Search results for: mortality improvement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5391

Search results for: mortality improvement

2481 Kluyveromyces marxianus ABB S8 as Yeast-Based Technology to Manufacture Low FODMAP Baking Good

Authors: Jordi Cuñé, Carlos de Lecea, Laia Marti

Abstract:

Small molecules known as fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) are quickly fermented in the large intestine after being poorly absorbed in the small intestine. There is proof that individuals suffering from functional gastrointestinal disorders, like irritable bowel syndrome (IBS), observe an improvement while following a diet low in FODMAPs. Because wheat has a relatively high fructan content, it is a key source of FODMAPs in our diet. A yeast-based method was created in this study to lower the amounts of FODMAP in (whole wheat) bread. In contrast to fermentation by regular baker yeast, the combination of Kluyveromyces marxianus ABB S7 with Saccharomyces cerevisiae allowed a reduction of fructan content by 60% without implying the appearance of other substrates categorized as FODMAP (excess fructose or polyols). The final FODMAP content in the developed whole wheat bread would allow its classification as a safe product for sensitive people, according to international consensus. Cocultures of S. cerevisiae and K. marxianus were established in order to ensure sufficient CO₂ generation; larger quantities of gas were produced due to the strains' synergistic relationship. Thus, this method works well for lowering the levels of FODMAPs in bread.

Keywords: Kluyveromyces marxianus, bakery, bread, FODMAP, IBS, functional gastro intestinal disorders

Procedia PDF Downloads 39
2480 Effect of Peppermint Essential Oil versus a Mixture of Formic and Propionic Acids on Corn Silage Volatile Fatty Acid Score

Authors: Mohsen Danesh Mesgaran, Ali Hodjatpanah Montazeri, Alireza Vakili, Mansoor Tahmasbei

Abstract:

To compare peppermint essential oil versus a mixture of formic and propionic acids a study was conducted to their effects on volatile fatty acid proportion and VFA score of corn silage. Chopped whole crop corn (control) was treated with peppermint essential oil (240 mg kg-1 DM) or a mixture of formic and propionic acids (2:1) at 0.4% of fresh forage weight, and ensiled for 30 days. Then, silage extract was provided and the concentration of each VFA was determined using gas chromatography. The VFA score was calculated according to the patented formula proposed by Dairy One Scientific Committee. The score is calculated based on the positive impact of lactic and acetic acids versus the negative effect of butyric acid to achieve a single value for evaluating silage quality. The essential oil declined pH and increased the concentration of lactic and acetic acids in the silage extract. All corn silages evaluated in this study had a VFA score between 6 through 8. However, silage with peppermint essential oils had lower volatile fatty acids score than those of the other treatments. Both of applied additives caused a significant improvement in silage aerobic stability.

Keywords: peppermint, essential oil, corn silage, VFA (volatile fatty acids)

Procedia PDF Downloads 378
2479 Optimal Design of InGaP/GaAs Heterojonction Solar Cell

Authors: Djaafar F., Hadri B., Bachir G.

Abstract:

We studied mainly the influence of temperature, thickness, molar fraction and the doping of the various layers (emitter, base, BSF and window) on the performances of a photovoltaic solar cell. In a first stage, we optimized the performances of the InGaP/GaAs dual-junction solar cell while varying its operation temperature from 275°K to 375 °K with an increment of 25°C using a virtual wafer fabrication TCAD Silvaco. The optimization at 300°K led to the following result Icc =14.22 mA/cm2, Voc =2.42V, FF =91.32 %, η = 22.76 % which is close with those found in the literature. In a second stage ,we have varied the molar fraction of different layers as well their thickness and the doping of both emitters and bases and we have registered the result of each variation until obtaining an optimal efficiency of the proposed solar cell at 300°K which was of Icc=14.35mA/cm2,Voc=2.47V,FF=91.34,and η =23.33% for In(1-x)Ga(x)P molar fraction( x=0.5).The elimination of a layer BSF on the back face of our cell, enabled us to make a remarkable improvement of the short-circuit current (Icc=14.70 mA/cm2) and a decrease in open circuit voltage Voc and output η which reached 1.46V and 11.97% respectively. Therefore, we could determine the critical parameters of the cell and optimize its various technological parameters to obtain the best performance for a dual junction solar cell. This work opens the way with new prospects in the field of the photovoltaic one. Such structures will thus simplify the manufacturing processes of the cells; will thus reduce the costs while producing high outputs of photovoltaic conversion.

