0.50% nitrogen are effective in producing fully austenitic stainless steels. The nitrogen contents were determined and compared with those calculated using the Institute of Metal Science (IMS) equation. The results showed great deviations between the actual nitrogen contents and predicted values through IMS equation. So, an equation has been derived based on chemical composition, pressure, and temperature at 1600oC. [N%] = 0.0078 + 0.0406*X, where X is a function of chemical composition and nitrogen pressure. The derived equation has been used to calculate the nitrogen content of different steels using published data. The results reveal the difficulty of deriving a general equation for the prediction of nitrogen content covering different steel compositions. So, it is necessary to use a narrow composition range.

Keywords: solubility, nitrogen, stainless steel, Schaeffler

Procedia PDF Downloads 238

Authors: Hassnen M. Jafer, W. Atherton, F. Ruddock, E. Loffill

Abstract:

This study represents the results of an experimental work using two types of fly ashes as a cement replacement in soft soil stabilisation. The fly ashes (FA1 and FA2) used in this study are by-products resulting from an incineration processes between 800 and 1200 ˚C. The stabilised soil in this study was an intermediate plasticity silty clayey soil with medium organic matter content. The experimental works were initially conducted on soil treated with different percentages of FA1 (0, 3, 6, 9, 12, and 15%) to identify the optimum FA1 content. Then FA1 was chemically activated by FA2 which has high alkalinity by blending the optimum content of FA1 with different portions of FA2. The improvement levels were evaluated dependent on the results obtained from consistency limits and compaction tests along with the results of unconfined compressive strength (UCS) tests which were conducted on specimens of soil treated with FA1 and FA2 and exposed to different periods of curing (zero, 7, 14, and 28 days). The results indicated that the FA1 and FA2 used in this study effectively improved the physical and geotechnical properties of the soft soil where the index of plasticity (IP) was decreased significantly from 21 to 13.17 with 12% of FA1; however, there was a slight increase in IP with the use of FA2. Meanwhile, 12% of FA1 was identified as the optimum percentage improving the UCS of stabilised soil significantly. Furthermore, FA2 was found effective as a chemical activator to FA1 where the UCS was improved significantly after using FA2.

Keywords: fly ashes, soft soil stabilisation, waste materials, unconfined compressive strength

Procedia PDF Downloads 235

Authors: Katherine Russell

Abstract:

Background: Over recent decades the number of caesarean sections performed in the UK has continued to rise. The cause of the rising caesarean rate (CSR) is not well understood. However, one of the most heavily cited reasons is an increase in maternal request for caesarean section. Maternal request for caesarean section (CDMR) refers to a caesarean section performed on maternal request with no medical indication. The true rate of caesarean delivery on maternal request in the UK and its contribution to the caesarean section rate is not known. Methods: To elucidate current understanding of the cause of the rising caesarean section rate and the role of CDMR we conducted a systematic review of the literature. To determine the role of CDMR in the CSR at the PRH we conducted a retrospective observational study of the caesarean section rates and CDMR from 2009-2015. Results: We demonstrated a negative correlation between rates of elective sections and CDMR over the study period (-0.123). On average, there were more elective sections performed after 2011 (15.10% of all deliveries) than before 2011 (12.41% of all deliveries); this difference was statistically significant (p = < 0.001). There were more cases of CDMR after 2011 (1.39% of all deliveries) than before 2011 (0.85% of all deliveries). The difference in average rates of CDMR before and after 2011 was statistically significant (p ≤ 0.001). Conclusions: CDMR is only a minor contributor to the CSR at the PRH. However, it remains an important factor because it represents a target for the reduction of the CSR that is more manageable than other, more complex and ubiquitous causes of the rising CSR.

Keywords: cesarean section, maternal request for cesarean section, obstetrics, pre-natal health

Procedia PDF Downloads 99

Authors: S. U. Khan, T. Ayub, N. Shafiq

Abstract:

The properties of locally produced metakaolin (MK) as cement replacing material and the comparison of reactivity with commercially available micro-silica have been investigated. Compressive strength, splitting tensile strength, and load-deflection behaviour under bending are the properties that have been studied. The amorphous phase of MK with micro-silica was compared through X-ray diffraction (XRD) pattern. Further, interfacial transition zone of concrete with micro-silica and MK was observed through Field Emission Scanning Electron Microscopy (FESEM). Three mixes of concrete were prepared. One of the mix is without cement replacement as control mix, and the remaining two mixes are 10% cement replacement with micro-silica and MK. It has been found that MK, due to its irregular structure and amorphous phase, has high reactivity with portlandite in concrete. The compressive strength at early age is higher with MK as compared to micro-silica. MK concrete showed higher splitting tensile strength and higher load carrying capacity as compared to control and micro-silica concrete at all ages respectively.

