Search results for: delirium prevention bundle

Authors: C. Román, M. Guevara, P. Salas, D. Duclap, J. Houenou, C. Poupon, J. F. Mangin, P. Guevara

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Diffusion Magnetic Resonance Imaging (dMRI) allows the non-invasive study of human brain white matter. From diffusion data, it is possible to reconstruct fiber trajectories using tractography algorithms. Our previous work consists in an automatic method for the identification of short association bundles of the superficial white matter (SWM), based on a whole brain inter-subject hierarchical clustering applied to a HARDI database. The method finds representative clusters of similar fibers, belonging to a group of subjects, according to a distance measure between fibers, using a non-linear registration (DTI-TK). The algorithm performs an automatic labeling based on the anatomy, defined by a cortex mesh parcelated with FreeSurfer software. The clustering was applied to two independent groups of 37 subjects. The clusters resulting from both groups were compared using a restrictive threshold of mean distance between each pair of bundles from different groups, in order to keep reproducible connections. In the left hemisphere, 48 reproducible bundles were found, while 43 bundles where found in the right hemisphere. An inter-hemispheric bundle correspondence was then applied. The symmetric horizontal reflection of the right bundles was calculated, in order to obtain the position of them in the left hemisphere. Next, the intersection between similar bundles was calculated. The pairs of bundles with a fiber intersection percentage higher than 50% were considered similar. The similar bundles between both hemispheres were fused and symmetrized. We obtained 30 common bundles between hemispheres. An atlas was created with the resulting bundles and used to segment 78 new subjects from another HARDI database, using a distance threshold between 6-8 mm according to the bundle length. Finally, a laterality index was calculated based on the bundle volume. Seven bundles of the atlas presented right laterality (IP_SP_1i, LO_LO_1i, Op_Tr_0i, PoC_PoC_0i, PoC_PreC_2i, PreC_SM_0i, y RoMF_RoMF_0i) and one presented left laterality (IP_SP_2i), there is no tendency of lateralization according to the brain region. Many factors can affect the results, like tractography artifacts, subject registration, and bundle segmentation. Further studies are necessary in order to establish the influence of these factors and evaluate SWM laterality.

Keywords: dMRI, hierarchical clustering, lateralization index, tractography

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Authors: Fang Tan

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This research focuses on the appropriate use of lexical bundles in spoken discourse, particularly in English as a Foreign Language (EFL) classrooms in Northeast China. While previous studies have mainly examined lexical bundles in written discourse, there is a need to investigate their usage in spoken discourse due to the limited availability of spoken discourse corpora. English teachers’ use of lexical bundles is crucial for effective teaching and communication in the EFL classroom. The aim of this study is to investigate the functions of four-word lexical bundles in native English teachers’ EFL oral English classes in Northeast China. Specifically, the research focuses on the usage of stance bundles, which were found to be the most significant type of bundle in the analyzed corpus. By comparing the self-built university spoken English classroom discourse corpus with the other self-built university English for General Purposes (EGP) corpus, the study aims to highlight the difference in bundle usage between native and non-native teachers in EFL classrooms. The research employs a corpus-based study. The observed corpus consists of more than 300,000 tokens, in which the data has been collected in the past five years. The reference corpus is composed of over 800,000 tokens, in which the data has been collected over 12 years. All the primary data collection involved transcribing and annotating spoken English classes taught by native English teachers. The analysis procedures included identifying and categorizing four-word lexical bundles, with specific emphasis on stance bundles. Frequency counts, and comparisons with the Chinese English teachers’ corpus were conducted to identify patterns and differences in bundle usage. The research addresses the following questions: 1) What are the functions of four-word lexical bundles in native English teachers’ EFL oral English classes? 2) How do stance bundles differ in usage between native and non-native English teachers’ classes? 3) What implications can be drawn for English teachers’ professional development based on the findings? In conclusion, this study provides valuable insights into the usage of four-word lexical bundles, particularly stance bundles, in native English teachers’ EFL oral English classes in Northeast China. The research highlights the difference in bundle usage between native and non-native English teachers’ classes and provides implications for English teachers’ professional development. The findings contribute to the understanding of lexical bundle usage in EFL classroom discourse and have theoretical importance for language teaching methodologies. The self-built university English classroom discourse corpus used in this research is a valuable resource for future studies in this field.

