Search results for: absolutely continuous function

Authors: N. Dlamini, Mpumelelo G. Ndlela, Philisiwe Dlamini, Nicholus Kisyeri, Bhekizitha Sithole

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Accessing health services during the COVID-19 pandemic have exacerbated scarcity to routine medication. To ensure continuous accessibility to services, Eswatini launched Community Health Commodities Distribution (CHCD). Eligible Antiretroviral Therapy(ART) stable clients (VL<1,000) and patients on Non-Communicable Disease (NCD) medications were attended at community pick up points (PUP) based on distance between clients’ residence and the public health facility. Services provided includes ART and Pre-Exposure prophylaxis (PrEP) refills and NCD drug refills). The number of community PUP was 14% higher than health facility visits. Among all medications and commodities distributed between April and October 2020 at the PUP, 64% were HIV-related (HIV rapid test, HIVST, VL test, PrEP meds), and 36% were NCD related. The rapid roll out of CHCD during COVID-19 pandemic reduced the risk of COVID-19 transmission to clients as travel to health facilities was eliminated. It Additionally increased access to commodities during COVID-19-driven lockdown, decongested health facilities, integrated model of care, and increase service coverage. It was also noted that CHCD added different curative and HIV related services based on client specific needs and availability of the commodities.

Keywords: community health commodities distribution, pick up points, antiretroviral therapy, pre-exposure prophylaxis

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Authors: Rachel M. Lørum, Henrik Eriksson, Frida Smith

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Purpose: In recent years, the use of benchmarks for the improvement of healthcare has become increasingly common. There has been an increasing interest in why improvement initiatives so often fail to eliminate the problems they aspire to solve. Benchmarking comes with its fair share of challenges and problems, such as capturing the dynamics and complexities of the care environments, among others. In this study, we demonstrate how learning-oriented, voluntary benchmarks in the complex environment of public healthcare could be designed. Findings: Our four most important findings were the following: first, important organizational learning (OL) regarding the complexity of the service and implications on how to design a benchmark for learning and improvement occurred during the process. Second, participation by a wide range of professionals and stakeholders was crucial for capturing the complexity of people and organizations and increasing the quality of the template. Third, the continuous dialogue between all organizations involved was an important tool for ongoing organizational learning throughout the process. The last important finding was the impact of the facilitator’s role through supporting progress, coordination, and dialogue. Design: We chose participatory design as the research design. Data were derived from written materials such as e-mails, protocols, observational notes, and reflection notes collected during a period of 1.5 years. Originality: Our main contributions are the identification of important strategies, initiatives, and actors to involve when designing voluntary benchmarks for learning and improvement.

Keywords: organizational learning, quality improvement, learning-oriented benchmark, healthcare, patient safety

Procedia PDF Downloads 115

Authors: Y. Lasbet, A. L. Boukhalkhal, K. Loubar

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The study of mixed convection is, usually, focused on the straight channels in which the onset of the mixed convection is well defined as function of the ratio between Grashof number and Reynolds number, Gr/Re. This is not the case for a complex channel wherein the mixed convection is not sufficiently examined in the literature. Our paper focuses on the study of the mixed convection in a complex geometry in which our main contribution reveals that the critical value of the ratio Gr/Re for the onset of the mixed convection increases highly in the type of geometry contrary to the straight channel. Furthermore, the accentuated secondary flow in this geometry prevents the thermal stratification in the flow and consequently the buoyancy driven becomes negligible. To perform these objectives, a numerical study in complex geometry for several values of the ratio Gr/Re with prescribed wall heat flux (H2), was realized by using the CFD code.

Keywords: complex geometry, heat transfer, laminar flow, mixed convection, Nusselt number

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Authors: Indra Gonzalez Ojeda, Tatiana Quinones, Manuel Rosario, Igor Lednev, Juan Lopez Garriga

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Amyloid fibrils are stable aggregates of misfolded protein associated with many neurodegenerative disorders. It has been shown that hydrogen sulfide (H2S), inhibits the fibrillation of lysozyme through the formation of trisulfide (S-S-S) bonds. However, the overall mechanism remains elusive. Here, the concentration dependence of H2S effect was investigated using Atomic force microscopy (AFM), non-resonance Raman spectroscopy, Deep-UV Raman spectroscopy and circular dichroism (CD). It was found that small spherical aggregates with trisulfide bonds and a unique secondary structure were formed instead of amyloid fibrils when adding concentrations of 25 mM and 50 mM of H2S. This could indicate that H2S might serve as a protecting agent for the protein. However, further characterization of these aggregates and their trisulfide bonds is needed to fully unravel the function H2S has on protein fibrillation.