Keywords: metakaolin, compressive strength, splitting tensile strength, load deflection, interfacial transition zone

Procedia PDF Downloads 213

Authors: Taylor Harris

Abstract:

Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.

Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review

Procedia PDF Downloads 86

Authors: Saad Bin Saeed, Fayzan Ahmed, Shahbaz Ahmed, Amjad Hussain

Abstract:

The aim of this study is to evaluate dynamic log files (Dynalogs) at different dose rates by dose-volume histograms (DVH) and used as a (QA) procedure of IMRT. Seven patients of phase one head and neck cancer with similar OAR`s are selected randomly. Reference plans of dose rate 300 and 600 MU/Min with prescribed dose of 50Gy in 25 fractions for each patient is made. Dynalogs produced by delivery of reference plans processed by in-house MATLAB program which produces new field files contain actual positions of multi-leaf collimators (MLC`s) instead of planned positions in reference plans. Copies of reference plans are used to import new field files generated by MATLAB program and renamed as Dyn.plan. After dose calculations of Dyn.plans for different dose rates, DVH, and multiple linear regression tools are used to evaluate reference and Dyn.plans. The results indicate good agreement of correlation between different dose rate plans. The maximum dose difference among PTV and OAR`s are found to be less than 5% and 9% respectively. The study indicates the potential of dynalogs to be used as patient-specific QA of IMRT at different dose rate.

Keywords: IMRT, dynalogs, dose rate, DVH

Procedia PDF Downloads 535

Authors: Varsha Chorsiya, Pooja Aneja, Dhananjay Kaushik, Abhinav Yadav

Abstract:

Intoduction: Women’s Health Initiatives (WHI) focuses on defining the risks and benefits of strategies that could potentially reduce the incidence of obesity, heart disease, breast cancer and colorectal cancer, and fractures in menopause women. The utility of the present research work determines to find the role of Hormone Replacement Therapy (HRT) in changing the different component of body composition during perimenopause period. Methods: A comparative cross-sectional study included 30 subjects, aged between 40 and 50 years which were assigned into 2 groups i.e. 15 subjects in HRT (Group A) and 15 subjects in non-HRT (Group B). The subjects were taken from the hospitals and clinics of Faridabad undergoing HRT in supervision of the consultant gynecologist. The informed consents were signed before including the participants in the study. The body composition and lipid profile were evaluated for all the subjects. Result and Discussion: The BMI, body density, percent body fats and fat mass in both groups showed statistically significant differences i.e. p < 0.05. Our study did not reveal any statistically significant difference between non-HRT and HRT for lipid profile composition of HDL, LDL, VLDL, ratio, triglycerides and total cholesterol although these indicators (LDL, VLDL, ratio, triglycerides and total cholesterol) showed difference clinically with a higher mean values for non-HRT as compared to HRT group. The mean value for HDL was higher for HRT group in contrast to non-HRT group. The result clearly showed that HRT group has a good lipid profile composition. Conclusion: In conclusion, our data show that HRT has statistically significant role in determining BMI, fat percent mass and fat mass. The lipid profile including LDL, HDL, VLDL, ratio, triglycerides and total cholesterol found to be clinically better in HRT group as compared to the non-HRT group. The rationale for non-significant lipid profile probably lie in the fact that hormonal changes need a particular time period and might become significant in post-menopausal period.

