Search results for: Arthur Ricardo Deps Miguel Ferreira
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 475

Search results for: Arthur Ricardo Deps Miguel Ferreira

235 Dispersion Effects in Waves Reflected by Lossy Conductors: The Optics vs. Electromagnetics Approach

Authors: Oibar Martinez, Clara Oliver, Jose Miguel Miranda

Abstract:

The study of dispersion phenomena in electromagnetic waves reflected by conductors at infrared and lower frequencies is a topic which finds a number of applications. We aim to explain in this work what are the most relevant ones and how this phenomenon is modeled from both optics and electromagnetics points of view. We also explain here how the amplitude of an electromagnetic wave reflected by a lossy conductor could depend on both the frequency of the incident wave, as well as on the electrical properties of the conductor, and we illustrate this phenomenon with a practical example. The mathematical analysis made by a specialist in electromagnetics or a microwave engineer is apparently very different from the one made by a specialist in optics. We show here how both approaches lead to the same physical result and what are the key concepts which enable one to understand that despite the differences in the equations the solution to the problem happens to be the same. Our study starts with an analysis made by using the complex refractive index and the reflectance parameter. We show how this reflectance has a dependence with the square root of the frequency when the reflecting material is a good conductor, and the frequency of the wave is low enough. Then we analyze the same problem with a less known approach, which is based on the reflection coefficient of the electric field, a parameter that is most commonly used in electromagnetics and microwave engineering. In summary, this paper presents a mathematical study illustrated with a worked example which unifies the modeling of dispersion effects made by specialists in optics and the one made by specialists in electromagnetics. The main finding of this work is that it is possible to reproduce the dependence of the Fresnel reflectance with frequency from the intrinsic impedance of the reflecting media.

Keywords: dispersion, electromagnetic waves, microwaves, optics

Procedia PDF Downloads 102
234 Testing Nature Based Solutions for Air Quality Improvement: Aveiro Case Study

Authors: A. Ascenso, C. Silveira, B. Augusto, S. Rafael, S. Coelho, J. Ferreira, A. Monteiro, P. Roebeling, A. I. Miranda

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Innovative nature-based solutions (NBSs) can provide answers to the challenges that urban areas are currently facing due to urban densification and extreme weather conditions. The effects of NBSs are recognized and include improved quality of life, mental and physical health and improvement of air quality, among others. Part of the work developed in the scope of the UNaLab project, which aims to guide cities in developing and implementing their own co-creative NBSs, intends to assess the impacts of NBSs on air quality, using Eindhoven city as a case study. The state-of-the-art online air quality modelling system WRF-CHEM was applied to simulate meteorological and concentration fields over the study area with a spatial resolution of 1 km2 for the year 2015. The baseline simulation (without NBSs) was validated by comparing the model results with monitored data retrieved from the Eindhoven air quality database, showing an adequate model performance. In addition, land use changes were applied in a set of simulations to assess the effects of different types of NBSs. Finally, these simulations were compared with the baseline scenario and the impacts of the NBSs were assessed. Reductions on pollutant concentrations, namely for NOx and PM, were found after the application of the NBSs in the Eindhoven study area. The present work is particularly important to support public planners and decision makers in understanding the effects of their actions and planning more sustainable cities for the future.

Keywords: air quality, modelling approach, nature based solutions, urban area

Procedia PDF Downloads 216
233 Wear Performance of SLM Fabricated 1.2709 Steel Nanocomposite Reinforced by TiC-WC for Mould and Tooling Applications

Authors: Daniel Ferreira, José M. Marques Oliveira, Filipe Oliveira

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Wear phenomena is critical in injection moulding processes, causing failure of the components, and making the parts more expensive with an additional wasting time. When very abrasive materials are being injected inside the steel mould’s cavities, such as polymers reinforced with abrasive fibres, the consequences of the wear are more evident. Maraging steel (1.2709) is commonly employed in moulding components to resist in very aggressive injection conditions. In this work, the wear performance of the SLM produced 1.2709 maraging steel reinforced by ultrafine titanium and tungsten carbide (TiC-WC), was investigated using a pin-on-disk testing apparatus. A polypropylene reinforced with 40 wt.% fibreglass (PP40) disk, was used as the counterpart material. The wear tests were performed at 40 N constant load and 0.4 ms-1 sliding speed at room temperature and humidity conditions. The experimental results demonstrated that the wear rate in the 18Ni300-TiC-WC composite is lower than the unreinforced 18Ni300 matrix. The morphology and chemical composition of the worn surfaces was observed by 3D optical profilometry and scanning electron microscopy (SEM), respectively. The resulting debris, caused by friction, were also analysed by SEM and energy dispersive X-ray spectroscopy (EDS). Their morphology showed distinct shapes and sizes, which indicated that the wear mechanisms, may be different in maraging steel produced by casting and SLM. The coefficient of friction (COF) was recorded during the tests, which helped to elucidate the wear mechanisms involved.

Keywords: selective laser melting, nanocomposites, injection moulding, polypropylene with fibreglass

Procedia PDF Downloads 128
232 Effects of Accelerated Environment Aging on the Mechanical Properties of a Coir Fiber Reinforced Polyester Composite

Authors: Ricardo Mendoza, Jason Briceño, Juan F. Santa, Gabriel Peluffo, Mauricio Márquez, Beatriz Cardozo, Carlos Gutiérrez

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Coir natural fiber reinforced polyester composites were exposed to an accelerated environment aging in order to study the influence on the mechanical properties. Coir fibers were obtained in local plantations of the Caribbean coast of Colombia. A physical and mechanical characterization was necessary to found the best behavior between three types of coconut. Composites were fabricated by hand lay-up technique and samples were cut by water jet technique. An accelerated aging test simulates environmental climate conditions in a hygrothermal and ultraviolet chamber. Samples were exposed to the UV/moisture rich environment for 500 and 1000 hours. The tests were performed in accordance with ASTM G154. An additional water absorption test was carried out by immersing specimens in a water bath. Mechanical behaviors of the composites were tested by tensile, flexural and impact test according to ASTM standards, after aging and compared with unaged composite specimens. It was found that accelerated environment aging affects mechanical properties in comparison with unaged ones. Tensile and flexural strength were lower after aging, meantime elongation at break and flexural deflection increased. Impact strength was found that reduced after aging. Other result revealed that the percentage of moisture uptake increased with aging. This results showed that composite materials reinforced with natural fibers required an improvement adding a protective barrier to reduce water absorption and increase UV resistance.