Keywords: modeling, simulation, multijunction, optimization, silvaco ATLAS

Procedia PDF Downloads 607
2478 Increasing the Frequency of Laser Impulses with Optical Choppers with Rotational Shafts

Authors: Virgil-Florin Duma, Dorin Demian

Abstract:

Optical choppers are among the most common optomechatronic devices, utilized in numerous applications, from radiometry to telescopes and biomedical imaging. The classical configuration has a rotational disk with windows with linear margins. This research points out the laser signals that can be obtained with these classical choppers, as well as with another, novel, patented configuration, of eclipse choppers (i.e., with rotational disks with windows with non-linear margins, oriented outwards or inwards). Approximately triangular laser signals can be obtained with eclipse choppers, in contrast to the approximately sinusoidal – with classical devices. The main topic of this work refers to another, novel device, of choppers with shafts of different shapes and with slits of various profiles (patent pending). A significant improvement which can be obtained (with regard to disk choppers) refers to the chop frequencies of the laser signals. Thus, while 1 kHz is their typical limit for disk choppers, with choppers with shafts, a more than 20 times increase in the chop frequency can be obtained with choppers with shafts. Their transmission functions are also discussed, for different types of laser beams. Acknowledgments: This research is supported by the Romanian National Authority for Scientific Research, through the project PN-III-P2-2.1-BG-2016-0297.

Keywords: laser signals, laser systems, optical choppers, optomechatronics, transfer functions, eclipse choppers, choppers with shafts

Procedia PDF Downloads 176
2477 Case Report on Sepsis by Alpha-Hemolytic Streptococcus and Mannheimia haemolytica in Neonate Dogs

Authors: Maria L. G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Neonatal sepsis is a systemic response of acute infection by bacteria that may lead to high mortality in a litter. This study aims to report a case of sepsis by alpha-hemolytic Streptococcus and Mannheimia haemolytica in neonate dogs. A pregnant, mixed-breed bitch at approximately the 60th day of pregnancy was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, and subjected to a c-section due to uterine atony and fetuses no heartbeats on the ultrasound examination. The mother presented leukopenia of 1.6 thousand leukocytes, and there was no other information regarding previous clinical history. Among the offspring, four were stillborn, and five were born alive. On clinical examination, neonates weighed between 312 and 384 grams. Reflexes were present, and the newborn's body temperature was between 89.9 ºF and 96.4 ºF. Neonates also presented clinical signs of neonatal infection: omphalitis, abdomen, and extremities with cyanotic color, hematuria, and diarrhea (meconium). Complementary tests revealed leukopenia. The presence of alpha hemolytic streptococcus and Mannheimia haemolytica was revealed in the bacterial culture. The bacteria were sensitive to cephalosporins and penicillin on the antibiogram. Treatment for sepsis was instituted with the drug ceftriaxone, at a dose of 50 mg per kilogram, administered intravenous (jugular vein). Subsequently administered subcutaneous, every 12 hours, for seven days. Heated fluid therapy was performed, with Ringer lactate, at a dose of 4 ml per 100 grams of weight, intravenous. Heating measures were instituted. Blood plasma was also administered, at a dose of 2 mL per 100 grams of weight, administered subcutaneous, as a source of passive immunity. A maternal milk substitute was instituted, and lactation was discontinued since the mother was unable to nurse due to the infection. The mother was neutered during the c-section and treated with ceftriaxone (50 mg/kg). After seven days, the newborns presented normal clinical signs and no alterations in the hemogram. Early diagnosis and intervention were essential for the survival of these patients.

Keywords: neonatal infection, puppies, bacteria, newborn

Procedia PDF Downloads 105
2476 Comparative Operating Speed and Speed Differential Day and Night Time Models for Two Lane Rural Highways

Authors: Vinayak Malaghan, Digvijay Pawar

Abstract:

Speed is the independent parameter which plays a vital role in the highway design. Design consistency of the highways is checked based on the variation in the operating speed. Often the design consistency fails to meet the driver’s expectation which results in the difference between operating and design speed. Literature reviews have shown that significant crashes take place in horizontal curves due to lack of design consistency. The paper focuses on continuous speed profile study on tangent to curve transition for both day and night daytime. Data is collected using GPS device which gives continuous speed profile and other parameters such as acceleration, deceleration were analyzed along with Tangent to Curve Transition. In this present study, models were developed to predict operating speed on tangents and horizontal curves as well as model indicating the speed reduction from tangent to curve based on continuous speed profile data. It is observed from the study that vehicle tends to decelerate from approach tangent to between beginning of the curve and midpoint of the curve and then accelerates from curve to tangent transition. The models generated were compared for both day and night and can be used in the road safety improvement by evaluating the geometric design consistency.

Keywords: operating speed, design consistency, continuous speed profile data, day and night time

Procedia PDF Downloads 145
2475 A Monopole Intravascular Antenna with Three Parasitic Elements Optimized for Higher Tesla MRI Systems

Authors: Mohammad Mohammadzadeh, Alireza Ghasempour

Abstract:

In this paper, a new design of monopole antenna has been proposed that increases the contrast of intravascular magnetic resonance images through increasing the homogeneity of the intrinsic signal-to-noise ratio (ISNR) distribution around the antenna. The antenna is made of a coaxial cable with three parasitic elements. Lengths and positions of the elements are optimized by the improved genetic algorithm (IGA) for 1.5, 3, 4.7, and 7Tesla MRI systems based on a defined cost function. Simulations were also conducted to verify the performance of the designed antenna. Our simulation results show that each time IGA is executed different values for the parasitic elements are obtained so that the cost functions of those antennas are high. According to the obtained results, IGA can also find the best values for the parasitic elements (regarding cost function) in the next executions. Additionally, two dimensional and one-dimensional maps of ISNR were drawn for the proposed antenna and compared to the previously published monopole antenna with one parasitic element at the frequency of 64MHz inside a saline phantom. Results verified that in spite of ISNR decreasing, there is a considerable improvement in the homogeneity of ISNR distribution of the proposed antenna so that their multiplication increases.