Keywords: amyloid fibrils, hydrogen sulfide, protein folding, raman spectroscopy

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Authors: Michael Zaidman, Naum Simanovsky

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The most of brachial birth palsies are transient. Children with incomplete recovery almost always develop an internal rotation and adduction contracture. The muscle imbalance around the shoulder results in glenohumeral joint deformity and functional limitations. Natural history of glenohumeral deformity is it’s progression with worsening of function. Anteversion glenoid osteotomy with latissimus dorsi and teres major tendon transfers could be an alternative procedure of proximal humeral external rotation osteotomy for patients with severe glenohumeral dysplasia secondary to brachial plexus birth palsy. We will discuss pre-operative planning and stepped operative technique of the procedure on clinical example.

Keywords: obstetric brachial plexus palsy, glenoid anteversion osteotomy, tendon transfer, operative technique

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Authors: Arthur C. Tsai, Chii-Shyang Kuo, Vincent S. C. Chien, Michelle Liou, Philip E. Cheng

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Meditation enhances mental abilities and it is an antidote to anxiety. However, very little is known about brain mechanisms and cortico-subcortical interactions underlying meditation-induced anxiety relief. In this study, the changes of phase-amplitude coupling (PAC) in which the amplitude of the beta frequency band were modulated in phase with delta rhythm were investigated after eight-week of meditation training. The study hypothesized that through a concentrate but relaxed mental training the delta-beta coupling in the frontal regions is attenuated. The delta-beta coupling analysis was applied to within and between maximally-independent component sources returned from the extended infomax independent components analysis (ICA) algorithm on the continuous EEG data during mediation. A unique meditative concentration task through relaxing body and mind was used with a constant level of moderate mental effort, so as to approach an ‘emptiness’ meditative state. A pre-test/post-test control group design was used in this study. To evaluate cross-frequency phase-amplitude coupling of component sources, the modulation index (MI) with statistics to calculate circular phase statistics were estimated. Our findings reveal that a significant delta-beta decoupling was observed in a set of frontal regions bilaterally. In addition, beta frequency band of prefrontal component were amplitude modulated in phase with the delta rhythm of medial frontal component.

Keywords: phase-amplitude coupling, ICA, meditation, EEG

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Authors: Parminder Kaur Heer, Alexei Lapkin

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Due to global challenges of increased competition and demand for more sustainable products/processes, there is a rising pressure on the industry to develop innovative processes. Through Process Intensification (PI) the existing and new processes may be able to attain higher efficiency. However, very few PI options are generally considered. This is because processes are typically analysed at a unit operation level, thus limiting the search space for potential process options. PI performed at more detailed levels of a process can increase the size of the search space. The different levels at which PI can be achieved is unit operations, functional and phenomena level. Physical/chemical phenomena form the lowest level of aggregation and thus, are expected to give the highest impact because all the intensification options can be described by their enhancement. The objective of the current work is thus, generation of numerous process alternatives based on phenomena, and development of their corresponding computer aided models. The methodology comprises: a) automated generation of process options, and b) automated generation of process models. The process under investigation is disintegrated into functions viz. reaction, separation etc., and these functions are further broken down into the phenomena required to perform them. E.g., separation may be performed via vapour-liquid or liquid-liquid equilibrium. A list of phenomena for the process is formed and new phenomena, which can overcome the difficulties/drawbacks of the current process or can enhance the effectiveness of the process, are added to the list. For instance, catalyst separation issue can be handled by using solid catalysts; the corresponding phenomena are identified and added. The phenomena are then combined to generate all possible combinations. However, not all combinations make sense and, hence, screening is carried out to discard the combinations that are meaningless. For example, phase change phenomena need the co-presence of the energy transfer phenomena. Feasible combinations of phenomena are then assigned to the functions they execute. A combination may accomplish a single or multiple functions, i.e. it might perform reaction or reaction with separation. The combinations are then allotted to the functions needed for the process. This creates a series of options for carrying out each function. Combination of these options for different functions in the process leads to the generation of superstructure of process options. These process options, which are formed by a list of phenomena for each function, are passed to the model generation algorithm in the form of binaries (1, 0). The algorithm gathers the active phenomena and couples them to generate the model. A series of models is generated for the functions, which are combined to get the process model. The most promising process options are then chosen subjected to a performance criterion, for example purity of product, or via a multi-objective Pareto optimisation. The methodology was applied to a two-step process and the best route was determined based on the higher product yield. The current methodology can identify, produce and evaluate process intensification options from which the optimal process can be determined. It can be applied to any chemical/biochemical process because of its generic nature.

