Search results for: corona discharge
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 955

Search results for: corona discharge

835 Two Weeks of Multi-Modal Inpatient Treatment: Patients Suffering from Chronic Musculoskeletal Pain for over 12 Months

Authors: D. Schafer, H. Booke, R. Nordmeier

Abstract:

Patients suffering from chronic musculoskeletal pain ( > 12 months) are a challenging clientele for pain specialists. A multimodal approach, characterized by a two weeks inpatient treatment, often is the ultimate therapeutic attempt. The lasting effects of such a multimodal approach were analyzed, especially since two weeks of inpatient therapy, although very intense, often seem too short to make a difference in patients suffering from chronic pain for years. The study includes 32 consecutive patients suffering from chronic pain over years who underwent a two weeks multimodal inpatient treatment of pain. Twelve months after discharge, each patient was interviewed to objectify any lasting effects. Pain was measured on admission and 12 months after discharge using the numeric rating scale (NRS). For statistics, a paired students' t-test was used. Significance was defined as p < 0.05. The average intensity of pain on admission was 8,6 on the NRS. Twelve months after discharge, the intensity of pain was still reduced by an average of 48% (average NRS 4,4), p < 0.05. Despite this significant improvement in pain severity, two thirds (66%) of the patients still judge their treatment as not sufficient. In conclusion, inpatient treatment of chronic pain has a long-lasting effect on the intensity of pain in patients suffering from chronic musculoskeletal pain for more than 12 months.

Keywords: chronic pain, inpatient treatment, multimodal pain treatment, musculoskeletal pain

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834 Covid-19 Lockdown Experience of Elderly Female as Reflected in Their Artwork

Authors: Liat Shamri-Zeevi, Neta Ram-Vlasov

Abstract:

Today the world as a whole is attempting to cope with the COVID-19, which has affected all facets of personal and social life from country-wide confinement to maintaining social distance and taking protective measures to maintain hygiene. One of the populations faced with the most severe restrictions is seniors. Various studies have shown that creativity plays a crucial role in dealing with crisis events. Painting - regardless of media - allows for emotional and cognitive processing of these situations, and enables the expression of experiences in a tangible creative way that conveys and endows meaning to the artwork. The current study was conducted in Israel immediately after a 6-week lockdown. It was designed to specifically examine the impact of the COVID-19 pandemic on the quality of life of elderly women as reflected in their artworks. The sample was composed of 21 Israeli women aged 60-90, in good mental health (without diagnosed dementia or Alzheimer's), all of whom were Hebrew-speaking, and retired with an extended family, who indicated that they painted and had engaged in artwork on an ongoing basis throughout the lockdown (from March 12 to May 30, 2020). The participants' artworks were collected, and a semi-structured in-depth interview was conducted that lasted one to two hours. The participants were asked about their feelings during the pandemic and the artworks they produced during this time, and completed a questionnaire on well-being and mental health. The initial analysis of the interviews and artworks revealed themes related to the specific role of each piece of artwork. The first theme included notions that the artwork was an activity and a framework for doing, which supported positive emotions, and provided a sense of vitality during the closure. Most of the participants painted images of nature and growth which were ascribed concrete and symbolic meaning. The second theme was that the artwork enabled the processing of difficult and /or conflicting emotions related to the situation, including anxiety about death and loneliness that were symbolically expressed in the artworks, such as images of the Corona virus and the respiratory machines. The third theme suggested that the time and space prompted by the lockdown gave the participants time for a gathering together of the self, and freed up time for creative activities. Many participants stated that they painted more and more frequently during the Corona lockdown. At the conference, additional themes and findings will be presented.

Keywords: Corona virus, artwork, quality of life of elderly

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833 Effect of Povidone Iodine in Treatment of Epidemic Keratoconjunctivitis: Clinical Trail Study

Authors: Mohammad Hossain Validad

Abstract:

Background and Aim: Epidemic keratoconjunctivitis is a type of conjunctivitis caused by adenoviruses that can spread rapidly through direct and indirect contact. The aim of this study was to evaluate the therapeutic effects of Povidone-Iodine 0.4% and 0.2% in improving the symptoms and signs of patients with epidemic keratoconjunctivitis. Materials and Methods: In this clinical trial study, 60 patients with a mean age of 27.8±8.4 years who were eligible for inclusion criteria were randomly divided into three groups. The first group received eye drops of Povidone-Iodine 0.4% and betamethasone 0.1%, the second group received PovidoneIodine 0.2% and betamethasone 0.1% and the third group received betamethasone 0.1%. Follow-ups were on the first, fourth, seventh and tenth days after starting treatment. Parameters examined at each examination were hyperaemia, mucopurulent discharge, eyelid edema, hemorrhage, and subepithelial infiltration. Results: The results showed that mucopurulent discharge on the fourth day of the examination (P = 0.005) and the seventh day of the examination (P = 0.001) were significantly different in the three treatment groups. Sub-epithelial infiltration on the tenth day after treatment did not show a significant difference in the 3 groups (P = 0.287). Conclusion: Based on the results of this study, Povidone-Iodine is more effective in relieving some of signs of EKC, such as reduced mucopurulent discharge than steroids alone.