Keywords: body composition, hormone replacement therapy, perimenopause, women health

Procedia PDF Downloads 292

Authors: Sunmyeng Kim

Abstract:

IEEE 802.11a/b/g standards provide multiple transmission rates, which can be changed dynamically according to the channel condition.Cooperative communications we reintroduced to improve the overallperformance of wireless LANs with the help of relay nodes with higher transmission rates. The cooperative communications are based on the fact that the transmission is much faster when sending data packets to a destination node through a relay node with higher transmission rate, rather than sending data directly to the destination node at low transmission rate. To apply the cooperative communications in wireless LAN, several MAC protocols have been proposed. Some of them can result in collisions among relay nodes in a dense network. In order to solve this problem, we propose a new protocol. Relay nodes are grouped based on their transmission rates. And then, relay nodes only in the highest group try to get channel access. Performance evaluation is conducted using simulation, and shows that the proposed protocol significantly outperforms the previous protocol in terms of throughput and collision probability.

Keywords: cooperative communications, MAC protocol, relay node, WLAN

Procedia PDF Downloads 466

Authors: Omar Ibrahim, Aly A. Gaafar, K. A. Ratib

Abstract:

Two field experiments in micro plots were carried out during the winter seasons of 2012/2013 and 2013/2014, Soil Salinity Laboratory, Alexandria, Egypt, to study the effect of three levels of salicylic acid (SA) as a growth regulator (0, 50, 100 ppm) and three rates of nitrogen fertilizer (75, 100, 125 kg N/feddan) on growth and yield of a spring wheat (Giza 168). The experimental design was a split plot with the main plots in randomized complete block design (RCBD) and four replicates. The results indicated that increasing nitrogen fertilizer rates resulted in insignificant effect on both plant height (cm) and grain weight/spike only. However, a significant effect was observed in all the other studied characters due to the increase in nitrogen fertilizer. On the other hand, increasing salicylic acid rates resulted in insignificant effect in all the studied characters except for chlorophyll a, chlorophyll b, number of grain/spike, and grain yield (gm/ plot). The highest effects on grain yield in wheat were obtained by the rate of 125 kg/feddan of nitrogen fertilizer and 100 ppm of salicylic acid. In conclusion, the data indicated that a high grain yield could be obtained by adding 100 kg/feddan of nitrogen fertilizer and spraying of 50 ppm of salicylic acid with no significant difference with the highest rates. Finally, the interaction had no significant effect on all the studied characters.

Keywords: growth regulator, nitrogen fertilizer, spring wheat, salicylic acid

Procedia PDF Downloads 117

Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

Abstract:

Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

Procedia PDF Downloads 206

Authors: P. T. Collett, M. Kershaw

Abstract:

Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

Procedia PDF Downloads 127

Authors: Hasan Ustun Basaran

Abstract:

Diesel engines are widely used in transportation sector due to their high thermal efficiency. However, they also release high rates of NOₓ and PM (particulate matter) emissions into the environment which have hazardous effects on human health. Therefore, environmental protection agencies have issued strict emission regulations on automotive diesel engines. Recently, these regulations are even increasingly strengthened. Engine producers search novel on-engine methods such as advanced combustion techniques, utilization of renewable fuels, exhaust gas recirculation, advanced fuel injection methods or use exhaust after-treatment (EAT) systems in order to reduce emission rates on diesel engines. Although those aforementioned on-engine methods are effective to curb emission rates, they result in inefficiency or cannot decrease emission rates satisfactorily at all operating conditions. Therefore, engine manufacturers apply both on-engine techniques and EAT systems to meet the stringent emission norms. EAT systems are highly effective to diminish emission rates, however, they perform inefficiently at low loads due to low exhaust gas temperatures (below 250°C). Therefore, the objective of this study is to demonstrate that engine-out temperatures can be elevated above 250°C at low-loaded cases via cylinder disablement. The engine studied and modeled via Lotus Engine Simulation (LES) software is a six-cylinder turbocharged and intercooled diesel engine. Exhaust temperatures and mass flow rates are predicted at 1200 rpm engine speed and several low loaded conditions using LES program. It is seen that cylinder deactivation results in a considerable exhaust temperature rise (up to 100°C) at low loads which ensures effective EAT management. The method also improves fuel efficiency through reduced total pumping loss. Decreased total air induction due to inactive cylinders is thought to be responsible for improved engine pumping loss. The technique reduces exhaust gas flow rate as air flow is cut off on disabled cylinders. Still, heat transfer rates to the after-treatment catalyst bed do not decrease that much since exhaust temperatures are increased sufficiently. Simulation results are promising; however, further experimental studies are needed to identify the true potential of the method on fuel consumption and EAT improvement.

