Search results for: invasive procedure

Authors: Andressa dos Santos Nicolau, João P. da S.C Algusto, Claudio Márcio do N. A. Pereira, Roberto Schirru

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In case of abnormal situations, the nuclear power plant (NPP) operators must follow written procedures to check the condition of the plant and to classify the type of emergency. In this paper, we proposed a Real Time Expert System in order to improve operator’s performance in case of transient or accident with reactor shutdown. The expert system’s knowledge is based on the sequence of events (SoE) of known accident and two emergency procedures of the Brazilian Pressurized Water Reactor (PWR) NPP and uses two kinds of knowledge representation: rule and logic trees. The results show that the system was able to classify the response of the automatic protection systems, as well as to evaluate the conditions of the plant, diagnosing the type of occurrence, recovery procedure to be followed, indicating the shutdown root cause, and classifying the emergency level.

Keywords: emergence procedure, expert system, operator support, PWR nuclear power plant

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Authors: Farhad Fakoursevom

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Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

Procedia PDF Downloads 75

Authors: Hessah Alsulami, Majedah Aldosari

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Introduction: Platelet threshold of 10x109 /L is recommended for clinically stable thrombocytopenic pediatric patients. Transfusions at a higher level (given the absence of research evidence, as determined by clinical circumstances, generally at threshold of 40x109 /L) may be required for patients with signs of bleeding, high fever, hyper-leukocytosis, rapid fall in platelet count, concomitant coagulation abnormality, critically ill patients, and those with impaired platelet function (including drug induced). Transfusions at a higher level may be also required for patients undergoing invasive procedures. Method: This study is a retrospective observational analysis of platelet transfusion thresholds in a single secondary pediatric hospital in Riyadh. From the blood bank database, the list of the patients who received platelet transfusions in the second half of 2018 was retrieved. Patients were divided into two groups; group A, those belong to the category of high platelet level for transfusion (such as those with bleeding, high fever, rapid fall in platelet count, impaired platelet function or undergoing invasive procedures) and group B, those who were not. Then we looked at the pre and post transfusion platelet levels for each group. The data was analyzed using GraphPad software and the data expressed as Mean ± SD. Result: A total of 112 of transfusion episodes in 61 patients (38% female) were analyzed. The age ranged from 24 days to 8 years. The distribution of platelet transfusion episodes was 64% (n=72) for group A and 36% (n= 40) for group B. The mean pre-transfusion platelet count was 46x103 ± (11x 103) for group A and 28x103 ± (6x103) for group B. the post-transfusion mean platelet count was 61 x 103 ± (14 x 103) and 60 x103 ± (24 x 103) for group A and B respectively. Among the groups the rise in the mean platelet count after transfusion was significant among stable patients (group B) compared to unstable patients (group A) (P < 0.001). Conclusion: The platelet count threshold for transfusion varied with the clinical condition and is higher among unstable patients’ group which is expected. For stable patients the threshold was higher than what it should be which means that the clinicians don’t follow the guidelines in this regard. The rise of platelet count after transfusion was higher among stable patients.

Keywords: platelet, transfusion, threshold, pediatric

Procedia PDF Downloads 49

Authors: Trad Khodja Rafik, Mahtout Amine, Ghoul Rachid, Benbouali Amine, Boulahlib Amine, Hariza Abdelmalik

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Cranioplasty with custom implant realized using 3D printing technology. Cranioplasty is a surgical act that aims restoring cranial bone losses in order to protect the brain from external aggressions and to improve the patient aesthetic appearance. This objective can be achieved with taking advantage of the current technological development in computer science and biomechanics. The objective of this paper it to present an approach for the realization of high precision biocompatible cranial implants using new 3D printing technologies at the lowest cost. The proposed method is to reproduce the missing part of the skull by referring to its healthy contralateral part. Once the model is validated by the neurosurgeons, a mold is 3D printed for the production of a biocompatible implant in Poly-Methyl-Methacrylate (PMMA) acrylic cement. Using this procedure four patients underwent this procedure with excellent aesthetic results.

Keywords: cranioplasty, cranial bone loss, 3D printing technology, custom-made implants, PMMA

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Authors: Pengfei Liu, Yiyi Xu

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There have been substantial incidents of wind turbine blade fractures and failures due to the lack of systematic blade strength design method incorporated with the aerodynamic forces and power generation efficiency. This research was to develop a methodology and procedure for the wind turbine rotor blade strength taking into account the strength, integration, and aerodynamic performance in terms of power generation efficiency. The wind turbine blade designed using this method and procedure will have a uniform strength across the span to save unnecessary thickness in many blade radial locations and yet to maintain the optimum power generation performance. A turbine rotor code, taking into account both aerodynamic and structural properties, was developed. An existing wind turbine blade was used as an example. For a condition of extreme wind speed of 100 km per hour, the design reduced about 19% of material usage while maintaining the optimum power regeneration efficiency.