Keywords: EKC, topical bethadine, adenovirus, sub epithelial opacity

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832 Compensation of Cable Attenuation in Step Current Generators to Enable the Convolution Method for Calibration of Current Transducers

Authors: P. Treyer, M. Kujda, H. Urs

Abstract:

The purpose of this paper is to digitally compensate for the apparent discharge time constant of the coaxial cable so that the current step response is flat and can be used to calibrate current transducers using the convolution method. For proper use of convolution, the step response record length is required to be at least the same as the waveform duration to be evaluated. The current step generator based on the cable discharge is compared to the Blumlein generator. Moreover, the influence of each component of the system on the performance of the step is described, which allows building the appropriate measurement set-up. In the end, the calibration of current viewing resistors dedicated to high current impulse is computed.

Keywords: Blumlein generator, cable attenuation, convolution, current step generator

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831 The Use of PD and Tanδ Characteristics as Diagnostic Technique for the Insulation Integrity of XLPE Insulated Cable Joints

Authors: Mazen Al-Bulaihed, Nissar Wani, Abdulrahman Al-Arainy, Yasin Khan

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Partial Discharge (PD) measurements are widely used for diagnostic purposes in electrical equipment used in power systems. The main cause of these measurements is to prevent large power failures as cables are prone to aging, which usually results in embrittlement, cracking and eventual failure of the insulating and sheathing materials, exposing the conductor and risking a potential short circuit, a likely cause of the electrical fire. Many distribution networks rely heavily on medium voltage (MV) power cables. The presence of joints in these networks is a vital part of serving the consumer demand for electricity continuously. Such measurements become even more important when the extent of dependence increases. Moreover, it is known that the partial discharge in joints and termination are difficult to track and are the most crucial point of failures in large power systems. This paper discusses the diagnostic techniques of four samples of XLPE insulated cable joints, each included with a different type of defect. Experiments were carried out by measuring PD and tanδ at very low frequency applied high voltage. The results show the importance of combining PD and tanδ for effective cable assessment.

Keywords: partial discharge, tan delta, very low frequency, XLPE cable

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830 Variability of the X-Ray Sun during Descending Period of Solar Cycle 23

Authors: Zavkiddin Mirtoshev, Mirabbos Mirkamalov

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We have analyzed the time series of full disk integrated soft X-ray (SXR) and hard X-ray (HXR) emission from the solar corona during 2004 January 1 to 2009 December 31, covering the descending phase of solar cycle 23. We employed the daily X-ray index (DXI) derived from X-ray observations from the Solar X-ray Spectrometer (SOXS) mission in four different energy bands: 4-5.5; 5.5-7.5 keV (SXR) and 15-20; 20-25 keV (HXR). The application of Lomb-Scargle periodogram technique to the DXI time series observed by the Silicium detector in the energy bands reveals several short and intermediate periodicities of the X-ray corona. The DXI explicitly show the periods of 13.6 days, 26.7 days, 128.5 days, 151 days, 180 days, 220 days, 270 days, 1.24 year and 1.54 year periods in SXR as well as in HXR energy bands. Although all periods are above 70% confidence level in all energy bands, they show strong power in HXR emission in comparison to SXR emission. These periods are distinctly clear in three bands but somehow not unambiguously clear in 5.5-7.5 keV band. This might be due to the presence of Ferrum and Ferrum/Niccolum line features, which frequently vary with small scale flares like micro-flares. The regular 27-day rotation and 13.5 day period of sunspots from the invisible side of the Sun are found stronger in HXR band relative to SXR band. However, flare activity Rieger periods (150 and 180 days) and near Rieger period 220 days are very strong in HXR emission which is very much expected. On the other hand, our current study reveals strong 270 day periodicity in SXR emission which may be connected with tachocline, similar to a fundamental rotation period of the Sun. The 1.24 year and 1.54 year periodicities, represented from the present research work, are well observable in both SXR as well as in HXR channels. These long-term periodicities must also have connection with tachocline and should be regarded as a consequence of variation in rotational modulation over long time scales. The 1.24 year and 1.54 year periods are also found great importance and significance in the life formation and it evolution on the Earth, and therefore they also have great astro-biological importance. We gratefully acknowledge support by the Indian Centre for Space Science and Technology Education in Asia and the Pacific (CSSTEAP, the Centre is affiliated to the United Nations), Physical Research Laboratory (PRL) at Ahmedabad, India. This work has done under the supervision of Prof. Rajmal Jain and paper consist materials of pilot project and research part of the M. Tech program which was made during Space and Atmospheric Science Course.

