Search results for: interventional radiology procedures
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1893

Search results for: interventional radiology procedures

1593 Characteristics of Nanosilica-Geopolymer Nanocomposites and Mixing Effect

Authors: H. Assaedi, F. U. A. Shaikh, I. M. Low

Abstract:

This paper presents the effects of mixing procedures on mechanical properties of flyash-based geopolymer matrices containing nanosilica (NS) at 0.5%, 1.0%, 2.0%, and 3.0% by wt.. Comparison is made with conventional mechanical dry-mixing of NS with flyash and wet-mixing of NS in alkaline solutions. Physical and mechanical properties are investigated using X-Ray Diffraction (XRD) and Scanning Electron Microscope (SEM). Results show that generally the addition of NS particles enhanced the microstructure and improved flexural and compressive strengths of geopolymer nanocomposites. However, samples prepared using dry-mixing approach demonstrate better physical and mechanical properties than wet-mixing of NS.

Keywords: geopolymer, nano-silica, dry mixing, wet mixing, physical properties, mechanical properties

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1592 How Group Education Impacts Female Factory Workers’ Behavior and Readiness to Receive Mammography and Pap Smears

Authors: Memnun Seven, Mine Bahar, Aygül Akyüz, Hatice Erdoğan

Abstract:

Background: The workplace has been deemed a suitable location for educating many women at once about cancer screening. Objective: To determine how group education about early diagnostic methods for breast and cervical cancer affects women’s behavior and readiness to receive mammography and Pap smears. Methods: This semi-interventional study was conducted at a textile factory in Istanbul, Turkey. Female workers (n = 125) were included in the study. A participant identification form and knowledge evaluation form developed for this study, along with the trans-theoretical model, were used to collect data. A 45-min interactive group education was given to the participants. Results: Upon contacting participants 3 months after group education, 15.4% (n = 11) stated that they had since received a mammogram and 9.8% (n = 7) a Pap smear. As suggested by the trans-theoretical model, group education increased participants’ readiness to receive cancer screening, along with their knowledge of breast and cervical cancer. Conclusions: Group education positively impacted women’s knowledge of cancer and their readiness to receive mammography and Pap smears. Group education can therefore potentially create awareness of cancer screening tests among women and improve their readiness to receive such tests.

Keywords: cancer screening, educational intervention, participation, women

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1591 Comparison of Peri- and Post-Operative Outcomes of Three Left Atrial Incisions: Conventional Direct, Transseptal and Superior Septal Left Atriotomy

Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

Abstract:

Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

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1590 Industrial Ergonomics Improvement at a Refrigerator Manufacturing Company in Iran: An Approach on Interventional Ergonomics

Authors: Hassan S. Naeini

Abstract:

Nowadays a lot of people are working in several sorts of industrial sectors in which there are some risk factors which threaten human being especially in developing countries. One of the main problems which effect on workers’ health refers to Ergonomics. Ergonomics as multidisciplinary science concerns workers’ health and safety in terms of somatic and mental concepts. Surely ergonomics interventions and improvement make a better condition for workers and change the quality of working life to better condition. In this study, one of the factories in Iran which is producing some kinds of small and medium size of refrigerators was chosen as the sample. The preliminary ergonomics observation of the mentioned factory showed that there are some risk factors in terms of ergonomics aspects, so an ergonomic intervention was defined, then some ergonomic assessment methods such as NMQ,OWAS, and Environmental Ergonomic Assessment were used. Also Anthropometric measurement was done. This study shows that there are some workstations and plants which suffer some degrees of ergonomic problems. Considering with the gathered data, illumination, noise control and workstation design in metal workstation are known as the priority actions. Some parts of the mentioned interventions are ongoing actions. it seems that the mentioned intervention and workstations design make a better condition for workers, because ergonomics make a safer and more sustainable environments for human being.

Keywords: anthropometry, ergonomics, health, NMQ, OWAS

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1589 Static and Dynamic Tailings Dam Monitoring with Accelerometers

Authors: Cristiana Ortigão, Antonio Couto, Thiago Gabriel

Abstract:

In the wake of Samarco Fundão’s failure in 2015 followed by Vale’s Brumadinho disaster in 2019, the Brazilian National Mining Agency started a comprehensive dam safety programmed to rank dam safety risks and establish monitoring and analysis procedures. This paper focuses on the use of accelerometers for static and dynamic applications. Static applications may employ tiltmeters, as an example shown later in this paper. Dynamic monitoring of a structure with accelerometers yields its dynamic signature and this technique has also been successfully used in Brazil and this paper gives an example of tailings dam.

Keywords: instrumentation, dynamic, monitoring, tailings, dams, tiltmeters, automation

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1588 The Effect of Different Parameters on a Single Invariant Lateral Displacement Distribution to Consider the Higher Modes Effect in a Displacement-Based Pushover Procedure

Authors: Mohamad Amin Amini, Mehdi Poursha

Abstract:

Nonlinear response history analysis (NL-RHA) is a robust analytical tool for estimating the seismic demands of structures responding in the inelastic range. However, because of its conceptual and numerical complications, the nonlinear static procedure (NSP) is being increasingly used as a suitable tool for seismic performance evaluation of structures. The conventional pushover analysis methods presented in various codes (FEMA 356; Eurocode-8; ATC-40), are limited to the first-mode-dominated structures, and cannot take higher modes effect into consideration. Therefore, since more than a decade ago, researchers developed enhanced pushover analysis procedures to take higher modes effect into account. The main objective of this study is to propose an enhanced invariant lateral displacement distribution to take higher modes effect into consideration in performing a displacement-based pushover analysis, whereby a set of laterally applied displacements, rather than forces, is monotonically applied to the structure. For this purpose, the effect of different parameters such as the spectral displacement of ground motion, the modal participation factor, and the effective modal participating mass ratio on the lateral displacement distribution is investigated to find the best distribution. The major simplification of this procedure is that the effect of higher modes is concentrated into a single invariant lateral load distribution. Therefore, only one pushover analysis is sufficient without any need to utilize a modal combination rule for combining the responses. The invariant lateral displacement distribution for pushover analysis is then calculated by combining the modal story displacements using the modal combination rules. The seismic demands resulting from the different procedures are compared to those from the more accurate nonlinear response history analysis (NL-RHA) as a benchmark solution. Two structures of different heights including 10 and 20-story special steel moment resisting frames (MRFs) were selected and evaluated. Twenty ground motion records were used to conduct the NL-RHA. The results show that more accurate responses can be obtained in comparison with the conventional lateral loads when the enhanced modal lateral displacement distributions are used.