Keywords: renewable energy, wind turbine, turbine blade strength, aerodynamics-strength coupled optimization

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Authors: Hatice Torcu Koc, Zeliha Erdogan

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This study presented the investigation of the population structure of Upeneus moluccensis in order to provide further knowledge and to compare the data with the studies before and thus help in the management of the population in the İskenderun Bay. For this purpose, a total of 370 golden-banded goatfish were caught by a commercial vessel monthly at a depth of 50-60 m. from İskenderun Bay in the years 2016-2018. Von Bertalanffy growth equation,length-weight relationships, sex ratio, age, condition, and gonado and hepato-somatic index values of U.peneus moluccensis specimens were determined. For this, the lengths and weights were measured using a dial caliper of 0.05 mm and a sensitive balance. Total lengths were 7.2–17.5 cm in females and 7.0–17.9 cm in males, while total weight ranges for females and males were 3.91-64.26 g and 3.69-60.95 g., respectively. Length-weight relationship for all individuals was calculated as W=0.004*L³ ³⁸, R²=0.85. Growth parameter was determined as L∞= 20.75 cm, k=0.33, t₀= - 0.56. The age readings were done by using the Bhattacharya method. The population was composed of 3 ages (1-3). The sex ratio was found as 1:1.42, corresponding to 41.4% males and 58.6% females, in favor of females (p<0.05). Values of the average condition and hepatosomatic index were found to be shown a similar pattern for males (1.088, 1.104) and females (1.124, 1.177), respectively. According to GSI values, the spawning period started in March and increased to April, May, and September. It was estimated that total (Z) mortality, natural (M) mortality, and fishing (F) mortality rates were estimated as Z=0.94 year-¹, M=0.033 year-¹, and F=0.63 year-¹, respectively. As the exploitation rate was estimated to be E=0.67, it can be shown that the golden-banded goatfish stock was influenced by overfishing. The findings of this study are very important to point out the population of U. moluccensis, which penetrated into the eastern Mediterranean Sea of Türkiye due to global heating and the construction of the Suez Canal and to be basic data for the next fisheries investigations.

Keywords: biology, U. moluccensis, invasive, lessepsian, İskenderun Bay

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: Yasemin Kaya, Ahmet N. Eraslan

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In this study, the thermoelastic behavior of a long tube is studied by taking into account the temperature dependency of all mechanical and thermal properties. As the tube is heated slowly, an uncoupled solution procedure is adopted under free and radially constrained boundary conditions. The nonlinear heat conduction equation is solved by a finite element collocation procedure and the corresponding distributions of stress and strain are computed by shooting iterations. The computational model is verified in comparison to the analytical solution by shutting down the temperature dependency of physical properties. In the analysis, experimental data available in the literature is used to describe the coefficient of thermal expansion $\alpha$, the thermal conductivity $k$, the modulus of rigidity $G$, the yield strength $\sigma_{0}$, and the Poisson's ratio $\nu$ of Nickel. Results of the analysis are presented in comparison to those having constant physical properties. As a result of the calculations, the temperature dependency of the material properties should be taken into account at higher temperature ranges.

Keywords: thermoelasticity, long tube, temperature-dependent properties, internal heating

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Authors: Fares A. Mayia, Mahmoud A. Yamany, Mushabbab A. Asiri

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In recent years, non-invasive Focused Ultrasound (FU) has been utilized for generating bubbles (cavities) to ablate target tissue by mechanical fractionation. Intensities >10 kW/cm² are required to generate the inertial cavities. The generation, rapid growth, and collapse of these inertial cavities cause tissue fractionation and the process is called Histotripsy. The ability to fractionate tissue from outside the body has many clinical applications including the destruction of the tumor mass. The process of tissue fractionation leaves a void at the treated site, where all the affected tissue is liquefied to particles at sub-micron size. The liquefied tissue will eventually be absorbed by the body. Histotripsy is a promising non-invasive treatment modality. This paper presents a technique for generating inertial cavities at lower intensities (< 1 kW/cm²). The technique (patent pending) is based on amplitude modulation (AM), whereby a low frequency signal modulates the amplitude of a higher frequency FU wave. Cavitation threshold is lower at low frequencies; the intensity required to generate cavitation in water at 10 kHz is two orders of magnitude lower than the intensity at 1 MHz. The Amplitude Modulation technique can operate in both continuous wave (CW) and pulse wave (PW) modes, and the percentage modulation (modulation index) can be varied from 0 % (thermal effect) to 100 % (cavitation effect), thus allowing a range of ablating effects from Hyperthermia to Histotripsy. Furthermore, changing the frequency of the modulating signal allows controlling the size of the generated cavities. Results from in vitro work demonstrate the efficacy of the new technique in fractionating soft tissue and solid calcium carbonate (Chalk) material. The technique, when combined with MR or Ultrasound imaging, will present a precise treatment modality for ablating diseased tissue without affecting the surrounding healthy tissue.