Keywords: intravascular MR antenna, monopole antenna, parasitic elements, signal-to-noise ratio (SNR), genetic algorithm

Procedia PDF Downloads 284
2474 Effective Urban Design on Environmental Quality Improvement of Historical Textures: A Case Study on Khajeh Khezr Neighborhood in Kerman City

Authors: Saman Sobhani

Abstract:

Historical neighborhoods have special values inside them, and, in addition to inducing a sense of collective memories, they have to have some criteria in respect of achieving desirable environmental quality in order for citizens to live. From the perspective of urban planners and designers, a neighborhood as an urban space has to satisfy various needs of citizens in terms of activities as well as their spiritual requirements. In the research based on the component of environmental quality in one of the neighborhoods with historical value resulting from the theoretical model presented (functional-structural, physical-spatial, and substantive), integrated analysis has been performed on the Khajeh Khezr neighborhood in Kerman. Then, after studying the weaknesses and strengths points of it based on the AIDA model, some mechanisms have been presented to promote environmental quality based on neighborhood organization, and related urban design projects have been defined accordingly. Analyzing the findings shows that inhabitants in the Khajeh Khezr neighborhood are not much satisfied with the quality of the urban environment of the neighborhood. In the research, the descriptive-analytical method and review of texts have been used in the form of library studies, and case study has been applied as well as observation and questionnaire in the form of field studies.

Keywords: environmental quality, Kerman, Khajeh Khezr, neighborhood

Procedia PDF Downloads 69
2473 Improvement of Analysis Vertical Oil Exploration Wells (Case Study)

Authors: Azza Hashim Abbas, Wan Rosli Wan Suliman

Abstract:

The old school of study, well testing reservoir engineers used the transient pressure analyses to get certain parameters and variable factors on the reservoir's physical properties, such as, (permeability-thickness). Recently, the difficulties facing the newly discovered areas are the convincing fact that the exploration and production (E&p) team should have sufficiently accurate and appropriate data to work with due to different sources of errors. The well-test analyst does the work without going through well-informed and reliable data from colleagues which may consequently cause immense environmental damage and unnecessary financial losses as well as opportunity losses to the project. In 2003, new potential oil field (Moga) face circulation problem well-22 was safely completed. However the high mud density had caused an extensive damage to the nearer well area which also distracted the hypothetical oil rate of flow that was not representive of the real reservoir characteristics This paper presents methods to analyze and interpret the production rate and pressure data of an oil field. Specifically for Well- 22 using the Deconvolution technique to enhance the transient pressure .Applying deconvolution to get the best range of certainty of results needed for the next subsequent operation. The range determined and analysis of skin factor range was reasonable.

Keywords: well testing, exploration, deconvolution, skin factor, un certainity

Procedia PDF Downloads 433
2472 A Numerical Study for Mixing Depth and Applicability of Partial Cement Mixing Method Utilizing Geogrid and Fixing Unit

Authors: Woo-seok Choi, Eun-sup Kim, Nam-Seo Park

Abstract:

The demand for new technique in soft ground improvement continuously increases as general soft ground methods like PBD and DCM have a application problem in soft grounds with deep depth and wide distribution in Southern coast of Korea and Southeast. In this study, partial cement mixing method utilizing geogrid and fixing unit(CMG) is suggested and Finite element analysis is performed for analyzing the depth of surface soil and deep soil stabilization and comparing with DCM method. In the result of the experiment, the displacement in DCM method were lower than the displacement in CMG, it's because the upper load is transferred to deep part soil not treated by cement in CMG method case. The differential settlement in DCM method was higher than the differential settlement in CMG, because of the effect load transfer effect by surface part soil treated by cement and geogrid. In conclusion, CMG method has the advantage of economics and constructability in embankment road, railway, etc in which differential settlement is the important consideration.

Keywords: soft ground, geogrid, fixing unit, partial cement mixing, finite element analysis

Procedia PDF Downloads 366
2471 Improving Axial-Attention Network via Cross-Channel Weight Sharing

Authors: Nazmul Shahadat, Anthony S. Maida

Abstract:

In recent years, hypercomplex inspired neural networks improved deep CNN architectures due to their ability to share weights across input channels and thus improve cohesiveness of representations within the layers. The work described herein studies the effect of replacing existing layers in an Axial Attention ResNet with their quaternion variants that use cross-channel weight sharing to assess the effect on image classification. We expect the quaternion enhancements to produce improved feature maps with more interlinked representations. We experiment with the stem of the network, the bottleneck layer, and the fully connected backend by replacing them with quaternion versions. These modifications lead to novel architectures which yield improved accuracy performance on the ImageNet300k classification dataset. Our baseline networks for comparison were the original real-valued ResNet, the original quaternion-valued ResNet, and the Axial Attention ResNet. Since improvement was observed regardless of which part of the network was modified, there is a promise that this technique may be generally useful in improving classification accuracy for a large class of networks.