Keywords: displacement-based pushover, enhanced lateral load distribution, higher modes effect, nonlinear response history analysis (NL-RHA)

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1587 Building in Language Support in a Hong Kong Chemistry Classroom with English as a Medium of Instruction: An Exploratory Study

Authors: Kai Yip Michael Tsang

Abstract:

Science writing has played a crucial part in science assessments. This paper reports a study in an area that has received little research attention – how Language across the Curriculum (LAC, i.e. science language and literacy) learning activities in science lessons can increase the science knowledge development of English as a foreign language (EFL) students in Hong Kong. The data comes from a school-based interventional study in chemistry classrooms, with written data from questionnaires, assessments and teachers’ logs and verbal data from interviews and classroom observations. The effectiveness of the LAC teaching and learning activities in various chemistry classrooms were compared and evaluated, with discussion of some implications. Students in the treatment group with lower achieving students received LAC learning and teaching activities while students in the control group with higher achieving students received conventional learning and teaching activities. After the study, they performed better in control group in formative assessments. Moreover, they had a better attitude to learning chemistry content with a richer language support. The paper concludes that LAC teaching and learning activities yielded positive learning outcomes among chemistry learners with low English ability.

Keywords: science learning and teaching, content and language integrated learning, language across the curriculum, English as a foreign language

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1586 Health Promotion Program on Prevention of Zoonotic Diseases among Aborigines in Peninsular Malaysia

Authors: Siti Fatimah Kader Maideen, Abdul Rashid, Nur Indah Ahmad

Abstract:

Introduction: Indigenous people have an increased risk of contracting zoonotic infections due to their practices. Similarly, the aborigines in Peninsular Malaysia, the Orang Asli, have a higher risk too. This study aimed to empower the Jahai children on the prevention of zoonotic infections by implementing a health promotion intervention program. Methods: A non-experimental pre and post-test interventional study was conducted among the indigenous primary school children aged between nine and 12 years in Perak, Malaysia. A structured questionnaire was used to assess the pre-and post-knowledge and attitudes towards zoonotic infections and hand hygiene practice. This is followed by three sessions of the health promotion program. Ethical approval was obtained prior to the data collection. Data were analysed using SPSS software. Results: The knowledge on whether diseases can spread from animals to humans, transmission via saliva and faeces, types of organisms that can infect, and signs and symptoms increased significantly between pre and post. Significant improvements were observed in the attitude and practices too. Conclusion: The intervention program demonstrated improvement in the knowledge, attitude, and practice among the children. The continuous program needs to be conducted for a sustainable outcome.

Keywords: health promotion, zoonotic infections, aborigines, knowledge, practice

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1585 Pain Control by Ketamine in Combat Situation; Consideration and Outcomes

Authors: Mohammad Javad Behzadnia, Hamidreza Javadzadeh

Abstract:

Background: Pain management is essential to surmounting multi-injured people in an overcrowded emergency setting. Its role would be more apparent when the physician encounters a mass casualty in a war zone or even a military prehospital. Having sedative and analgesic properties, rapid onset and offset effects, and maintaining the cardiovascular and respiratory contain are the main reason for selecting Ketamine as a good choice in the war zone. Methods: In a prospective interventional study in a war zone, we have selected and followed two groups of casualties for pain management. All were men with an average age of 26.6±8 y/o and 27.5 ±7 y/o in A and B groups, respectively. Group A received only Ketamine and Group B received Ketamine and diazepam. Results: This study showed that all of the injured patients who received Ketamine had experienced some agitation, and they may finally need benzodiazepines for sedation, but in group B that received benzodiazepine before or simultaneous with Ketamine, the agitation was significantly reduced. (P Value ≤0.05) Conclusion: Various factors may affect pain score and perception; patients' culture, mental health, previous drug usage, and addiction could alter the pain score in similar situations. It seems that the significant agitation is due to catecholamine release in stressful Moments of the battlefield. Accordingly, this situation could be exacerbated due to ketamine properties. Nonetheless, as a good choice in the war zone, Ketamine is now recommended to combine with benzodiazepines for procedural sedation and analgesia (PSA).

Keywords: battlefield, ketamine, benzodiazepine, pain control

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1584 Considerations When Using the Beach Chair Position for Surgery

Authors: Aniko Babits, Ahmad Daoud

Abstract:

Introduction: The beach chair position (BCP) is a good approach to almost all types of shoulder procedures. However, moving an anaesthetized patient from the supine to sitting position may pose a risk of cerebral hypoperfusion and potential cerebral ischaemia as a result of significant reductions in blood pressure and cardiac output. Hypocapnia in ventilated patients and impaired blood flow to the vertebral artery due to hyperextension, rotation, or tilt of the head may have an impact too. Co-morbidities that may increase the risk of cerebral ischaemia in the BCP include diabetes with autonomic neuropathy, cerebrovascular disease, cardiac disease, severe hypertension, generalized vascular disease, history of fainting, and febrile conditions. Beach chair surgery requires a careful anaesthetic and surgical management to optimize patient safety and minimize the risk of adverse outcomes. Methods: We describe the necessary steps for optimal patient positioning and the aims of intraoperative management, including anaesthetic techniques to ensure patient safety in the BCP. Results: Regardless of the anaesthetic technique, adequate patient positioning is paramount in the BCP. The key steps to BCP are aimed at optimizing surgical success and minimizing the risk of severe neurovascular complications. The primary aim of anaesthetic management is to maintain cardiac output and mean arterial pressure (MAP) to protect cerebral perfusion. Blood pressure management includes treating a fall in MAP of more than 25% from baseline or a MAP less than 70 mmHg. This can be achieved by using intravenous fluids or vasopressors. A number of anaesthetic techniques could also improve cerebral oxygenation, including avoidance of intermittent positive pressure ventilation (IPPV) with general anaesthesia (GA), using regional anaesthesia, maintaining normocapnia and normothermia, and the application of compression stockings. Conclusions: In summary, BCP is a reliable and effective position to perform shoulder procedures. Simple steps to patient positioning and careful anaesthetic management could maximize patient safety and avoid unwanted adverse outcomes in patients undergoing surgery in BCP.