Keywords: corona, flares, solar activity, X-ray emission

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829 Hierarchical Porous Carbon Composite Electrode for High Performance Supercapacitor Application

Authors: Chia-Chia Chang, Jhen-Ting Huang, Hu-Cheng Weng, An-Ya Lo

Abstract:

This study developed a simple hierarchical porous carbon (HPC) synthesis process and used for supercapacitor application. In which, mesopore provides huge specific surface area, meanwhile, macropore provides excellent mass transfer. Thus the hierarchical porous electrode improves the charge-discharge performance. On the other hand, cerium oxide (CeO2) have also got a lot research attention owing to its rich in content, low in price, environmentally friendly, good catalytic properties, and easy preparation. Besides, a rapid redox reaction occurs between trivalent cerium and tetravalent cerium releases oxygen atom and increase the conductivity. In order to prevent CeO2 from disintegration under long-term charge-discharge operation, the CeO2 carbon porous materials were was integrated as composite material in this study. For in the ex-situ analysis, scanning electron microscope (SEM), X-ray diffraction (XRD), transmission electron microscope (TEM) analysis were adopted to identify the surface morphology, crystal structure, and microstructure of the composite. 77K Nitrogen adsorption-desorption analysis was used to analyze the porosity of each specimen. For the in-situ test, cyclic voltammetry (CV) and chronopotentiometry (CP) were conducted by potentiostat to understand the charge and discharge properties. Ragone plot was drawn to further analyze the resistance properties. Based on above analyses, the effect of macropores/mespores and the CeO2/HPC ratios on charge-discharge performance were investigated. As a result, the capacitance can be greatly enhanced by 2.6 times higher than pristine mesoporous carbon electrode.

Keywords: hierarchical porous carbon, cerium oxide, supercapacitor

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828 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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827 Multi-Objective Optimization of Electric Discharge Machining for Inconel 718

Authors: Pushpendra S. Bharti, S. Maheshwari

Abstract:

Electric discharge machining (EDM) is one of the most widely used non-conventional manufacturing process to shape difficult-to-cut materials. The process yield, in terms of material removal rate, surface roughness and tool wear rate, of EDM may considerably be improved by selecting the optimal combination(s) of process parameters. This paper employs Multi-response signal-to-noise (MRSN) ratio technique to find the optimal combination(s) of the process parameters during EDM of Inconel 718. Three cases v.i.z. high cutting efficiency, high surface finish, and normal machining have been taken and the optimal combinations of input parameters have been obtained for each case. Analysis of variance (ANOVA) has been employed to find the dominant parameter(s) in all three cases. The experimental verification of the obtained results has also been made. MRSN ratio technique found to be a simple and effective multi-objective optimization technique.

Keywords: electric discharge machining, material removal rate, surface roughness, too wear rate, multi-response signal-to-noise ratio, multi response signal-to-noise ratio, optimization

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826 Energy Efficiency Analysis of Discharge Modes of an Adiabatic Compressed Air Energy Storage System

Authors: Shane D. Inder, Mehrdad Khamooshi

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Efficient energy storage is a crucial factor in facilitating the uptake of renewable energy resources. Among the many options available for energy storage systems required to balance imbalanced supply and demand cycles, compressed air energy storage (CAES) is a proven technology in grid-scale applications. This paper reviews the current state of micro scale CAES technology and describes a micro-scale advanced adiabatic CAES (A-CAES) system, where heat generated during compression is stored for use in the discharge phase. It will also describe a thermodynamic model, developed in EES (Engineering Equation Solver) to evaluate the performance and critical parameters of the discharge phase of the proposed system. Three configurations are explained including: single turbine without preheater, two turbines with preheaters, and three turbines with preheaters. It is shown that the micro-scale A-CAES is highly dependent upon key parameters including; regulator pressure, air pressure and volume, thermal energy storage temperature and flow rate and the number of turbines. It was found that a micro-scale AA-CAES, when optimized with an appropriate configuration, could deliver energy input to output efficiency of up to 70%.