Keywords: axial attention, representational networks, weight sharing, cross-channel correlations, quaternion-enhanced axial attention, deep networks

Procedia PDF Downloads 63
2470 The Communication Library DIALOG for iFDAQ of the COMPASS Experiment

Authors: Y. Bai, M. Bodlak, V. Frolov, S. Huber, V. Jary, I. Konorov, D. Levit, J. Novy, D. Steffen, O. Subrt, M. Virius

Abstract:

Modern experiments in high energy physics impose great demands on the reliability, the efficiency, and the data rate of Data Acquisition Systems (DAQ). This contribution focuses on the development and deployment of the new communication library DIALOG for the intelligent, FPGA-based Data Acquisition System (iFDAQ) of the COMPASS experiment at CERN. The iFDAQ utilizing a hardware event builder is designed to be able to readout data at the maximum rate of the experiment. The DIALOG library is a communication system both for distributed and mixed environments, it provides a network transparent inter-process communication layer. Using the high-performance and modern C++ framework Qt and its Qt Network API, the DIALOG library presents an alternative to the previously used DIM library. The DIALOG library was fully incorporated to all processes in the iFDAQ during the run 2016. From the software point of view, it might be considered as a significant improvement of iFDAQ in comparison with the previous run. To extend the possibilities of debugging, the online monitoring of communication among processes via DIALOG GUI is a desirable feature. In the paper, we present the DIALOG library from several insights and discuss it in a detailed way. Moreover, the efficiency measurement and comparison with the DIM library with respect to the iFDAQ requirements is provided.

Keywords: data acquisition system, DIALOG library, DIM library, FPGA, Qt framework, TCP/IP

Procedia PDF Downloads 304
2469 A Brief Narrative Intervention to Improve Well-being and Relational Ethics in Couples: A Mixed-Method Case Study

Authors: Kevser Cakmak, Adrián Montesano, Lourdes Artigas, Marta Salla, Clara Mateu

Abstract:

The main objective of this research is to explore the relational letter writing technique as an intervention in couple therapy for reconnecting couples with their values and ethical preferences. This is a recently developed therapeutic tool within the framework of Narrative Therapy that consists of two interviews and a letter writing task, in which a meta-conversation between the relationship itself, the couple members, and the therapists is fostered. Although this specific therapeutic technique can be used within the therapy process, in this case study, it is used as a brief stand-alone narrative intervention for a middle age heterosexual couple breast cancer survivor. Couple’s relational and personal wellbeing was monitored before, during, and after the intervention by means of the dyadic adjustment and the clinical outcomes in routine evaluation-outcome measure, respectively. The couple showed a significant improvement after the intervention in both levels. The content of the letter writing exercises was qualitatively analysed to explore the reconstruction of their ethical values. Results from both methods are integrated in order to get an in-depth perspective of the newly developed tool. The potential of the letter writing technique as stand-alone and as adjunct brief intervention is discussed.

Keywords: couple therapy, narrative therapy, psychotherapy tool, relational letter writing

Procedia PDF Downloads 115
2468 A Comprehensive Safety Analysis for a Pressurized Water Reactor Fueled with Mixed-Oxide Fuel as an Accident Tolerant Fuel

Authors: Mohamed Y. M. Mohsen

Abstract:

The viability of utilising mixed-oxide fuel (MOX) ((U₀.₉, rgPu₀.₁) O₂) as an accident-tolerant fuel (ATF) has been thoroughly investigated. MOX fuel provides the best example of a nuclear waste recycling process. The MCNPX 2.7 code was used to determine the main neutronic features, especially the radial power distribution, to identify the hot channel on which the thermal-hydraulic (TH) study was performed. Based on the computational fluid dynamics technique, the simulation of the rod-centered thermal-hydraulic subchannel model was implemented using COMSOL Multiphysics. TH analysis was utilised to determine the axially and radially distributed temperatures of the fuel and cladding materials, as well as the departure from the nucleate boiling ratio (DNBR) along the coolant channel. COMSOL Multiphysics can simulate reality by coupling multiphysics, such as coupling between heat transfer and solid mechanics. The main solid structure parameters, such as the von Mises stress, volumetric strain, and displacement, were simulated using this coupling. When the neutronic, TH, and solid structure performances of UO₂ and ((U₀.₉, rgPu₀.₁) O₂) were compared, the results showed considerable improvement and an increase in safety margins with the use of ((U₀.₉, rgPu₀.₁) O₂).