Keywords: beach chair position, cerebral oxygenation, cerebral perfusion, sitting position

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1583 Thermoelectric Blanket for Aiding the Treatment of Cerebral Hypoxia and Other Related Conditions

Authors: Sarayu Vanga, Jorge Galeano-Cabral, Kaya Wei

Abstract:

Cerebral hypoxia refers to a condition in which there is a decrease in oxygen supply to the brain. Patients suffering from this condition experience a decrease in their body temperature. While there isn't any cure to treat cerebral hypoxia as of date, certain procedures are utilized to help aid in the treatment of the condition. Regulating the body temperature is an example of one of those procedures. Hypoxia is well known to reduce the body temperature of mammals, although the neural origins of this response remain uncertain. In order to speed recovery from this condition, it is necessary to maintain a stable body temperature. In this study, we present an approach to regulating body temperature for patients who suffer from cerebral hypoxia or other similar conditions. After a thorough literature study, we propose the use of thermoelectric blankets, which are temperature-controlled thermal blankets based on thermoelectric devices. These blankets are capable of heating up and cooling down the patient to stabilize body temperature. This feature is possible through the reversible effect that thermoelectric devices offer while behaving as a thermal sensor, and it is an effective way to stabilize temperature. Thermoelectricity is the direct conversion of thermal to electrical energy and vice versa. This effect is now known as the Seebeck effect, and it is characterized by the Seebeck coefficient. In such a configuration, the device has cooling and heating sides with temperatures that can be interchanged by simply switching the direction of the current input in the system. This design integrates various aspects, including a humidifier, ventilation machine, IV-administered medication, air conditioning, circulation device, and a body temperature regulation system. The proposed design includes thermocouples that will trigger the blanket to increase or decrease a set temperature through a medical temperature sensor. Additionally, the proposed design allows an efficient way to control fluctuations in body temperature while being cost-friendly, with an expected cost of 150 dollars. We are currently working on developing a prototype of the design to collect thermal and electrical data under different conditions and also intend to perform an optimization analysis to improve the design even further. While this proposal was developed for treating cerebral hypoxia, it can also aid in the treatment of other related conditions, as fluctuations in body temperature appear to be a common symptom that patients have for many illnesses.

Keywords: body temperature regulation, cerebral hypoxia, thermoelectric, blanket design

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1582 Double Fortified Salt-An Effective Measure to Prevent Micronutrient Deficiencies in Indian Pregnant Women

Authors: Kejal Joshi Reddy, Sirimavo Nair

Abstract:

Micronutrient malnutrition affects pregnant women and children extremely with reference to growth manifestations in gestation as well as after birth. Early fetal development affected by iodine and iron deficiency leads to poor life quality. Various researchers have found interesting interrelations between iron and iodine. A few studies on impact assessment of DFS supplementation during pregnancy have been reported in India. Aim To provide meaningful contribution by assessing the efficacy of DFS supplementation on iodine and iron status of pregnant women. Design An interventional study. Setting A semi government hospital of urban Vadodara. Subjects Pregnant women (n=150) enrolled during first trimester (< 12 weeks) and followed up till the end of gestation, n=75 were divided in experimental (DFS supplemented) and control (Non supplemented) group. Results Impact on iron and iodine status was assessed by Hb concentration and UIE respectively. Mean Hb improved significantly (p < 0.001) (+0.42 g/dl) in experimental group and reduced non significantly (-0.20 g/dl) in control group at the end, since DFS provided additional 93 mg of iron within 6 months. Median UIE improved non significantly (278.6 to 299.01µg/L) in experimental group and decreased significantly (p < 0.05) (376.59 to 288.66 µg/L) in control group. Conclusion DFS could improve iron and iodine status of experimental group compared to control group. It is an effective measure to control two essential micronutrient deficiencies together.

Keywords: DFS supplementation, anemia, pregnancy, iodine deficiency, iron

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1581 Development of a Nursing Care Program Based on Anthroposophic External Therapy for the Pediatric Hospital in Brazil and Germany

Authors: Karina Peron, Ricardo Ghelman, Monica Taminato, Katia R. Oliveira, Debora C. A. Rodrigues, Juliana R. C. Mumme, Olga K. M. Sunakozaua, Georg Seifert, Vicente O. Filho

Abstract:

The nurse is the most available health professional for the interventions of support in the integrative approach in hospital environment, therefore a professional group key to changes in the model of care. The central components in the performance of anthroposophic nursing procedures are direct physical contact, promotion of proper rhythm, thermal regulation and the construction of a calm and empathic atmosphere, safe for patients and their caregivers. The procedures of anthroposophic external therapies (AET), basically composed of the application of compresses and the use of natural products, provide an opportunity to intensify the therapeutic results through an innovative, complementary and integrative model in the university hospital. The objective of this work is to report the implementation of a program of nursing techniques (AET) through a partnership between the Pediatric Oncology Sector of the Department of Pediatrics of the Faculty of Medicine of the University of Sao Paulo and Charite University of Berlin, with lecturers from Berlin's Integrative Hospital Havelhöhe and Witten-Herdecke Integrative Hospital, both in Germany. Intensive training activities of the Hospital's nursing staff and a survey on AET needs were developed based on the most prevalent complaints in pediatric oncology patients in the three environments of the Hospital of Pediatric Oncology: Bone Marrow Transplantation Unit, Intensive Care Unit and Division of Internal Patients. We obtained the approval of the clinical protocol of external anthroposophic therapies for nursing care by the Ethics Committee and the Academic Council of the Hospital. With this project, we highlight the key AET needs that will be part of the standard program of pediatric oncology care with appropriate scientific support. The results of the prevalent symptoms were: vomiting, nausea, pain, difficulty in starting sleep, constipation, cold extremities, mood disorder and psychomotor agitation. This project was the pioneer within the Integrative Pediatrics Program, as an innovative concept of Medicine and Integrative Health presented at scientific meetings.