Keywords: CAES, adiabatic compressed air energy storage, expansion phase, micro generation, thermodynamic

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825 Vitamin D Intoxication with Hypercalcemia Due to Overuse of Supplement

Authors: Sara Ataei, Mohammad Bagher Oghazian, Mania Radfar

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We describe a patient with hypercalcemia associated with the injection of high doses vitamin D as supplement for a period of six months. A 76-year-old woman had been taking an intramuscular injection of vitamin D 300,000 IU every ten days for six months. She was hospitalized with symptoms of hypercalcemia: chronic constipation, unstable gait, a chronic generalized musculoskeletal pain and increased fatigue. On admission her 25 (OH) vitamin D and Calcium levels were 559 nmol/L and 13.85 mg/dL respectively, and Parathyroid Hormone (PTH) level was 7.1 pg/mL. Immediately she received diuresis therapy with saline and furosemide in conjunction with calcitonin and pamidronate. At discharge her serum calcium level was 11.5 mg/dL. To lower endogenous overproduction of calcitriol, prednisolone 20 mg/day for 10 days was administered at discharge time.

Keywords: vitamin D, hypercalcemia, vitamin D toxicity, parathyroid hormone

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824 Process Modeling of Electric Discharge Machining of Inconel 825 Using Artificial Neural Network

Authors: Himanshu Payal, Sachin Maheshwari, Pushpendra S. Bharti

Abstract:

Electrical discharge machining (EDM), a non-conventional machining process, finds wide applications for shaping difficult-to-cut alloys. Process modeling of EDM is required to exploit the process to the fullest. Process modeling of EDM is a challenging task owing to involvement of so many electrical and non-electrical parameters. This work is an attempt to model the EDM process using artificial neural network (ANN). Experiments were carried out on die-sinking EDM taking Inconel 825 as work material. ANN modeling has been performed using experimental data. The prediction ability of trained network has been verified experimentally. Results indicate that ANN can predict the values of performance measures of EDM satisfactorily.

Keywords: artificial neural network, EDM, metal removal rate, modeling, surface roughness

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823 Prediction of Covid-19 Cases and Current Situation of Italy and Its Different Regions Using Machine Learning Algorithm

Authors: Shafait Hussain Ali

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Since its outbreak in China, the Covid_19 19 disease has been caused by the corona virus SARS N coyote 2. Italy was the first Western country to be severely affected, and the first country to take drastic measures to control the disease. In start of December 2019, the sudden outbreaks of the Coronary Virus Disease was caused by a new Corona 2 virus (SARS-CO2) of acute respiratory syndrome in china city Wuhan. The World Health Organization declared the epidemic a public health emergency of international concern on January 30, 2020,. On February 14, 2020, 49,053 laboratory-confirmed deaths and 1481 deaths have been reported worldwide. The threat of the disease has forced most of the governments to implement various control measures. Therefore it becomes necessary to analyze the Italian data very carefully, in particular to investigates and to find out the present condition and the number of infected persons in the form of positive cases, death, hospitalized or some other features of infected persons will clear in simple form. So used such a model that will clearly shows the real facts and figures and also understandable to every readable person which can get some real benefit after reading it. The model used must includes(total positive cases, current positive cases, hospitalized patients, death, recovered peoples frequency rates ) all features that explains and clear the wide range facts in very simple form and helpful to administration of that country.

Keywords: machine learning tools and techniques, rapid miner tool, Naive-Bayes algorithm, predictions

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822 Applying of an Adaptive Neuro-Fuzzy Inference System (ANFIS) for Estimation of Flood Hydrographs

Authors: Amir Ahmad Dehghani, Morteza Nabizadeh

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This paper presents the application of an Adaptive Neuro-Fuzzy Inference System (ANFIS) to flood hydrograph modeling of Shahid Rajaee reservoir dam located in Iran. This was carried out using 11 flood hydrographs recorded in Tajan river gauging station. From this dataset, 9 flood hydrographs were chosen to train the model and 2 flood hydrographs to test the model. The different architectures of neuro-fuzzy model according to the membership function and learning algorithm were designed and trained with different epochs. The results were evaluated in comparison with the observed hydrographs and the best structure of model was chosen according the least RMSE in each performance. To evaluate the efficiency of neuro-fuzzy model, various statistical indices such as Nash-Sutcliff and flood peak discharge error criteria were calculated. In this simulation, the coordinates of a flood hydrograph including peak discharge were estimated using the discharge values occurred in the earlier time steps as input values to the neuro-fuzzy model. These results indicate the satisfactory efficiency of neuro-fuzzy model for flood simulating. This performance of the model demonstrates the suitability of the implemented approach to flood management projects.

Keywords: adaptive neuro-fuzzy inference system, flood hydrograph, hybrid learning algorithm, Shahid Rajaee reservoir dam

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821 Analytical Formulae for the Approach Velocity Head Coefficient

Authors: Abdulrahman Abdulrahman

Abstract:

Critical depth meters, such as abroad crested weir, Venture Flume and combined control flume are standard devices for measuring flow in open channels. The discharge relation for these devices cannot be solved directly, but it needs iteration process to account for the approach velocity head. In this paper, analytical solution was developed to calculate the discharge in a combined critical depth-meter namely, a hump combined with lateral contraction in rectangular channel with subcritical approach flow including energy losses. Also analytical formulae were derived for approach velocity head coefficient for different types of critical depth meters. The solution was derived by solving a standard cubic equation considering energy loss on the base of trigonometric identity. The advantage of this technique is to avoid iteration process adopted in measuring flow by these devices. Numerical examples are chosen for demonstration of the proposed solution.

