Search results for: return of spontaneous circulation

Authors: Yiyuan David Hu, Alex Lindqwister, Samuel B. Klein, Karen Moodie, Norman A. Paradis

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Introduction: Pseudo-Pulseless Electrical Activity (p-PEA) is a lifeless form of profound cardiac shock characterized by measurable cardiac mechanical activity without clinically detectable pulses. Patients in pseudo-PEA carry different prognoses than those in true PEA and may require different therapies. End-tidal carbon dioxide (ET-CO2) is a reliable indicator of the return of spontaneous circulation (ROSC) in ventricular fibrillation and true-PEA but has not been studied p-PEA. Hypothesis: ET-CO2 can be used as an independent indicator of ROSC in p-PEA resuscitation. Methods: 30kg female swine (N = 14) under intravenous anesthesia were instrumented with aortic and right atrial micromanometer pressure. ECG and ET-CO2 were measured continuously. p-PEA was induced by ventilation with 6% oxygen in 94% nitrogen and was defined as a systolic Ao less than 40 mmHg. The statistical relationships between ET-CO2 and ROSC are reported. Results: ET-CO2 during resuscitation strongly correlated with ROSC (Figure 1). Mean ET-CO2 during p-PEA was 28.4 ± 8.4, while mean ET-CO2 in ROSC for 100% O2 cohort was 42.2 ± 12.6 (p < 0.0001), mean ET-CO2 in ROSC for 100% O2 + CPR was 33.0 ± 15.4 (p < 0.0001). Analysis of slope was limited to one minute of resuscitation data to capture local linearity; assessment began 10 seconds after resuscitation started to allow the ventilator to mix 100% O2. Pigs who would recover with 100% O2 had a slope of 0.023 ± 0.001, oxygen + CPR had a slope of 0.018 ± 0.002, and oxygen + CPR + epinephrine had a slope of 0.0050 ± 0.0009. Conclusions: During resuscitation from porcine hypoxic p-PEA, a rise in ET-CO2 is indicative of ROSC.

Keywords: ET-CO2, resuscitation, capnography, pseudo-PEA

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Authors: Panagodage Janaka Sampath Fernando

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Brain circulation has become a buzzword in the skilled migration literature. However, promoting brain circulation; returning of skilled migrants is challenging. Success stories in Asia, for instances, Taiwan, and China, are results of rigorous policy interventions of the respective governments. Nonetheless, the same policy mix has failed in other countries making it skeptical to attribute the success of brain circulation to the policy interventions per se. The paper seeks to answer whether the success of brain circulation within the Knowledge Services Industry (KSI) in Sri Lanka is a policy driven or a market driven process. Mixed method approach, which is a combination of case study and survey methods, was employed. Qualitative data derived from ten case studies of returned entrepreneurs whereas quantitative data generated from a self-administered survey of 205 returned skilled migrants (returned skilled employees and entrepreneurs) within KSI. The pull factors have driven the current flow of brain circulation within KSI but to a lesser extent, push factors also have influenced. The founding stone of the industry has been laid by a group of returned entrepreneurs, and the subsequent growth of the industry has attracted returning skilled employees. Sri Lankan government has not actively implemented the reverse brain drain model, however, has played a passive role by creating a peaceful and healthy environment for the industry. Therefore, in contrast to the other stories, brain circulation within KSI has emerged as a market driven process with minimal government interventions. Entrepreneurs play the main role in a market-driven process of brain circulation, and it is free from the inherent limitations of the reverse brain drain model such as discriminating non-migrants and generating a sudden flow of low-skilled migrants. Thus, to experience a successful brain circulation, developing countries should promote returned entrepreneurs by creating opportunities in knowledge-based industries.

Keywords: brain circulation, knowledge services industry, return migration, Sri Lanka

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Authors: Rojith K. Balakrishnan

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Spontaneous tumour lysis syndrome is a constellation of electrolyte abnormalities and an acute renal failure which occurs in the setting of rapid cell turnover prior to the administration of cytotoxic chemotherapy. While spontaneous tumour lysis well-described in patients with Burkitt lymphoma, it is thought to occur less commonly in patients with other hematological malignancies. We present a case of forty-year-old female who presented with features of acute renal failure, on further evaluation turned out to be a newly diagnosed acute myeloid leukemia with spontaneous tumour lysis best of our knowledge only three cases of AML with spontaneous tumour lysis has reported world wide.