Keywords: Phenomena, Process intensification, Process models , Process options

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Authors: Munir Tasdemir

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Polymer/clay composites have received great attention in the past three decades owing to their light weight coupled with significantly better mechanical and barrier properties than the corresponding neat polymer resins. An investigation was carried out on the effects of red mud powder size and ratio on the mechanical and thermal properties of polypropylene /red mud polymer composites. Red mud, in four different concentrations (0, 10, 20 and 30 wt %) and three different powder size (180, 63 and 38 micron) were added to PP to produce composites. The mechanical properties, including the elasticity modulus, tensile & yield strength, % elongation, hardness, Izod impact strength and the thermal properties including the melt flow index, heat deflection temperature and vicat softening point of the composites were investigated. The structures of the composites were investigated by scanning electron microscopy and compared to mechanical and thermal properties as a function of red mud powder content and size.

Keywords: polypropylene, powder, red mud, mechanical properties

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Authors: Pattra Pukdeekiat, Siriluk Ruangrungrote

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This work was originated to precisely determine direct solar radiation by using atmospheric physics models since the accurate prediction of solar radiation is necessary and useful for solar energy applications including atmospheric research. The possible models and techniques for a calculation of regional direct solar radiation were challenging and compulsory for the case of unavailable instrumental measurement. The investigation was mathematically governed by six astronomical parameters i.e. declination (δ), hour angle (ω), solar time, solar zenith angle (θz), extraterrestrial radiation (Iso) and eccentricity (E0) along with two atmospheric parameters i.e. air mass (mr) and dew point temperature at Bangna meteorological station (13.67° N, 100.61° E) in Bangkok, Thailand. Analyses of five models of solar radiation determination with the assumption of clear sky were applied accompanied by three statistical tests: Mean Bias Difference (MBD), Root Mean Square Difference (RMSD) and Coefficient of determination (R2) in order to validate the accuracy of obtainable results. The calculated direct solar radiation was in a range of 491-505 Watt/m2 with relative percentage error 8.41% for winter and 532-540 Watt/m2 with relative percentage error 4.89% for summer 2014. Additionally, dataset of seven continuous days, representing both seasons were considered with the MBD, RMSD and R2 of -0.08, 0.25, 0.86 and -0.14, 0.35, 3.29, respectively, which belong to Kumar model for winter and CSR model for summer. In summary, the determination of direct solar radiation based on atmospheric models and empirical equations could advantageously provide immediate and reliable values of the solar components for any site in the region without a constraint of actual measurement.

Keywords: atmospheric physics models, astronomical parameters, atmospheric parameters, clear sky condition

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Authors: Tsegahun Manyazewal, Francesco Marinucci, Getachew Belay, Abraham Tesfaye, Gonfa Ayana, Amaha Kebede, Tsegahun Manyazewal, Francesco Marinucci, Getachew Belay, Abraham Tesfaye, Gonfa Ayana, Amaha Kebede, Yewondwossen Tadesse, Susan Lehman, Zelalem Temesgen