Keywords: EFL classroom discourse, four-word lexical bundles, stance, implication

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Authors: Hyungmo Kim, Hwang Bae, Seok-Kyu Chang, Dong Won Lee, Yung Joo Ko, Sun Rock Choi, Hae Seob Choi, Hyeon Seok Woo, Dong-Jin Euh, Hyeong-Yeon Lee

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Flow mixing characteristics in the wire-wrapped 37-pin rod bundle were measured by using a wire-mesh sensing system for a sodium-cooled fast reactor (SFR). The subchannel flow mixing in SFR core subchannels was an essential characteristic for verification of a core thermal design and safety analysis. A dedicated test facility including the wire-mesh sensor system and tracing liquid injection system was developed, and the conductivity fields at the end of 37-pin rod bundle were visualized in several different flow conditions. These experimental results represented the reasonable agreements with the results of CFD, and the uncertainty of the mixing experiments has been conducted to evaluate the experimental results.

Keywords: core thermal design, flow mixing, a wire-mesh sensor, a wire-wrap effect

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Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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Authors: Sukhee Park, Gaab Soo Kim

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Purpose: We aimed to evaluate the adequacy of second-generation laryngeal mask airway use during prolonged abdominal surgery in respect of ventilation, oxygenation, postoperative pulmonary complications (PPC), and postoperative non-pulmonary complications on living donor kidney transplant (LDKT) surgery. Methods: In total, 257 recipients who underwent LDKT using either laryngeal mask airway-ProSeal (LMA-P) or endotracheal tube (ETT) were retrospectively analyzed. Arterial partial pressure of carbon dioxide (PaCO2 and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between two groups. In addition, PPC including pulmonary aspiration and postoperative non-pulmonary complications including nausea, vomiting, hoarseness, vocal cord palsy, delirium, and atrial fibrillation were also compared. Results: PaCO2 and PFR during surgery were not significantly different between the two groups. PPC was also not significantly different between the two groups. Interestingly, the incidence of delirium was significantly lower in the LMA-P group than the ETT group (3.0% vs. 10.3%, P = 0.029). Conclusions: During prolonged abdominal surgery such as LDKT, second-generation laryngeal mask airway offers adequate ventilation and oxygenation and can be considered a suitable alternative to ETT.

Keywords: laryngeal mask airway, prolonged abdominal surgery, kidney transplantation, postoperative pulmonary complication

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Authors: S. Öcal, A. Erakgün, E. Yüksel, M. N. Deniz, E. Erhan, A. Çertuğ

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Background: Emergence agitation (EA) is defined as a dissociated state of consciousness during the early post-anesthesia period in which the child is inconsolable, irritable, uncompromising or uncooperative, typically thrashing, crying, moaning, or incoherent, and not recognizing or identifying familiar and known objects or people. Some studies found preoperative parental anxiety to be a predictor of EA. Methods: Seventy-four children, between the ages of 3-12 undergoing adenoidectomy/tonsillectomy at Ege University Hospital, were studied. Anesthesia was induced and maintained using 2% sevoflurane in 50% oxygen and 50% air following a premedicative dose of 0.5mg/kg oral midazolam. After the children were taken into the operating theater, the mothers were given the State-Trait Anxiety Inventory (STAI) questionnaire. To evaluate EA, Post Anesthetic Emergence Delirium (PAED) score of the children were noted every 10min during the first 30min of the postoperative period. EA was defined with a highest PAED score of ≥ 10, and non-EA with a highest PAED score of ≤ 9. Results: In this study, the incidence of postoperative EA was 31% (34% under the age of 6 and 19% over). Mothers of children with EA were found not to be significantly more anxious on STAI compared to mothers of non-EA children. Conclusions: Contrary to some earlier studies, we were unable to find an association between preoperative parental anxiety and postoperative EA.

Keywords: parental anxiety, emergence agittion, Post Anesthetic Emergence Delirium, anesthesia

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Authors: Sudip Sudhir Godbole

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In transmission line surface potential gradient is a critical design parameter for planning overhead line, as it determines the level of corona loss (CL), radio interference (RI) and audible noise (AN).With increase of transmission line voltage level bulk power transfer is possible, using bundle conductor configuration used, it is more complex to find accurate surface stress in bundle configuration. The majority of existing models for surface gradient calculations are based on analytical methods which restrict their application in simulating complex surface geometry. This paper proposes a novel technique which utilizes both analytical and numerical procedure to predict the surface gradient. One of 400 kV transmission line configurations has been selected as an example to compare the results for different methods. The different strand shapes are a key variable in determining.