Keywords: focused ultrasound therapy, histotripsy, inertial cavitation, mechanical tissue ablation

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Authors: Jitendra Pratap, Daphne Prybyszcuk, Luke Elliott, Arnold Ng

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Introduction: Coronary CT angiography is a non-invasive imaging technique for the assessment of coronary artery disease and has high sensitivity and negative predictive value. However, the correlation between the degree of CT coronary stenosis and the significance of hemodynamic obstruction is poor. The assessment of myocardial perfusion has mostly been undertaken by Nuclear Medicine (SPECT), but it is now possible to perform stress myocardial CT perfusion (CTP) scans quickly and effectively using CT scanners with high temporal resolution. Myocardial CTP is in many ways similar to neuro perfusion imaging technique, where radiopaque iodinated contrast is injected intravenously, transits the pulmonary and cardiac structures, and then perfuses through the coronary arteries into the myocardium. On the Siemens Force CT scanner, a myocardial perfusion scan is performed using a dynamic axial acquisition, where the scanner shuffles in and out every 1-3 seconds (heart rate dependent) to be able to cover the heart in the z plane. This is usually performed over 38 seconds. Report: A CT myocardial perfusion scan can be utilised to complement the findings of a CT Coronary Angiogram. Implementing a CT Myocardial Perfusion study as part of a routine CT Coronary Angiogram procedure provides a ‘One Stop Shop’ for diagnosis of coronary artery disease. This case study demonstrates that although the CT Coronary Angiogram was within normal limits, the perfusion scan provided additional, clinically significant information in regards to the haemodynamics within the myocardium of a patient with Hypertrophic Obstructive Cardio Myopathy (HOCM). This negated the need for further diagnostics studies such as cardiac ECHO or Nuclear Medicine Stress tests. Conclusion: CT coronary angiography with adenosine stress myocardial CTP was utilised in this case to specifically exclude coronary artery disease in conjunction with accessing perfusion within the hypertrophic myocardium. Adenosine stress myocardial CTP demonstrated the reduced myocardial blood flow within the hypertrophic myocardium, but the coronary arteries did not show any obstructive disease. A CT coronary angiogram scan protocol that incorporates myocardial perfusion can provide diagnostic information on the haemodynamic significance of any coronary artery stenosis and has the potential to be a “One Stop Shop” for cardiac imaging.

Keywords: CT, cardiac, myocardium, perfusion

Procedia PDF Downloads 98

Authors: László Schmidt

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In the context of artificial intelligence, we need to pay primary and particular attention to ethical principles not only in the design process but also during the application process. According to the European Commission's Ethical Guidelines, AI must have three main characteristics: it must be legal, ethical and stabil. We must never lose sight of the ethical principles because we risk that this new technology will not help democratic decision-making under the rule of law, but will, on the contrary, destroy it. The rapid spread and use of artificial intelligence poses an enormous challenge to both lawmaking and law enforcement. On legislation because AI permeates many areas of our daily lives that the legislator must regulate. We can see how challenging it is to regulate e.g., selfdriving cars/taxis/vans etc. Not to mention, more recently, cryptocurrencies and Chat GPT, the use of which also requires legislative intervention, from copyright to scientific use and even law of succession. Artificial intelligence also poses an extraordinary challenge to law enforcement. In criminal cases, police and prosecutors can make great use of AI in investigations, e.g. in forensics, DNA samples, reconstruction, identification, etc. But it can also be of great help in the detection of crimes committed in cyberspace. In criminal or civil court proceedings, AI can also play a major role in the evaluation of evidence and proof. For example, a photo or video or audio recording could be immediately revealed as genuine or fake. Likewise, the authenticity or falsification of a document could be determined much more quickly and cheaply than with current procedure (expert witnesses). Neither the current Hungarian Civil Procedure Act nor the Criminal Procedure Act allows the use of artificial intelligence in the evidentiary process. However, this should be changed. To use this technology in court proceedings would be very useful. The procedures would be faster, simpler, and therefore cheaper. Artificial intelligence could also replace much of the work of expert witnesses. Its introduction into judicial procedures would certainly be justified, but with due respect for human rights, the right to a fair trial and other democratic and rule of law guarantees.

Keywords: artificial intelligence, judiciary, Hungarian, court practice

Procedia PDF Downloads 50

Authors: K. N. Dinesh Babu

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In this paper, the protection of a complicated bus arrangement with a dual bus coupler and bus sectionalizer using low impedance differential protection applicable for very high voltages like 220kV and 400kV is discussed. In many power generation stations, several operational procedures are implemented to utilize the transfer bus as the main bus and to facilitate the maintenance of circuit breakers and current transformers (in each section) without shutting down the bay(s). Owing to this fact, the complications in operational philosophy have thrown challenges for the bus bar protection implementation. Many bus topologies allow any one of the main buses available in the station to be used as an auxiliary bus. In such a system, pre-defined precautions and procedures are made as guidelines, which are followed before assigning any bus as an auxiliary bus. The procedure involves shifting of links, changing rotary switches, insertion of test block, and so on, thereby causing unreliable operation. This kind of unreliable operation or inadvertent procedural lapse may result in the isolation of the bus bar from the grid due to the unpredictable operation of the bus bar protection relay, which is a commonly occurring phenomenon due to manual mistakes. With the sophisticated configuration and implementation of logic in modern intelligent electronic devices, the operator is free to select the transfer arrangement without sacrificing the protection required by a bus differential system for a reliable operation, and labor-intensive processes are completely eliminated. This paper deals with the procedure to test the security logic for such special scenarios using Megger make SMRT, bus bar protection relay to assure system stability and get rid of all the specific operational precautions/procedure.