Keywords: integrative health care, integrative nursing, pediatric nursing, pediatric oncology

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1580 Two-Component Biocompartible Material for Reconstruction of Articular Hyaline Cartilage

Authors: Alena O. Stepanova, Vera S. Chernonosova, Tatyana S. Godovikova, Konstantin A. Bulatov, Andrey Y. Patrushev, Pavel P. Laktionov

Abstract:

Trauma and arthrosis, not to mention cartilage destruction in overweight and elders put hyaline cartilage lesion among the most frequent diseases of locomotor system. These problems combined with low regeneration potential of the cartilage make regeneration of articular cartilage a high-priority task of tissue engineering. Many types of matrices, the procedures of their installation and autologous chondrocyte implantation protocols were offered, but certain aspects including adhesion of the implant with surrounding cartilage/bone, prevention of the ossification and fibrosis were not resolved. Simplification and acceleration of the procedures resulting in restoration of normal cartilage are also required. We have demonstrated that human chondroblasts can be successfully cultivated at the surface of electrospun scaffolds and produce extracellular matrix components in contrast to chondroblasts grown in homogeneous hydrogels. To restore cartilage we offer to use stacks of electrospun scaffolds fixed with photopolymerized solution of prepared from gelatin and chondroitin-4-sulfate both modified by glycidyl methacrylate and non-toxic photoinitator Darocur 2959. Scaffolds were prepared from nylon 6, polylactide-co-glicolide and their mixtures with modified gelatin. Illumination of chondroblasts in photopolymerized solution using 365 nm LED light had no effect on cell viability at compressive strength of the gel less than0,12 MPa. Stacks of electrospun scaffolds provide good compressive strength and have the potential for substitution with cartilage when biodegradable scaffolds are used. Vascularization can be prevented by introduction of biostable scaffolds in the layers contacting the subchondral bone. Studies of two-component materials (2-3 sheets of electrospun scaffold) implanted in the knee-joints of rabbits and fixed by photopolymerization demonstrated good crush resistance, biocompatibility and good adhesion of the implant with surrounding cartilage. Histological examination of the implants 3 month after implantation demonstrates absence of any inflammation and signs of replacement of the biodegradable scaffolds with normal cartilage. The possibility of intraoperative population of the implants with autologous cells is being investigated.

Keywords: chondroblasts, electrospun scaffolds, hyaline cartilage, photopolymerized gel

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1579 The Use of STIMULAN Resorbable Antibiotic Beads in Conjunction with Autologous Tissue Transfer to Treat Recalcitrant Infections and Osteomyelitis in Diabetic Foot Wounds

Authors: Hayden R Schott, John M Felder III

Abstract:

Introduction: Chronic lower extremity wounds in the diabetic and vasculopathic populations are associated with a high degree of morbidity.When wounds require more extensive treatment than can be offered by wound care centers, more aggressive solutions involve local tissue transfer and microsurgical free tissue transfer for achieving definitive soft tissue coverage. These procedures of autologous tissue transfer (ATT) offer resilient, soft tissue coverage of limb-threatening wounds and confer promising limb salvage rates. However, chronic osteomyelitis and recalcitrant soft tissue infections are common in severe diabetic foot wounds and serve to significantly complicate ATT procedures. Stimulan is a resorbable calcium sulfate antibiotic carrier. The use of stimulan antibiotic beads to treat chronic osteomyelitis is well established in the orthopedic and plastic surgery literature. In these procedures, the beads are placed beneath the skin flap to directly deliver antibiotics to the infection site. The purpose of this study was to quantify the success of Stimulan antibiotic beads in treating recalcitrant infections in patients with diabetic foot wounds receiving ATT. Methods: A retrospective review of clinical and demographic information was performed on patients who underwent ATT with the placement of Stimulan antibiotic beads for attempted limb salvage from 2018-21. Patients were analyzed for preoperative wound characteristics, demographics, infection recurrence, and adverse outcomes as a result of product use. The primary endpoint was 90 day infection recurrence, with secondary endpoints including 90 day complications. Outcomes were compared using basic statistics and Fisher’s exact tests. Results: In this time span, 14 patients were identified. At the time of surgery, all patients exhibited clinical signs of active infection, including positive cultures and erythema. 57% of patients (n=8) exhibited chronic osteomyelitis prior to surgery, and 71% (n=10) had exposed bone at the wound base. In 57% of patients (n=8), Stimulan beads were placed beneath a free tissue flap and beneath a pedicle tissue flap in 42% of patients (n=6). In all patients, Stimulan beads were only applied once. Recurrent infections were observed in 28% of patients (n=4) at 90 days post-op, and flap nonadherence was observed in 7% (n=1). These were the only Stimulan related complications observed. Ultimately, lower limb salvage was successful in 85% of patients (n=12). Notably, there was no significant association between the preoperative presence of osteomyelitis and recurrent infections. Conclusions: The use of Stimulanantiobiotic beads to treat recalcitrant infections in patients receiving definitive skin coverage of diabetic foot wounds does not appear to demonstrate unnecessary risk. Furthermore, the lack of significance between the preoperative presence of osteomyelitis and recurrent infections indicates the successful use of Stimulan to dampen infection in patients with osteomyelitis, as is consistent with the literature. Further research is needed to identify Stimulan as the significant contributor to infection treatment using future cohort and case control studies with more patients. Nonetheless, the use of Stimulan antibiotic beads in patients with diabetic foot wounds demonstrates successful infection suppression and maintenance of definitive soft tissue coverage.