Keywords: surface gradient, Maxwell potential coefficient method, market and Mengele’s method, successive images method, charge simulation method, finite element method

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Authors: Yan Cheng, Yijun Shao, James Rudolph, Charlene R. Weir, Beth Sahlmann, Qing Zeng-Treitler

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Supervised predictive models require labeled data for training purposes. Complete and accurate labeled data, i.e., a ‘gold standard’, is not always available, and imperfectly labeled data may need to serve as an alternative. An important question is if the accuracy of the labeled data creates a performance ceiling for the trained model. In this study, we trained several models to recognize the presence of delirium in clinical documents using data with annotations that are not completely accurate (i.e., weakly-supervised learning). In the external evaluation, the support vector machine model with a linear kernel performed best, achieving an area under the curve of 89.3% and accuracy of 88%, surpassing the 80% accuracy of the training sample. We then generated a set of simulated data and carried out a series of experiments which demonstrated that models trained on imperfect data can (but do not always) outperform the accuracy of the training data, e.g., the area under the curve for some models is higher than 80% when trained on the data with an error rate of 40%. Our experiments also showed that the error resistance of linear modeling is associated with larger sample size, error type, and linearity of the data (all p-values < 0.001). In conclusion, this study sheds light on the usefulness of imperfect data in clinical research via weakly-supervised learning.

Keywords: weakly-supervised learning, support vector machine, prediction, delirium, simulation

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Authors: L. Q. Yuan, J. Yang, A. Siddiqui

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A new regression uncertainty analysis methodology was applied to determine the uncertainties of the critical heat flux (CHF) power correlation for an advanced 43-element bundle design, which was developed by Canadian Nuclear Laboratories (CNL) to achieve improved economics, resource utilization and energy sustainability. The new methodology is considered more appropriate than the traditional methodology in the assessment of the experimental uncertainty associated with regressions. The methodology was first assessed using both the Monte Carlo Method (MCM) and the Taylor Series Method (TSM) for a simple linear regression model, and then extended successfully to a non-linear CHF power regression model (CHF power as a function of inlet temperature, outlet pressure and mass flow rate). The regression uncertainty assessed by MCM agrees well with that by TSM. An equation to evaluate the CHF power regression uncertainty was developed and expressed as a function of independent variables that determine the CHF power.

Keywords: CHF experiment, CHF correlation, regression uncertainty, Monte Carlo Method, Taylor Series Method

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Authors: Jian-Na Zhang, Xiao-Li Chen, Si-Jian Li

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Objective: In order to investigate current status on knowledge of disaster prevention and reduction in rural pupils, to explore education method on disaster prevention and reduction for rural pupils. Method: A questionnaire was designed based on literature review. Convenient sampling was used in the survey. The questionnaire survey was conducted among 180 students from Huodehong town central primary school which located in Ludian county of Zhaotong city in Yunnan province, where 6.5 magnitude earthquake happened in 2014. The result indicated that the pupils’ knowledge and skills on disaster prevention and reduction relevant poor. The source for them to obtain the knowledge of disaster prevention and reduction included TV (68.9%), followed by their parents (43.9%), while only 24.4% of knowledge is from the teachers. The scores about different natural disaster are ranking in descending order: earthquake (5.39 ±1.27), floods (3.77 ±1.17); debris flow (2.81 ±1.05), family fire (2.16± 0.96). And the disaster experience did not help the pupils enhance the knowledge reserves. There is no statistical significance (P > 0.05) in knowledge scores of disaster prevention and reduction between experienced and non-experienced group. Conclusion: The local disaster experiences did not draw the attention of parents and schools. Knowledge popularization of disaster for local pupils is extremely urgent. It is necessary to take advantage of more mediums to popularize the knowledge and skills about disaster prevention and reduction, for example, family education, school education, newspapers, brochures, etc. The training courses on disaster prevention and reduction which are based on the characteristics of the local rural pupils and the characteristics of the local disasters would be useful.

Keywords: rural, pupils, disaster prevention and reduction knowledge, popularization

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Authors: Pornthip Seangsanga

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Sepsis or septic shock needs urgent care because it is a cause of the high mortality rate if patients do not receive timely treatment. Songkhla Hospital does not have a clear system or clinical practice guidelines for treatment of patients with severe sepsis or septic shock, which contributes to the said problem.To compare clinical outcomes based on the protocol after using the clinical guidelines between the Emergency Room, Intensive Care Unit, and the Ward. This quasi-experimental study was conducted on the population and 50 subjects who were diagnosed with severe sepsis or septic shock from December 2013 to May 2014. The data were collected using a nursing care and referring record form for patients with severe sepsis or septic shock at Songkhla Hospital. The record form had been tested for its validity by three experts, and the IOC was 1.The mortality rate in patients with severe sepsis or septic shock who were moved from the ER to the ICU was significantly lower than that of those patients moved from the Ward to the ICU within 48 hours. This was because patients with severe sepsis or septic shock who were moved from the ER to the ICU received more fluid within the first six hours according to the protocol which helped patients to have adequate tissue perfusion within the first six hours, and that helped improve blood flow to the kidneys, and the patients’ urine was found to be with a higher quantity of 0.5 cc/kg/hr, than those patients who were moved from the Ward to the ICU. This study shows that patients with severe sepsis or septic shock need to be treated immediately. Using the clinical practice guidelines along with timely diagnosis and treatment based on the sepsis bundle in giving sufficient and suitable amount of fluid to help improve blood circulation and blood pressure can clearly prevent or reduce severity of complications.

