Search results for: air ventilation

Authors: Somayeh Negahdari, Mohsen Ghanbarzadeh, Masoud Nikbakht, Heshmatolah Tavakol

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Asthma, obesity and overweight are the main factors causing change within the heart and respiratory airways. Asthma symptoms are normally observed during exercising. Epidemiological studies have indicated asthma symptoms occurring due to certain lifestyle habits; for example, a sedentary lifestyle. In this study, eight weeks of aerobic exercises resulted in a positive effect overall in overweight women experiencing mild chronic asthma. The quasi-experimental applied research has been done based on experimental and control groups. The experimental group (seven patients) and control group (n = 7) were graded before and after the test. According to the Borg dyspnea and fatigue Perception Index, the training intensity has determined. Participants in the study performed a sub-maximal aerobic activity schedule (45% to 80% of maximum heart rate) for two months, while the control group (n = 7) stayed away from aerobic exercise. Data evaluation and analysis of covariance compared both the pre-test and post-test with paired t-test at significance level of P≤ 0.05. After eight weeks of exercise, the results of the experimental group show a significant decrease in resting heart rate, systolic blood pressure, minute ventilation, while a significant increase in maximal oxygen uptake and tolerance activity (P ≤ 0.05). In the control group, there was no significant difference in these parameters ((P ≤ 0.05). The results indicate the aerobic activity can strengthen the respiratory muscles, while other physiological factors could result in breathing and heart recovery. Aerobic activity also resulted in favorable changes in cardiovascular parameters, and exercise tolerance of overweight women with chronic asthma.

Keywords: asthma, respiratory cardiac index, exercise tolerance, aerobic, overweight

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Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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Authors: Junaid Asimiyu Mohammed, Olakunle Docas Tosin

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The housing environment in many developing countries is fraught with risks that have potential negative impacts on the lives of the residents. The study examined the risk factors in residential areas of two neighborhoods in Bosso Local Government Areas of Minna in Nigeria with a view to determining the level of their potential impacts. A sample of 378 households was drawn from the estimated population of 22,751 household heads. The questionnaire and direct observation were used as instruments for data collection. The data collected were analyzed using the Relative Importance Index (RII) rule to determine the level of the potential impact of the risk factors while ArcGIS was used for mapping the spatial distribution of the risks. The study established that the housing environment of Angwan Biri and El-Waziri areas of Bosso is poor and vulnerable as 26% of the houses were not habitable and 57% were only fairly habitable. The risks of epidemics, building collapse and rainstorms were evident in the area as 53% of the houses had poor ventilation; 20% of residents had no access to toilets; 47% practiced open waste dumping; 46% of the houses had cracked walls while 52% of the roofs were weak and sagging. The results of the analysis of the potential impact of the risk factors indicate a RII score of 0.528 for building collapse, 0.758 for rainstorms and 0.830 for epidemics, indicating a moderate to very high level of potential impacts. The mean RII score of 0.639 shows a significant potential impact of the risk factors. The study recommends the implementation of sanitation measures, provision of basic urban facilities and neighborhood revitalization through housing infrastructure retrofitting as measures to mitigate the risks of disasters and improve the living conditions of the residents of the study area.

Keywords: assessment, risk, residential, Nigeria

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Authors: Mahdiyeh Zafaranchi, Ethan S. Cantor, William T. Riddell, Jess W. Everett

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The New Jersey Department of Military and Veteran’s Affairs (NJ DMAVA) operates over 50 facilities throughout the state of New Jersey, U.S. NJDMAVA is under a mandate to move toward decarbonization, which will eventually include eliminating the use of natural gas and other fossil fuels for heating. At the same time, the organization requires increased resiliency regarding electric grid disruption. These competing goals necessitate adopting the use of on-site renewables such as photovoltaic and geothermal power, as well as implementing power control strategies through microgrids. Planning for these changes requires a detailed understanding of current and future electricity use on yearly, monthly, and shorter time scales, as well as a breakdown of consumption by heating, ventilation, and air conditioning (HVAC) equipment. This paper discusses case studies of two buildings that were simulated using the QUick Energy Simulation Tool (eQUEST). Both buildings use electricity from the grid and photovoltaics. One building also uses natural gas. While electricity use data are available in hourly intervals and natural gas data are available in monthly intervals, the simulations were developed using monthly and yearly totals. This approach was chosen to reflect the information available for most NJ DMAVA facilities. Once completed, simulation results are compared to metrics recommended by several organizations to validate energy use simulations. In addition to yearly and monthly totals, the simulated peak demands are compared to actual monthly peak demand values. The simulations resulted in monthly peak demand values that were within 30% of the measured values. These benchmarks will help to assess future energy planning efforts for NJ DMAVA.