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In-service health trainings in Sub-Saharan Africa are mostly content-centered with higher disconnection with the real practice in the facility. This study intended to evaluate in-service training approach aimed to strengthen health care human resources. A combined web-based and face-to-face training was designed and piloted in Ethiopia with the diagnosis of tuberculosis. During the first part, which lasted 43 days, trainees accessed web-based material and read without leaving their work; while the second part comprised a one-day hands-on evaluation. Trainee’s competency was measured using multiple-choice questions, written-assignments, exercises and hands-on evaluation. Of 108 participants invited, 81 (75%) attended the course and 71 (88%) of them successfully completed. Of those completed, 73 (90%) scored a grade from A to C. The approach was effective to transfer knowledge and turn it into practical skills. In-service health training should transform from a passive one-time-event to a continuous behavioral change of participants and improvements on their actual work.

Keywords: Ethiopia, health care, Mycobacterium tuberculosis, training

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Authors: Changyin Zhou

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Ba constructions are a special type of constructions in Chinese. Their syntactic behaviors are closely related to their event structural properties. The existing study which treats the semantic function of Ba as causative meets difficulty in treating the discrepancy between Ba constructions and their corresponding constructions without Ba in expressing causativity. This paper holds that Ba in Ba constructions is a functional category expressing affectedness. The affectedness expressed by Ba can be positive or negative. The functional category Ba expressing negative affectedness has the semantic property of being 'expected'. The precondition of Ba construction is the boundedness of the event concerned. This paper, holding the parallelism between motion events and change-of-state events, proposes a syntactic model based on the notions of boundedness and affectedness, discusses the transformations between Ba constructions and the related resultative constructions, and derivates the various Ba constructions concerned.

Keywords: affectedness, Ba constructions, boundedness, event structure, resultative constructions

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Authors: Yuanqing Li, Changyi Lei, Zhaopeng Xue, Zhuo Zheng, Yanbo Long

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In agricultural production and breeding, implementing automatic picking robot in orchard farming to reduce human labour and error is challenging. The core function of it is automatic identification based on machine vision. This paper focuses on apple detection and counting in orchards and implements several deep learning methods. Extensive datasets are used and a semi-automatic annotation method is proposed. The proposed deep learning models are in state-of-the-art YOLO family. In view of the essence of the models with various backbones, a multi-dimensional comparison in details is made in terms of counting accuracy, mAP and model memory, laying the foundation for realising automatic precision agriculture.

Keywords: agricultural object detection, deep learning, machine vision, YOLO family

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Authors: Ankitsinh Chauhan, Vimal Patel, A. D. Parekh, Ishant patil

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This study delves into the crucial influence of cooling tower fan operation on the performance of a chiller plant, with a specific focus on the Chiller Plant at SVNIT. Continuous operation of the chiller plant led to unexpected damage to the cooling tower's belt drive, rendering the cooling tower fan non-operational. Consequently, the efficiency of heat transfer in the condenser was significantly impaired. In response, we analyzed and calculated several vital parameters, including the Coefficient of Performance (COP), heat rejection in the condenser (Qc), work required for the compressor (Wc), and heat absorbed by the refrigerant in the evaporator (Qe). Our findings revealed that in the absence of the cooling tower fan, relying solely on natural convection, the COP of the chiller plant reached a minimum value of 5.49. However, after implementing a belt drive to facilitate forced convection for the cooling tower fan, the COP of the chiller plant experienced a noteworthy improvement, reaching approximately 6.27. Additionally, the utilization of forced convection resulted in an impressive reduction of 8.9% in compressor work, signifying enhanced energy efficiency. This study underscores the critical role of cooling tower fan operation in optimizing chiller plant performance, with practical implications for energy-efficient HVAC systems. It highlights the potential benefits of employing forced convection mechanisms, such as belt drives, to ensure efficient heat transfer in the condenser, ultimately contributing to improved energy utilization and reduced operational costs in cooling.

Keywords: cooling tower, chiller Plant, cooling tower fan, energy efficiency, VCRS.

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Authors: Natalia Kajka, Agnieszka Kulik

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The aim of the study is to present the results regarding differences in perception of cognitive progress of children with Attention Deficit Hyperactivity Disorder (ADHD) by adults and children themselves. The experiment was attended by 45 children with ADHD, their parents and teachers. The children attended the 3-month metacognitive training. Both children and adults were examined before and after joining this project. In order to show significant differences between the first and second measurement of the test, non-parametric Wilcoxon tests were performed. The analysis showed statistically significant differences in the change of cognitive functioning in children with ADHD participating in metacognitive training, this was also confirmed by the results of the parents' research. There were no significant differences in the teachers' assessment of these children.