Keywords: bus bar protection, by-pass isolator, blind spot, breaker failure, intelligent electronic device, end fault, bus unification, directional principle, zones of protection, breaker re-trip, under voltage security, smart megger relay tester

Procedia PDF Downloads 47

Authors: Adya H. Uluwita, Fernando B. D. S. Pedrosa, Georgi M. Georgiev, Raoul Masterson

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CERN is an international organisation funded by 23 countries which provides the particle physics community with excellence in particle accelerators and other related facilities. Founded in 1954, CERN has a wide range of accelerators that allow groundbreaking science to be conducted. Accelerators bring particles to high levels of energy and make them collide with each other or with fixed targets, creating specific conditions that are of high interest to physicists. A chain of accelerators is used to ramp up the energy of particles and eventually inject them into the largest and most recent one of them: the Large Hadron Collider (LHC). Among this chain of machines is, for instance, the Proton Synchrotron, which was started in 1959 and is still in operation. These machines, called "injectors”, keep evolving over time, as well as the related infrastructure. Massive decommissioning of obsolete cables started in 2015 at CERN in the frame of the so-called "injectors de-cabling project phase 1". Its goal was to replace aging cables and remove unused ones, freeing space for new cables necessary for upgrades and consolidation campaigns. To proceed with the de-cabling, a project coordination team was assembled. The start of this project phase led to the investigation of legacy cables throughout the organisation. The identification of cables stacked during half a century proved to be arduous. Phase 1 of the injectors de-cabling was implemented for three years with success after overcoming some difficulties. Phase 2, which started 3 years later, focused on improving safety and structure with the introduction of a quality assurance procedure. This paper discusses the implementation of this quality assurance procedure throughout phase 2 of the project and the transition between the two phases. Over hundreds of kilometres of cable were removed in the injectors complex at CERN from 2015 to 2023.

Keywords: CERN, de-cabling, injectors, quality assurance procedure

Procedia PDF Downloads 30

Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

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Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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Authors: Ananya Barui, Provas Banerjee, Jyotirmoy Chatterjee

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Application of optical technology in medicine and biology has a long track-record. In this endeavor, OCT is able to attract both engineers and biologists to work together in the field of photonics for establishing a striking non-invasive imaging technology. In contrast to other in vivo imaging modalities like Raman imaging, confocal imaging, two-photon microscopy etc. which can perform in vivo imaging upto 100-200 micron depth due to limitation in numerical aperture or scattering, however, OCT can achieve high-resolution imaging upto few millimeters of tissue structures depending on their refractive index in different anatomical location. This tomographic system depends on interference of two light waves in an interferometer to produce a depth profile of specimen. In wound healing, frequent collection of biopsies for follow-up of repair process could be avoided by such imaging technique. Real time skin OCT (the optical biopsy) has efficacy in deeper and faster illumination of cutaneou tissue to acquire high resolution cross sectional images of their internal micro-structure. Swept Source-OCT (SS-OCT), a novel imaging technique, can generate high-speed depth profile (~ 2 mm) of wound at a sweeping rate of laser with micron level resolution and optimum coherent length of 5-6 mm. Normally multi-layered skin tissue depicts different optical properties along with variation in thickness, refractive index and composition (i.e. keratine layer, water, fat etc.) according to their anatomical location. For instance, stratum corneum, the upper-most and relatively dehydrated layer of epidermis reflects more light and produces more lucid and a sharp demarcation line with rest of the hydrated epidermal region. During wound healing or regeneration, optical properties of cutaneous tissue continuously altered with maturation of wound bed. More mature and less hydrated tissue component reflects more light and becomes visible as a brighter area in comparison to immature region which content higher amount water or fat that depicts as a darker area in OCT image. Non-healing wound possess prolonged inflammation and inhibits nascent proliferative stage. Accumulation of necrotic tissues also prevents the repair of non-healing wounds. Due to high resolution and potentiality to reflect the compositional aspects of tissues in terms of their optical properties, this tomographic method may facilitate in differentiating non-healing and acute wounds in addition to clinical observations. Non-invasive OCT offers better insight regarding specific biological status of tissue in health and pathological conditions, OCT images could be associated with histo-pathological ‘gold standard’. This correlated SS-OCT and microscopic evaluation of the wound edges can provide information regarding progressive healing and maturation of the epithelial components. In the context of searching analogy between two different imaging modalities, their relative performances in imaging of healing bed were estimated for probing an alternative approach. Present study validated utility of SS-OCT in revealing micro-anatomic structure in the healing bed with newer information. Exploring precise correspondence of OCT images features with histo-chemical findings related to epithelial integrity of the regenerated tissue could have great implication. It could establish the ‘optical biopsy’ as a potent non-invasive diagnostic tool for cutaneous pathology.