Keywords: mixed-oxide, MCNPX, neutronic analysis, COMSOL-multiphysics, thermal-hydraulic, solid structure

Procedia PDF Downloads 90
2467 Aerodynamic Design of Three-Dimensional Bellmouth for Low-Speed Open-Circuit Wind Tunnel

Authors: Harshavardhan Reddy, Balaji Subramanian

Abstract:

A systematic parametric study to find the optimum bellmouth profile by relating geometric and performance parameters to satisfy a set of specifications is reported. A careful aerodynamic design of bellmouth intake is critical to properly direct the flow with minimal losses and maximal flow uniformity into the honeycomb located inside the settling chamber of an indraft wind tunnel, thus improving the efficiency of the entire unit. Design charts for elliptically profiled bellmouths with two different contraction ratios (9 and 18) and three different test section speeds (25 m/s, 50 m/s, and 75 m/s) were presented. A significant performance improvement - especially in the Coefficient of discharge and in the flow angularity and boundary layer thickness at the honeycomb inlet - was observed when an entry corner radius (r/D = 0.08) was added to the bellmouth profile. The nonuniformity at the honeycomb inlet drops by about three times (~1% to 0.3%) when moving from square to regular octagonal cross-section. An octagonal cross-sectioned bellmouth intake with L/d = 0.55, D/d = 1.625, and r/D = 0.08 met all the four target performance specifications and is proposed as the best choice for a low-speed wind tunnel.

Keywords: bellmouth intake, low-speed wind tunnel, coefficient of discharge, nonuniformity, flow angularity, boundary layer thickness, CFD, aerodynamics

Procedia PDF Downloads 177
2466 A 10 Year Review of the Complications of Ingested and Aspirated Dentures

Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

Abstract:

Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

Procedia PDF Downloads 123
2465 The Efects of Viable Marketing on Sustainable Development

Authors: Gabriela Tutuanu

Abstract:

The economic, social and environmental undesirable impact of the existing development pattern pushes to the adoption and use of a new development paradigm that of sustainable development. This paper intends to substantiate how the marketing can help the sustainable development. It begins with the subjects of sustainable development and sustainable marketing as they are discussed in literature. The sustainable development is a three dimensional concept which embeds the economic dimension, the social dimension and the environmental dimension that ask to have in view the simultaneous pursuit of economic prosperity, social equity and environmental quality. A major challenge to achieve these goals at business level and to integrate all three dimensions of sustainability is the sustainable marketing. The sustainable marketing is a relationship marketing that aims at building lasting relationships with the social and natural environment on a long-term thinking and futurity and this philosophy allows helping all three dimensions of sustainability. As marketing solutions that could contribute to the sustainable development. We advance the stimulation of sustainable demand, the constant innovation and improvement of sustainable products, the design and use of customized communication, a multichannel distribution network and the sale of sustainable products and services at fair prices. Their implementation will increase the economic, social and environmental sustainability at a large extent in the future if they are supported by political, governmental and legal authorities.

Keywords: sustainable development, sustainable marketing, sustainable demand, sustainable product, credible communication, multi-channel distribution network, fair price

Procedia PDF Downloads 461
2464 The Usefulness of Medical Scribes in the Emengecy Department

Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

Abstract:

Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

Procedia PDF Downloads 81
2463 Orientational Pair Correlation Functions Modelling of the LiCl6H2O by the Hybrid Reverse Monte Carlo: Using an Environment Dependence Interaction Potential

Authors: Mohammed Habchi, Sidi Mohammed Mesli, Rafik Benallal, Mohammed Kotbi

Abstract:

On the basis of four partial correlation functions and some geometric constraints obtained from neutron scattering experiments, a Reverse Monte Carlo (RMC) simulation has been performed in the study of the aqueous electrolyte LiCl6H2O at the glassy state. The obtained 3-dimensional model allows computing pair radial and orientational distribution functions in order to explore the structural features of the system. Unrealistic features appeared in some coordination peaks. To remedy to this, we use the Hybrid Reverse Monte Carlo (HRMC), incorporating an additional energy constraint in addition to the usual constraints derived from experiments. The energy of the system is calculated using an Environment Dependence Interaction Potential (EDIP). Ions effects is studied by comparing correlations between water molecules in the solution and in pure water at room temperature Our results show a good agreement between experimental and computed partial distribution functions (PDFs) as well as a significant improvement in orientational distribution curves.

Keywords: LiCl6H2O, glassy state, RMC, HRMC

Procedia PDF Downloads 450
2462 Exploring the Challenges to Usage of Building Construction Cost Indices in Ghana

Authors: Jerry Gyimah, Ernest Kissi, Safowaa Osei-Tutu, Charles Dela Adobor, Theophilus Adjei-Kumi, Ernest Osei-Tutu

Abstract:

Price fluctuation contract is imperative and of paramount essence, in the construction industry as it provides adequate relief and cushioning for changes in the prices of input resources during construction. As a result, several methods have been devised to better help in arriving at fair recompense in the event of price changes. However, stakeholders often appear not to be satisfied with the existing methods of fluctuation evaluation, ostensibly because of the challenges associated with them. The aim of this study was to identify the challenges to the usage of building construction cost indices in Ghana. Data was gathered from contractors and quantity surveying firms. The study utilized a survey questionnaire approach to elicit responses from the contractors and the consultants. Data gathered was analyzed scientifically, using the relative importance index (RII) to rank the problems associated with the existing methods. The findings revealed the following, among others, late release of data, inadequate recovery of costs, and work items of interest not included in the published indices as the main challenges of the existing methods. Findings provide useful lessons for policymakers and practitioners in decision making towards the usage and improvement of available indices.