Keywords: ADHD, executive function, Golem effect metacognitive training

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Authors: Naushad Mamode Khan

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The Com-Poisson (CMP) model is one of the most popular discrete generalized linear models (GLMS) that handles both equi-, over- and under-dispersed data. In longitudinal context, an integer-valued autoregressive (INAR(1)) process that incorporates covariate specification has been developed to model longitudinal CMP counts. However, the joint likelihood CMP function is difficult to specify and thus restricts the likelihood based estimating methodology. The joint generalized quasilikelihood approach (GQL-I) was instead considered but is rather computationally intensive and may not even estimate the regression effects due to a complex and frequently ill conditioned covariance structure. This paper proposes a new GQL approach for estimating the regression parameters (GQLIII) that are based on a single score vector representation. The performance of GQL-III is compared with GQL-I and separate marginal GQLs (GQL-II) through some simulation experiments and is proved to yield equally efficient estimates as GQL-I and is far more computationally stable.

Keywords: longitudinal, com-Poisson, ill-conditioned, INAR(1), GLMS, GQL

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Authors: Pim Terachinda, Witaya Wannasuphoprasit, Wasuwat Kitisomprayoonkul, Anan Srikiatkhachorn

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Restoration of hand function and dexterity remain challenges in rehabilitation after stroke. We have developed soft exoskeleton hand robot in which using tendon-driven mechanism. Finger flexion and extension can be triggered by a foot switch and force can be adjusted manually depending on patient’s grip strength. The objective of this study is to investigate feasibility and safety of this device. The study was done in 2 stroke patients with the strength of the finger flexors/extensors grade 1/0 and 3/1 on Medical Research Council scale, respectively. Grasp and release training was performed for 30 minutes. No complication was observed. Results demonstrated that the device is safe, and therapy can be tailored to individual patient’s need. However, further study is required to determine recovery and rehabilitation outcomes after training in patients after nervous system injury.

Keywords: hand, rehabilitation, robot, stroke

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Authors: Yu Qin

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In order to tackle the ever-growing problem of the lack of parking space, this paper presents the design and implementation of a smart unmanned parking system that is based on RFID (radio frequency identification) technology and Wireless communication technology. This system uses RFID technology to achieve the identification function (transmitted by 2.4 G wireless module) and is equipped with an STM32L053 micro controller as the main control chip of the smart vehicle. This chip can accomplish automatic parking (in/out), charging and other functions. On this basis, it can also help users easily query the information that is stored in the database through the Internet. Experimental tests have shown that the system has the features of low power consumption and stable operation, among others. It can effectively improve the level of automation control of the parking lot management system and has enormous application prospects.

Keywords: RFID, embedded system, unmanned, parking management

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Authors: Christine P. Gibson, Ramona Alex, Michael Farney, Johana Vallejo-Elias, Mitra Esfandiarei