Keywords: coir fiber, polyester composites, environmental aging, mechanical properties

Procedia PDF Downloads 251
231 Ventriculo-Gallbladder Shunt: Case Series and Literature Review

Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

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BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

Procedia PDF Downloads 49
230 Networks in the Tourism Sector in Brazil: Proposal of a Management Model Applied to Tourism Clusters

Authors: Gysele Lima Ricci, Jose Miguel Rodriguez Anton

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Companies in the tourism sector need to achieve competitive advantages for their survival in the market. In this way, the models based on association, cooperation, complementarity, distribution, exchange and mutual assistance arise as a possibility of organizational development, taking as reference the concept of networks. Many companies seek to partner in local networks as clusters to act together and associate. The main objective of the present research is to identify the specificities of management and the practices of cooperation in the tourist destination of São Paulo - Brazil, and to propose a new management model with possible cluster of tourism. The empirical analysis was carried out in three phases. As a first phase, a research was made by the companies, associations and tourism organizations existing in São Paulo, analyzing the characteristics of their business. In the second phase, the management specificities and cooperation practice used in the tourist destination. And in the third phase, identifying the possible strengths and weaknesses that potential or potential tourist cluster could have, proposing the development of the management model of the same adapted to the needs of the companies, associations and organizations. As a main result, it has been identified that companies, associations and organizations could be looking for synergies with each other and collaborate through a Hiperred organizational structure, in which they share their knowledge, try to make the most of the collaboration and to benefit from three concepts: flexibility, learning and collaboration. Finally, it is concluded that, the proposed tourism cluster management model is viable for the development of tourism destinations because it makes it possible to strategically address agents which are responsible for public policies, as well as public and private companies and organizations in their strategies competitiveness and cooperation.

Keywords: cluster, management model, networks, tourism sector

Procedia PDF Downloads 261
229 Seismic Vulnerability Assessment of Masonry Buildings in Seismic Prone Regions: The Case of Annaba City, Algeria

Authors: Allaeddine Athmani, Abdelhacine Gouasmia, Tiago Ferreira, Romeu Vicente

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Seismic vulnerability assessment of masonry buildings is a fundamental issue even for moderate to low seismic hazard regions. This fact is even more important when dealing with old structures such as those located in Annaba city (Algeria), which the majority of dates back to the French colonial era from 1830. This category of buildings is in high risk due to their highly degradation state, heterogeneous materials and intrusive modifications to structural and non-structural elements. Furthermore, they are usually shelter a dense population, which is exposed to such risk. In order to undertake a suitable seismic risk mitigation strategies and reinforcement process for such structures, it is essential to estimate their seismic resistance capacity at a large scale. In this sense, two seismic vulnerability index methods and damage estimation have been adapted and applied to a pilot-scale building area located in the moderate seismic hazard region of Annaba city: The first one based on the EMS-98 building typologies, and the second one derived from the Italian GNDT approach. To perform this task, the authors took the advantage of an existing data survey previously performed for other purposes. The results obtained from the application of the two methods were integrated and compared using a geographic information system tool (GIS), with the ultimate goal of supporting the city council of Annaba for the implementation of risk mitigation and emergency planning strategies.

Keywords: Annaba city, EMS98 concept, GNDT method, old city center, seismic vulnerability index, unreinforced masonry buildings

Procedia PDF Downloads 594
228 Proposal of Blue and Green Infrastructure for the Jaguaré Stream Watershed, São Paulo, Brazil

Authors: Juliana C. Alencar, Monica Ferreira do Amaral Porto

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The blue-green infrastructure in recent years has been pointed out as a possibility to increase the environmental quality of watersheds. The regulation ecosystem services brought by these areas are many, such as the improvement of the air quality of the air, water, soil, microclimate, besides helping to control the peak flows and to promote the quality of life of the population. This study proposes a blue-green infrastructure scenario for the Jaguaré watershed, located in the western zone of the São Paulo city in Brazil. Based on the proposed scenario, it was verified the impact of the adoption of the blue and green infrastructure in the control of the peak flow of the basin, the benefits for the avifauna that are also reflected in the flora and finally, the quantification of the regulation ecosystem services brought by the adoption of the scenario proposed. A survey of existing green areas and potential areas for expansion and connection of these areas to form a network in the watershed was carried out. Based on this proposed new network of green areas, the peak flow for the proposed scenario was calculated with the help of software, ABC6. Finally, a survey of the ecosystem services contemplated in the proposed scenario was made. It was possible to conclude that the blue and green infrastructure would provide several regulation ecosystem services for the watershed, such as the control of the peak flow, the connection frame between the forest fragments that promoted the environmental enrichment of these fragments, improvement of the microclimate and the provision of leisure areas for the population.