Keywords: clinical practice guidelines, caring, septic shock, sepsis bundle protocol

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Authors: Sayed A. Elsayed, Emad Z. Ibrahim, Osama M. Mesalhy, Mohamed A. Abdelatief

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An experimental and numerical study has been conducted to clarify fluid flow characteristics and pressure drop distributions of a cross-flow heat exchanger employing staggered wing-shaped tubes at different angels of attack. The water-side Rew and the air-side Rea were at 5 x 102 and at from 1.8 x 103 to 9.7 x 103, respectively. Three cases of the tubes arrangements with various angles of attack, row angles of attack and 90° cone angles were employed at the considered Rea range. Correlation of pressure drop coefficient Pdc in terms of Rea, design parameters for the studied cases were presented. The flow pattern around the staggered wing-shaped tubes bundle were predicted by using commercial CFD FLUENT 6.3.26 software package. Results indicated that the values of Pdc were increased by increasing the angle of attack from 0° to 45°, while the opposite was true for angles of attack from 135° to 180°. Comparisons between the experimental and numerical results of the present study and those, previously, obtained for similar available studies showed good agreements.

Keywords: wing-shaped tubes, cross-flow cooling, staggered arrangement, CFD

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Authors: Dongyeob Han, Jungwon Huh, Quang Huy Tran, Choonghyun Kang

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Unmanned Aerial Vehicles (UAVs) have been used for surveillance, monitoring, inspection, and mapping. In this paper, we present a systematic approach for automatic registration of UAV images for monitoring facilities such as building, green house, and civil structures. The two-step process is applied; 1) an image matching technique based on SURF (Speeded up Robust Feature) and RANSAC (Random Sample Consensus), 2) bundle adjustment of multi-temporal images. Image matching to find corresponding points is one of the most important steps for the precise registration of multi-temporal images. We used the SURF algorithm to find a quick and effective matching points. RANSAC algorithm was used in the process of finding matching points between images and in the bundle adjustment process. Experimental results from UAV images showed that our approach has a good accuracy to be applied to the change detection of facility.

Keywords: building, image matching, temperature, unmanned aerial vehicle

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Authors: M. Rahou, A. J. Andrews, G. Rosengarten

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One of the main challenges in high-temperature solar thermal applications transfer concentrated solar radiation to the load with minimum energy loss and maximum overall efficiency. The use of a solar concentrator in conjunction with bundled optical fibres has potential advantages in terms of transmission energy efficiency, technical feasibility and cost-effectiveness compared to a conventional heat transfer system employing heat exchangers and a heat transfer fluid. In this paper, a theoretical and computer simulation method is described to estimate the net solar radiation transmission from a solar concentrator into and through optical fibres to a thermal application at the end of the fibres over distances of up to 100 m. A key input to the simulation is the angular distribution of radiation intensity at each point across the aperture plane of the optical fibre. This distribution depends on the optical properties of the solar concentrator, in this case, a parabolic mirror with a small secondary mirror with a common focal point and a point-focus Fresnel lens to give a collimated beam that pass into the optical fibre bundle. Since solar radiation comprises a broad band of wavelengths with very limited spatial coherence over the full range of spectrum only ray tracing models absorption within the fibre and reflections at the interface between core and cladding is employed, assuming no interference between rays. The intensity of the radiation across the exit plane of the fibre is found by integrating across all directions and wavelengths. Results of applying the simulation model to a parabolic concentrator and point-focus Fresnel lens with typical optical fibre bundle will be reported, to show how the energy transmission varies with the length of fibre.

Keywords: concentrated radiation, fibre bundle, parabolic dish, fresnel lens, transmission

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Authors: Mark De Ste Croix, Jonathan Hughes, Francisco Ayala, Michal Lehnert