Keywords: building construction cost indices, challenges, usage, Ghana

Procedia PDF Downloads 134
2461 Pushover Analysis of Reinforced Concrete Beam-Column Joint Strengthening with Ultra High Performance Concrete

Authors: Abdulsamee Halahla, Emad Allout

Abstract:

The purpose of this research is to study the behavior of exterior beam-column joints (BCJs) strengthened with ultra-high performance concrete (UHPC), in terms of the shear strength and maximum displacement using pushover analysis at the tip of the beam. A finite element (F.E) analysis was performed to study three main parameters – the level of the axial load in the column (N), the beam shear reinforcement (Av/s)B, and the effect of using UHPC. The normal concrete at the studied joint region was replaced by UHPC. The model was verified by using experimental results taken from the literature. The results showed that the UHPC contributed to the transference of the plastic hinge from the joint to the beam-column interface. In addition, the strength of the UHPC-strengthened joints was enhanced dramatically from 8% to 38% for the joints subjected to 12.8MPa and zero axial loads, respectively. Moreover, the UHPC contributed in improving the maximum deflection. This improvement amounted to 1% and 176% for the joints subjected to zero and 12.8MPa axial load, respectively.

Keywords: ultra high performance concrete, ductility, reinforced concrete joints, finite element modeling, nonlinear behavior; pushover analysis

Procedia PDF Downloads 117
2460 Genotyping of Rotaviruses in Pediatric Patients with Gastroenteritis by Using Real-Time Reverse Transcription Polymerase Chain Reaction

Authors: Recep Kesli, Cengiz Demir, Riza Durmaz, Zekiye Bakkaloglu, Aysegul Bukulmez

Abstract:

Objective: Acute diarrhea disease in children is a major cause of morbidity worldwide and is a leading cause of mortality, and it is the most common agent responsible for acute gastroenteritis in developing countries. With hospitalized children suffering from acute enteric disease up to 50% of the analyzed specimen were positive for rotavirus. Further molecular surveillance could provide a sound basis for improving the response to epidemic gastroenteritis and could provide data needed for the introduction of vaccination programmes in the country. The aim of this study was to investigate the prevalence of viral etiology of the gastroenteritis in children aged 0-6 years with acute gastroenteritis and to determine predominant genotypes of rotaviruses in the province of Afyonkarahisar, Turkey. Methods: An epidemiological study on rotavirus was carried out during 2016. Fecal samples obtained from the 144 rotavirus positive children with 0-6 years of ages and applied to the Pediatric Diseases Outpatient of ANS Research and Practice Hospital, Afyon Kocatepe University with the complaint of diarrhea. Bacterial agents causing gastroenteritis were excluded by using bacteriological culture methods and finally, no growth observed. Rotavirus antigen was examined by both the immunochromatographic (One Step Rotavirus and Adenovirus Combo Test, China) and ELISA (Premier Rotaclone, USA) methods in stool samples. Rotavirus RNA was detected by using one step real-time reverse transcription-polymerase chain reaction (RT-PCR). G and P genotypes were determined using RT-PCR with consensus primers of VP7 and VP4 genes, followed by semi nested type-specific multiplex PCR. Results: Of the total 144 rotavirus antigen-positive samples with RT-PCR, 4 (2,8%) were rejected, 95 (66%) were examined, and 45 (31,2%) have not been examined for PCR yet. Ninety-one (95,8%) of the 95 examined samples were found to be rotavirus positive with RT-PCR. Rotavirus subgenotyping distributions in G, P and G/P genotype groups were determined as; G1:45%, G2:27%, G3:13%, G9:13%, G4:1% and G12:1% for G genotype, and P[4]:33%, P[8]:66%, P[10]:1% for P genotype, and G1P[8]:%37, G2P[4]:%21, G3P[8]:%10, G4P[8]:%1, G9P[8]:%8, G2P[8]:%3 for G/P genotype . Not common genotype combination were %20 in G/P genotype. Conclusions: This study subscribes to the global agreement of the molecular epidemiology of rotavirus which will be useful in guiding the alternative and application of rotavirus vaccines or effective control and interception. Determining the diversity and rates of rotavirus genotypes will definitely provide guidelines for developing the most suitable vaccine.

Keywords: gastroenteritis, genotyping, rotavirus, RT-PCR

Procedia PDF Downloads 222
2459 Establishment and Improvement of Oil Palm Liquid Culture for Clonal Propagation

Authors: Mohd Naqiuddin Bin Husri, Siti Rahmah Abd Rahman, Dalilah Abu Bakar, Dayang Izawati Abang Masli, Meilina Ong Abdullah

Abstract:

A serious shortage of prime agricultural land coupled with environmental concerns inland expansion has daunted efforts to increase the national yield average. To address this issue, maximising yield per unit hectare through quality planting material is of great importance. Breeding for improved planting materials has been a continuous effort since the early days of this industry, it is time-consuming, and the likelihood of segregation within the progenies further impedes progress in this area. Incorporation of the cloning technology in oil palm breeding programmes is therefore advantageous to expedite the development of commercial elite and high-yielding planting materials. After more than 22 years of research and development through this project, reliable protocols for liquid/suspension culture systems coupled with various innovative technologies which are effective at promoting proliferation and growth of oil palm culture have been established. Subsequently, clonal palms derived from the suspension culture system were extensively studied in the field, and the results have been encouraging. Clones such as CPS1, CPS2 and a few others recorded superior performance in comparison with D x P standard crosses.