Keywords: histo-pathology, non invasive imaging, OCT, wound healing

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Authors: Mohammed Hussein Ahmed, Bahar Mohammed Kareem

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This study is concerned with the pragmatic discoursal study of hedging constructions in English language. Hedging is a mitigated word used to lessen the impact of the utterance uttered by the speakers. Hedging could be either adverbs, adjectives, verbs and sometimes it may consist of clauses. It aims at finding out the extent to which speakers and participants of the discourse use hedging constructions during their conversations. The study also aims at finding out whether or not there are any significant differences in the types and functions of the frequency of hedging constructions employed by male and female. It is hypothesized that hedging constructions are frequent in English discourse more than any other languages due to its formality and that the frequency of the types and functions are influenced by the gender of the participants. To achieve the aims of the study, two types of procedures have been followed: theoretical and practical. The theoretical procedure consists of presenting a theoretical background of hedging topic which includes its definitions, etymology and theories. The practical procedure consists of selecting a sample of texts and analyzing them according to an adopted model. A number of conclusions will be drawn based on the findings of the study.

Keywords: hedging, pragmatics, politeness, theoretical

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Authors: Tahsin A. H. Nishat, Raquib Ahsan

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Sensitivity analysis of design parameters of the optimization procedure can become a significant factor while designing any structural system. The objectives of the study are to analyze the sensitivity of deck slab thickness parameter obtained from both the conventional and optimum design methodology of pre-stressed post-tensioned I-girder and deck system and to compare the relative significance of slab thickness. For analysis on conventional method, the values of 14 design parameters obtained by the conventional iterative method of design of a real-life I-girder bridge project have been considered. On the other side for analysis on optimization method, cost optimization of this system has been done using global optimization methodology 'Evolutionary Operation (EVOP)'. The problem, by which optimum values of 14 design parameters have been obtained, contains 14 explicit constraints and 46 implicit constraints. For both types of design parameters, sensitivity analysis has been conducted on deck slab thickness parameter which can become too sensitive for the obtained optimum solution. Deviations of slab thickness on both the upper and lower side of its optimum value have been considered reflecting its realistic possible ranges of variations during construction. In this procedure, the remaining parameters have been kept unchanged. For small deviations from the optimum value, compliance with the explicit and implicit constraints has been examined. Variations in the cost have also been estimated. It is obtained that without violating any constraint deck slab thickness obtained by the conventional method can be increased up to 25 mm whereas slab thickness obtained by cost optimization can be increased only up to 0.3 mm. The obtained result suggests that slab thickness becomes less sensitive in case of conventional method of design. Therefore, for realistic design purpose sensitivity should be conducted for any of the design procedure of girder and deck system.

Keywords: sensitivity analysis, optimum design, evolutionary operations, PC I-girder, deck system

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Authors: Alberto Sanchidrián, José A. Parra, Jesús Alonso, Julián Pecharromán, Antonia Pacios, Consuelo Huerta

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Glass is a commonly used material in building; there is not a unique design solution as plates with a different number of layers and interlayers may be used. In most façades, a security glazing have to be used according to its performance in the impact pendulum. The European Standard EN 12600 establishes an impact test procedure for classification under the point of view of the human security, of flat plates with different thickness, using a pendulum of two tires and 50 kg mass that impacts against the plate from different heights. However, this test does not replicate the actual dimensions and border conditions used in building configurations and so the real stress distribution is not determined with this test. The influence of different boundary conditions, as the ones employed in construction sites, is not well taking into account when testing the behaviour of safety glazing and there is not a detailed procedure and criteria to determinate the glass resistance against human impact. To reproduce the actual boundary conditions on site, when needed, the pendulum test is arranged to be used "in situ", with no account for load control, stiffness, and without a standard procedure. Fracture stress of small and large glass plates fit a Weibull distribution with quite a big dispersion so conservative values are adopted for admissible fracture stress under static loads. In fact, test performed for human impact gives a fracture strength two or three times higher, and many times without a total fracture of the glass plate. Newest standards, as for example DIN 18008-4, states for an admissible fracture stress 2.5 times higher than the ones used for static and wing loads. Now two working areas are open: a) to define a standard for the ‘in situ’ test; b) to prepare a laboratory procedure that allows testing with more real stress distribution. To work on both research lines a laboratory that allows to test medium size specimens with different border conditions, has been developed. A special steel frame allows reproducing the stiffness of the glass support substructure, including a rigid condition used as reference. The dynamic behaviour of the glass plate and its support substructure have been characterized with finite elements models updated with modal tests results. In addition, a new portable impact machine is being used to get enough force and direction control during the impact test. Impact based on 100 J is used. To avoid problems with broken glass plates, the test have been done using an aluminium plate of 1000 mm x 700 mm size and 10 mm thickness supported on four sides; three different substructure stiffness conditions are used. A detailed control of the dynamic stiffness and the behaviour of the plate is done with modal tests. Repeatability of the test and reproducibility of results prove that procedure to control both, stiffness of the plate and the impact level, is necessary.