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Aortic aneurysm is the leading cause of death in Marfan syndrome (MFS), a connective tissue disorder caused by mutations in fibrillin-1 gene (FBN1). MFS aneurysm is characterized by weakening of the aortic wall due to elastin fibers fragmentation and disorganization. The above-average height and distinct physical features make young adults with MFS desirable candidates for competitive sports; but little is known about the exercise limit at which they will be at risk for aortic rupture. On the other hand, aerobic cardiovascular exercise has been shown to have protective effects on the heart and aorta. We have previously reported that mild aerobic exercise can delay the formation of aortic aneurysm in a mouse model of MFS. In this study, we aimed to investigate the effects of various levels of exercise intensity on the progression of aortic aneurysm in the mouse model. Starting at 4 weeks of age, we subjected control and MFS mice to different levels of exercise intensity (8m/min, 10m/min, 15m/min, and 20m/min, corresponding to 55%, 65%, 75%, and 85% of VO2 max, respectively) on a treadmill for 30 minutes per day, five days a week for the duration of the study. At 24 weeks of age, aortic tissue were isolated and subjected to structural and functional studies using histology and wire myography in order to evaluate the effects of different exercise routines on elastin fragmentation and organization and aortic wall elasticity/stiffness. Our data shows that exercise training at the intensity levels between 55%-75% significantly reduces elastin fragmentation and disorganization, with less recovery observed in 85% MFS group. The reversibility of elasticity was also significantly restored in MFS mice subjected to 55%-75% intensity; however, the recovery was less pronounced in MFS mice subjected to 85% intensity. Furthermore, our data shows that smooth muscle cells (SMCs) contractilion in response to vasoconstrictor agent phenylephrine (100nM) is significantly reduced in MFS aorta (54.84 ± 1.63 mN/mm2) as compared to control (95.85 ± 3.04 mN/mm2). At 55% of intensity, exercise did not rescue SMCs contraction (63.45 ± 1.70 mN/mm2), while at higher intensity levels, SMCs contraction in response to phenylephrine was restored to levels similar to control aorta [65% (81.88 ± 4.57 mN/mm2), 75% (86.22 ± 3.84 mN/mm2), and 85% (83.91 ± 5.42 mN/mm2)]. This study provides the first time evidence that high intensity exercise (e.g. 85%) may not provide the most beneficial effects on aortic function (vasoconstriction) and structure (elastin fragmentation, aortic wall elasticity) during the progression of aortic aneurysm in MFS mice. On the other hand, based on our observations, medium intensity exercise (e.g. 65%) seems to provide the utmost protective effects on aortic structure and function in MFS mice. These findings provide new insights into the potential capacity, in which MFS patients could participate in various aerobic exercise routines, especially in young adults affected by cardiovascular complications particularly aortic aneurysm. This work was funded by Midwestern University Research Fund.

Keywords: aerobic exercise, aortic aneurysm, aortic wall elasticity, elastin fragmentation, Marfan syndrome

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Authors: Tami A. Ulhiza, Noor I. M. Puad, Azlin S. Azmi, Mohd. I. A. Malek

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High amount of chemical oxygen demand (COD) in starchy waste can be harmful to the environment. In common practice, starch processing wastewater is discharged to the river without proper treatment. However, starchy waste still contains complex sugars and organic acids. By the right pretreatment method, the complex sugar can be hydrolyzed into more readily digestible sugars which can be utilized to be converted into more valuable products. At the same time, the global demand of energy is inevitable. The continuous usage of fossil fuel as the main source of energy can lead to energy scarcity. Hydrogen is a renewable form of energy which can be an alternative energy in the future. Moreover, hydrogen is clean and carries the highest energy compared to other fuels. Biohydrogen produced from waste has significant advantages over chemical methods. One of the major problems in biohydrogen production is the raw material cost. The carbohydrate-rich starchy wastes such as tapioca, maize, wheat, potato, and sago wastes is a promising candidate to be used as a substrate in producing biohydrogen. The utilization of those wastes for biohydrogen production can provide cheap energy generation with simultaneous waste treatment. Therefore this paper aims to review variety source of starchy wastes that has been widely used to synthesize biohydrogen. The scope includes the source of waste, the performance in yielding hydrogen, the pretreatment method and the type of culture that is suitable for starchy waste.

Keywords: biohydrogen, dark fermentation, renewable energy, starchy waste

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Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

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Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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Authors: Jhon Vargas, Gilberto Osorio-Gomez, Tatiana Manrique

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This work presents an optimal driving strategy proposal for a 125 c.c. street-type hybrid electric motorcycle with a parallel configuration. The results presented in this article are complementary regarding the control proposal of a hybrid motorcycle. In order to carry out such developments, a representative dynamic model of the motorcycle is used, in which also are described different optimization functionalities for predetermined driving modes. The purpose is to implement an off-line optimal driving strategy which distributes energy to both engines by minimizing an objective torque requirement function. An optimal dynamic contribution is found from the optimization routine, and the optimal percentage contribution for vehicle cruise speed is implemented in the proposed online PID controller.