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There are well-known challenges to implementing injury prevention training for youth players but no data are available on the knowledge and understanding of deliverers of such programmes at grass root level. To increase adoption and adherence to such programmes coach knowledge and understanding of injury risk and prevention is essential. Therefore, the purpose of this study was to examine grass-root coaches knowledge and understanding of injury risk and prevention in youth players. 68 grass root coaches (18 females and 50 males) who were attending a one-day injury prevention workshop completed a modified validated questionnaire exploring knowledge and understanding of injury risk and prevention in youth players. Only 59% of coaches agreed that youth players are at a high risk of suffering an injury. There were high levels of agreement that injuries can have negative impacts on team performance (75%) and can cause physical problems in later life (85%), however only around half of coaches felt that injuries affect youth players current quality of life (59%). There was strong agreement that it is possible to prevent injuries in youth players (84%), but coaches were generally unaware of programs to help prevent injuries (84%), and only 9% used some form of injury prevention program. Despite this, nearly all coaches felt that their coaching could benefit from a greater understanding of growth and maturation (91%), injury prevention programmes (91%) and specific exercises (93%) for youth athletes. 17% of coaches rated their knowledge of injury prevention as good/very good at the start of the workshop and this increased to 94% at the end of the workshop. 62% of coaches identified their attitude towards injury prevention as indifferent at the start of the workshop compared with only 1% at the end. Only 14% of coaches at the start of the workshop were confident to deliver an injury prevention session but 83% stated they were confident by the end of the workshop. Finally, 98% of coaches felt that the workshop provided them with the confidence and the knowledge to deliver an injury prevention session and 98% suggested that they would implement injury prevention into their coaching. These data suggest that there is a lack of understanding of grass root coaches that children are a high-risk group for injuries, and that such injuries impact on current quality of life. Despite understanding that injuries can be prevented most grass root coaches do not have the knowledge to implement injury prevention into their coaching and very few do. There is a common consensus amongst these coaches that a greater understanding of such programmes will enhance their coaching. The injury prevention workshop appears to have increased the knowledge and changed the attitude of coaches towards injury prevention. All coaches felt that the workshop provided them with the tools to adopt, implement and deliver injury prevention in their coaching. These data highlight that there is a clear need for education regarding injury risk and prevention to be embedded within the coach education pathway, especially at grass root level.

Keywords: coach education, injury prevention, knowledge, and understanding, youth

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Authors: S. Buloyan, V. Mamikonyan, H. Hakobyan, H. Harutyunyan, H. Gasparyan

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The liver is the strongest regenerating organ of the organism, and even with 2/3 surgically removed, it can regenerate completely. Hence, liver cirrhosis may only develop when the regenerating system is off. We present the results of a comparative study of structural and functional characteristics of rat liver tissue under the conditions of toxic liver cirrhosis development, induced by carbon tetrachloride, and its prevention/treatment by natural compounds with antioxidant and immune stimulating action. Studies were made on Wister rats, weighing 120~140 g. Grape seeds extracts, separately and in combination with well known anticirrhotic drug ursodeoxycholic acid (ursodiol) have demonstrated effectiveness in prevention of liver cirrhosis development and its treatment.

Keywords: carbon tetrachloride, GSE, liver cirrhosis, prevention, treatment

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Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

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Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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Authors: Megan E. Davies

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As substance use become an increasing prevalent occurrence amongst young people, prevention programs designed specifically for children and adolescents are required to protect against associated cognitive, psychological, and behavioural issues. Further, young people from marginalized backgrounds would highly benefit from culturally adapted substance use prevention programs. The first and second phase of the Life Skills Training (LST) program, the Maskwacis Life Skills Training (MLST) program, the Bii-Zin-Da-De-Da (BZDDD; “Listening to One Another”), and a culturally sensitive smoking prevention program, all of which have been adapted to Canadian Indigenous cultures and are applied within the school and family settings, are discussed. Additionally, comorbid disorders, at-risk personality types, and motivating factors associated with substance use amongst Canadian children and adolescents, specifically Indigenous youth, are explored through the application of a biopsychosocial model. Requital efforts being made in Canada towards Indigenous communities are described within a historical context, and substance use prevention programs targeting Indigenous children and adolescents are compared. Through this lens, suggestions are presented for future research on preventative interventions directed towards substance use within minority groups.

Keywords: early intervention, cultural appropriateness, life skills training, smoking prevention, drug and alcohol prevention

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Authors: Abdulnasser Ahmed Haza’a, Marzoq Ali Odhah, Saddam Ahmed Al-Ahdal, Abdulfatah Saleh Al-Jaradi, Gamil Ghaleb Alrubaiee