Keywords: building energy modeling, eQUEST, peak demand, smart meters

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Authors: Chun-Han Li, Tien-Fu Yang, Chen-Yu Chen, Wei-Mon Yan

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The conventional dehumidification method in air-conditioning system mostly utilizes a cooling coil to remove the moisture in the air via cooling the supply air down below its dew point temperature. During the process, it needs to reheat the supply air to meet the set indoor condition that consumes a considerable amount of energy and affect the coefficient of performance of the system. If the processes of dehumidification and cooling are separated and operated respectively, the indoor conditions will be more efficiently controlled. Therefore, decoupling the dehumidification and cooling processes in heating, ventilation and air conditioning system is one of the key technologies as membrane dehumidification processes for the next generation. The membrane dehumidification method has the advantages of low cost, low energy consumption, etc. It utilizes the pore size and hydrophilicity of the membrane to transfer water vapor by mass transfer effect. The moisture in the supply air is removed by the potential energy and driving force across the membrane. The process can save the latent load used to condense water, which makes more efficient energy use because it does not involve heat transfer effect. In this work, the performance measurements including the permeability and selectivity of water vapor and air with the composite and commercial membranes were conducted. According to measured data, we can choose the suitable dehumidification membrane for designing the flow channel length and components of the planar dehumidifier. The vacuum membrane dehumidification system was set up to examine the effects of temperature, humidity, vacuum pressure, flow rate, the coefficient of performance and other parameters on the dehumidification efficiency. The results showed that the commercial Nafion membrane has better water vapor permeability and selectivity. They are suitable for filtration with water vapor and air. Meanwhile, Nafion membrane has promising potential in the dehumidification process.

Keywords: vacuum membrane dehumidification, planar membrane dehumidifier, water vapour and air permeability, air conditioning

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Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

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Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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Authors: Jubril Olatunbosun Akinde

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Unplanned population growth are mostly attributed to a lack of infrastructural facilities and poor economic condition in the rural dwellings and the incidence of rural-urban migration, which has resulted in severe housing deficiency in the urban centre, with a resultant pressure on housing delivery in the cities. Affordable housing does not only encompass environmental factors that make living acceptable and comfortable, which include good access routes, ventilation, sanitation and access to other basic human needs, which include water and safety. The research assessed the housing affordability and safety measures in the varied residential area of lagos by examining the demographic and socioeconomic attributes of residents; examining the existing residential safety measures; by examining the residential quality in terms of safety; the researcher therefore examined if relationship between housing affordability and safety in the varied residential areas. The research adopted the bartlett, kotrlik and higgins (2001) method of t-test to determine the sample size which specifies different populations at different levels of significance (α). The researcher adopted primary data which was sourced from a field survey where the sample population was simply randomly selected to give a member of the population an equal chance of being selected, therefore, the sample size for the field survey was two hundred (200) respondents, and subjected to necessary testing. The research come to conclusion that housing safety and security is the responsibility of every resident, the landlords/landladies possess a better sense of security in their neighbourhood than renters in the community, therefore they need to be aware of their responsibility of ensuring the safety of lives and property.

Keywords: housing, housing affordability, housing security, residential, residential quality

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Authors: Abdullahi Mannir Rawayau

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This paper identifies the problems that have aided the decoy to adequate basic infrastructural amenities, sub-standard housing, over-crowding, poor ventilation in homes and work places, sanitation, and non-compliance with building bye-laws and regulation. The paper also asserts the efficient disposal of solid and liquid waste is one of the challenges in the informal areas due to threats on the environment and public health. Sanitation services in the informal settlements have been found to be much lower compared to the average for unban. Bearing in mind a factor which prevents sustainable sanitation in informal areas which include low incomes, insecure tenure, low education levels, difficulty topography and transitory populations, and this study aim to identify effective strategies for achieving sustainable sanitation with specific reference to the informal settlement. Using the Shanghai Low-Cost as a case study. The primary data collected was through observation and interview method. Similarly, the secondary data used for the study was collected through literature reviews from extent studies with specific reference to informal settlement. A number of strategies towards achieving sustainable sanitation in the study were identified here in classified into three (3):- Advocacy and capacity building, infrastructural provision and institutionalization of systems and processes. The paper concludes with the premise on the need to build alliances between the government and stakeholders concerned with sanitation provision through the creation of sanitation and employ adaptable technology. Provision of sanitation facilities in public areas and to establish a statutory body for timely response to sanitation waste management in Katsina. It is imperative to check and prevent further decay for harmonious living and sustainable development.

Keywords: built environment, sanitation, facilities, settlement

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Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

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Authors: Balázs Ádám, Randi Nørgaard Fløe Pedersen, Jørgen Riis Jepsen

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Volatile chemicals that accumulate and release from freight containers constitute significant health risks. Fumigation to prevent spread of pests and off-gassing of freight are sources of hazardous chemicals. The aim of our study was to investigate the regulation and practice of container handling with focus on preventive measures applied against chemical exposures in Denmark. A comprehensive systematic search of scientific literature and organizational domains of international and Danish regulatory bodies was performed to explore regulations related to safe work with transport containers. The practice of container work was investigated in a series of semi-structured interviews with managers and health and safety representatives of organizations that handle transport containers. Although there are several international and national regulations and local safety instructions that relate to container handling, the provided information is not specific or up-to-date enough to conduct safe practice in many aspects. The interviewees estimate high frequency of containers with chemical exposure and deem that they can potentially damage health, although recognizable health effects are rare. Knowledge is limited about the chemicals and most of them cannot be measured by available devices. Typical preventive measures are passive ventilation and personal protective equipment but their use is not consistent and may not provide adequate protection. Hazardous chemicals are frequently present in transport containers; however, managers, workers and even occupational health professionals have limited knowledge about the problem. Detailed risk assessment and specific instructions on risk management are needed to provide safe conditions for work with containers.