Keywords: cylinder disablement, diesel engines, exhaust after-treatment, exhaust temperature, fuel efficiency

Procedia PDF Downloads 176

Authors: Iveta Nováková, Martin-Andrè S. Husby, Boy-Arne Buyle

Abstract:

The building industry has one of the most significant contributions to global warming due to the production of building materials, transportation, building activities, and demolition of structures when they reach the end of their life. Implementation of circular material flow and circular economy can significantly reduce greenhouse gasses and simultaneously reduce the need for natural resources. The use of recycled concrete aggregates (RCA) is one of the possibilities for reducing the depletion of raw materials for concrete production. Concrete is the most used building material worldwide, and aggregates constitute 70% of its volume. RCA can replace a certain amount of natural aggregates (NA), and concrete will still perform as required. The aim of this scientific paper is to evaluate RCA properties with and without mechanical treatment. Analysis of RCA itself will be followed by compressive strength of concrete containing various amounts of treated and non-treated RCA. Results showed improvement in compressive strength of the mix with mechanically treated RCA compared to standard RCA, and even the strength of concrete with mechanically treated RCA in dose 50% of coarse aggregates was higher than the reference mix by 4%. Based on obtained results, it can be concluded that integration of RCA in industrial concrete production is feasible, at a replacement ratio of 50% for mechanically treated RCA and 30% if untreated RCA is used, without affecting the compressive strength negatively.

Keywords: recycled concrete aggregates, mechanical treatment, aggregate properties, compression strength

Procedia PDF Downloads 243

Authors: Anupam Sibal

Abstract:

Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

Procedia PDF Downloads 301

Authors: Prakash Parasivamurthy, Vivek Rama Das, Ravikant Talluri, Veena Jawali

Abstract:

India ranks among third in the production of coconut besides Philippines and Indonesia. About 92% of the total production in the country is contributed from four southern states especially, Kerala (45.22%), Tamil Nadu (26.56%), Karnataka (10.85%), and Andhra Pradesh (8.93%). Other states, such as Goa, Maharashtra, Odisha, West Bengal, and those in the northeast (Tripura and Assam) account for the remaining 8.44%. The use of coconut shell as coarse aggregate in concrete has never been a usual practice in the industry, particularly in areas where light weight concrete is required for non-load bearing walls, non-structural floors, and strip footings. The high cost of conventional building materials is a major factor affecting construction delivery in India. In India, where abundant agricultural and industrial wastes are discharged, these wastes can be used as potential material or replacement material in the construction industry. This will have double the advantages viz., reduction in the cost of construction material and also as a means of disposal of wastes. Therefore, an attempt has been made in this study to utilize the coconut shell (CS) as coarse aggregate in rigid pavement. The present study was initiated with the characterization of materials by the basic material testing. The casted moulds are cured and tests are conducted for hardened concrete. The procedure is continued with determination of fck (Characteristic strength), E (Modulus of Elasticity) and µ (Poisson Value) by the test results obtained. For the analytical studies, rigid pavement was modeled by the KEN PAVE software, finite element software developed specially for road pavements and simultaneously design of rigid pavement was carried out with Indian standards. Results show that physical properties of CSAC (Coconut Shell Aggregate Concrete) with 10% replacement gives better results. The flexural strength of CSAC is found to increase by 4.25% as compared to control concrete. About 13 % reduction in pavement thickness is observed using optimum coconut shell.

Keywords: coconut shell, rigid pavement, modulus of elasticity, poison ratio

Procedia PDF Downloads 237

Authors: Ramanen Sugunesegran, Michael L. Williams

Abstract:

Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

Procedia PDF Downloads 82

Authors: Felix Aberu

Abstract:

The high rate of greenhouse gas (CO₂) emission and increased concentration of Carbon Dioxide in the atmosphere are not unconnected to both human and natural activities. This has caused climate change and global warming in the world. The adverse effect of these climatic changes has no doubt threatened human existence. Hence, this study examined the effects of environmental and climate influence on mortality and morbidity rates, with particular reference to the world’s leading CO₂ emission countries, using both the pre-estimation, estimation, and post-estimation techniques for more dependable outcomes. Hence, the System Generalized Method of Moments (SGMM) was adopted as the main estimation technique for the data analysis from 1996 to 2023. The coefficient of carbon emissions confirmed a positive and significant relationship among CO₂ emission, mortality, and morbidity rates in the world’s leading CO₂ emissions countries, which implies that carbon emission has contributed to mortality and morbidity rates in the world. Therefore, significant action should be taken to facilitate the expansion of environmental protection and sustainability initiatives in any CO₂ emissions nations of the world.