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Patient safety in hospitals is an essential professional indicator that should be noticed. The threat of fires is potentially the most dangerous risk that could harm patients and personnel. The aim of the study is to assess the knowledge of operating room (OR) staff toward prevention and control sources of fires. Between March 1 and March 30, 2022, data collection was done. A descriptive cross-sectional study was conducted. The sample of the study consisted of 89 OR staff from different governmental hospitals. Convenient sampling was applied to select the sample size. Official approvals were obtained from selected settings for start collection data. Data were collected using a close-ended questionnaire and tested for knowledge. This study was conducted in four governmental hospitals in Sana'a, Yemen. Most of the OR staff were male. Of these, 50.6% of them were operation technician professionals. More than two-thirds of OR staff have less than ten years of experience; 93% of OR staff had inadequate knowledge of sources of fires, and inadequate knowledge of them toward controls and prevention of fires (73%, 79.8%), respectively; 77.5% of OR staff had inadequate knowledge of prevention and control sources of fires. The study concluded that most of OR staff had inadequate knowledge of sources, controls, and prevention of fires, while 22.5% of them had adequate knowledge of prevention and control sources of fires. We recommended the implementation of training programs toward sources, controls, and prevention of fires or related workshops in their educational planning for OR staff of hospitals.

Keywords: knowledge, operation rooms staff, fires, prevention

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Authors: Y. Khulief, S. Bashmal, S. Said, D. Al-Otaibi, K. Mansour

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The prediction of flow rates at which the vibration-induced instability takes place in tubular heat exchangers due to cross-flow is of major importance to the performance and service life of such equipment. In this paper, the semi-analytical model for square tube arrays was extended and utilized to study the triangular tube patterns. A laboratory test rig with instrumented test section is used to measure the fluidelastic coefficients to be used for tuning the mathematical model. The test section can be made of any bundle pattern. In this study, two test sections were constructed for both the normal triangular and the rotated triangular tube arrays. The developed scheme is utilized in predicting the onset of flow-induced instability in the two triangular tube arrays. The results are compared to those obtained for two other bundle configurations. The results of the four different tube patterns are viewed in the light of TEMA predictions. The comparison demonstrated that TEMA guidelines are more conservative in all configurations considered

Keywords: fluid-structure interaction, cross-flow, heat exchangers,

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Authors: A. Ghadbane, M. N. Bouaziz, S. Hanini, B. Baggoura, M. Abbaci

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The spacer grids are used to fix the rods bundle in a nuclear reactor core also act as turbulence-enhancing devices to improve the heat transfer from the hot surfaces of the rods to the surrounding coolant stream. Therefore, the investigation of thermal-hydraulic characteristics inside the rod bundles is important for optima design and safety operation of a nuclear reactor power plant. This contribution presents a feasibility study to use the ribbed spacer grids as mixing devices. The present study evaluates the effects of different ribbed spacer grids configurations on flow pattern and heat transfer in the downstream of the mixing devices in a 2 x 2 rod bundle array. This is done by obtaining velocity and pressure fields, turbulent intensity and the heat transfer coefficient using a three-dimensional CFD analysis. Numerical calculations are performed by employing K-ε turbulent model. The computational results obtained are promising and the comparison with standard spacer grids shows a clear difference which required the experimental approach to validate.

Keywords: PWR fuel assembly, spacer grid, mixing vane, swirl flow, turbulent heat transfer, CFD

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Authors: Musa Akdere, Gunnar Seide, Thomas Gries

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Carbon fibres are fibrous materials with a carbon atom amount of more than 90%. They combine excellent mechanicals properties with a very low density. Thus carbon fibre reinforced plastics (CFRP) are very often used in lightweight design and construction. The precursor material is usually polyacrylonitrile (PAN) based and wet-spun. During the production of carbon fibre, the precursor has to be stabilized thermally to withstand the high temperatures of up to 1500 °C which occur during carbonization. Even though carbon fibre has been used since the late 1970s in aerospace application, there is still no general method available to find the optimal production parameters and the trial-and-error approach is most often the only resolution. To have a much better insight into the process the chemical reactions during stabilization have to be analyzed particularly. Therefore, a model of the chemical reactions (cyclization, dehydration, and oxidation) based on the research of Dunham and Edie has been developed. With the presented model, it is possible to perform a complete simulation of the fibre undergoing all zones of stabilization. The fiber bundle is modeled as several circular fibers with a layer of air in-between. Two thermal mechanisms are considered to be the most important: the exothermic reactions inside the fiber and the convective heat transfer between the fiber and the air. The exothermic reactions inside the fibers are modeled as a heat source. Differential scanning calorimetry measurements have been performed to estimate the amount of heat of the reactions. To shorten the required time of a simulation, the number of fibers is decreased by similitude theory. Experiments were conducted to validate the simulation results of the fibre temperature during stabilization. The experiments for the validation were conducted on a pilot scale stabilization oven. To measure the fibre bundle temperature, a new measuring method is developed. The comparison of the results shows that the developed simulation model gives good approximations for the temperature profile of the fibre bundle during the stabilization process.