Keywords: wound care, stimulan antibiotic beads, free tissue transfer, plastic surgery, wound, infection

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1578 Reducing the Incidence Rate of Pressure Sore in a Medical Center in Taiwan

Authors: Chang Yu Chuan

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Background and Aim: Pressure sore is not only the consequence of any gradual damage of the skin leading to tissue defects but also an important indicator of clinical care. If hospitalized patients develop pressure sores without proper care, it would result in delayed healing, wound infection, increase patient physical pain, prolonged hospital stay and even death, which would have a negative impact on the quality of care and also increase nursing manpower and medical costs. This project is aimed at decreasing the incidence of pressure sore in one ward of internal medicine. Our data showed 53 cases (0.61%) of pressure sore in 2015, which exceeded the average (0.5%) of Taiwan Clinical Performance Indicator (TCPI) for medical centers. The purpose of this project is to reduce the incidence rate of pressure sore in the ward. After data collection and analysis from January to December 2016, the reasons of developing pressure sore were found: 1. Lack of knowledge to prevent pressure among nursing staffs; 2. No relevant courses about preventing pressure ulcers and pressure wound care being held in this unit; 3. Low complete rate of pressure sore care education that family members should receive from nursing staffs; 4. Decompression equipment is not enough; 5. Lack of standard procedures for body-turning and positioning care. After team members brainstorming, several strategies were proposed, including holding in-service education, pressure sore care seed training, purchasing decompression mattress and memory pillows, designing more elements of health education tools, such as health education pamphlet, posters and multimedia films of body-turning and positioning demonstration, formulation and promotion of standard operating procedures. In this way, nursing staffs can understand the body-turning and positioning guidelines for pressure sore prevention and enhance the quality of care. After the implementation of this project, the pressure sore density significantly decreased from 0.61%(53 cases) to 0.45%(28 cases) in this ward. The project shows good results and good example for nurses working at the ward and helps to enhance quality of care.

Keywords: body-turning and positioning, incidence density, nursing, pressure sore

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1577 Thermalytix: An Advanced Artificial Intelligence Based Solution for Non-Contact Breast Screening

Authors: S. Sudhakar, Geetha Manjunath, Siva Teja Kakileti, Himanshu Madhu

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Diagnosis of breast cancer at early stages has seen better clinical and survival outcomes. Survival rates in developing countries like India are very low due to accessibility and affordability issues of screening tests such as Mammography. In addition, Mammography is not much effective in younger women with dense breasts. This leaves a gap in current screening methods. Thermalytix is a new technique for detecting breast abnormality in a non-contact, non-invasive way. It is an AI-enabled computer-aided diagnosis solution that automates interpretation of high resolution thermal images and identifies potential malignant lesions. The solution is low cost, easy to use, portable and is effective in all age groups. This paper presents the results of a retrospective comparative analysis of Thermalytix over Mammography and Clinical Breast Examination for breast cancer screening. Thermalytix was found to have better sensitivity than both the tests, with good specificity as well. In addition, Thermalytix identified all malignant patients without palpable lumps.

Keywords: breast cancer screening, radiology, thermalytix, artificial intelligence, thermography

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1576 [Keynote Speech]: Risk Management during the Rendition Process: Use of Screen-Voice Recordings in Translator Training

Authors: Maggie Hui

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Risk management is not a new concept; however, it is an uncharted area as applied to the translation process and translator training. Serving as one of the self-discovery activities in their practicum course, a two-cycle experiment was carried out with a class of 13 MA translation students with an attempt to explore their risk management while translating in a simulated setting that involves translator-client relations. To test the effects of the main variable of translators’ interaction with the simulated clients, the researcher employed control-group translators and two experiment groups (with Group A being the translator in Cycle 1 and the client in Cycle 2, and Group B on the client position in Cycle 1 and the translator position in Cycle 2). Experiment cycle 1 aims to explore if there would be any behavioral difference in risk management between translators with interaction with the simulated clients, i.e. experiment group A, and their counterparts without such interaction, i.e. control group. Design of Cycle 2 concerns the order of playing different roles of the translator and client in the experiment, and provides information to compare behavior of translators of the two experiment groups. Since this is process-oriented research, it is necessary to hypothesize what was happening in the translators’ minds. The researcher made use of a user-friendly screen-voice recording freeware to record subjects’ screen activities, including every word the translator typed and every change they made to the rendition, the websites they browsed and the reference tools they used, in addition to the verbalization of their thoughts throughout the process. The research observes the translation procedures subjects considered and finally adopted, and looks into the justifications for their procedures, in order to interpret their risk management. The qualitative and quantitative results of this study have some implications for translator training: (a) the experience of being a client seems to reinforce the translator’s risk aversion; (b) the use of role-playing simulation can empower students’ learning by enhancing their attitudinal or psycho-physiological competence, interpersonal competence and strategic competence; and (c) the screen-voice recordings serve as a helpful tool for learners to reflect on their rendition processes, i.e. what they performed satisfactorily and unsatisfactorily while translating and what they could do for improvement in future translation tasks.

Keywords: risk management, screen-voice recordings, simulated translator-client relations, translation pedagogy, translation process-oriented research

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1575 The Impacts of Technology on Operations Costs: The Mediating Role of Operation Flexibility

Authors: Fazli Idris, Jihad Mohammad

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The study aims to determine the impact of technology and service operations flexibility, which is divided into external flexibility and internal robustness, on operations costs. A mediation model is proposed that links technology to operations costs via operation flexibility. Drawing on a sample of 475 of operations managers of various service sectors in Malaysia and South Africa, Structural Equation Modeling (SEM) was employed to test the relationship using Smart-PLS procedures. It was found that a significant relationship was established between technologies to operations costs via both operations flexibility dimensions. Theoretical and managerial implications are offered to explain the results.