Keywords: chemical exposure, fumigation, occupational health and safety regulation, transport container

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Authors: Tafadzwa Makonese, Harold Annegarn, Patricia Forbes

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Residential coal combustion is one of the largest sources of carbonaceous aerosols in the Highveld region of South Africa, significantly affecting the local and regional climate. In this study, we investigated single coal burning particles emitted when using different fire-ignition techniques (top-lit up-draft vs bottom-lit up-draft) and air ventilation rates (defined by the number of air holes above and below the fire grate) in selected informal braziers. Aerosol samples were collected on nucleopore filters at the SeTAR Centre Laboratory, University of Johannesburg. Individual particles (~700) were investigated using a scanning electron microscope equipped with an energy-dispersive X-ray spectroscopy (EDS). Two distinct forms of spherical organic particles (SOPs) were identified, one less oxidized than the other. The particles were further classified into "electronically" dark and bright, according to China et al. [2014]. EDS analysis showed that 70% of the dark spherical organic particles balls had higher (~60%) relative oxygen content than in the bright SOPs. We quantify the morphology of spherical organic particles and classify them into four categories: ~50% are bare single particles; ~35% particles are aggregated and form diffusion accretion chains; 10% have inclusions; and 5% are deformed due to impaction on filter material during sampling. We conclude that there are two distinct kinds of coal burning spherical organic particles and that dark SOPs are less volatile than bright SOPs. We also show that these spherical organic particles are similar in nature and characteristics to tar balls observed in biomass combustion, and that they have the potential to absorb sunlight thereby affecting the earth’s radiative budget and climate. This study provides insights on the mixing states, morphology, and possible formation mechanisms of these organic particles from residential coal combustion in informal stoves.

Keywords: spherical organic particles, residential coal combustion, fixed-bed, aerosols, morphology, stoves

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Authors: Jamil Hijazi, Stirling Howieson

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Reducing energy consumption and CO₂ emissions are probably the greatest challenge now facing mankind. From considerations surrounding global warming and CO₂ production, it has to be recognized that oil is a finite resource and the KSA like many other oil-rich countries will have to start to consider a horizon where hydro-carbons are not the dominant energy resource. The employment of hybrid ground-cooling pipes in combination with the black body solar collection and radiant night cooling systems may have the potential to displace a significant proportion of oil currently used to run conventional air conditioning plant. This paper presents an investigation into the viability of such hybrid systems with the specific aim of reducing cooling load and carbon emissions while providing all year-round thermal comfort in a typical Saudi Arabian urban housing block. Soil temperatures were measured in the city of Jeddah. A parametric study then was carried out by computational simulation software (DesignBuilder) that utilized the field measurements and predicted the cooling energy consumption of both a base case and an ideal scenario (typical block retro-fitted with insulation, solar shading, ground pipes integrated with hypocaust floor slabs/stack ventilation and radiant cooling pipes embed in floor). Initial simulation results suggest that careful ‘ecological design’ combined with hybrid radiant and ground pipe cooling techniques can displace air conditioning systems, producing significant cost and carbon savings (both capital and running) without appreciable deprivation of amenity.

Keywords: cooling load, energy efficiency, ground pipe cooling, hybrid cooling strategy, hydronic radiant systems, low carbon emission, passive designs, thermal comfort

Procedia PDF Downloads 202

Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida

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Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.

Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis

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Authors: Yehya Elsayed, Sarah Dalibalta, Fareedah Alqtaishat, Ioline Gomes, Nagelle Fernandes

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Bakhour or Arabian incense is traditionally used to perfume houses, shops and clothing as part of cultural or religious practices in several Middle Eastern countries. Conventionally, Bakhour consists of a mixture of natural ingredients such as chips of agarwood (oud), musk and sandalwoods that are soaked in scented oil. Bakhour is usually burned by charcoal or by using gas or electric burners to produce the scented smoke. It is necessary to evaluate the impact of such practice on human health and environment especially that the burning of Bakhour is usually done on a regular basis and in closed areas without proper ventilation. Although significant amount of research has been reported in scientific literature on the chemical analysis of various types of incense smoke, unfortunately only very few of them focused specifically on the health impacts of Bakhour. Raw Bakhour samples, their smoke emissions and the ash residue were analyzed to assess the existence of toxic ingredients and their possible influence on health and the environment. Three brands of Bakhour samples were analyzed for the presence of harmful heavy metals and organic compounds. Thermal Desorption Gas Chromatography-Mass Spectrometry (TD-GC-MS) was used to identify organic compounds while Inductively Coupled Plasma (ICP) and Scanning Electron Microscope-Energy Dispersive X-Ray Spectrometer (SEM-EDS) were used to analyze the presence of toxic and heavy metals. Organic compounds from the smoke were collected on specific tenax and activated carbon adsorption tubes. More than 850 chemical compounds were identified. The presence of 19 carcinogens, 23 toxins and 173 irritants were confirmed. Additionally, heavy metals were detected in amounts similar to those present in cigarettes. However, it was noticed that many of the detected compounds in the smoke lacked clinical studies on their health effects which shows the need for further clinical studies to be devoted to this area of study.