Keywords: glass plates, human impact test, modal test, plate boundary conditions

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Authors: Mohanad Moustafa, Julia Sieberer, Rhys Davies

Abstract:

Background: Orbital compartment syndrome (OCS) is a sight-threatening Ophthalmologic emergency caused by rapidly increasing intraorbital pressure. It is usually caused by a retrobulbar hemorrhage as a result of trauma. If not treated in a timely manner, permanent vision loss can occur. Lateral canthotomy and cantholysis are minor procedures that can be performed bedside with equipment available in the emergency department. The aim of the procedure is to release the attachments between the suspensory ligaments of the eye and the bony orbital wall, leading to a decrease in intraorbital pressure and preventing irreversible loss of vision. As most Ophthalmologists across the UK provide non-resident on-call service, this may lead to a delay in the treatment of OCS and stresses the need for Emergency medical staff to be able to provide this sight-saving procedure independently. Aim: To survey current training, experience, and confidence levels among Emergency Medicine doctors in performing emergency lateral canthotomy and to establish whether these variables change the following teaching from experienced ophthalmologists. RESULTS: Most EM registrars had little to no experience in performing lateral canthotomy and cantholysis. The majority of them showed a significant increase in their confidence to perform the procedure following ophthalmic-led teaching. The survey also showed that the registrars felt such training should be added to/part of the EM curriculum. Conclusion: The involvement of Ophthalmologists in the teaching of EM doctors to recognise and treat OCS independently may prevent delays in treatment and reduce the risk of permanent sight loss. This project showed potential in improving patient care and will lead to a National Survey of EM doctors across the UK.

Keywords: lateral canthotomy, retrobulbar hemorrhage, Ophthalmology, orbital compartment syndrome, sight loss, blindness

Procedia PDF Downloads 78

Authors: Kartik Gupta, Umar Khan, Mayur Parab, Dhiraj Chaudhari, Afzal Ansari

Abstract:

The report focuses on the study related to the Design and Simulation of a stabilator (an all-movable horizontal stabilizer) for a fixed-wing aircraft. The project involves the development of a computerized direct optimization procedure for designing an aircraft all-movable stabilator. This procedure evaluates various design variables to synthesize an optimal stabilator that meets specific requirements, including performance, control, stability, strength, and flutter velocity constraints. The work signifies the CFD (Computational Fluid Dynamics) analysis of the airfoils used in the stabilator along with the CFD analysis of the Stabilizer and Stabilator of an aircraft named Thorp- T18 in software like XFLR5 and ANSYS-Fluent. A comparative analysis between a Stabilizer and Stabilator of equal surface area and under the same environmental conditions was done, and the percentage of drag reduced by the Stabilator for the same amount of lift generated as the Stabilizer was also calculated lastly, Wind tunnel testing was performed on a scale down model of the Stabilizer and Stabilator and the results of the Wind tunnel testing were compared with the results of CFD.

Keywords: wind tunnel testing, CFD, stabilizer, stabilator

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Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault

Abstract:

Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.

Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design

Procedia PDF Downloads 324

Authors: H. A. Algahtani, A. S. Khan, O. Alzahrani, N. Hussein, M. A. Khan, Loudhi Y. I. Soliman

Abstract:

Objective: To report on the Saudi experience (developing country) of neurological complications from bariatric surgery. The literature on the subject is reviewed. Method: This is a cross sectional study done in King Abdul Aziz Medical City Jeddah, WR, where we reviewed all charts of the patients who underwent bariatric surgery between January 1st, 2009 to December 31st , 2014. Personal and clinical data including age, sex, BMI, comorbidities, type of procedure, duration of stay in hospital, complications and postoperative follow up were collected. In addition follow up visit and remote complication if present were collected. All patients with neurological complications were reviewed in details including their clinical examination, laboratory and imaging results, treatment and prognosis. This report is essentially descriptive with no statistical analysis performed. Results: Fifteen cases were collected in this study (3%). Axonal polyneuropathy was the most frequent neurological complica¬tion, but cases of Wernicke syndrome, vitamin B12 deficiency, Guillain-Barre syndrome and cupper deficiency were also identified. Fourteen patients (93.3%) had full recovery from the neurological signs and symptoms but unfortunately one patient died. Conclusion: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications. A clear education, guidelines and follow-up program should be planned and practiced. Facts should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

Keywords: bariatric surgery, neurological complications, neuropathy, Wenicke syndrome

Procedia PDF Downloads 304

Authors: Beata Cieniawska, Deta Łuczycka, Katarzyna Dereń

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When assessing the quality of the spraying procedure, three indicators are used: uneven distribution of precipitation of liquid sprayed, degree of coverage of sprayed surfaces, and deposition of liquid spraying However, there is a lack of information on the relationship between the quality parameters of the procedure. Therefore, the research was carried out at the Institute of Agricultural Engineering of Wrocław University of Environmental and Life Sciences. The aim of the study was to determine the relationship between the degree of coverage of sprayed surfaces and the deposition of liquid in the aspect of the parametric characteristics of the protected plant using selected single and double stream nozzles. Experiments were conducted under laboratory conditions. The carrier of nozzles acted as an independent self-propelled sprayer used for spraying, whereas the parametric characteristics of plants were determined using artificial plants as the ratio of the vertical projection surface and the horizontal projection surface. The results and their analysis showed a strong and very strong correlation between the analyzed parameters in terms of the characteristics of the sprayed object.