Keywords: broad crested weir, combined control meter, control structures, critical flow, discharge measurement, flow control, hydraulic engineering, hydraulic structures, open channel flow

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820 2D Numerical Modeling for Induced Current Distribution in Soil under Lightning Impulse Discharge

Authors: Fawwaz Eniola Fajingbesi, Nur Shahida Midia, Elsheikh M. A. Elsheikh, Siti Hajar Yusoff

Abstract:

Empirical analysis of lightning related phenomena in real time is extremely dangerous due to the relatively high electric discharge involved. Hence, design and optimization of efficient grounding systems depending on real time empirical methods are impeded. Using numerical methods, the dynamics of complex systems could be modeled hence solved as sets of linear and non-linear systems . In this work, the induced current distribution as lightning strike traverses the soil have been numerically modeled in a 2D axial-symmetry and solved using finite element method (FEM) in COMSOL Multiphysics 5.2 AC/DC module. Stratified and non- stratified electrode system were considered in the solved model and soil conductivity (σ) varied between 10 – 58 mS/m. The result discussed therein were the electric field distribution, current distribution and soil ionization phenomena. It can be concluded that the electric field and current distribution is influenced by the injected electric potential and the non-linearity in soil conductivity. The result from numerical calculation also agrees with previously laboratory scale empirical results.

Keywords: current distribution, grounding systems, lightning discharge, numerical model, soil conductivity, soil ionization

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819 Chemically Enhanced Primary Treatment: Full Scale Trial Results Conducted at a South African Wastewater Works

Authors: Priyanka Govender, S. Mtshali, Theresa Moonsamy, Zanele Mkwanazi, L. Mthembu

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Chemically enhanced primary treatment (CEPT) can be used at wastewater works to improve the quality of the final effluent discharge, provided that the plant has spare anaerobic digestion capacity. CEPT can transfer part of the organic load to the digesters thereby effectively relieving the hydraulic loading on the plant and in this way can allow the plant to continue operating long after the hydraulic capacity of the plant has been exceeded. This can allow a plant to continue operating well beyond its original design capacity, requiring only fairly simple and inexpensive modifications to the primary settling tanks as well as additional chemical costs, thereby delaying or even avoiding the need for expensive capital upgrades. CEPT can also be effective at plants where high organic loadings prevent the wastewater discharge from meeting discharge standards, especially in the case of COD, phosphates and suspended solids. By increasing removals of these pollutants in the primary settling tanks, CEPT can enable the plant to conform to specifications without the need for costly upgrades. Laboratory trials were carried out recently at the Umbilo WWTW in Durban and these were followed by a baseline assessment of the current plant performance and a subsequent full scale trial on the Conventional plant i.e. West Plant. The operating conditions of the plant are described and the improvements obtained in COD, phosphate and suspended solids, are discussed. The PST and plant overall suspended solids removal efficiency increased by approximately 6% during the trial. Details regarding the effect that CEPT had on sludge production and the digesters are also provided. The cost implications of CEPT are discussed in terms of capital costs as well as operation and maintenance costs and the impact of Ferric chloride on the infrastructure was also studied and found to be minimal. It was concluded that CEPT improves the final quality of the discharge effluent, thereby improving the compliance of this effluent with the discharge license. It could also allow for a delay in upgrades to the plant, allowing the plant to operate above its design capacity. This will be elaborated further upon presentation.

Keywords: chemically enhanced, ferric, wastewater, primary

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818 To Investigate a Discharge Planning Connect with Long Term Care 2.0 Program in a Medical Center in Taiwan

Authors: Chan Hui-Ya, Ding Shin-Tan

Abstract:

Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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817 Optimization of Machining Parameters of Wire Electric Discharge Machining (WEDM) of Inconel 625 Super Alloy

Authors: Amitesh Goswami, Vishal Gulati, Annu Yadav

Abstract:

In this paper, WEDM has been used to investigate the machining characteristics of Inconel-625 alloy. The machining characteristics namely material removal rate (MRR) and surface roughness (SR) have been investigated along with surface microstructure analysis using SEM and EDS of the machined surface. Taguchi’s L27 Orthogonal array design has been used by considering six varying input parameters viz. Pulse-on time (Ton), Pulse-off time (Toff), Spark Gap Set Voltage (SV), Peak Current (IP), Wire Feed (WF) and Wire Tension (WT) for the responses of interest. It has been found out that Pulse-on time (Ton) and Spark Gap Set Voltage (SV) are the most significant parameters affecting material removal rate (MRR) and surface roughness (SR) are. Microstructure analysis of workpiece was also done using Scanning Electron Microscope (SEM). It was observed that, variations in pulse-on time and pulse-off time causes varying discharge energy and as a result of which deep craters / micro cracks and large/ small number of debris were formed. These results were helpful in studying the effects of pulse-on time and pulse-off time on MRR and SR. Energy Dispersive Spectrometry (EDS) was also done to check the compositional analysis of the material and it was observed that Copper and Zinc which were initially not present in the Inconel 625, later migrated on the material surface from the brass wire electrode during machining

Keywords: MRR, SEM, SR, taguchi, Wire Electric Discharge Machining

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816 New Kinetic Effects in Spatial Distribution of Electron Flux and Excitation Rates in Glow Discharge Plasmas in Middle and High Pressures

Authors: Kirill D. Kapustin, Mikhail B. Krasilnikov, Anatoly A. Kudryavtsev

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Physical formation mechanisms of differential electron fluxes is high pressure positive column gas discharge are discussed. It is shown that the spatial differential fluxes of the electrons are directed both inward and outward depending on the energy relaxation law. In some cases the direction of energy differential flux at intermediate energies (5-10eV) in whole volume, except region near the wall, appeared to be down directed, so electron in this region dissipate more energy than gain from axial electric field. Paradoxical behaviour of electron flux in spatial-energy space is presented.

Keywords: plasma kinetics, electron distribution function, excitation and radiation rates, local and nonlocal EDF

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815 A Retrospective Study - Demographical, Clinical and Pharmacological Correlate of Seclusion, Self-Discharge, Physical Aggression and Use of PRN Psychotropics Within The First 72 Hours Of Admission in The Acute Psychiatric Unit in Saudi Arabia

Authors: Asma AlAmri, Ahmed Hassab Errasoul

Abstract:

Background & Objectives: Psychiatric disorders are common, affecting approximately one of five adults (17.6%) of the population. While most patients can be successfully treated as outpatients, admission to psychiatric wards is required during relapses or as part of crisis intervention. The first 72h of admission could be particularly critical due to increased risk of physical violence, non-medical discharge and absconding. Many patients requiring interventions such as seclusion, physical restrain, PRN psychotropic medications. This study aims to investigate the relationship between demographical, clinical and pharmacological factors in one hand and certain outcomes (physical aggression, use of PRN medications, need for seclusions and non-medical discharges) within the first 72hours of admission to acute psychiatric wards in KKUH/Riyadh Methods: All admissions to psychiatric wards over a 20 month period, between (May 2015- January 2017) were included. Data was collected on demographics, diagnosis, psychotropic medications prescription, documented physical aggression, and seclusion, self-discharge and absconding. Results: 134 males and 171 females were admitted over the study period. Mean age was 34.2 years (SD 11.96).48.9% (n=149) were single and most patients (n=198) were either unemployed or in educations. Bipolar disorder was the most frequent diagnosis recorded on admission (39.3%, n=120); followed by Schizophrenia and related disorders (34.8%; n=106). Most patients (77.4%, n= 236) received regular psychotropic medications on admission. Vis a vis, 223 patients (73%) received PRN medications. Nominal regression model revealed positive relationship between “no psychotropics prescribed on admission” and self-discharge in women but not in men. No statistically significant relationship was found between age, gender, admission diagnosis and use of regular psychotropic medications on admission and need for seclusion, time spent in seclusion, documented physical aggression and use of PRN medications. Conclusion: Contrary to what is expected, our study does not show association between gender, physical aggression and need for seclusion. This could be due to poor documentation practices by nursing staff in male ward comparing with those in the female ward. Use of PRN psychotropics in the first 72 hours of admission was quite high possibly leading to a “ceiling effect”. A limitation of this study is the retrospective data collection.

Keywords: discharge against medical advice, physical aggression, psychotropics, seclusion

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814 Rule-Of-Mixtures: Predicting the Bending Modulus of Unidirectional Fiber Reinforced Dental Composites

Authors: Niloofar Bahramian, Mohammad Atai, Mohammad Reza Naimi-Jamal

Abstract:

Rule of mixtures is the simple analytical model is used to predict various properties of composites before design. The aim of this study was to demonstrate the benefits and limitations of the Rule-of-Mixtures (ROM) for predicting bending modulus of a continuous and unidirectional fiber reinforced composites using in dental applications. The Composites were fabricated from light curing resin (with and without silica nanoparticles) and modified and non-modified fibers. Composite samples were divided into eight groups with ten specimens for each group. The bending modulus (flexural modulus) of samples was determined from the slope of the initial linear region of stress-strain curve on 2mm×2mm×25mm specimens with different designs: fibers corona treatment time (0s, 5s, 7s), fibers silane treatment (0%wt, 2%wt), fibers volume fraction (41%, 33%, 25%) and nanoparticles incorporation in resin (0%wt, 10%wt, 15%wt). To study the fiber and matrix interface after fracture, single edge notch beam (SENB) method and scanning electron microscope (SEM) were used. SEM also was used to show the nanoparticles dispersion in resin. Experimental results of bending modulus for composites made of both physical (corona) and chemical (silane) treated fibers were in reasonable agreement with linear ROM estimates, but untreated fibers or non-optimized treated fibers and poor nanoparticles dispersion did not correlate as well with ROM results. This study shows that the ROM is useful to predict the mechanical behavior of unidirectional dental composites but fiber-resin interface and quality of nanoparticles dispersion play important role in ROM accurate predictions.

Keywords: bending modulus, fiber reinforced composite, fiber treatment, rule-of-mixtures

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813 Optimization of Wire EDM Parameters for Fabrication of Micro Channels

Authors: Gurinder Singh Brar, Sarbjeet Singh, Harry Garg

Abstract:

Wire Electric Discharge Machining (WEDM) is thermal machining process capable of machining very hard electrically conductive material irrespective of their hardness. WEDM is being widely used to machine micro-scale parts with the high dimensional accuracy and surface finish. The objective of this paper is to optimize the process parameters of wire EDM to fabricate the microchannels and to calculate the surface finish and material removal rate of microchannels fabricated using wire EDM. The material used is aluminum 6061 alloy. The experiments were performed using CNC wire cut electric discharge machine. The effect of various parameters of WEDM like pulse on time (TON) with the levels (100, 150, 200), pulse off time (TOFF) with the levels (25, 35, 45) and current (IP) with the levels (105, 110, 115) were investigated to study the effect on output parameter i.e. Surface Roughness and Material Removal Rate (MRR). Each experiment was conducted under different conditions of a pulse on time, pulse off time and peak current. For material removal rate, TON and Ip were the most significant process parameter. MRR increases with the increase in TON and Ip and decreases with the increase in TOFF. For surface roughness, TON and Ip have the maximum effect and TOFF was found out to be less effective.

Keywords: microchannels, Wire Electric Discharge Machining (WEDM), Metal Removal Rate (MRR), surface finish

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812 Plasma-Assisted Decomposition of Cyclohexane in a Dielectric Barrier Discharge Reactor

Authors: Usman Dahiru, Faisal Saleem, Kui Zhang, Adam Harvey

Abstract:

Volatile organic compounds (VOCs) are atmospheric contaminants predominantly derived from petroleum spills, solvent usage, agricultural processes, automobile, and chemical processing industries, which can be detrimental to the environment and human health. Environmental problems such as the formation of photochemical smog, organic aerosols, and global warming are associated with VOC emissions. Research showed a clear relationship between VOC emissions and cancer. In recent years, stricter emission regulations, especially in industrialized countries, have been put in place around the world to restrict VOC emissions. Non-thermal plasmas (NTPs) are a promising technology for reducing VOC emissions by converting them into less toxic/environmentally friendly species. The dielectric barrier discharge (DBD) plasma is of interest due to its flexibility, moderate capital cost, and ease of operation under ambient conditions. In this study, a dielectric barrier discharge (DBD) reactor has been developed for the decomposition of cyclohexane (as a VOC model compound) using nitrogen, dry, and humidified air carrier gases. The effect of specific input energy (1.2-3.0 kJ/L), residence time (1.2-2.3 s) and concentration (220-520 ppm) were investigated. It was demonstrated that the removal efficiency of cyclohexane increased with increasing plasma power and residence time. The removal of cyclohexane decreased with increasing cyclohexane inlet concentration at fixed plasma power and residence time. The decomposition products included H₂, CO₂, H₂O, lower hydrocarbons (C₁-C₅) and solid residue. The highest removal efficiency (98.2%) was observed at specific input energy of 3.0 kJ/L and a residence time of 2.3 s in humidified air plasma. The effect of humidity was investigated to determine whether it could reduce the formation of solid residue in the DBD reactor. It was observed that the solid residue completely disappeared in humidified air plasma. Furthermore, the presence of OH radicals due to humidification not only increased the removal efficiency of cyclohexane but also improves product selectivity. This work demonstrates that cyclohexane can be converted to smaller molecules by a dielectric barrier discharge (DBD) non-thermal plasma reactor by varying plasma power (SIE), residence time, reactor configuration, and carrier gas.