Keywords: carbon fibre, coupled simulation, exothermic reactions, fibre-air-interface

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Authors: Mustafa Jaradat

Abstract:

Reasonable energy saving for dehumidification is feasible with the use of desiccants. Desiccants are able to lower the humidity content in the air irrespective of the dew point temperature. In this paper, a tube bundle liquid desiccant air conditioner was experimentally designed and evaluated using lithium chloride as a desiccant. Several experiments were conducted to evaluate the influence of the inlet parameters on the dehumidifier performance. The results show a reduction in the relative humidity in the range of 17 to 46%, and the change in the humidity ratio was between 1.5 to 4.7 g/kg, depending on the inlet conditions. A water removal rate in the range between 0.54 and 1.67 kg/h was observed. The effects of air relative humidity and the desiccant flow rate on the dehumidifier’s performance were investigated. It was found that the moisture removal rate remarkably increased with increasing desiccant flow rate and air inlet humidity ratio. The dehumidifier effectiveness increased sharply with increasing desiccant flow rate. Also, it was found that the dehumidifier effectiveness slightly decreased with air humidity ratio.

Keywords: air conditioning, dehumidification, desiccant, lithium chloride, tube bundle

Procedia PDF Downloads 116

Authors: S. Wietrzychowski

Abstract:

This systematic review incorporates concepts used in the field of positive psychology in order to integrate important elements into suicide prevention programs for children and adolescents. The goal of this review is to help students and professionals gain insight to available prevention programs for suicide and to incorporate aspects of positive psychology into these programs. Evidence-based interventions such as Positive Youth Development will be discussed in detail in its relation to prevention and positive psychology. Concepts such as hope, optimism, coping, and resilience will be related to these interventions in order to improve these interventions. The review will also explain how these programs can help prevent suicidal thoughts and/or behaviors. Research on mentorship programs and early intervention programs will be included and related to the aforementioned positive psychology concepts. Since children and adolescents are such a vulnerable population, the review will highlight specific considerations for working with children in order to prevent risk factors for suicide and to build protective factors. This review will discuss the effectiveness of school-based programs that are integrated with positive psychology. Elements of these programs that have been shown to be most effective in preventing suicide in schools will also be identified. As a result of this presentation, participants will be able to 1) List at least 2 evidence-based suicide prevention programs, 2) Understand the connection between specific positive psychology concepts and suicide prevention, 3) Identify at least 3 factors which protect against suicide, 4) Describe at least 3 risk factors for suicide, and 5) Think critically about the positive elements of suicide prevention programs.

Keywords: children, adolescents, suicide, positive

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Authors: Olivier Mesly

Abstract:

This article examines the likelihood of deception on the part of borrowers wishing to obtain credit from institutional or private lenders. In our first study, we identify five explanatory variables that account for nearly forty percent of the propensity to act deceitfully: a poor credit history, debt, risky behavior, and to a much lesser degree, irrational behavior and disconnection from the bundle of needs, goals, and preferences. For the second study, we remodeled the initial questionnaire to adapt it to the needs of institutional bankers and borrowers, especially those that engage in money on-line peer-to-peer lending, a growing business fueled by the COVID pandemic. We find that the three key psychological variables that help to indirectly predict the likelihood of deceitful behaviors and possible default on loan reimbursement, i.e., risky behaviors, ir-rationality, and dis-connection, interact with each other to form a loop. This study presents two benefits: first, we provide evidence that it is to some degree possible to tighten control over lending practices. Second, we offer a pragmatic tool: a questionnaire, that lenders can use or adapt to gauge potential borrowers’ deceit, notably by combining their results with standard hard-data measures of risk.

Keywords: bundle of needs, default, debt, deception, risk, peer-to-peer lending

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Authors: Abraham Rotich

Abstract:

The purpose of this study was to determine the effects of relationship banking on the financial performance of SMEs. The paper attempted to establish the link between the constructs of relationship banking and SME performance. The study was guided by relationship lending, relationship monitoring, relationship risk sharing and bundle of products as independent variables while financial performance will be the dependent variable. The study used a quasi experimental design with population being the 620 SMEs who have a relationship banking arrangement with banks in Nairobi. The study used stratified sampling to pick a sample of 235. The population of interest will be the CEOs of the respective companies. The basis of stratification is the sectors in which the SMEs operate in. The study will use a questionnaire to collect data. The questionnaire will have both open and close ended questions. A pilot study will be conducted to test reliability and validity of questionnaire. The data was analyzed using descriptive statistics. Regression analysis was employed to test if there is a relationship between the dependent and the independent variable. The study found evidence that relationship banking positively impacts on financial performance of SMEs. Specifically, the study established that each component of relationship banking in this study i.e relationship lending, monitoring, bundle of products and risk sharing positively affects financial performance.