Keywords: Bakhour, incense smoke, pollution, indoor environment, health risk, chemical analysis

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Authors: Yehya Elsayed, Sarah Dalibalta, Fareedah Alqtaishat, Ioline Gomes, Nagelle Fernandes

Abstract:

Bakhour, or Arabian incense, is traditionally used to perfume houses, shops and clothing as part of cultural or religious practices in several Middle Eastern countries. Conventionally, Bakhour consists of a mixture of natural ingredients such as chips of agarwood (oud), musk and sandalwoods that are soaked in scented oil. Bakhour is usually burned by charcoal or by using gas or electric burners to produce the scented smoke. It is necessary to evaluate the impact of such practice on human health and environment especially that the burning of Bakhour is usually done on a regular basis and in closed areas without proper ventilation. Although significant amount of research has been reported in scientific literature on the chemical analysis of various types of incense smoke, unfortunately, only very few of them focused specifically on the health impacts of Bakhour. Raw Bakhour samples, their smoke emissions and the ash residue were analyzed to assess the existence of toxic ingredients and their possible influence on health and the environment. Three brands of Bakhour samples were analyzed for the presence of harmful heavy metals and organic compounds. Thermal Desorption Gas Chromatography-Mass Spectrometry (TD-GC-MS) was used to identify organic compounds while Inductively Coupled Plasma (ICP) and Scanning Electron Microscope-Energy Dispersive X-Ray Spectrometer (SEM-EDS) were used to analyze the presence of toxic and heavy metals.. Organic compounds from the smoke were collected on specific tenax and activated carbon adsorption tubes. More than 850 chemical compounds were identified. The presence of 19 carcinogens, 23 toxins, and 173 irritants were confirmed. Additionally, heavy metals were detected in amounts similar to those present in cigarettes. However, it was noticed that many of the detected compounds in the smoke lacked clinical studies on their health effects which shows the need for further clinical studies to be devoted to this area of study.

Keywords: bakhour, incense smoke, pollution, indoor environment, health risk, chemical analysis

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Authors: Kishor T. Zingre, Seshadhri Srinivasan

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Energy consumption by the building sector is increasing at an alarming rate throughout the world and leading to more building-related CO₂ emissions into the environment. In buildings, the main contributors to energy consumption are heating, ventilation, and air-conditioning (HVAC) systems, lighting, and electrical appliances. It is hypothesised that the energy efficiency in buildings can be achieved by implementing sustainable technologies such as i) enhancing the thermal resistance of fabric materials for reducing heat gain (in hotter climates) and heat loss (in colder climates), ii) enhancing daylight and lighting system, iii) HVAC system and iv) occupant localization. Energy performance of various sustainable technologies is highly dependent on climatic conditions. This paper investigated the use of machine learning techniques for accurate prediction of air-conditioning energy in seasonal climates. The data required to train the machine learning techniques is obtained using the computational simulations performed on a 3-story commercial building using EnergyPlus program plugged-in with OpenStudio and Google SketchUp. The EnergyPlus model was calibrated against experimental measurements of surface temperatures and heat flux prior to employing for the simulations. It has been observed from the simulations that the performance of sustainable fabric materials (for walls, roof, and windows) such as phase change materials, insulation, cool roof, etc. vary with the climate conditions. Various renewable technologies were also used for the building flat roofs in various climates to investigate the potential for electricity generation. It has been observed that the proposed technique overcomes the shortcomings of existing approaches, such as local linearization or over-simplifying assumptions. In addition, the proposed method can be used for real-time estimation of building air-conditioning energy.

Keywords: building energy efficiency, energyplus, machine learning techniques, seasonal climates

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Authors: Ram Sharan Mehta, Gayanandra Malla, Anita Gurung, Anu Aryal, Divya Labh, Hricha Neupane

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Objectives: Lack of resuscitation skills of nurses and doctors in basic life support (BLS) and advanced life support (ALS) has been identified as a contributing factor to poor outcomes of cardiac arrest victims. The objective of this study was to examine retention of life support measures (BLS/ALS) knowledge and skills of nurses following education intervention programme. Materials and Methods: Pre-experimental research design was used to conduct the study among the nurses working in medical units of B.P Koirala Institute of Health Sciences, where CPR is very commonly performed. Using convenient sampling technique total of 20 nurses agreed to participate and give consent were included in the study. The theoretical, demonstration and re-demonstration were arranged involving the trained doctors and nurses during the three hours educational session. Post-test was carried out after two week of education intervention programme. The 2010 BLS & ALS guidelines were used as guide for the study contents. The collected data were analyzed using SPSS-15 software. Results: It was found that there is significant increase in knowledge after education intervention in the components of life support measures (BLS/ALS) i.e. ratio of chest compression to ventilation in BLS (P=0.001), correct sequence of CPR (p <0.001), rate of chest compression in ALS (P=0.001), the depth of chest compression in adult CPR (p<0.001), and position of chest compression in CPR (P=0.016). Nurses were well appreciated the programme and request to continue in future for all the nurses. Conclusions: At recent BLS/ALS courses (2010), a significant number of nurses remain without any such training. Action is needed to ensure all nurses receive BLS training and practice this skill regularly in order to retain their knowledge.