Keywords: dynamic model, driving strategies, parallel hybrid motorcycle, PID controller, optimization

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Authors: Shazalina Mat Zin, Ahmad Abd. Majid, Ahmad Izani Md. Ismail, Muhammad Abbas

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The generalized wave equation models various problems in sciences and engineering. In this paper, a new three-time level implicit approach based on cubic trigonometric B-spline for the approximate solution of wave equation is developed. The usual finite difference approach is used to discretize the time derivative while cubic trigonometric B-spline is applied as an interpolating function in the space dimension. Von Neumann stability analysis is used to analyze the proposed method. Two problems are discussed to exhibit the feasibility and capability of the method. The absolute errors and maximum error are computed to assess the performance of the proposed method. The results were found to be in good agreement with known solutions and with existing schemes in literature.

Keywords: collocation method, cubic trigonometric B-spline, finite difference, wave equation

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Authors: Ragy Raafat Gaber Attaalla

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Background: The research begins with a summary of the state of pharmacy practice research, both now and in the future. The concerns that are relevant to practice research are then covered in this research to set the stage. These concerns include shifts in the demography of the population, technological advancements, the institutional function of pharmacies, consumer behavior, and the pharmacy profession itself. It also describes the significant changes in pharmacy practice research, such as interprofessional collaboration and patient teaming, the description and measurement of intervention results, and the cultural diversity of patients. Methods: It would be most frequently employed in the next pharmacy practice research are highlighted in the conclusion. They cover the cultural diversity of patients, documenting and assessing the results of interventions, and interdisciplinary communication and partnership with patients. Results: The rise of large and complicated data sets, the handling of electronic health records, and the use of a wide range of mixed techniques by pharmacy practice researchers are a few potential future methodological obstacles.

Keywords: pharmacy, practice, research, significant changes

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Authors: Sara Melkonyan

Abstract:

Over the past decades, the political (and partly legal) doctrine of remedial secession has emerged on the basis of the development of internationally recognized human rights and rights of peoples stemming from various multilateral treaties, which stipulates that aggrieved and persecuted nations have the right to secede from the parent state as a remedy for their continuous and unstoppable grievances. The 44-day war in Nagorno-Karabakh and the following events posed severe challenges for Nagorno-Karabakh and its people. Constant aggression and threat, the humanitarian crisis caused by the closure of the Lachin Corridor, the persistent threat of ethnic cleansing of Artsakhi Armenians, and the state policy that has been executed towards Artsakhi people by the Azerbaijani authorities come to prove that the Artsakhi people cannot survive under Azerbaijani control and secession may be the last resort for ending oppression. The paper tries to make parallels with similar cases and discuss the doctrine of remedial secession applied selectively among different cases. This paper aims to figure out why in some cases the secessionist movements succeeded to gain independence based on the doctrine of remedial secession, in other cases, they refused to gain recognition from the international community. Through analyzing the domestic-level and then international-level factors, the study concluded that the doctrine of remedial secession is inherently in the political realm and almost impossible to draw substantial “recipes” for warranting secession, and the latter is not applied similarly among the cases, so its success mainly depends on the geopolitical interests of the great powers involved.

Keywords: R2P, remedial secession, self-determination, conflicts

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Authors: Harche Rima, Laoufi Nadia Aicha

Abstract:

The present work consists of studying the behavior of steel, copper, and aluminum vis-à-vis the corrosion in an aqueous medium in the presence of the antifreeze COOLELF MDX -26°C. For this, we have studied the influence of the temperature and the different concentrations of the antifreeze on the corrosion of these three metals, this will last for two months by the polarization method and weight loss. In the end, we investigated the samples with the optic microscope to know their surface state. The aim of this work is the protection of contraptions. The use of antifreeze in ordinary water has a high efficiency against steel corrosion, as demonstrated by electrochemical tests (potential monitoring as a function of time and tracing polarization curves). The inhibition rate is greater than 99% for different volume concentrations, ranging from 40% to 60%. The speeds are in turn low in the order of 10-4 mm/year. On the other hand, the addition of antifreeze to ordinary water increases the corrosion potential of steel by more than 400 mV.