Keywords: relationship banking, SMEs, financial performance, entrepreneurial orientation

Procedia PDF Downloads 281

Authors: Mohsin Ali Shaikh, Song Weiguo, Muhammad Kashan Surahio, Usman Shahid, Rehmat Karim

Abstract:

When the area of a structure that is threatened by a disaster affects personal safety, the effectiveness of disaster prevention, evacuation, and rescue operations can be summarized by three assessment indicators: personal safety, property preservation, and attribution of responsibility. These indicators are applicable regardless of the disaster that affects the building. People need to get out of the hazardous area and to a safe place as soon as possible because there's no other way to respond. The results of the tragedy are thus closely related to how quickly people are advised to evacuate and how quickly they are rescued. This study considers present fire prevention systems to address catastrophes and improve building safety. It proposes the methods of Prevention Level for Deployment in Advance and Spatial Transformation by Human-Machine Collaboration. We present and prototype a real-time fire protection system architecture for building disaster prevention, evacuation, and rescue operations. The design encourages the use of simulations to check the efficacy of evacuation, rescue, and disaster prevention procedures throughout the planning and design phase of the structure.

Keywords: prevention level, building information modeling, quality management system, simulated reality

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Authors: Alexander Glebovskiy

Abstract:

Practitioners charged with fraud prevention and investigation strongly rely on the Fraud Triangle framework developed by Joseph T. Wells in 1997 while analyzing the causes of fraud at business organizations. The Fraud Triangle model explains fraud by elements such as pressure, opportunity, and rationalization. This view is not fully suitable for effective fraud prevention as the Fraud Triangle model provides limited insight into the causation of fraud. Fraud is a multifaceted phenomenon, the contextual factors of which may not fit into any framework. Employee criminal behavior in business organizations is influenced by environmental, individual, and organizational aspects. Therefore, further criminogenic factors and processes facilitating fraud in organizational settings need to be considered in the root-cause analysis: organizational culture, leadership style, groupthink effect, isomorphic behavior, crime of obedience, displacement of responsibility, lack of critical thinking and unquestioning conformity and loyalty.

Keywords: criminogenesis, fraud triangle, fraud prevention, organizational culture

Procedia PDF Downloads 253

Authors: Birgit Reime, Sonja Gscheidle, Toni Hübener, Lara Hübener

Abstract:

Suicide in individuals under 30 years is a global public health concern. The objective of this study was to identify strategies for the prevention of suicide and suicidal behavior preferred by adolescents and young adults who are vulnerable to suicidal behavior and by relevant experts. Using semi-structured interviews with n= 17 adolescents and young adults (18-25 years of age) and with n= 11 experts from relevant fields, we have applied an inductive approach and applied thematic content analysis. Six strategies for suicide prevention in young individuals were reported. These were digital solutions with appealing designs, anonymous support, trained peer support, spiritual support, improving existing structures, and raising suicide literacy. Accessibility of anonymous digital support may contribute to suicide prevention in young people.

Keywords: suicide prevention, adolescents, E-health, Germany

Procedia PDF Downloads 147

Authors: Anatoly Krivinsh

Abstract:

The results of dissertation research "Preventing and combating corruption in public procurement" are presented in this publication. The study was conducted 2011 till 2013 in a Member State of the European Union, in the Republic of Latvia. Goal of the thesis is to explore corruption prevention and combating issues in public procurement sphere, to identify the prevalence rates, determinants and contributing factors and prevention opportunities in Latvia. In the first chapter the author analyses theoretical aspects of understanding corruption in public procurement, with particular emphasis on corruption definition problem, its nature, causes and consequences. A separate section is dedicated to the public procurement concept, mechanism and legal framework. In the first part of this work the author presents cognitive methodology of corruption in public procurement field, based on which the author has carried out an analysis of corruption situation in public procurement in Republic of Latvia. In the second chapter of the thesis, the author analyzes the problem of corruption in public procurement, including its historical aspects, typology and classification of corruption subjects involved, corruption risk elements in public procurement and their identification. During the development of the second chapter author's practical experience in public procurements was widely used. The third and fourth chapter deals with issues related to the prevention and combating corruption in public procurement, namely the operation of the concept, principles, methods and techniques, subjects in Republic of Latvia, as well as an analysis of foreign experience in preventing and combating corruption. The fifth chapter is devoted to the corruption prevention and combating perspectives and their assessment. In this chapter the author has made the evaluation of corruption prevention and combating measures efficiency in Republic of Latvia, assessment of anti-corruption legislation development stage in public procurement field in Latvia.

Keywords: prevention of corruption, public purchases, good governance, human rights

Procedia PDF Downloads 300