Keywords: green and blue infrastructure, sustainable drainage, urban waters, ecosystem services

Procedia PDF Downloads 95
227 Potential Use of Leaching Gravel as a Raw Material in the Preparation of Geo Polymeric Material as an Alternative to Conventional Cement Materials

Authors: Arturo Reyes Roman, Daniza Castillo Godoy, Francisca Balarezo Olivares, Francisco Arriagada Castro, Miguel Maulen Tapia

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Mining waste–based geopolymers are a sustainable alternative to conventional cement materials due to their contribution to the valorization of mining wastes as well as to the new construction materials with reduced fingerprints. The objective of this study was to determine the potential of leaching gravel (LG) from hydrometallurgical copper processing to be used as a raw material in the manufacture of geopolymer. NaOH, Na2SiO3 (modulus 1.5), and LG were mixed and then wetted with an appropriate amount of tap water, then stirred until a homogenous paste was obtained. A liquid/solid ratio of 0.3 was used for preparing mixtures. The paste was then cast in cubic moulds of 50 mm for the determination of compressive strengths. The samples were left to dry for 24h at room temperature, then unmoulded before analysis after 28 days of curing time. The compressive test was conducted in a compression machine (15/300 kN). According to the laser diffraction spectroscopy (LDS) analysis, 90% of LG particles were below 500 μm. The X-ray diffraction (XRD) analysis identified crystalline phases of albite (30 %), Quartz (16%), Anorthite (16 %), and Phillipsite (14%). The X-ray fluorescence (XRF) determinations showed mainly 55% of SiO2, 13 % of Al2O3, and 9% of CaO. ICP (OES) concentrations of Fe, Ca, Cu, Al, As, V, Zn, Mo, and Ni were 49.545; 24.735; 6.172; 14.152, 239,5; 129,6; 41,1;15,1, and 13,1 mg kg-1, respectively. The geopolymer samples showed resistance ranging between 2 and 10 MPa. In comparison with the raw material composition, the amorphous percentage of materials in the geopolymer was 35 %, whereas the crystalline percentage of main mineral phases decreased. Further studies are needed to find the optimal combinations of materials to produce a more resistant and environmentally safe geopolymer. Particularly are necessary compressive resistance higher than 15 MPa are necessary to be used as construction unit such as bricks.

Keywords: mining waste, geopolymer, construction material, alkaline activation

Procedia PDF Downloads 71
226 Medical Imaging Fusion: A Teaching-Learning Simulation Environment

Authors: Cristina Maria Ribeiro Martins Pereira Caridade, Ana Rita Ferreira Morais

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The use of computational tools has become essential in the context of interactive learning, especially in engineering education. In the medical industry, teaching medical image processing techniques is a crucial part of training biomedical engineers, as it has integrated applications with healthcare facilities and hospitals. The aim of this article is to present a teaching-learning simulation tool developed in MATLAB using a graphical user interface for medical image fusion that explores different image fusion methodologies and processes in combination with image pre-processing techniques. The application uses different algorithms and medical fusion techniques in real time, allowing you to view original images and fusion images, compare processed and original images, adjust parameters, and save images. The tool proposed in an innovative teaching and learning environment consists of a dynamic and motivating teaching simulation for biomedical engineering students to acquire knowledge about medical image fusion techniques and necessary skills for the training of biomedical engineers. In conclusion, the developed simulation tool provides real-time visualization of the original and fusion images and the possibility to test, evaluate and progress the student’s knowledge about the fusion of medical images. It also facilitates the exploration of medical imaging applications, specifically image fusion, which is critical in the medical industry. Teachers and students can make adjustments and/or create new functions, making the simulation environment adaptable to new techniques and methodologies.

Keywords: image fusion, image processing, teaching-learning simulation tool, biomedical engineering education

Procedia PDF Downloads 91
225 Economic Impact of Mediation: Analyzing the Strengths and Weaknesses of Portuguese Mediation System

Authors: M. L. Mesquita, V. H. Ferreira, C. M. Cebola

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Mediation is an increasingly important mechanism, particularly in the European context, as demonstrated, for example, by the publication by the European Union of the Directive 2008/52/EC on certain aspects of mediation in civil and mercantile matters. Developments in international trade and globalization in this new century have led to an increase of the number of litigations, often cross-border, and the courts have failed to respond adequately. From the economic point of view, competitive negotiation can generate negative external effects in social terms. Not always the solution found in court is the most efficient solution taking into account all elements of society. On the other hand, the administration of justice adds in economic terms transaction costs that can be mitigated by the application of other forms of conflict resolution, such as mediation. In this paper, the economic benefits of mediation will be analysed in the light of various studies on the functioning of justice. Several theoretical arguments will be confronted with empirical studies to demonstrate that mediation has significant positive economic effects. In the Portuguese legal system, legislative frameworks for mediation display a state committed to creating a new architecture for the administration of justice, based on the construction of a multi-faceted legal system for dispute resolution mechanisms. Understanding the way in which the system of mediation in Portugal was introduced, allows us to point out that our internal ordering is creating the legal instruments which can assist citizens in the effective protection of their rights. However, data on the use of mediation in concrete proceedings and the consequent effectiveness of mediation in settling disputes, reveal a mechanism that is still far from the ideal results that were initially sought.