Keywords: pre-experimental, basic and advance life support, nurses, sampling technique

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Authors: Selim M. Khan, Aaron A. Goodarzi, Joshua M. Taron, Tryggve Rönnqvist

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Indoor air quality, a prime determinant of health, is strongly influenced by the presence of hazardous radon gas within the built environment. As a health issue, dangerously high indoor radon arose within the 20th century to become the 2nd leading cause of lung cancer. While the 21st century building metrics and human behaviors have captured, contained, and concentrated radon to yet higher and more hazardous levels, the issue is rapidly worsening in Canada. It is established that Canadians in the Prairies are the 2nd highest radon-exposed population in the world, with 1 in 6 residences experiencing 0.2-6.5 millisieverts (mSv) radiation per week, whereas the Canadian Nuclear Safety Commission sets maximum 5-year occupational limits for atomic workplace exposure at only 20 mSv. This situation is also deteriorating over time within newer housing stocks containing higher levels of radon. Deep machine learning (LSTM) algorithms were applied to analyze multiple quantitative and qualitative features, determine the most important contributory factors, and predicted radon levels in the known past (1990-2020) and projected future (2021-2050). The findings showed gradual downwards patterns in Sweden, whereas it would continue to go from high to higher levels in Canada over time. The contributory factors found to be the basement porosity, roof insulation depthness, R-factor, and air dynamics of the indoor environment related to human window opening behaviour. Building codes must consider including these factors to ensure adequate indoor ventilation and healthy living that can prevent lung cancer in non-smokers.

Keywords: radon, building metrics, deep learning, LSTM prediction model, lung cancer, canada, sweden

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Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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Authors: Sherif Sabri, Suzy Fawzi, Sanaa Abdelshafy, Ayman Nagah

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Introduction: Static derangements in lactate homeostasis during ICU stay have become established as a clinically useful marker of increased risk of hospital and ICU mortality. Lactate indices or kinetic alteration of the anaerobic metabolism make it a potential parameter to evaluate disease severity and intervention adequacy. This is an inexpensive and simple clinical parameter that can be obtained by a minimally invasive means. Aim of work: Comparing the predictive value of dynamic indices of hyperlactatemia in the first twenty four hours of intensive care unit (ICU) admission with other static values are more commonly used. Patients and Methods: This study included 40 critically ill patients above 18 years old of both sexes with Hyperlactamia (≥ 2 m mol/L). Patients were divided into septic group (n=20) and low oxygen transport group (n=20), which include all causes of low-O2. Six lactate indices specifically relating to the first 24 hours of ICU admission were considered, three static indices and three dynamic indices. Results: There were no statistically significant differences among the two groups regarding age, most of the laboratory results including ABG and the need for mechanical ventilation. Admission lactate was significantly higher in low-oxygen transport group than the septic group [37.5±11.4 versus 30.6±7.8 P-value 0.034]. Maximum lactate was significantly higher in low-oxygen transport group than the septic group P-value (0.044). On the other hand absolute lactate (mg) was higher in septic group P-value (< 0.001). Percentage change of lactate was higher in the septic group (47.8±11.3) than the low-oxygen transport group (26.1±12.6) with highly significant P-value (< 0.001). Lastly, time weighted lactate was higher in the low-oxygen transport group (1.72±0.81) than the septic group (1.05±0.8) with significant P-value (0.012). There were statistically significant differences regarding lactate indices in survivors and non survivors, whether in septic or low-oxygen transport group. Conclusion: In critically ill patients, time weighted lactate and percent in lactate change in the first 24 hours can be an independent predictive factor in ICU mortality. Also, a rising compared to a falling blood lactate concentration over the first 24 hours can be associated with significant increase in the risk of mortality.

Keywords: critically ill patients, lactate indices, mortality in intensive care, anaerobic metabolism

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Authors: R. K. Agrawal, Shiv Agrawal