Keywords: environmental, mortality, morbidity, health outcomes, carbon emissions

Procedia PDF Downloads 54

Authors: Mohamed M. M. Elnasharty, Azhar M. Elwan

Abstract:

Irradiation deposits energy through ionisation changing the bio-system’s net dipole, allowing the use of dielectric parameters and thermodynamic state functions related to these parameters as biophysical detectors to electrical inhomogeneity within the biosystem. This part is concerned with the effect of Moringa leaves extract, natural supplement, on the response of the biosystem to two different dose rates of irradiation. Having Hb molecule as a representative to the biosystem to be least invasive to the biosystem, dielectric measurements were used to extract the relaxation time of certain process found in the Hb spectrum within the indicated frequency window and the interrelated thermodynamic state functions were calculated from the deduced relaxation time. The results showed that relaxation time was decreased for both dose rates indicating a strong influence of Moringa on the response of biosystem and consequently Hb molecule. This influence was presented in the relaxation time and other parameters as well.

Keywords: activation energy, DC conductivity, dielectric relaxation, enthalpy change, Moringa leaves extract, relaxation time

Procedia PDF Downloads 146

Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

Abstract:

Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

Procedia PDF Downloads 62

Authors: Yashas Mattur, Jensen Coonradt

Abstract:

Muon flux, the rate of muons reaching Earth from the atmosphere, is impacted by various factors such as air pressure, temperature, and humidity. However, the influence of concentrations of PM₂.₅ (particulate matter with diameters 2.5 mm or smaller) on muon detection rates remains unexplored. During the summer of 2023, smoke from Canadian wildfires (containing significant amounts of particulate matter) blew over regions in the Northern US, introducing huge fluctuations in PM₂.₅ concentrations, thus inspiring our experiment to investigate the correlation of PM₂.₅ concentrations and muon rates. To investigate this correlation, muon collision rates were measured and analyzed alongside PM₂.₅ concentration data over the periods of both light and heavy smoke. Other confounding variables, including temperature, humidity, and atmospheric pressure, were also considered. The results reveal a statistically significant inverse correlation between muon flux and PM₂.₅ concentrations, indicating that particulate matter has an impact on the rate of muons reaching the earth’s surface.

Keywords: Muon Flux, atmospheric effects on muons, PM₂.₅, airborne particulate matter

Procedia PDF Downloads 73

Authors: Shahin A. Abdel-Naby, James P. Colgan, Michael S. Pindzola

Abstract:

A time-dependent close-coupling method is developed to calculate a total, double and triple autoionization rates for hollow atomic ions of four-electron systems. This work was motivated by recent observations of the four-electron Auger process in near K-edge photoionization of C+ ions. The time-dependent close-coupled equations are solved using lattice techniques to obtain a discrete representation of radial wave functions and all operators on a four-dimensional grid with uniform spacing. Initial excited states are obtained by relaxation of the Schrodinger equation in imaginary time using a Schmidt orthogonalization method involving interior subshells. The radial wave function grids are partitioned over the cores on a massively parallel computer, which is essential due to the large memory requirements needed to store the coupled-wave functions and the long run times needed to reach the convergence of the ionization process. Total, double, and triple autoionization rates are obtained by the propagation of the time-dependent close-coupled equations in real-time using integration over bound and continuum single-particle states. These states are generated by matrix diagonalization of one-electron Hamiltonians. The total autoionization rates for each L excited state is found to be slightly above the single autoionization rate for the excited configuration using configuration-average distorted-wave theory. As expected, we find the double and triple autoionization rates to be much smaller than the total autoionization rates. Future work can be extended to study electron-impact triple ionization of atoms or ions. The work was supported in part by grants from the American University of Sharjah and the US Department of Energy. Computational work was carried out at the National Energy Research Scientific Computing Center (NERSC) in Berkeley, California, USA.