Keywords: Operations flexibility, technology, costs, mediation

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1574 Simulated Translator-Client Relations in Translator Training: Translator Behavior around Risk Management

Authors: Maggie Hui

Abstract:

Risk management is not a new concept; however, it is an uncharted area as applied to the translation process and translator training. Risk managers are responsible for managing risk, i.e. adopting strategies with the intention to minimize loss and maximize gains in spite of uncertainty. Which risk strategy to use often depends on the frequency of an event (i.e. probability) and the severity of its outcomes (i.e. impact). This is basically the way translation/localization project managers handle risk management. Although risk management could involve both positive and negative impacts, impact seems to be always negative in professional translators’ management models, e.g. how many days of project time are lost or how many clients are lost. However, for analysis of translation performance, the impact should be possibly positive (e.g. increased readability of the translation) or negative (e.g. loss of source-text information). In other words, the straight business model of risk management is not directly applicable to the study of risk management in the rendition process. This research aims to explore trainee translators’ risk managing while translating in a simulated setting that involves translator-client relations. A two-cycle experiment involving two roles, the translator and the simulated client, was carried out with a class of translation students to test the effects of the main variable of peer-group interaction. The researcher made use of a user-friendly screen-voice recording freeware to record subjects’ screen activities, including every word the translator typed and every change they made to the rendition, the websites they browsed and the reference tools they used, in addition to the verbalization of their thoughts throughout the process. The research observes the translation procedures subjects considered and finally adopted, and looks into the justifications for their procedures, in order to interpret their risk management. The qualitative and quantitative results of this study have some implications for translator training: (a) the experience of being a client seems to reinforce the translator’s risk aversion; (b) there is a wide gap between the translator’s internal risk management and their external presentation of risk; and (c) the use of role-playing simulation can empower students’ learning by enhancing their attitudinal or psycho-physiological competence, interpersonal competence and strategic competence.

Keywords: risk management, role-playing simulation, translation pedagogy, translator-client relations

Procedia PDF Downloads 238
1573 Power Management in Wireless Combustible Gas Sensors

Authors: Denis Spirjakin, Alexander Baranov, Saba Akbari, Natalia Kalenova, Vladimir Sleptsov

Abstract:

In this paper we propose the approach to power management in wireless combustible gas sensors. This approach makes possible drastically prolong sensor nodes autonomous lifetime. That is necessary to tie battery replacement to every year technical service procedures which are claimed by safety standards. Using this approach the current consumption of the wireless combustible gas sensor node was decreased from 80 mA to less than 2 mA and the power consumption from more than 220 mW to 4.6 mW. These values provide autonomous lifetime of the node more than one year.

Keywords: Gas sensors, power management, wireless sensor network

Procedia PDF Downloads 693
1572 Teaching a Senior Design Course in Industrial Engineering

Authors: Mehmet Savsar

Abstract:

Industrial Engineering is one of the engineering disciplines that deal with analysis, design, and improvement of systems, which include manufacturing, supply chain, healthcare, communication, and general service systems. Industrial engineers involve with comprehensive study of a given system, analysis of its interacting units, determination of problem areas, application of various optimization and operations research tools, and recommendation of solutions resulting in significant improvements. The Senior Design course in Industrial Engineering is the culmination of the Industrial Engineering Curriculum in a Capstone Design course, which fundamentally deals with systems analysis and design. The course at Kuwait University has been carefully designed with various course objectives and course outcomes in mind to achieve several program outcomes by practices and learning experiences, which are explicitly gained by systems analysis and design. The Senior Design Course is carried out in a selected industrial or service organization, with support from its engineering personnel, during a full semester by a team of students, who are usually in the last semester of their academic programs. A senior faculty member constantly administers the course to ensure that the students accomplish the prescribed objectives. Students work in groups to formulate issues and propose solutions and communicate, results in formal written and oral presentations. When the course is completed, they emerge as engineers that can be clearly identified as more mature, able to communicate better, able to participate in team work, able to see systems perspective in analysis and design, and more importantly, able to assume responsibility at entry level as engineers. The accomplishments are mainly due to real life experiences gained during the course of their design study. This paper presents methods, procedures, and experiences in teaching a Senior Design Course in Industrial Engineering Curriculum. A detailed description of the course, its role, its objectives, outcomes, learning practices, and assessments are explained in relation to other courses in Industrial Engineering Curriculum. The administration of the course, selected organizations where the course project is carried out, problems and solution tools utilized, student accomplishments and obstacles faced are presented. Issues discussed in this paper could help instructors in teaching the course as well as in clarifying the contribution of a design course to the industrial engineering education in general. In addition, the methods and teaching procedures presented could facilitate future improvements in industrial engineering curriculum.

Keywords: senior design course, industrial engineering, capstone design, education

Procedia PDF Downloads 105
1571 Standardization of Solar Water Pumping System for Remote Areas in Indonesia

Authors: Danar Agus Susanto, Hermawan Febriansyah, Meilinda Ayundyahrini

Abstract:

The availability of spring water to meet people demand is often a problem, especially in tropical areas with very limited surface water sources, or very deep underground water. Although the technology and equipment of pumping system are available and easy to obtain, but in remote areas, the availability of pumping system is difficult, due to the unavailability of fuel or the lack of electricity. Solar Water Pumping System (SWPS) became one of the alternatives that can overcome these obstacles. In the tropical country, sunlight can be obtained throughout the year, even in remote areas. SWPS were already widely built in Indonesia, but many encounter problems during operations, such as decreased of efficiency; pump damaged, damaged of controllers or inverters, and inappropriate photovoltaic performance. In 2011, International Electrotechnical Commission (IEC) issued the IEC standard 62253:2011 titled Photovoltaic pumping systems - Design qualification and performance measurements. This standard establishes design qualifications and performance measurements related to the product of a solar water pumping system. National Standardization Agency of Indonesia (BSN) as the national standardization body in Indonesia, has not set the standard related to solar water pumping system. This research to study operational procedures of SWPS by adopting of IEC Standard 62253:2011 to be Indonesia Standard (SNI). This research used literature study and field observation for installed SWPS in Indonesia. Based on the results of research on SWPS already installed in Indonesia, IEC 62253: 2011 standard can improve efficiency and reduce operational failure of SWPS. SWPS installed in Indonesia still has GAP of 51% against parameters in IEC standard 62253: 2011. The biggest factor not being met is related to operating and maintenance handbooks for personnel that included operation and repair procedures. This may result in operator ignorance in installing, operating and maintaining the system. The Photovoltaic (PV) was also the most non-compliance factor of 71%, although there are 22 Indonesia Standard (SNI) for PV (modules, installation, testing, and construction). These research samples (installers, manufacturers/distributors, and experts) agreed on the parameter in the IEC standard 62253: 2011 able to improve the quality of SWPS in Indonesia. Recommendations of this study, that is required the adoption of IEC standard 62253:2011 into SNI to support the development of SWPS for remote areas in Indonesia.

Keywords: efficiency, inappropriate installation, remote areas, solar water pumping system, standard

Procedia PDF Downloads 177
1570 Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of Stroke; A Systematic Review

Authors: Zahra Hassani

Abstract:

Background and Purpose: Poststroke depression (PSD) is one of the complications of a stroke that reduces the patient's chance of recovery, becomes irritable, and changes personality. Cognitive rehabilitation is one of the non-pharmacological methods that improve deficits such as attention, memory, and symptoms of depression. Therefore, the purpose of the present study is to evaluate the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke. Method: In this study, a systematic review of the databases Google Scholar, PubMed, Science Direct, Elsevier between the years 2015 and 2019 with the keywords cognitive rehabilitation therapy, post-stroke, depression Search is done. In this process, studies that examined the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke were included in the study. Results: Inclusion criteria were full-text availability, interventional study, and non-review articles. There was a significant difference between the articles in terms of the indices studied, sample number, method of implementation, and so on. A review of studies have shown that cognitive rehabilitation therapy has a significant role in reducing the symptoms of post-stroke depression. The use of these interventions is also effective in improving problem-solving skills, improving memory, and improving attention and concentration. Conclusion: This study emphasizes on the development of efficient and flexible adaptive skills through cognitive processes and its effect on reducing depression in patients after stroke.

Keywords: cognitive therapy, depression, stroke, rehabilitation

Procedia PDF Downloads 100
1569 Prescribed Organization of Nursing Work and Psychosocial Risks: A Cross-Sectional Study

Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

Abstract:

To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

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1568 Hepatitis B, Hepatitis C and HIV Infections and Associated Risk Factors among Substance Abusers in Mekelle Substance Users Treatment and Rehabilitation Centers, Tigrai, Northern Ethiopia

Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

Abstract:

Background: Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV) constitute serious healthcare problems worldwide. Blood-borne pathogens HBV, HCV and HIV are commonly associated with infections among substance or Injection Drug Users (IDUs). The objective of this study was to determine the prevalence of HBV, HCV, and HIV infections among substance users in Mekelle Substance users Treatment and Rehabilitation Centers. Methods: A cross-sectional study design was used from Dec 2020 to Sep / 2021 to conduct the study. A total of 600 substance users were included. Data regarding the socio-demographic, clinical and sexual behaviors of the substance users were collected using a structured questionnaire. For laboratory analysis, 5-10 ml of venous blood was taken from the substance users. The laboratory analysis was performed by Enzyme-Linked Immunosorbent Assay (ELISA) at Mekelle University, Department of Medical Microbiology and Immunology Research Laboratory. The Data was analyzed using SPSS and Epi-data. The association of variables with HBV, HCV and HIV infections was determined using multivariate analysis and a P value < 0.05 was considered statistically significant. Result: The overall prevalence rate of HBV, HCV and HIV infections were 10%, 6.6%, and 7.5%, respectively. The mean age of the study participants was 28.12 ± 6.9. A higher prevalence of HBV infection was seen in participants who were users of drug injections and in those who were infected with HIV. HCV was comparatively higher in those who had a previous history of unsafe surgical procedures than their counterparts. Homeless participants were highly exposed to HCV and HIV infections than their counterparts. The HBV/HIV Co-infection prevalence was 3.5%. Those doing unprotected sexual practices [P= 0.03], Injection Drug users [P= 0.03], those who had an HBV-infected person in their family [P=0.02], infected with HIV [P= 0.025] were statistically associated with HBV infection. HCV was significantly associated with Substance users and previous history of unsafe surgical procedures [p=0.03, p=0.04), respectively. HIV was significantly associated with unprotected sexual practices and being homeless [p=0.045, p=0.05) respectively. Conclusion-The highly prevalent viral infection was HBV compared to others. There was a High prevalence of HBV/HIV co-infection. The presence of HBV-infected persons in a family, unprotected sexual practices and sharing of needles for drug injection were the risk factors associated with HBV, HIV, and HCV. Continuous health education and screening of the viral infection coupled with medical and psychological treatment is mandatory for the prevention and control of the infections.