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Fines and micro create fundamental problems of respiration. From mines to mills steel plants generate lot of pollutants. Legislation & Government laws are stricter day by day & each plant has to think of recycling, reuse &reintegration of pollutants generated during the process of steel making. This paper deals with experiments conducted in Bhilai Steel Plant and Real Ispat and Power Limited for reuse, recycle & reintegrate some of the steel making process fines. Iron ore fines with binders have been agglomerated to be used as a part of the charge for small furnaces. This will improve yield at nominal cost. Rolling mill fines have been recycled to increase the yield of sinter making. This will solve the problems of fine disposal. Huge saving on account of recycling will be achieved. Lime fines after briquetting is used along with prime lime. Lime fines have also been used as a binding material during production of fly ash bricks. These fines serve as low-cost binder. Experiments have been conducted along with coke breeze & gas cleaning plant sludge. As a result, the anti-sloping compound has been developed for converter vessels. Dolo char and Char during Sponge Iron production have been successfully used in power generation and brick making. Pellets have been made with ventilation dust & flue dust. These samples have been tried as a coolant in the converter. Pellets have been made with Sinter Plant electrostatic precipitator micro fines with liquid binder. Trials have been conducted to reuse these pellets in sinter making. Coke breeze from coke-ovens fines and mill scale along with binders were agglomerated. This was used in furnace after attaining required screening and reactivity index. These actions will definitely bring social, economic and environment-friendly universe.

Keywords: briquette, dolo char, electrostatic precipitator, pellet, sinter

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Authors: Vacharee Svamivastu

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This research investigates the application of geometrical relationship to the ancient religious assembly hall (Vihara) housing a reclining Buddha statue of Thailand's Kamphaeng Phet Historical Park. The study utilizes the archaeological and wooden roof structure remains of the Vihara as the prima facie evidence, supplemented with evidence from other active archaeological sites with architectural kinship as well as Buddhist ideology. At present, the wooden roofs of the Vihara fell prey to the elements and there remain only the base, columns and enclosing walls. Unlike typical Viharas whose floor plan are of rectangular shape, the floor plan of the Vihara housing the reclining Buddha is of square configuration of 25x25m. Further observation has revealed the utilization of large laterite boulders as the principal construction material of the assembly hall (Vihara) columns. The laterite columns are of square shape (1x1m) and various heights (H), ranging from 3.50m to 5.50m. The erection of the Vihara required a total of 36 laterite columns. The pattern of columns arrangement is of two rows of inner columns, two rows of outer columns and two rows of verandah columns. The space between pairs of the verandah columns was stacked with laterite blocks of varying sizes to form the Vihara walls with small openings for ventilation. Upon applying the geometrical relationship-grid system to the Vihara, the results reveal that the placement of the columns was deliberately and masterfully undertaken such that the center of the square-shaped Vihara is conspicuously spacious so as to accommodate the sacred reclining Buddha statue. The elegance of the Vihara demonstrates the ingenious application of geometrical relationship to transforming a space into a structure (i.e. Vihara) of architectural and religious significance.

Keywords: geometrical relationship, the religious assembly hall, Vihara, Kamphaeng Phet School of Master Builder

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Authors: Ekele T. Ochedi, Ahmad H. Taki, Birgit Painter

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The effect of the sun and its path on thermal comfort and energy consumption in residential buildings in tropical climates constitute a serious concern for designers, building owners, and users. Passive design approaches based on the sun and its path have been identified as a means of reducing energy consumption as well as enhancing thermal comfort in buildings worldwide. Hence, a thorough understanding regarding the sun path is key to achieving this. This is necessary due to energy need, poor energy supply, and distribution, energy poverty, and over-dependence on electric generators for power supply in Nigeria. These challenges call for a change in the approach to energy-related issues, especially in terms of buildings. The aim of this study is to explore the influence of building orientation, glazing and the use of shading devices on residential buildings in Nigeria. This is intended to provide data that will guide designers in the design of energy-efficient residential buildings. The paper used EnergyPlus to analyze a typical semi-detached residential building in Lokoja, Nigeria using hourly weather data for a period of 10 years. Building performance was studied as well as possible improvement regarding different orientations, glazing types and shading devices. The simulation results show some reductions in energy consumption in response to changes in building orientation, types of glazing and the use of shading devices. The results indicate 29.45% reduction in solar gains and 1.90% in annual operative temperature using natural ventilation only. This shows a huge potential to reduce energy consumption and improve people’s well-being through the use of proper building orientation, glazing and appropriate shading devices on building envelope. The study concludes that for a significant reduction in total energy consumption by residential buildings, the design should focus on multiple design options rather than concentrating on one or few building elements. Moreover, the investigation confirms that energy performance modeling can be used by building designers to take advantage of the sun and to evaluate various design options.

Keywords: energy consumption, energy-efficient buildings, glazing, thermal comfort, shading devices, solar gains

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Authors: Xiaoyang Zhao, Kaiying Wang

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The choice of stocking density in poultry farming is a potential way for determining welfare level of poultry. However, it is difficult to measure stocking densities in poultry farming because of a lot of variables such as species, age and weight, feeding way, house structure and geographical location in different broiler houses. A method was proposed in this paper to measure the differences of young broilers reared under different stocking densities by sound analysis. Vocalisations of broilers were recorded and analysed under different stocking densities to identify the relationship between sounds and stocking densities. Recordings were made continuously for three-week-old chickens in order to evaluate the variation of sounds emitted by the animals at the beginning. The experimental trial was carried out in an indoor reared broiler farm; the audio recording procedures lasted for 5 days. Broilers were divided into 5 groups, stocking density treatments were 8/m², 10/m², 12/m² (96birds/pen), 14/m² and 16/m², all conditions including ventilation and feed conditions were kept same except from stocking densities in every group. The recordings and analysis of sounds of chickens were made noninvasively. Sound recordings were manually analysed and labelled using sound analysis software: GoldWave Digital Audio Editor. After sound acquisition process, the Mel Frequency Cepstrum Coefficients (MFCC) was extracted from sound data, and the Support Vector Machine (SVM) was used as an early detector and classifier. This preliminary study, conducted in an indoor reared broiler farm shows that this method can be used to classify sounds of chickens under different densities economically (only a cheap microphone and recorder can be used), the classification accuracy is 85.7%. This method can predict the optimum stocking density of broilers with the complement of animal welfare indicators, animal productive indicators and so on.