Keywords: access to justice, alternative dispute resolution, mediation, litigation

Procedia PDF Downloads 139
224 An Integrated Experimental and Numerical Approach to Develop an Electronic Instrument to Study Apple Bruise Damage

Authors: Paula Pascoal-Faria, Rúben Pereira, Elodie Pinto, Miguel Belbut, Ana Rosa, Inês Sousa, Nuno Alves

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Apple bruise damage from harvesting, handling, transporting and sorting is considered to be the major source of reduced fruit quality, resulting in loss of profits for the entire fruit industry. The three factors which can physically cause fruit bruising are vibration, compression load and impact, the latter being the most common source of bruise damage. Therefore, prediction of the level of damage, stress distribution and deformation of the fruits under external force has become a very important challenge. In this study, experimental and numerical methods were used to better understand the impact caused when an apple is dropped from different heights onto a plastic surface and a conveyor belt. Results showed that the extent of fruit damage is significantly higher for plastic surface, being dependent on the height. In order to support the development of a biomimetic electronic device for the determination of fruit damage, the mechanical properties of the apple fruit were determined using mechanical tests. Preliminary results showed different values for the Young’s modulus according to the zone of the apple tested. Along with the mechanical characterization of the apple fruit, the development of the first two prototypes is discussed and the integration of the results obtained to construct the final element model of the apple is presented. This work will help to reduce significantly the bruise damage of fruits or vegetables during the entire processing which will allow the introduction of exportation destines and consequently an increase in the economic profits in this sector.

Keywords: apple, fruit damage, impact during crop and post-crop, mechanical characterization of the apple, numerical evaluation of fruit damage, electronic device

Procedia PDF Downloads 273
223 Spatio-Temporal Analysis of Rabies Incidence in Herbivores of Economic Interest in Brazil

Authors: Francisco Miroslav Ulloa-Stanojlovic, Gina Polo, Ricardo Augusto Dias

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In Brazil, there is a high incidence of rabies in herbivores of economic interest (HEI) transmitted by the common vampire bat Desmodus rotundus, the presence of human rabies cases and the huge economic losses in the world's largest cattle industry, it is important to assist the National Program for Control of Rabies in herbivores in Brazil, that aims to reduce the incidence of rabies in HEI populations, mainly through epidemiological surveillance, vaccination of herbivores and control of vampire-bat roosts. Material and Methods: A spatiotemporal retrospective Kulldorff's spatial scan statistic based on a Poisson model and Monte Carlo simulation and an Anselin's Local Moran's I statistic were used to uncover spatial clustering of HEI rabies from 2000 – 2014. Results: Were identify three important clusters with significant year-to-year variation (Figure 1). In 2000, was identified one area of clustering in the North region, specifically in the State of Tocantins. Between the year 2000 and 2004, a cluster centered in the Midwest and Southeast region including the States of Goiás, Minas Gerais, Rio de Janeiro, Espirito Santo and São Paulo was prominent. And finally between 2000 and 2005 was found an important cluster in the North, Midwest and South region. Conclusions: The HEI rabies is endemic in the country, in addition, appears to be significant differences among the States according to their surveillance services, that may be difficulting the control of the disease, also other factors could be influencing in the maintenance of this problem like the lack of information of vampire-bat roosts identification, and limited human resources for realization of field monitoring. A review of the program control by the authorities it’s necessary.

Keywords: Brazil, Desmodus rotundus, herbivores, rabies

Procedia PDF Downloads 387
222 Evaluation of Electro-Flocculation for Biomass Production of Marine Microalgae Phaodactylum tricornutum

Authors: Luciana C. Ramos, Leandro J. Sousa, Antônio Ferreira da Silva, Valéria Gomes Oliveira Falcão, Suzana T. Cunha Lima

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The commercial production of biodiesel using microalgae demands a high-energy input for harvesting biomass, making production economically unfeasible. Methods currently used involve mechanical, chemical, and biological procedures. In this work, a flocculation system is presented as a cost and energy effective process to increase biomass production of Phaeodactylum tricornutum. This diatom is the only species of the genus that present fast growth and lipid accumulation ability that are of great interest for biofuel production. The algae, selected from the Bank of Microalgae, Institute of Biology, Federal University of Bahia (Brazil), have been bred in tubular reactor with photoperiod of 12 h (clear/dark), providing luminance of about 35 μmol photons m-2s-1, and temperature of 22 °C. The medium used for growing cells was the Conway medium, with addition of silica. The seaweed growth curve was accompanied by cell count in Neubauer camera and by optical density in spectrophotometer, at 680 nm. The precipitation occurred at the end of the stationary phase of growth, 21 days after inoculation, using two methods: centrifugation at 5000 rpm for 5 min, and electro-flocculation at 19 EPD and 95 W. After precipitation, cells were frozen at -20 °C and, subsequently, lyophilized. Biomass obtained by electro-flocculation was approximately four times greater than the one achieved by centrifugation. The benefits of this method are that no addition of chemical flocculants is necessary and similar cultivation conditions can be used for the biodiesel production and pharmacological purposes. The results may contribute to improve biodiesel production costs using marine microalgae.

Keywords: biomass, diatom, flocculation, microalgae

Procedia PDF Downloads 305
221 Outcomes in New-Onset Diabetic Foot Ulcers Stratified by Etiology

Authors: Pedro Gomes, Lia Ferreira, Sofia Garcia, Jaime Babulal, Luís Costa, Luís Castelo, José Muras, Isabel Gonçalves, Rui Carvalho

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Introduction: Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. Objectives: The present study aims to evaluate the outcomes in terms of need for hospitalization, amputation, healing time and mortality in patients with new-onset diabetic foot ulcers in subgroups stratified by etiology. Methods: A retrospective study based on clinical assessment of patients presenting with new ulcers to a multidisciplinary diabetic foot consult during 2012. Outcomes were determined until September 2014, from hospital registers. Baseline clinical examination was done to classify ulcers as neuropathic, ischemic or neuroischemic. Results: 487 patients with new diabetic foot ulcers were observed; 36%, 15% and 49% of patients had neuropathic, ischemic and neuroischemic ulcers, respectively. For analysis, patients were classified as having predominantly neuropathic (36%) or ischemic foot (64%). The mean age was significantly higher in the group with ischemic foot (70±12 vs 63±12 years; p <0.001), as well as the duration of diabetes (18±10 vs 16 ± 10years, p <0.05). A history of previous amputation was also significantly higher in this group (24.7% vs 15.6%, p <0.05). The evolution of ischemic ulcers was significantly worse, with a greater need for hospitalization (27.2% vs 18%, p <0.05), amputation (11.5% vs 3.6% p <0.05) mainly major amputation (3% vs. 0%; p <0.001) and higher mean healing time (151 days vs 89 days, p <0.05). The mortality rate at 18 months, was also significantly higher in the ischemic foot group (7.3% vs 1.8%, p <0.05). Conclusions: All types of diabetic foot ulcers are associated with high morbidity and mortality, however, the presence of arterial disease confers a poor prognosis. Diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care.