Keywords: hepatitis b virus, hepatitis c virus, HIV, substance users

Procedia PDF Downloads 59
1567 SockGEL/PLUG: Injectable Nano-Scaled Hydrogel Platforms for Oral and Maxillofacial Interventional Application

Authors: Z. S. Haidar

Abstract:

Millions of teeth are removed annually, and dental extraction is one of the most commonly performed surgical procedures globally. Whether due to caries, periodontal disease, or trauma, exodontia and the ensuing wound healing and bone remodeling processes of the resultant socket (hole in the jaw bone) usually result in serious deformities of the residual alveolar osseous ridge and surrounding soft tissues (reduced height/width). Such voluminous changes render the placement of a proper conventional bridge, denture, or even an implant-supported prosthesis extremely challenging. Further, most extractions continue to be performed with no regard for preventing the onset of alveolar osteitis (also known as dry socket, a painful and difficult-to-treat/-manage condition post-exodontia). Hence, such serious resorptive morphological changes often result in significant facial deformities and a negative impact on the overall Quality of Life (QoL) of patients (and oral health-related QoL); alarming, particularly for the geriatric with compromised healing and in light of the thriving longevity statistics. Despite advances in tissue/wound grafting, serious limitations continue to exist, including efficacy and clinical outcome predictability, cost, treatment time, expertise, and risk of immune reactions. For cases of dry socket, specifically, the commercially available and often-prescribed home remedies are highly-lacking. Indeed, most are not recommended for use anymore. Alveogyl is a fine example. Hence, there is a great market demand and need for alternative solutions. Herein, SockGEL/PLUG (patent pending), an innovative, all-natural, drug-free, and injectable thermo-responsive hydrogel, was designed, formulated, characterized, and evaluated as an osteogenic, angiogenic, anti-microbial, and pain-soothing suture-free intra-alveolar dressing, safe and efficacious for use in fresh extraction sockets, immediately post-exodontia. It is composed of FDA-approved, biocompatible and biodegradable polymers, self-assembled electro-statically to formulate a scaffolding matrix to (1) prevent the on-set of alveolar osteitis via securing the fibrin-clot in situ and protecting/sealing the socket from contamination/infection; and (2) endogenously promote/accelerate wound healing and bone remodeling to preserve the volume of the alveolus. The intrinsic properties of the SockGEL/PLUG hydrogel were evaluated physical-chemical-mechanically for safety (cell viability), viscosity, rheology, bio-distribution, and essentially, capacity to induce wound healing and osteogenesis (small defect, in vivo) without any signaling cues from exogenous cells, growth factors or drugs. The proposed animal model of cranial critical-sized and non-vascularized bone defects shall provide new and critical insights into the role and mechanism of the employed natural bio-polymer blend and gel product in endogenous reparative regeneration of soft tissues and bone morphogenesis. Alongside, the fine-tuning of our modified formulation method will further tackle appropriateness, reproducibility, scalability, ease, and speed in producing stable, biodegradable, and sterilizable thermo-sensitive matrices (3-dimensional interpenetrating yet porous polymeric network) suitable for the intra-socket application. Findings are anticipated to provide sufficient evidence to translate into pilot clinical trials and validate the innovation before engaging the market for feasibility, acceptance, and cost-effectiveness studies.

Keywords: hydrogel, nanotechnology, bioengineering, bone regeneration, nanogel, drug delivery

Procedia PDF Downloads 86
1566 A Study on Coronary Artery Dominance and Divisions of Main Trunk of Left Coronary Artery in Adult Human Cadaveric Hearts of South Indian Population

Authors: Chethan Purushothama

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Coronary artery disease is one of the major causes of death in developing countries. The coronary arteries show wide range of variations and these variations have not been dealt with different population groups. The present study aims to focus on the pattern and variations of coronary artery in south Indian population. The study was performed to analyze the coronary artery dominance and divisions of main trunk of left coronary artery in 81 isolated adult human cadaveric hearts of South Indian population. The specimens were fixed in 10% formalin and were dissected manually. In our specimens, 74.1% of the hearts were right dominant, 11.1% were left dominant, and 14.8% were co-dominant. Bifurcation, trifurcation, and quadrifurcation of main trunk of left coronary artery were seen in 49.4%, 48.1%, and 2.5% cases respectively. The right dominant hearts had bifurcation, trifurcation and quadrifurcation of main trunk of left coronary artery in 46.7%, 50% and 3.3% hearts respectively. The left dominant hearts had bifurcation and trifurcation of main trunk of left coronary artery in 55.6% and 44.4% cases respectively. The co-dominant hearts had bifurcation and trifurcation of main trunk of left coronary artery in 58.3% and 41.7% respectively. Quadrifurcation of main trunk of left coronary artery were seen only in right dominant hearts. We believe that the data obtained from the present study are important to the interventional cardiologists and radiologists. The details obtained will also be helpful for the clinical anatomists.

Keywords: bifurcation, coronary artery, trifurcation, quadrifurcation

Procedia PDF Downloads 366
1565 Overcoming 4-to-1 Decryption Failure of the Rabin Cryptosystem

Authors: Muhammad Rezal Kamel Ariffin, Muhammad Asyraf Asbullah

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The square root modulo problem is a known primitive in designing an asymmetric cryptosystem. It was first attempted by Rabin. Decryption failure of the Rabin cryptosystem caused by the 4-to-1 decryption output is overcome efficiently in this work. The proposed scheme to overcome the decryption failure issue (known as the AAβ-cryptosystem) is constructed using a simple mathematical structure, it has low computational requirements and would enable communication devices with low computing power to deploy secure communication procedures efficiently.

Keywords: Rabin cryptosystem, 4-to-1 decryption failure, square root modulo problem, integer factorization problem

Procedia PDF Downloads 433
1564 Computational Tool for Surface Electromyography Analysis; an Easy Way for Non-Engineers

Authors: Fabiano Araujo Soares, Sauro Emerick Salomoni, Joao Paulo Lima da Silva, Igor Luiz Moura, Adson Ferreira da Rocha

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This paper presents a tool developed in the Matlab platform. It was developed to simplify the analysis of surface electromyography signals (S-EMG) in a way accessible to users that are not familiarized with signal processing procedures. The tool receives data by commands in window fields and generates results as graphics and excel tables. The underlying math of each S-EMG estimator is presented. Setup window and result graphics are presented. The tool was presented to four non-engineer users and all of them managed to appropriately use it after a 5 minutes instruction period.

Keywords: S-EMG estimators, electromyography, surface electromyography, ARV, RMS, MDF, MNF, CV

Procedia PDF Downloads 527