Keywords: broiler, stocking density, poultry farming, sound monitoring, Mel Frequency Cepstrum Coefficients (MFCC), Support Vector Machine (SVM)

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Authors: Dyna Ann C. Sevilles, Noel J. Belonguel, Jarungchai Anton S. Vatanagul, Mary Jeanne O. Flordelis, Grace G. Anota

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Guillain Barre syndrome is an acute inflammatory polyradiculoneuropathy causing progressive symmetrical weakness which can be debilitating to the patient. Early diagnosis is important especially in the acute phase when treatment favors good outcome and reduces the incidence of the need for mechanical ventilation. Electrodiagnostic studies aid in the evaluation of patients suspected with GBS. However, the characteristic electrical changes may not be evident until after several weeks. Thus, studies performed early in the course may give unclear results. The aim of this study is to associate the symptom onset of patients diagnosed with Guillain Barre syndrome with the EMG NCV results and determine the earliest time when there is evident findings supporting the diagnosis. This is a retrospective descriptive chart review study involving patients of >/= 18 years of age with GBS written on their charts in a Tertiaty hospital in Cebu City, Philippines from January 2000 to July 2014. Twenty patients showed electrodiagnostic findings suggestive of GBS. The mean day of illness when EMG NCV was carried out was 7 days. The earliest with suggestive findings was done on day 2 (10%) of illness. Moreover, the highest frequency with positive results was done on day 3 (20%) of illness. Based on the Dutch Guillain Barre Study group criteria, the most frequent variables noted were: prolonged distal motor latency in both median and ulnar nerves(65%) and both peroneal and tibial nerves (71%); and reduced CMAP in both median and ulnar nerves (65%) and both tibial and peroneal nerves (71%). The EMG NCV findings showed majority of demyelinating type (59%). Electrodiagnostic studies are helpful in aiding the physician in the diagnosis and treatment of the disease in the early stage. Based on this study, neurophysiologic evidence of GBS can be seen in as early as day 2 of clinical illness.

Keywords: Acute Inflammatory Demyelinating Polyneuropathy, electrophysiologic study, EMG NCV, Guillain Barre Syndrome

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Authors: Ali Göksenli, Barlas Eryürek

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In this study, failure analysis of pipe system at a micro hydroelectric power plant is investigated. Failure occurred at the pipe system in the powerhouse during shut down operation of the water flow by a valve. This locking had caused a sudden shock wave, also called “Water-hammer effect”, resulting in noise and inside pressure increase. After visual investigation of the effect of the shock wave on the system, a circumference crack was observed at the pipe flange weld region. To establish the reason for crack formation, calculations of pressure and stress values at pipe, flange and welding seams were carried out and concluded that safety factor was high (2.2), indicating that no faulty design existed. By further analysis, pipe system and hydroelectric power plant was examined. After observations it is determined that the plant did not include a ventilation nozzle (air trap), that prevents the system of sudden pressure increase inside the pipes which is caused by water-hammer effect. Analyses were carried out to identify the influence of water-hammer effect on inside pressure increase and it was concluded that, according Jowkowsky’s equation, shut down time is effective on inside pressure increase. The valve closing time was uncertain but by a shut down time of even one minute, inside pressure would increase by 7.6 bar (working pressure was 34.6 bar). Detailed investigations were also carried out on the assembly of the pipe-flange system by considering technical drawings. It was concluded that the pipe-flange system was not installed according to the instructions. Two of five weld seams were not applied and one weld was carried out faulty. This incorrect and inadequate weld seams resulted in; insufficient connection of the pipe to the flange constituting a strong notch effect at weld seam regions, increase in stress values and the decrease of strength and safety factor

Keywords: failure analysis, hydroelectric plant, crack, shock wave, welding seam

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Authors: Jamil Hijazi, Stirling Howieson