Keywords: diabetes, foot ulcers, etiology, outcome

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220 Heterologous Expression of a Clostridium thermocellum Proteins and Assembly of Cellulosomes 'in vitro' for Biotechnology Applications

Authors: Jessica Pinheiro Silva, Brenda Rabello De Camargo, Daniel Gusmao De Morais, Eliane Ferreira Noronha

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The utilization of lignocellulosic biomass as source of polysaccharides for industrial applications requires an arsenal of enzymes with different mode of action able to hydrolyze its complex and recalcitrant structure. Clostridium thermocellum is gram-positive, thermophilic bacterium producing lignocellulosic hydrolyzing enzymes in the form of multi-enzyme complex, termed celulossomes. This complex has several hydrolytic enzymes attached to a large and enzymically inactive protein known as Cellulosome-integrating protein (CipA), which serves as a scaffolding protein for the complex produced. This attachment occurs through specific interactions between cohesin modules of CipA and dockerin modules in enzymes. The present work aims to construct celulosomes in vitro with the structural protein CipA, a xylanase called Xyn10D and a cellulose called CelJ from C.thermocellum. A mini-scafoldin was constructed from modules derived from CipA containing two cohesion modules. This was cloned and expressed in Escherichia coli. The other two genes were cloned under the control of the alcohol oxidase 1 promoter (AOX1) in the vector pPIC9 and integrated into the genome of the methylotrophic yeast Pichia pastoris GS115. Purification of each protein is being carried out. Further studies regarding enzymatic activity of the cellulosome is going to be evaluated. The cellulosome built in vitro and composed of mini-CipA, CelJ and Xyn10D, can be very interesting for application in industrial processes involving the degradation of plant biomass.

Keywords: cellulosome, CipA, Clostridium thermocellum, cohesin, dockerin, yeast

Procedia PDF Downloads 206
219 Canine Neonatal Mortality at the São Paulo State University Veterinary Hospital, Botucatu, São Paulo, Brazil – Preliminary Data

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

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The neonatal mortality rates in dogs are considered high, varying between 5.7 and 21.2% around the world, and the causes of the deaths are often unknown. Data regarding canine neonatal mortality are scarce in Brazil. This study aims at describing the neonatal mortality rates in dogs, as well as the main causes of death. The study included 152 litters and 669 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil between January 2018 and September 2019. The overall mortality rate was 16.7% (112/669), with 40% (61/152) of the litters presenting at least one case of stillbirth or neonatal mortality. The rate of stillbirths was 7.7% (51/669), while the neonatal mortality rate was 9% (61/669). The early mortality rate (0 to 2 days) was 13.7% (92/669), accounting for 82.1% (92/112) of all deaths. The late mortality rate (3 to 30 days) was 2.7% (18/669), accounting for 16% (18/112) of all deaths. Infection was the causa mortis in 51.8% (58/112) of the newborns, of which 30.3% (34/112) were caused by bacterial sepsis, and 21.4% (24/112) were caused by other bacterial, viral or parasite infections. Other causes of death included congenital malformations (15.2%, 17/112), of which 5.3% (6/112) happened through euthanasia due to malformations incompatible with life; asphyxia/hypoxia by dystocia (9.8%, 11/112); wasting syndrome in debilitated newborns (6.2%, 7/112); aspiration pneumonia (3.6%, 4/112); agalactia (2.7%, 3/112); trauma (1.8%, 2/112); administration of contraceptives to the mother (1.8%, 2/112) and unknown causes (7.1%, 8/112). The neonatal mortality rate was considered high, but they may be even higher in locations without adequate care for the mothers and neonates. Therefore, prenatal examinations and early neonatal care are of utmost importance for the survival of these patients.

Keywords: neonate dogs, puppies, mortality rate, neonatal death

Procedia PDF Downloads 178
218 Influence of Local Soil Conditions on Optimal Load Factors for Seismic Design of Buildings

Authors: Miguel A. Orellana, Sonia E. Ruiz, Juan Bojórquez

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Optimal load factors (dead, live and seismic) used for the design of buildings may be different, depending of the seismic ground motion characteristics to which they are subjected, which are closely related to the type of soil conditions where the structures are located. The influence of the type of soil on those load factors, is analyzed in the present study. A methodology that is useful for establishing optimal load factors that minimize the cost over the life cycle of the structure is employed; and as a restriction, it is established that the probability of structural failure must be less than or equal to a prescribed value. The life-cycle cost model used here includes different types of costs. The optimization methodology is applied to two groups of reinforced concrete buildings. One set (consisting on 4-, 7-, and 10-story buildings) is located on firm ground (with a dominant period Ts=0.5 s) and the other (consisting on 6-, 12-, and 16-story buildings) on soft soil (Ts=1.5 s) of Mexico City. Each group of buildings is designed using different combinations of load factors. The statistics of the maximums inter-story drifts (associated with the structural capacity) are found by means of incremental dynamic analyses. The buildings located on firm zone are analyzed under the action of 10 strong seismic records, and those on soft zone, under 13 strong ground motions. All the motions correspond to seismic subduction events with magnitudes M=6.9. Then, the structural damage and the expected total costs, corresponding to each group of buildings, are estimated. It is concluded that the optimal load factors combination is different for the design of buildings located on firm ground than that for buildings located on soft soil.