Keywords: corrosion and prevention, steel, copper, aluminum, corrosion inhibitor, anti-cooling

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Authors: Brahim Mahfoud, Rachid Bessaïh

Abstract:

In this paper, a numerical study of steady and oscillatory flows with heat transfer submitted to an axial magnetic field is studied. The governing Navier-Stokes, energy, and potential equations along with appropriate boundary conditions are solved by using the finite-volume method. The flow and temperature fields are presented by stream function and isotherms, respectively. The flow between counter-rotating end disks is very unstable and reveals a great richness of structures. The results are presented for various values of the Hartmann number, Ha=5, 10, 20, and 30, and Richardson numbers , Ri=0, 0.5, 1, 2, and 4, in order to see their effects on the value of the critical Reynolds number, Recr. Stability diagrams are established according to the numerical results of this investigation. These diagrams put in evidence the dependence of Recr with the increase of Ha for various values of Ri.

Keywords: swirling, counter-rotating end disks, magnetic field, oscillatory, cylinder

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Authors: Jan Ceselsky

Abstract:

Construction and reconstruction of settlements and individual municipalities, environmental management and the creation, deployment of the forces of production and building transport and technical equipment requires a large expenditure of material and human resources. That is why the economic aspects of the majority decision in these planes built in the foreground and are often decisive. Thereby but more serious is that the economic aspects of the settlement, the creation and function remain in their whole, unprocessed, and can not speak of a set of individual techniques and methods traditional indicators and experiments with new approaches. This is true both at the level of the national economy, and in their own urban designs. Still a few remain identified specific economic shaping patterns of settlement and the less it is possible to speak of their control. Also practical assessing economics of specific solutions are often used non-apt indicators in addition to economics usually identifies with the lowest acquisition cost or high-intensity land use with little regard for functional efficiency and little studied much higher operating and maintenance costs.

Keywords: investment, municipal engineering, value for money, construction

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Authors: Prosper Kudzanai Mushauri

Abstract:

Shock therapy has been used in persons living with depression and deeply depressed persons. It has been used in children also. Shock therapy has been also among its pros believed to improve the quality of life and an effective treatment of depression. The review of the literature on ECT papers have highlighted that benefits to users of ECT are elusive, and iatrogenic harm often occurs showing that the approach will always fall far in comporting to psychological ethics. On the contrary, ECT is known as shock therapy which is the administration of electric shock within the brain; it has been challenged on ethical grounds if it’s proper ethically. From this ethical aperture, it has emerged that relapse rates are approximately higher than 50%, it results in diencephalon disturbances and has also side effects related to cognitive function among other negative effects. It is from these reviewed studies that that ECT should not be viewed as an effective treatment of depression as it does not comport to the mores of psychological ethics.

Keywords: anterograde amnesia, depression, electroconvulsive therapy, ethics, retrograde amnesia

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Authors: Karen Odendaal

Abstract:

Accounting transactions are becoming more complex, and more extensive accounting guidance is provided on a continuous basis. It is widely perceived that conceptual teaching of accounting contributes to lifelong learning. Such a conceptual teaching approach also contributes to effective accounting problem-solving. This framework-based approach is rooted in educational psychologies such as constructivism and Ausubel’s subsumption theory. This study aimed at investigating the ability of students to solve complex accounting problems by using only concepts underlying the Conceptual Framework. An assignment was administered to pre-graduate students at a South African university and this study made use of an interpretative research design which implemented multiple research instruments to investigate the ability of students to solve complex accounting problems using only concepts underlying the Conceptual Framework. Student perceptions were analysed and were aided by a related reflective questionnaire. The importance of the study indicates the necessity of Accounting educators to enhance a conceptual understanding among students as a mechanism for problem-solving of accounting issues. The results indicate that the ability of students to solve accounting problems effectively using only the Conceptual Framework depends on the complexity of the scenario and the students’ familiarity with the problem. The study promotes a balanced and more conceptual (rather than only technical) preference to the problem-solving of complex accounting problems. The study indubitably promotes considerable emphasis on the importance of the Conceptual Framework in accounting education and the promotion of life-long learning in the subject field.

Keywords: accounting education, conceptual teaching, constructivism, framework-based, problem-solving

Procedia PDF Downloads 236