Keywords: hollow atoms, autoionization, auger rates, time-dependent close-coupling method

Procedia PDF Downloads 153

Authors: Shams Ul Khaliq, Khan Shahzada, Bashir Alam, Fawad Bilal, Mushtaq Zeb, Faizan Akbar

Abstract:

Marble industry contributes its fair share in environmental deterioration, producing voluminous amounts of mud and other excess residues obtained from marble and granite processing, polluting soil, water and air. Reusing these products in other products will not just prevent our environment from polluting but also help with economy. In this research, an attempt has been made to study the expediency of waste Marble Powder (MP) in concrete production. Various laboratory tests were performed to investigate permeability, physical and mechanical properties, such as slump, compressive strength, split tensile test, etc. Concrete test samples were fabricated with varying MP content (replacing 5-30% cement), furnished from two different sources. 5% replacement of marble dust caused 6% and 12% decrease in compressive and tensile strength respectively. These parameters gradually decreased with increasing MP content up to 30%. Most optimum results were obtained with 10% replacement. Improvement in consistency and permeability were noticed. The permeability was improved with increasing MP proportion up to 10% without substantial decrease in compressive strength. Obtained results revealed that MP as an alternative to cement in concrete production is a viable option considering its economic and environment friendly implications.

Keywords: marble powder, strength, permeability, consistency, environment

Procedia PDF Downloads 332

Authors: Mojtaba Ahmadabadi, Akbar Masoudi, Morteza Rezai

Abstract:

In this paper, using the finite element method, the effect of soil and wall characteristics was investigated. Thirty and two different models were studied by different parameters. These studies could calculate displacement at any height of the wall for frictional-cohesive soils. The main purpose of this research is to determine the most effective soil characteristics in reducing the wall displacement. Comparing different models showed that the overall increase in internal friction angle, angle of friction between soil and wall and modulus of elasticity reduce the replacement of the wall. In addition, increase in special weight of soil will increase the wall displacement. Based on results, it can be said that all wall displacements were overturning and in the backfill, soil was bulging. Results show that the highest impact is seen in reducing wall displacement, internal friction angle, and the angle friction between soil and wall. One of the advantages of this study is taking into account all the parameters of the soil and walls replacement distribution in wall and backfill soil. In this paper, using the finite element method and considering all parameters of the soil, we investigated the impact of soil parameter in wall displacement. The aim of this study is to provide the best conditions in reducing the wall displacement and displacement wall and soil distribution.

Keywords: retaining wall, fem, soil and wall interaction, angle of internal friction of the soil, wall displacement

Procedia PDF Downloads 387

Authors: Przemyslaw Brzyski, Stanislaw Fic

Abstract:

Hydrated lime, because of the life cycle (return to its natural form as a result of the setting and hardening) has a positive environmental impact. The lime binder is used in mortars. Lime is a slow setting binder with low mechanical properties. The aim of the study was to evaluate the possibility of improving the properties of the lime binder by using different pozzolanic materials as partial replacement of hydrated lime binder. Pozzolan materials are the natural or industrial waste, so do not affect the environmental impact of the lime binder. The following laboratory tests were performed: the analysis of the physical characteristics of the tested samples of lime mortars (bulk density, porosity), flexural and compressive strength, water absorption and the capillary rise of samples and consistency of fresh mortars. As a partial replacement of hydrated lime (in the amount of 10%, 20%, 30% by weight of lime) a metakaolin, silica fume, and zeolite were used. The shortest setting and hardening time showed mortars with the addition of metakaolin. All additives noticeably improved strength characteristic of lime mortars. With the increase in the amount of additive, the increase in strength was also observed. The highest flexural strength was obtained by using the addition of metakaolin in an amount of 20% by weight of lime (2.08 MPa). The highest compressive strength was obtained by using also the addition of metakaolin but in an amount of 30% by weight of lime (9.43 MPa). The addition of pozzolan caused an increase in the mortar tightness which contributed to the limitation of absorbability. Due to the different surface area, pozzolanic additives affected the consistency of fresh mortars. Initial consistency was assumed as plastic. Only the addition of silica fume an amount of 20 and 30% by weight of lime changed the consistency to the thick-plastic. The conducted study demonstrated the possibility of applying lime mortar with satisfactory properties. The features of lime mortars do not differ significantly from cement-based mortar properties and show a lower environmental impact due to CO₂ absorption during lime hardening. Taking into consideration the setting time, strength and consistency, the best results can be obtained with metakaolin addition to the lime mortar.