Keywords: life-cycle cost, optimal load factors, reinforced concrete buildings, total costs, type of soil

Procedia PDF Downloads 279
217 Aeronautical Noise Management inside an Aerodrome: Analysis of Sound Exposure on Aviation Professional’s Health

Authors: Rafael Felipe Guatura da Silva, José Luis Gomes da Silva, Luiz Antonio, Ferreira Perrone de Brito

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Noise can cause serious damage to human health, such as hearing loss, stress, irritability, fatigue, and others. Aviation is a place where your entire process should be work out with the utmost attention and commitment of human resources, thus the need to study the effects of noise in this sector, as aeronautical noise levels are high. This study aimed to evaluate the impact of noise pollution on the performance of professionals regarding the fatigue generated by aeronautical noise and time to noise exposure. The methodology used consists of measurements of sound pressure levels at 42 points of the aerodrome. The selected points are located inside the hangars and outside the airfield hangars. All points chosen are close to the professionals' work areas, seeking to identify the sound pressure levels to which they submitted. The other part of the research used the principle on the application of a self-report questionnaire to a sample of 207 people working inside the aerodrome. The 207 professionals surveyed consist of aircraft mechanics, pilots, maintenance managers, and administrative professionals. The questionnaire was intended to evaluate the knowledge that professionals have about health risks caused by sound exposure as well as to identify diseases that professionals have, and that may be associated with exposure to high levels of sound pressure. Preliminary results identify points with sound pressure levels of up to 91.7 dB, thus highlighting the need for the use of personal protective equipment that reduces noise exposure. It was also identified a large number of professionals who are bothered by the sound exposure and approximately 25% of professionals interviewed reported having a hearing disorder.

Keywords: aeronautical noise, fatigue, noise and health, noise management

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216 A Closed Loop Audit of Pre-operative Transfusion Samples in Orthopaedic Patients at a Major Trauma Centre

Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns

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There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.

Keywords: blood transfusion, quality improvement, orthopaedics, trauma

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215 The Relationship of Socioeconomic Status and Levels of Delinquency among Senior High School Students with Secured Attachment to Their Mothers

Authors: Aldrin Avergas, Quennie Mariel Peñaranda, Niña Karen San Miguel, Alexis Katrina Agustin, Peralta Xusha Mae, Maria Luisa Sison

Abstract:

The research is entitled “The Relationship of Socioeconomic Status and Levels of Delinquency among Senior High School Students with Secured Attachment to their Mothers”. The researchers had explored the relationship between socioeconomic status and delinquent tendencies among grade 11 students. The objective of the research is to discover if delinquent behavior will have a relationship with the current socio-economic status of an adolescent student having a warm relationship with their mothers. The researchers utilized three questionnaires that would measure the three variables of the study, namely: (1) 1SEC 2012: The New Philippines Socioeconomic Classification System was used to show the current socioeconomic status of the respondents, (2) Self-Reported Delinquency – Problem Behavior Frequency Scale was utilized to determine the individual's frequency in engaging to delinquent behavior, and (3) Inventory of Parent and Peer Attachment Revised (IPPA-R) was used to determine the attachment style of the respondents. The researchers utilized a quantitative research design, specifically correlation research. The study concluded that there is no significant relationship between socioeconomic status and academic delinquency despite the fact that these participants had secured attachment to their mother hence this research implies that delinquency is not just a problem for students belonging in the lower socio-economic status and that even having a warm and close relationship with their mothers is not sufficient enough for these students to completely be free from engaging in delinquent acts. There must be other factors (such as peer pressure, emotional quotient, self-esteem or etc.) that are might be contributing to delinquent behaviors.

Keywords: adolescents, delinquency, high school students, secured attachment style, socioeconomic status

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214 The Severity of Electric Bicycle Injuries Compared to Classic Bicycle Injuries in Children: A Retrospective Review

Authors: Tali Capua, Karin Hermon, Miguel Glatstein, Oren Tavor, Ayelet Rimon

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Background: Electric bicycles (E-bikes) are one of a wide range of light electric vehicles that provide convenient local transportation and attractive recreational opportunities. Along with their growing use worldwide, the E-bike related injury rate increases. To the best of our knowledge, this study is the first to specifically compare E-bike with classic bicycle related injuries in children. Methods: Data of all pediatric ( < 16 years of age) bicycle related injuries presenting to an urban level I trauma center between 2014 and 2015 were collected and analyzed. The recorded data included age, gender, details of the accident, as well severity of injury, medical diagnosis, and the outcome. Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) were calculated for each patient. Data of E-bike related injuries and classic bicycle were then compared. Results: A total of 124 bicycle related injuries and 97 E-bike related injuries presented to the emergency department. Once pedestrians and bicycle passengers were removed, the groups of riders consisted of 111 bikers and 85 E-bikers. The mean age of bikers was 9.9 years (range 3-16 years) and of E-bikers was 13.7 years (range 7.5-16 years). Injuries to the head and the extremities were common in both groups. Compared to bikers, E-bikers had significantly more injuries to intra-abdominal organs (p = 0.04). Twenty patients (16%) with bicycle related injuries were admitted, and 13 (15%) patients with E-bike related injuries, of the latter group four underwent surgical intervention. ISS scores were low overall, but the injuries of higher severity (ISS > 9) were among the E-bikers. Conclusions: This study provides unique information which suggests that injuries in E-bikers tend to be more severe than in classic bikers. There is a need for regulation regarding the use of E-bikes to enhance the safety of both bikers and other road and pavement users.