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Over one-quarter of the Kingdom of Saudi Arabia’s total oil production (2.8 million barrels a day) is used for electricity generation. The built environment is estimated to consume 77% of the total energy production. Of this amount, air conditioning systems consume about 80%. Apart from considerations surrounding global warming and CO2 production it has to be recognised that oil is a finite resource and the KSA like many other oil rich countries will have to start to consider a horizon where hydro-carbons are not the dominant energy resource. The employment of hybrid ground cooling pipes in combination with black body solar collection and radiant night cooling systems may have the potential to displace a significant proportion of oil currently used to run conventional air conditioning plant. This paper presents an investigation into the viability of such hybrid systems with the specific aim of reducing carbon emissions while providing all year round thermal comfort in a typical Saudi Arabian urban housing block. At the outset air and soil temperatures were measured in the city of Jeddah. A parametric study then was carried out by computational simulation software (Design Builder) that utilised the field measurements and predicted the cooling energy consumption of both a base case and an ideal scenario (typical block retro-fitted with insulation, solar shading, ground pipes integrated with hypocaust floor slabs/ stack ventilation and radiant cooling pipes embed in floor).Initial simulation results suggest that careful ‘ecological design’ combined with hybrid radiant and ground pipe cooling techniques can displace air conditioning systems, producing significant cost and carbon savings (both capital and running) without appreciable deprivation of amenity.

Keywords: energy efficiency, ground pipe, hybrid cooling, radiative cooling, thermal comfort

Procedia PDF Downloads 237

Authors: J. B. J. Njalam’mano, E. M. N. Chirwa

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In low resource settings in Africa and other developing regions, pit latrines remain the dominant basic minimum acceptable form of sanitation. However, unpleasant smells-malodours emitted from faecal sludge in the pit latrines, which elicit disgusting or repulsive response, are one of the factors that thwart people to use latrines and instead opt for open defecation as an alternative. This provides an important but often overlooked major impediment, dissuading people from adopting and using the pit latrines hence affecting successful, effective sanitation promotion. The malodours are primarily attributed to four odorants: butanoic acid (C₄H₈O₂), dimethyl trisulphide (C₂H₆S₃), indole (C₈H₇N) and para-cresol (C₇H₈O). Several pit latrine deodorisation methods such as addition of carbonous materials, use of ventilation systems and urine separation are available, and they continue to occupy their niche, but social, economic, environmental and technological shortfalls remain. Bioremediation has been gaining popularity because it is inexpensive, simple to operate and environmentally friendly. Recently, the biodegradation of butanoic acid as individual odorant has been studied. However, to the best of our knowledge, there have been no kinetic studies of the butanoic acid in the presence of other key odorous compounds. In this study, a series of experiments were conducted to investigate the effects of indole on the removal of butanoic acid under aerobic conditions using indigenous bacteria strains, Pseudomonas aeruginosa, and Serratia marcescens isolated from faecal sludge as pure cultures as well as mixed cultures. In this purpose, butanoic acid removal was performed in a batch reactor containing the bacterial strains in mineral salt medium (MSM) amended with 3000 ppm of butanoic acid at the temperature of 30°C, under continuous stirring rate of 150 rpm and the concentration of indole was varied from 50-200 ppm. The initial pH of the solution was in the range of 6.0-7.2. Overall, there were significant differences in the bacterial growth rate and total butanoic acid removal dependent on the concentration of indole in the solution.

Keywords: biodegradation, butanoic acid, indole, pit latrine

Procedia PDF Downloads 162

Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: Oktavian Prasetia Wardana, Martono Tri Utomo, Risa Etika, Kartika Darma Handayani, Dina Angelika, Wurry Ayuningtyas

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Background: Critically ill neonates are newborn babies with high-risk factors that potentially cause disability and/or death. Scoring systems for determining the severity of the disease have been widely developed as well as some designs for use in neonates. The SNAPPE-II method, which has been used as a mortality predictor scoring system in several referral centers, was found to be slow in assessing the outcome of critically ill neonates in the Neonatal Intensive Care Unit (NICU). Objective: To analyze the predictive value of MSNS on the outcome of critically ill neonates at the time of arrival up to 24 hours after being admitted to the NICU. Methods: A longitudinal observational analytic study based on medical record data was conducted from January to August 2022. Each sample was recorded from medical record data, including data on gestational age, mode of delivery, APGAR score at birth, resuscitation measures at birth, duration of resuscitation, post-resuscitation ventilation, physical examination at birth (including vital signs and any congenital abnormalities), the results of routine laboratory examinations, as well as the neonatal outcomes. Results: This study involved 105 critically ill neonates who were admitted to the NICU. The outcome of critically ill neonates was 50 (47.6%) neonates died, and 55 (52.4%) neonates lived. There were more males than females (61% vs. 39%). The mean gestational age of the subjects in this study was 33.8 ± 4.28 weeks, with the mean birth weight of the subjects being 1820.31 ± 33.18 g. The mean MSNS score of neonates with a deadly outcome was lower than that of the lived outcome. ROC curve with a cut point MSNS score <10.5 obtained an AUC of 93.5% (95% CI: 88.3-98.6) with a sensitivity value of 84% (95% CI: 80.5-94.9), specificity 80 % (CI 95%: 88.3-98.6), Positive Predictive Value (PPV) 79.2%, Negative Predictive Value (NPV) 84.6%, Risk Ratio (RR) 5.14 with Hosmer & Lemeshow test results p>0.05. Conclusion: The MSNS score has a good predictive value and good calibration of the outcomes of critically ill neonates admitted to the NICU.

Keywords: critically ill neonate, outcome, MSNS, NICU, predictive value

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