Keywords: lime, binder, mortar, pozzolan, properties

Procedia PDF Downloads 194

Authors: Angela Cristina Da F. De Oliveira, Salma E. Asmar, Norbert P. Battlori, Yaz Vera, Uriel R. Valencia, Tâmara Duarte Borges, Antoni D. Bueno, Leandro Batista Costa

Abstract:

As homeothermic animals, pigs manifest maximum performance when kept at comfortable temperature levels, represented by a limit where thermoregulatory processes are minimal (18 - 20°C). In a stress situation where it will have a higher energy demand for thermal maintenance, the energy contribution to the productive functions will be reduced, generating health imbalances, drop in productive rates and welfare problems. The hypothesis of this project is that 5% starch replacement per 5% sunflower oil (SO), in growing and finishing pig’s diet (Iberic x Duroc), is effective as a nutritional strategy to reduce the negative impacts of thermal stress on performance and animal welfare. Seventy-two crossbred males (51± 6,29 kg body weight- BW) were housed according to the initial BW, in climate-controlled rooms, in collective pens, and exposed to heat stress conditions (30 - 32°C; 35% to 50% humidity). The experiment lasted 90 days, and it was carried out in a randomized block design, in a 2 x 2 factorial, composed of two diets (starch or sunflower oil (with or without) and two feed intake management (ad libitum and restriction). The treatments studied were: 1) control diet (5% starch x 0% SO) with ad libitum intake (n = 18); 2) SO diet (replacement of 5% of starch per 5% SO) with ad libitum intake (n = 18); 3) control diet with restriction feed intake (n = 18); or 4) SO diet with restriction feed intake (n = 18). Feed was provided in two phases, 50–100 Kg BW for growing and 100-140 Kg BW for finishing period, respectively. Hematological, biochemical and growth performance parameters were evaluated on all animals at the beginning of the environmental treatment, on the transition of feed (growing to finishing) and in the final of experiment. After the experimental period, when animals reached a live weight of 130-140 kg, they were slaughtered by carbon dioxide (CO2) stunning. Data have shown for the growing phase no statistical interaction between diet (control x SO) and management feed intake (ad libitum x restriction) on animal performance. At finishing phase, pigs fed with SO diet with restriction feed intake had the same average daily gain (ADG) compared with pigs in control diet with ad libitum feed intake. Furthermore, animals fed with the same diet (SO), presented a better feed gain (p < 0,05) due to feed intake reduce (p < 0,05) when compared with control group. To hematological and biochemical parameters, animals under heat stress had an increase in hematocrit, corpuscular volume, urea concentration, creatinine, calcium, alanine aminotransferase and aspartate aminotransferase (p < 0,05) when compared with the beginning of experiment. These parameters were efficient to characterize the heat stress, although the experimental treatments were not able to reduce the hematological and biochemical stress indicators. In addition, the inclusion of SO on pig diets improve feed gain in pigs at finishing phase, even with restriction feed intake.

Keywords: hematological, performance, pigs, welfare

Procedia PDF Downloads 281

Authors: Olalekan Olaluwoye, Joanne Williams, Elizabeth Hoban

Abstract:

Background: Modern contraceptives are effective in preventing unwanted pregnancies and therefore the potential to reduce abortion rates. There is a need for information about how rates of contraceptive use and abortion vary across Cambodia and the relationship between the prevalence of modern contraception use and abortion rates. This study compares the use of contraception and abortion among female garment factory workers in rural and urban areas of Cambodia. Method: Cross-sectional surveys were conducted with 1701 women working in eleven garment factories in rural and urban areas of Cambodia. Sexual and reproductive health data were collected using Audio-Assisted Survey Interviews and analysed using STATA 14 software. Findings: Over 70% of the respondents were less than 30 years of age across both rural and urban settings and over 50% have only primary education, thus the study population was largely young women with limited education. A significantly higher proportion of the rural women earned over $200 in the previous month compared with their urban counterparts. The majority of the urban women (51.5%) were married, while single women (46.9%) made up the largest group working in the rural factories. A significantly larger proportion of women in the rural areas (83.9%) were sexually active compared to the urban women (50.9%). More women from the rural areas (41.4%) had been pregnant at some time compared with the urban population (37.7%). The use of any contraceptive method among sexually active women was significantly higher in the rural areas (80.1%) compared to the urban areas (65.7%) with p-value=0.000. However, among those women who used contraception, the prevalence of modern contraception use was slightly higher in the urban population (68.8% urban, 63.4% rural, p-value=0.1). For women who had a history of pregnancy the abortion prevalence was higher among rural women (43.8%) compared to their urban counterparts (37.7%). Regression analysis showed that after adjustment for the demographic variables (age, relationship status, income, education) only age and relationship status had a significant influence on the use of modern contraception.Single females who were sexually active and older women, who had potentially completed their families, were more likely to choose modern contraception. Conclusion: Although overall the use of contraception was higher among rural women, the use of modern contraception was higher among urban women.This finding may partly explain the higher rates of abortion among women in the rural areas as traditional contraception methods have higher failure rates and are more likely to result in an unplanned pregnancy.Despite the regional variation, the high rates of abortion across the country suggest there is a need for improve education on family planning among female garment factory workers in Cambodia.