Keywords: bicycle, electric bicycle, injury, pediatric, trauma

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213 Rescaled Range Analysis of Seismic Time-Series: Example of the Recent Seismic Crisis of Alhoceima

Authors: Marina Benito-Parejo, Raul Perez-Lopez, Miguel Herraiz, Carolina Guardiola-Albert, Cesar Martinez

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Persistency, long-term memory and randomness are intrinsic properties of time-series of earthquakes. The Rescaled Range Analysis (RS-Analysis) was introduced by Hurst in 1956 and modified by Mandelbrot and Wallis in 1964. This method represents a simple and elegant analysis which determines the range of variation of one natural property (the seismic energy released in this case) in a time interval. Despite the simplicity, there is complexity inherent in the property measured. The cumulative curve of the energy released in time is the well-known fractal geometry of a devil’s staircase. This geometry is used for determining the maximum and minimum value of the range, which is normalized by the standard deviation. The rescaled range obtained obeys a power-law with the time, and the exponent is the Hurst value. Depending on this value, time-series can be classified in long-term or short-term memory. Hence, an algorithm has been developed for compiling the RS-Analysis for time series of earthquakes by days. Completeness time distribution and locally stationarity of the time series are required. The interest of this analysis is their application for a complex seismic crisis where different earthquakes take place in clusters in a short period. Therefore, the Hurst exponent has been obtained for the seismic crisis of Alhoceima (Mediterranean Sea) of January-March, 2016, where at least five medium-sized earthquakes were triggered. According to the values obtained from the Hurst exponent for each cluster, a different mechanical origin can be detected, corroborated by the focal mechanisms calculated by the official institutions. Therefore, this type of analysis not only allows an approach to a greater understanding of a seismic series but also makes possible to discern different types of seismic origins.

Keywords: Alhoceima crisis, earthquake time series, Hurst exponent, rescaled range analysis

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212 Toxicological Interactions of Silver Nanoparticles and Non-Essential Metals in Human Hepatocarcinoma Cell Line

Authors: Renata Rank Miranda, Arandi Ginane Bezerra, Ciro Alberto Oliveira Ribeiro, Marco AntôNio Ferreira Randi, Carmen Lúcia Voigt, Lilian Skytte, Kaare Lund Rasmussen, Francisco Filipak Neto, Frank Kjeldsen

Abstract:

Synergetic and antagonistic effects of drugs are well-known concerns in pharmacological assessments of dose and toxicity. Similar approach should be used in assessing cellular uptake and cytotoxicity of nanoparticles. Since nanoparticles are released into the aquatic environment they may interact with existing xenobiotics. Here we used biochemical assays and quantitative proteomics to assess the cytotoxicity of silver nanoparticles (AgNP) when human hepatoma HepG2 cells were co-exposed to 2 nm AgNP together with either Cd2+ or Hg2+ ions. Time-course experiments (2h, 4h, and 24h) were conducted to assess the first response to the exposure studies. The general trend was that a synergetic toxicological response was observed in cells exposed to both AgNP and Cd2+ or Hg2+, with AgNP and Cd2+ being more toxic. This was observed by a significant increase in the ROS and superoxide level of >35% in the case of AgNP+Cd2+ compared to the sum of responses of AgNP and Cd2+, individually. Metabolic activity and viability also dropped more for AgNP+Cd2+ (>10%) than for AgNP and Cd2+ combined. We used inductively coupled plasma mass spectrometry to investigate if AgNP facilitates larger influx of toxic metal ions into HepG2 cells. Only Hg2+ ions was found to be more efficiently engulfed as the concentration of Hg2+ was found 2.8 times larger compared to exposure experiments with only Hg2+. This effect was not observed for Cd2+. We now continue with deep proteomics studies to obtain wider details on the mechanism of the toxicity related to AgNP, Cd2+, and AgNP+Cd2+, respectively.

Keywords: nanotoxicology, silver nanoparticles, proteomics, human cell line

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211 Chemical Composition and Nutritional Value of Leaves and Pods of Leucaena Leucocephala, Prosopis Laevigata and Acacia Farnesiana in a Xerophyllous Shrubland

Authors: Miguel Mellado, Cecilia Zapata

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Goats can be exploited in harsh environments due to their capacity to adjust to limited quantity and quality forage sources. In these environments, leguminous trees can be used as supplementary feeds as foliage and fruits of these trees can contribute to maintain or improve production efficiency in ruminants. The objective of this study was to determine the nutritional value of three leguminous trees heavily selected by goats in a xerophyllous shrubland. Chemical composition and in vitro dry matter disappearance (IVDMD) of leaves and pods from leucaena (Leucaena leucocephala), mesquite (Prosopis laevigata) and huisache (Acacia farnesiana) is presented. Crude protein (CP) ranged from 17.3% for leaves of huisache to 21.9% for leucaena. The neutral detergent fiber (NDF) content ranged from 39.0 to 40.3 with no difference among fodder threes. Across tree species, mean IVDMD was 61.6% for pods and 52.2% for leaves. IVDMD for leaves was highest (P < 0.01) for leucaena (54.9%) and lowest for huisache (47.3%). Condensed tannins in an acetonic extract were highest for leaves of huisache (45.3 mg CE/g DM) and lowest for mesquite (25.9 mg CE/g DM). Pods and leaves of huisache presented the highest number of secondary metabolites, mainly related to hydrobenzoic acid and flavonols; leucaena and mesquite presented mainly flavonols and anthocyanins. It was concluded that leaves and pods of leucaena, mesquite and huisache constitute valuable forages for ruminant livestock due to its low fiber, high CP levels, moderate in vitro fermentation characteristics and high mineral content. Keywords: Fodder tree; ruminants; secondary metabolites; minerals; tannins