Keywords: degree of coverage, deposition of liquid, nozzle, spraying

Procedia PDF Downloads 311

Authors: Aleksandar Zhelyazkov, Daniele Zonta, Helmut Wenzel, Peter Furtner

Abstract:

In the current research structural health monitoring is considered for addressing the critical issue of post-earthquake damage detection. A non-standard approach for damage detection via acoustic emission is presented - acoustic emissions are monitored in the low frequency range (up to 120 Hz). Such emissions are termed high-frequency transients. Further a damage indicator defined as the Time-Ratio Damage Indicator is introduced. The indicator relies on time-instance measurements of damage initiation and deformation peaks. Based on the time-instance measurements a procedure for estimation of the maximum drift ratio is proposed. Monitoring data is used from a shaking-table test of a full-scale reinforced concrete bridge pier. Damage of the experimental column is successfully detected and the proposed damage indicator is calculated.

Keywords: acoustic emission, damage detection, shaking table test, structural health monitoring

Procedia PDF Downloads 199

Authors: Ming Zhou, Taeho Park

Abstract:

Early stage technologies have been particularly challenging to manage due to high degrees of their numerous uncertainties. Most research results directly out of a research lab tend to be at their early, if not the infant stage. A long while uncertain commercialization process awaits these lab results. The majority of such lab technologies go nowhere and never get commercialized due to various reasons. Any efforts or financial resources put into managing these technologies turn fruitless. High stake naturally calls for better results, which make a patenting decision harder to make. A good and well protected patent goes a long way for commercialization of the technology. Our preliminary research showed that there was not a simple yet productive procedure for such valuation. Most of the studies now have been theoretical and overly comprehensive where practical suggestions were non-existent. Hence, we attempted to develop a simple and highly implementable procedure for efficient and scalable valuation. We thoroughly reviewed existing research, interviewed practitioners in the Silicon Valley area, and surveyed university technology offices. Instead of presenting another theoretical and exhaustive research, we aimed at developing a practical guidance that a government agency and/or university office could easily deploy and get things moving to later steps of managing early stage technologies. We provided a procedure to thriftily value and make the patenting decision. A patenting index was developed using survey data and expert opinions. We identified the most important factors to be used in the patenting decision using survey ratings. The rating then assisted us in generating good relative weights for the later scoring and weighted averaging step. More importantly, we validated our procedure by testing it with our practitioner contacts. Their inputs produced a general yet highly practical cut schedule. Such schedule of realistic practices has yet to be witnessed our current research. Although a technology office may choose to deviate from our cuts, what we offered here at least provided a simple and meaningful starting point. This procedure was welcomed by practitioners in our expert panel and university officers in our interview group. This research contributed to our current understanding and practices of managing early stage technologies by instating a heuristically simple yet theoretical solid method for the patenting decision. Our findings generated top decision factors, decision processes and decision thresholds of key parameters. This research offered a more practical perspective which further completed our extant knowledge. Our results could be impacted by our sample size and even biased a bit by our focus on the Silicon Valley area. Future research, blessed with bigger data size and more insights, may want to further train and validate our parameter values in order to obtain more consistent results and analyze our decision factors for different industries.

Keywords: technology management, early stage technology, patent, decision

Procedia PDF Downloads 315

Authors: Ana B. Vivas, Antonia Ypsilanti, Aristea I. Ladas, Angeles F. Estevez

Abstract:

Mild Cognitive Impairment (MCI) is considered an intermediate stage between normal and pathological aging, as a substantial percentage of people diagnosed with MCI converts later to dementia of the Alzheimer’s type. Memory is of the first cognitive processes to deteriorate in this condition. In the present study we employed the differential outcomes procedure (DOP) to improve visuospatial memory in a group of participants with MCI. The DOP requires the structure of a conditional discriminative learning task in which a correct choice response to a specific stimulus-stimulus association is reinforced with a particular reinforcer or outcome. A group of 10 participants with MCI, and a matched control group had to learn and keep in working memory four target locations out of eight possible locations where a shape could be presented. Results showed that participants with MCI had a statistically significant better terminal accuracy when a unique outcome was paired with a location (76% accuracy) as compared to a non differential outcome condition (64%). This finding suggests that the DOP is useful in improving working memory in MCI patients, which may delay their conversion to dementia.