Keywords: abortion, Cambodia, contraception, garment factory

Procedia PDF Downloads 150

Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

Procedia PDF Downloads 69

Authors: Joel Santhosh, N. Bhavani Shankar Rao

Abstract:

Problems associated with construction site have been known for many years. Construction industry has to support a world of continuing population growth and economic development. The rising costs of construction materials and the need to adhere to sustainability, alternative construction techniques and materials are being sought. To increase the applications of concrete paving blocks, greater understanding of products produced with locally available materials and indigenously produced mineral admixtures is essential. In the present investigation, concrete paving blocks may be produced with locally available aggregates, cement, fly ash and waste glass powder as the mineral admixture. The ultimate aim of this work is to ascertain the performance of concrete paving blocks containing fly ash and glass powder and compare it with the performance of conventional concrete paving blocks. Mix design is carried out to form M40 grade of concrete by using IS: 10262: 2009 and specification given by IRC: SP: 63: 2004. The paving blocks are tested in accordance to IS: 15658: 2006. It showed that the partial replacement of cement by fly ash and waste glass powder satisfies the minimum requirement as specified by the Indian standard IS: 15658: 2006 for concrete paving blocks to be used in non traffic, light traffic and medium-heavy traffic areas. The study indicated that fly ash and waste glass powder can effectively be used as cement replacement without substantial change in strength.

Keywords: paving block, fly ash, glass powder, strength, abrasion resistance, durability

Procedia PDF Downloads 297

Authors: Larry Wang

Abstract:

The aim of this paper is to demonstrate how an online homework system is integrated in teaching and learning mathematics and how it improves the student success rates in some gateway mathematics courses. WeBWork provided by the Mathematical Association of America is adopted as the online homework system. During the period of 2010-2015, the system was implemented in classes of precalculus, calculus, probability and statistics, discrete mathematics, linear algebra, and differential equations. As a result, the passing rates of the sections with WeBWork are well above other sections without WeBWork (about 7-10% higher). The paper also shows how the WeBWork system was used.

Keywords: gateway mathematics, online grading, pass rate, WeBWorK

Procedia PDF Downloads 299

Authors: Lablali Mohammed, Mes-Adi Hassan, Mazroui M’Hammed

Abstract:

To tackle the complexity of grasping atomic-scale structures and unraveling the factors affecting the development of thin films. In our work, we perform the deposition of Nb atoms on Cu substrates using the molecular dynamics simulation combined with the embedded atom method to describe the interaction between different atoms. We investigated the impact of varying deposition rates and thermal annealing processes on the microstructural, morphological, and mechanical characteristics of the deposited Nb film. Our findings reveal that Nb atom growth on the Cu substrate occurs in island mode, accompanied by the presence of nucleation phenomena during growth. On the other hand, mixing behavior was observed at the interface between the film and the substrate, where Nb penetration is initially limited to the first Cu layer, whereas Cu atoms diffuse until reaching the third layer in the Nb film. Furthermore, Nb exhibits a BCC structure, with a significant concentration observed at a rate of 5 atoms/ps, and annealing further amplifies these percentages. Deposition at different rates leads to distinct levels of compressive normal and biaxial stress.

Keywords: molecular dynamics, Nb thin film, structure and morphology, atomic penetration

Procedia PDF Downloads 31