Keywords: fodder tree, ruminants, secondary metabolites, minerals, tannins

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210 Optimization of Enzymatic Hydrolysis of Cooked Porcine Blood to Obtain Hydrolysates with Potential Biological Activities

Authors: Miguel Pereira, Lígia Pimentel, Manuela Pintado

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Animal blood is a major by-product of slaughterhouses and still represents a cost and environmental problem in some countries. To be eliminated, blood should be stabilised by cooking and afterwards the slaughterhouses must have to pay for its incineration. In order to reduce the elimination costs and valorise the high protein content the aim of this study was the optimization of hydrolysis conditions, in terms of enzyme ratio and time, in order to obtain hydrolysates with biological activity. Two enzymes were tested in this assay: pepsin and proteases from Cynara cardunculus (cardosins). The latter has the advantage to be largely used in the Portuguese Dairy Industry and has a low price. The screening assays were carried out in a range of time between 0 and 10 h and using a ratio of enzyme/reaction volume between 0 and 5%. The assays were performed at the optimal conditions of pH and temperature for each enzyme: 55 °C at pH 5.2 for cardosins and 37 °C at pH 2.0 for pepsin. After reaction, the hydrolysates were evaluated by FPLC (Fast Protein Liquid Chromatography) and tested for their antioxidant activity by ABTS method. FPLC chromatograms showed different profiles when comparing the enzymatic reactions with the control (no enzyme added). The chromatogram exhibited new peaks with lower MW that were not present in control samples, demonstrating the hydrolysis by both enzymes. Regarding to the antioxidant activity, the best results for both enzymes were obtained using a ratio enzyme/reactional volume of 5% during 5 h of hydrolysis. However, the extension of reaction did not affect significantly the antioxidant activity. This has an industrial relevant aspect in what concerns to the process cost. In conclusion, the enzymatic blood hydrolysis can be a better alternative to the current elimination process allowing to the industry the reuse of an ingredient with biological properties and economic value.

Keywords: antioxidant activity, blood, by-products, enzymatic hydrolysis

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209 The Use of TRIZ to Map the Evolutive Pattern of Products

Authors: Fernando C. Labouriau, Ricardo M. Naveiro

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This paper presents a model for mapping the evolutive pattern of products in order to generate new ideas, to perceive emerging technologies and to manage product’s portfolios in new product development (NPD). According to the proposed model, the information extracted from the patent system is filtered and analyzed with TRIZ tools to produce the input information to the NPD process. The authors acknowledge that the NPD process is well integrated within the enterprises business strategic planning and that new products are vital in the competitive market nowadays. In the other hand, it has been observed the proactive use of patent information in some methodologies for selecting projects, mapping technological change and generating product concepts. And one of these methodologies is TRIZ, a theory created to favor innovation and to improve product design that provided the analytical framework for the model. Initially, it is presented an introduction to TRIZ mainly focused on the patterns of evolution of technical systems and its strategic uses, a brief and absolutely non-comprehensive description as the theory has several others tools being widely employed in technical and business applications. Then, it is introduced the model for mapping the products evolutive pattern with its three basic pillars, namely patent information, TRIZ and NPD, and the methodology for implementation. Following, a case study of a Brazilian bike manufacturing is presented to proceed the mapping of a product evolutive pattern by decomposing and analyzing one of its assemblies along ten evolution lines in order to envision opportunities for further product development. Some of these lines are illustrated in more details to evaluate the features of the product in relation to the TRIZ concepts using a comparison perspective with patents in the state of the art to validate the product’s evolutionary potential. As a result, the case study provided several opportunities for a product improvement development program in different project categories, identifying technical and business impacts as well as indicating the lines of evolution that can mostly benefit from each opportunity.

Keywords: product development, patents, product strategy, systems evolution

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208 Public Attitudes toward Domestic Violence against Women in China and Spain: A Cross-Cultural Study

Authors: Menglu Yang, Ani Beybutyan, Rocio Pina, Miguel Angel Soria

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Domestic violence against women is one of the most serious social problems in the world. Attitudes toward domestic violence against women play an important role in the perpetration of violence against women, the way that victims respond to the violence, and how the community responds to violence against women. China and Spain are countries which have been influenced by the culture which males hold power and dominance over the female for a long time. However, as more connected with other European countries, the legal enforcement related to domestic violence against women developed earlier in Spain, and consequently, social awareness of violence against women evolved differently in two countries. The present study aimed to explore and compare the attitudes toward domestic violence against women across China and Spain, and their influence factors, such as gender equality attitudes and coercive control. Totally 506 participants, 255 from China and 251 from Spain completed questionnaires, including attitudes toward domestic violence against women, definition of violence behavior, justification for violence, gender equity attitudes, and coercive control. Results demonstrated that Chinese participants were less aware of domestic violence against women issue but more agreed that such issue was a crime than Spanish participants. In addition to cultural difference, gender equality attitudes, coercive control, gender, and age also affected attitudes toward domestic violence against women. Our findings imply attitudes toward domestic violence against women differ from countries along with the difference in gender equity attitudes and coercive control; such a difference may arise from cultural, traditional belief and current justice system influence. Despite the developed justice system, male dominance culture may lead to maintain the belief that domestic violence is domestic and private issue which police and justice force may not get involved.

Keywords: cross-cultural differences, domestic violence, public attitudes, violence against women

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207 Use of Alternative and Complementary Therapies in Patients with Chronic Pain in a Medical Institution in Medellin, Colombia, 2014

Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez

Abstract:

Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.

Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia

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206 Establishment of Virtual Fracture Clinic in Princess Royal Hospital Telford: Experience and Recommendations during the First 9 Months

Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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