Keywords: mild cognitive impairment, working memory, differential outcomes, cognitive process

Procedia PDF Downloads 437

Authors: Jaydip M. Desai, Antonio Valdevit, Arthur Ritter

Abstract:

Robotic surgery is used to enhance minimally invasive surgical procedure. It provides greater degree of freedom for surgical tools but lacks of haptic feedback system to provide sense of touch to the surgeon. Surgical robots work on master-slave operation, where user is a master and robotic arms are the slaves. Current, surgical robots provide precise control of the surgical tools, but heavily rely on visual feedback, which sometimes cause damage to the inner organs. The goal of this research was to design and develop a real-time simulink based robotic system to study force feedback mechanism during instrument-object interaction. Setup includes three Velmex XSlide assembly (XYZ Stage) for three dimensional movement, an end effector assembly for forceps, electronic circuit for four strain gages, two Novint Falcon 3D gaming controllers, microcontroller board with linear actuators, MATLAB and Simulink toolboxes. Strain gages were calibrated using Imada Digital Force Gauge device and tested with a hard-core wire to measure instrument-object interaction in the range of 0-35N. Designed simulink model successfully acquires 3D coordinates from two Novint Falcon controllers and transfer coordinates to the XYZ stage and forceps. Simulink model also reads strain gages signal through 10-bit analog to digital converter resolution of a microcontroller assembly in real time, converts voltage into force and feedback the output signals to the Novint Falcon controller for force feedback mechanism. Experimental setup allows user to change forward kinematics algorithms to achieve the best-desired movement of the XYZ stage and forceps. This project combines haptic technology with surgical robot to provide sense of touch to the user controlling forceps through machine-computer interface.

Keywords: surgical robot, haptic feedback, MATLAB, strain gage, simulink

Procedia PDF Downloads 510

Authors: Marina S. Basta, Kirollos S. Basta

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Cosmetic dermatology procedures have witnessed exponential growth and diversification over the last 10 years. Thus, the purpose of this study was to collect data about the latest trends for cosmetic procedures reported by dermatologists during the year 2018. This study was performed by American Society for Dermatologic Surgery (ASDS) in 2018 through sending survey invitations to 3,358 practicing dermatologists in the U.S. containing streamline questions as well as statistical questions targeted to specific analysis of cosmetic dermatology trends. Out of the targeted physicians, only 596 dermatologists reply to the survey invitation (15% overall response rate). It was noted that data collected from that survey was generalized to represent all ASDS members. Results show that there is an increase in cosmetic dermatology procedures since 12.5 million procedures were reported for 2018 compared to only 7.8 million for 2012. Injectable neuromodulators and soft tissue fillers have topped the list with a 3.7 million procedure count. Body sculpting, chemical peeling, hair transplantation, and microneedling procedures were reported to be 1.57 million cases combined. Also, the top two procedures using laser were represented in wrinkle treatment as well as sun damage correction, while the lowest two trends for laser usage were for treatments of tattoos and birthmarks. Cryolipolysis was found to be at the head of body sculpting procedures with 287,435 cases, while tumescent liposuction was reported as the least performed body sculpting procedure (18,286 cases). In conclusion, comparing the procedural trends for the last 7 years has indicated that there has been a 78% increase in soft tissue filler treatment compared to 2012. In addition, it was further noted that laser procedures scored 74% increase in the last 7 years while body contouring procedures have had four folds increase in general compared to 2012.

Keywords: cosmetic dermatology, ASDS procedure survey, laser, body sculpting

Procedia PDF Downloads 105

Authors: Henrik L. Funke, Lars Ulke-Winter, Sandra Gelbrich, Lothar Kroll

Abstract:

This work reports about an approach for an automatic adaptation of concrete formulations based on genetic algorithms (GA) to optimize a wide range of different fit-functions. In order to achieve the goal, a method was developed which provides a numerical description of a fibre reinforced concrete (FRC) mixture regarding the production technology and the property spectrum of the concrete. In a first step, the FRC mixture with seven fixed components was characterized by varying amounts of the components. For that purpose, ten concrete mixtures were prepared and tested. The testing procedure comprised flow spread, compressive and bending tensile strength. The analysis and approximation of the determined data was carried out by GAs. The aim was to obtain a closed mathematical expression which best describes the given seven-point cloud of FRC by applying a Gene Expression Programming with Free Coefficients (GEP-FC) strategy. The seven-parametric FRC-mixtures model which is generated according to this method correlated well with the measured data. The developed procedure can be used for concrete mixtures finding closed mathematical expressions, which are based on the measured data.

Keywords: concrete design, fibre reinforced concrete, genetic algorithms, GEP-FC

Procedia PDF Downloads 249

Authors: A. S. V Polgampala, F. Huang

Abstract:

This is an overview of what is entailed in an evaluation and issues to be aware of when class observation is being done. This study examined the effects of evaluating teaching practice of a 7-day ‘block teaching’ session in a pre -service science teacher training program at a reputed National College of Education in Sri Lanka. Effects were assessed in three areas: evaluation of the training process, evaluation of the training impact, and evaluation of the training procedure. Data for this study were collected by class observation of 18 teachers during 9th February to 16th of 2017. Prospective teachers of science teaching, the participants of the study were evaluated based on newly introduced format by the NIE. The data collected was analyzed qualitatively using the Miles and Huberman procedure for analyzing qualitative data: data reduction, data display and conclusion drawing/verification. It was observed that the trainees showed their confidence in teaching those competencies and skills. Teacher educators’ dissatisfaction has been a great impact on evaluation process.

Keywords: evaluation, perceptions & perspectives, pre-service, science teachering

Procedia PDF Downloads 286