Keywords: cyclohexane, dielectric barrier discharge reactor, non-thermal plasma, removal efficiency

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811 Introduction of a Standardised Proforma to Optimise Post-Operative Analgesia after Caesarean Section

Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

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Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

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810 Wildfire-Related Debris-Flow and Flooding Using 2-D Hydrologic Model

Authors: Cheong Hyeon Oh, Dongho Nam, Byungsik Kim

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Due to the recent climate change, flood damage caused by local floods and typhoons has frequently occurred, the incidence rate and intensity of wildfires are greatly increased due to increased temperatures and changes in precipitation patterns. Wildfires cause primary damage, such as loss of forest resources, as well as secondary disasters, such as landslides, floods, and debris flow. In many countries around the world, damage and economic losses from secondary damage are occurring as well as the direct effects of forest fires. Therefore, in this study, the Rainfall-Runoff model(S-RAT) was used for the wildfire affected areas in Gangneung and Goseong, which occurred on April 2019, when the stability of vegetation and soil were destroyed by wildfires. Rainfall data from Typhoon Rusa were used in the S-RAT model, and flood discharge was calculated according to changes in land cover before and after wildfire damage. The results of the calculation showed that flood discharge increased significantly due to changes in land cover, as the increase in flood discharge increases the possibility of the occurrence of the debris flow and the extent of the damage, the debris flow height and range were calculated before and after forest fire using RAMMS. The analysis results showed that the height and extent of damage increased after wildfire, but the result value was underestimated due to the characteristics that using DEM and maximum flood discharge of the RAMMS model. This research was supported by a grant(2017-MOIS31-004) from Fundamental Technology Development Program for Extreme Disaster Response funded by Korean Ministry of Interior and Safety (MOIS). This paper work (or document) was financially supported by Ministry of the Interior and Safety as 'Human resoure development Project in Disaster management'.

Keywords: wildfire, debris flow, land cover, rainfall-runoff meodel S-RAT, RAMMS, height

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809 Effect of Copper Particle on the PD Characteristics in a Coaxial Duct with Mixture of SF6 (10%) and N2 (90%) Gases

Authors: B. Rajesh Kamath, J. Sundara Rajan, M. K. Veeraiah, M. Z. Kurian

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Insulation performance of a gas insulated system is severely affected by particle contaminants. These metallic particles adversely affect the characteristics of insulating system. These particles can produce surface charges due to partial discharge activities. These particles which are free to move enhance the local electric fields. This paper deals with the influence of conducting particle placed in a co-axial duct on the discharge characteristics of gas mixtures. Co-axial duct placed in a high pressure chamber is used for the purpose. A gas pressure of 0.1, 0.2 and 0.3 MPa have been considered with a 10:90 SF6 and N2 gas mixtures. The 2D and 3D histograms of clean duct and duct with copper particle are discussed in this paper.

Keywords: coaxial duct, gas insulated system, gas mixtures, metallic particle, partial discharges, histograms

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808 Evaluating Viability of Solar Tubewell Irrigation Technology

Authors: Junaid N. Chauhdary, Bernard A. Engel, Allah Bakhsh

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Solar powered tubewells can be a reliable and affordable source of supplying irrigation water compared with electric or diesel operated tubewells due to frequent load shedding and soaring energy prices. A study was conducted on a solar tubewell installed at the Water Management Research Center (WMRC), University of Agriculture, Faisalabad to investigate the viability of a solar powered tubewell in terms of discharge and benefit cost ratio. The tubewell discharge was 50 m3hr-1 with a total dynamic head of 30 m. The depth of bore was 31 m (14 m blind + 17 m screen) with a casing diameter of 15.2 cm (6 inches). A 3-stage submersible pump of 10.2 cm (4 inch) diameter was lowered in the casing to a depth of 22 m. The pump was powered from 21 solar panels of 200 W capacity each. The tubewell peak discharge was observed as 6 and 7 hr day-1 in winter and summer, respectively. The breakeven analysis of the solar tubewell showed that the payback period of the solar tubewell was 1.5 years of its 10 year usable life with an IRR (internal rate of return) of 69 %. The BCR (benefit cost ratio) of the solar tubewell at 2, 4, 6, and 8 percent discount rate were 3.75, 3.45, 3.19 and 2.96, respectively. The NPV (net present value) of the solar tubewell at 2, 4, 6, and 8 % discount rates were 1.89, 1.65, 1.45 and 1.27 million rupees, respectively. These results indicated that the solar powered tubewells are a viable option as well as environmentally friendly and can be adopted by the farmers due to their affordable payback period.

Keywords: benefit cost ratio, internal rate of return (IRR), net present value (NPV), solar tubewell

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807 Preventing Discharge to No Fixed Address-Youth (NFA-Y)

Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

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The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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806 Exploring Content of Home-Based Care Education After Caesarean Section Provided by Nurse Midwives in Maternity Units

Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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