Keywords: tissue culture, suspension culture, oil palm, Elaeis guineensis

Procedia PDF Downloads 171
2458 Information Technology for Business Process Management in Insurance Companies

Authors: Vesna Bosilj Vukšić, Darija Ivandić Vidović, Ljubica Milanović Glavan

Abstract:

Information technology plays an irreplaceable role in introducing and improving business process orientation in a company. It enables implementation of the theoretical concept, measurement of results achieved and undertaking corrective measures aimed at improvements. Information technology is a key concept in the development and implementation of the business process management systems as it establishes a connection to business operations. Both in the literature and practice, insurance companies are often seen as highly process oriented due to the nature of their business and focus on customers. They are also considered leaders in using information technology for business process management. The research conducted aimed to investigate whether the perceived leadership status of insurance companies is well deserved, i.e. to establish the level of process orientation and explore the practice of information technology use in insurance companies in the region. The main instrument for primary data collection within this research was an electronic survey questionnaire sent to the management of insurance companies in the Republic of Croatia, Bosnia and Herzegovina, Slovenia, Serbia and Macedonia. The conducted research has shown that insurance companies have a satisfactory level of process orientation, but that there is also a huge potential for improvement, especially in the segment of information technology and its connection to business processes.

Keywords: business processes management, process orientation, information technology, insurance companies

Procedia PDF Downloads 364
2457 A Comparison between Underwater Image Enhancement Techniques

Authors: Ouafa Benaida, Abdelhamid Loukil, Adda Ali Pacha

Abstract:

In recent years, the growing interest of scientists in the field of image processing and analysis of underwater images and videos has been strengthened following the emergence of new underwater exploration techniques, such as the emergence of autonomous underwater vehicles and the use of underwater image sensors facilitating the exploration of underwater mineral resources as well as the search for new species of aquatic life by biologists. Indeed, underwater images and videos have several defects and must be preprocessed before their analysis. Underwater landscapes are usually darkened due to the interaction of light with the marine environment: light is absorbed as it travels through deep waters depending on its wavelength. Additionally, light does not follow a linear direction but is scattered due to its interaction with microparticles in water, resulting in low contrast, low brightness, color distortion, and restricted visibility. The improvement of the underwater image is, therefore, more than necessary in order to facilitate its analysis. The research presented in this paper aims to implement and evaluate a set of classical techniques used in the field of improving the quality of underwater images in several color representation spaces. These methods have the particularity of being simple to implement and do not require prior knowledge of the physical model at the origin of the degradation.

Keywords: underwater image enhancement, histogram normalization, histogram equalization, contrast limited adaptive histogram equalization, single-scale retinex

Procedia PDF Downloads 72
2456 Enhancement of Recycled Concrete Aggregates Properties by Mechanical Treatment and Verification in Concrete Mixes with Replacement up to 100%

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 224
2455 Physiotherapy Program for Frozen Shoulder on Pain, Onset of Symptom and Obtaining Modalities

Authors: Narupon Kunbootsri, J. Kraipoj, K. Phandech, P. Sirasaporn

Abstract:

Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom before physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on pain score, onset of symptom and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, pain score and obtaining physical modalities were recorded. There was a statistically significant improve in pain score, pretreatment score mean 7.24±1.52 and the last follow up pain score mean 3.88± 1.0 [mean difference 3.18 with 95%CI were [2.45- 3.92]. In addition, the onset of symptoms was 145 days before obtaining physiotherapy program. The physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the retrospective study show physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder in term of pain score. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, physiotherapy, pain score, onset of symptom, physical modality

Procedia PDF Downloads 157
2454 Extracorporeal Co2 Removal (Ecco2r): An Option for Treatment for Refractory Hypercapnic Respiratory Failure

Authors: Shweh Fern Loo, Jun Yin Ong, Than Zaw Oo

Abstract:

Acute respiratory distress syndrome (ARDS) is a common serious condition of bilateral lung infiltrates that develops secondary to various underlying conditions such as diseases or injuries. ARDS with severe hypercapnia is associated with higher ICU mortality and morbidity. Venovenous Extracorporeal membrane oxygenation (VV-ECMO) support has been established to avert life-threatening hypoxemia and hypercapnic respiratory failure despite optimal conventional mechanical ventilation. However, VV-ECMO is relatively not advisable in particular groups of patients, especially in multi-organ failure, advanced age, hemorrhagic complications and irreversible central nervous system pathology. We presented a case of a 79-year-old Chinese lady without any pre-existing lung disease admitted to our hospital intensive care unit (ICU) after acute presentation of breathlessness and chest pain. After extensive workup, she was diagnosed with rapidly progressing acute interstitial pneumonia with ARDS and hypercapnia respiratory failure. The patient received lung protective strategies of mechanical ventilation and neuromuscular blockage therapy as per clinical guidelines. However, hypercapnia respiratory failure was refractory, and she was deemed not a good candidate for VV-ECMO support given her advanced age and high vasopressor requirements from shock. Alternative therapy with extracorporeal CO2 removal (ECCO2R) was considered and implemented. The patient received 12 days of ECCO2R paired with muscle paralysis, optimization of lung-protective mechanical ventilation and dialysis. Unfortunately, the patient still had refractory hypercapnic respiratory failure with dual vasopressor support despite prolonged therapy. Given failed and futile medical treatment, the family opted for withdrawal of care, a conservative approach, and comfort care, which led to her demise. The effectivity of extracorporeal CO2 removal may depend on disease burden, involvement and severity of the disease. There is insufficient data to make strong recommendations about its benefit-risk ratio for ECCO2R devices, and further studies and data would be required. Nonetheless, ECCO2R can be considered an alternative treatment for refractory hypercapnic respiratory failure patients who are unsuitable for initiating venovenous ECMO.

Keywords: extracorporeal CO2 removal (ECCO2R), acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), hypercapnic respiratory failure

Procedia PDF Downloads 48
2453 Application of Mobile Aluminium Light Structure Housing System in Sustainable Building Process

Authors: Wang Haining, Zhang Hong

Abstract:

In China, rapid urbanization needs more and more buildings constructed for the growing population in cities. With the help of the methodology which contains investigation, contrastive analysis, design based on component with BIM and experiment before real construction, this research based on mobile light structure system, trying to the sustainable problems partly in present China by systematic study. The system cannot replace the permanent heavy structure completely. So the goal is the improvement of the whole building system by the addition of light structure. This house system uses modularized envelopes and standardized connections, which are pre-fabricated and assembled in factories and transported like containers. Aluminum is used as the structural material in this system, and inorganic thermal insulation material used in the envelope, which have high fireproof properties. The relationship between manufactory and construction of the system is progressive hierarchy. They exist as First Industrial, Second Industrial, Third Industrial and Site Assembly Stage. It could maximize the land usage capacity by fully exploit the area where normal permanent architecture can't take advantage of. Not only the building system itself especially the thermal isolated materials used and active solar photovoltaic system equipped can save energy, but also the way of product development is sustainable.

Keywords: aluminum house, light Structure, rapid assembly, repeat construction

Procedia PDF Downloads 476
2452 Bioefficiency of Cinnamomum verum Loaded Niosomes and Its Microbicidal and Mosquito Larvicidal Activity against Aedes aegypti, Anopheles stephensi and Culex quinquefasciatus

Authors: Aasaithambi Kalaiselvi, Michael Gabriel Paulraj, Ekambaram Nakkeeran

Abstract:

Emergences of mosquito vector-borne diseases are considered as a perpetual problem globally in tropical countries. The outbreak of several diseases such as chikungunya, zika virus infection and dengue fever has created a massive threat towards the living population. Frequent usage of synthetic insecticides like Dichloro Diphenyl Trichloroethane (DDT) eventually had its adverse harmful effects on humans as well as the environment. Since there are no perennial vaccines, prevention, treatment or drugs available for these pathogenic vectors, WHO is more concerned in eradicating their breeding sites effectively without any side effects on humans and environment by approaching plant-derived natural eco-friendly bio-insecticides. The aim of this study is to investigate the larvicidal potency of Cinnamomum verum essential oil (CEO) loaded niosomes. Cholesterol and surfactant variants of Span 20, 60 and 80 were used in synthesizing CEO loaded niosomes using Transmembrane pH gradient method. The synthesized CEO loaded niosomes were characterized by Zeta potential, particle size, Fourier Transform Infrared Spectroscopy (FT-IR), GC-MS and SEM analysis to evaluate charge, size, functional properties, the composition of secondary metabolites and morphology. The Z-average size of the formed niosomes was 1870.84 nm and had good stability with zeta potential -85.3 meV. The entrapment efficiency of the CEO loaded niosomes was determined by UV-Visible Spectrophotometry. The bio-potency of CEO loaded niosomes was treated and assessed against gram-positive (Bacillus subtilis) and gram-negative (Escherichia coli) bacteria and fungi (Aspergillus fumigatus and Candida albicans) at various concentrations. The larvicidal activity was evaluated against II to IV instar larvae of Aedes aegypti, Anopheles stephensi and Culex quinquefasciatus at various concentrations for 24 h. The mortality rate of LC₅₀ and LC₉₀ values were calculated. The results exhibited that CEO loaded niosomes have greater efficiency against mosquito larvicidal activity. The results suggest that niosomes could be used in various applications of biotechnology and drug delivery systems with greater stability by altering the drug of interest.

Keywords: Cinnamomum verum, niosomes, entrapment efficiency, bactericidal and fungicidal, mosquito larvicidal activity

Procedia PDF Downloads 152