Keywords: AML, tumour lysis, renal failure, myeloid leukemia

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Authors: Slawomir Pilip, Michal Wasilewski, Daniel Celinski, Leszek Szpakowski, Grzegorz Michalak

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The aim of the study was to evaluate the effectiveness of cardiopulmonary resuscitation taken by Medical Emergency Teams (MET) at the place of an accident including the usage of mechanical chest compression systems. In the period of January-May 2017, there were 137 cases of a sudden cardiac arrest in a chosen region of Eastern Poland with 360.000 inhabitants. Medical records and questionnaires filled by METs were analysed to prove the effectiveness of cardiopulmonary resuscitations that were considered to be effective when an early indication of spontaneous circulation was provided and the patient was taken to hospital. A chest compression system used by METs was applied in 60 cases (Lucas3 - 34 patients; Auto Pulse - 24 patients). The effectiveness of cardiopulmonary resuscitation among patients who were employed a chest compression system was much higher (43,3%) than the manual cardiac massage (36,4%). Thus, the usage of Lucas3 chest compression system resulted in 47% while Auto Pulse was 33,3%. The average ambulance arrival time could have had a significant impact on the subsequent effectiveness of cardiopulmonary resuscitation in these cases. Ambulances equipped with Lucas3 reached the destination within 8 minutes, and those with Auto Pulse needed 12,1 minutes. Moreover, taking effective basic life support (BLS) by bystanders before the ambulance arrival was much more frequent for ambulances with Lucas3 than Auto Pulse. Therefore, the percentage of BLS among the group of patients who were employed Lucas3 by METs was 26,5%, and 20,8% for Auto Pulse. The total percentage of taking BLS by bystanders before the ambulance arrival resulted in 25% of patients who were later applied a chest compression system by METs. Not only was shockable cardiac rhythm obtained in 47% of these cases, but an early indication of spontaneous circulation was also provided in all these patients. Both Lucas3 and Auto Pulse were evaluated to be significantly useful in improving the effectiveness of cardiopulmonary resuscitation by 97% of Medical Emergency Teams. Therefore, implementation of chest compression systems essentially makes the cardiopulmonary resuscitation even more effective. The ambulance arrival time, taking successful BLS by bystanders before the ambulance arrival and the presence of shockable cardiac rhythm determine an early indication of spontaneous circulation among patients after a sudden cardiac arrest.

Keywords: cardiac arrest, effectiveness, mechanical chest compression systems, resuscitation

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Authors: Anna Demian, Levi Howard, L. Ng, Leslie Simon, Mark Dragon, A. Desai, Timothy Devlantes, W. David Freeman

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Introduction: Out-of-hospital cardiac arrest (OHCA) can carry a high mortality. For survivors, the most common complication is hypoxic-ischemic brain injury (HIBI). Rarely, lumbosacral spinal cord and/or other spinal cord artery ischemia can occur due to anatomic variation and variable mean arterial pressure after the return of spontaneous circulation. We present a case of an OHCA survivor who later woke up with bilateral leg weakness with preserved sensation (ASIA grade B, L2 level). Methods: We describe a clinical, radiographic, and laboratory presentation, as well as a National Library of Medicine (NLM) search engine methodology, characterizing incidence/prevalence of this entity is discussed. A 70-year-old male, a longtime smoker, and alcohol user, suddenly collapsed at a bar surrounded by friends. He had complained of chest pain before collapsing. 911 was called. EMS arrived, and the patient was in pulseless electrical activity (PEA), cardiopulmonary resuscitation (CPR) was initiated, and the patient was intubated, and a LUCAS device was applied for continuous, high-quality CPR in the field by EMS. In the ED, central lines were placed, and thrombolysis was administered for a suspected Pulmonary Embolism (PE). It was a prolonged code that lasted 90 minutes. The code continued with the eventual return of spontaneous circulation. The patient was placed on an epinephrine and norepinephrine drip to maintain blood pressure. ECHO was performed and showed a “D-shaped” ventricle worrisome for PE as well as an ejection fraction around 30%. A CT with PE protocol was performed and confirmed bilateral PE. Results: The patient woke up 24 hours later, following commands, and was extubated. He was found paraplegic below L2 with preserved sensation, with hypotonia and areflexia consistent with “spinal shock” or anterior spinal cord syndrome. MRI thoracic and lumbar spine showed a conus medullaris level spinal cord infarction. The patient was given IV steroids upon initial discovery of cord infarct. NLM search using “cardiac arrest” and “spinal cord infarction” revealed 57 results, with only 8 review articles. Risk factors include age, atherosclerotic disease, and intraaortic balloon pump placement. AoA (Artery of Adamkiewicz) anatomic variation along with existing atherosclerotic factors and low perfusion were also known risk factors. Conclusion: Acute paraplegia from anterior spinal cord infarction of the AoA territory after cardiac arrest is rare. Larger prospective, multicenter trials are needed to examine potential interventions of hypothermia, lumbar drains, which are sometimes used in aortic surgery to reduce ischemia and/or other neuroprotectants.

Keywords: cardiac arrest, spinal cord infarction, artery of Adamkiewicz, paraplegia

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Authors: Salima R. Rajwani, Tazeen Ali, Rubina Barolia, Yasmin Parpio, Nasreen Alwani, Salima B. Virani

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Introduction: Nurses and physicians have a critical role in initiating lifesaving interventions during cardiac arrest. It is important that timely delivery of high quality Cardio Pulmonary Resuscitation (CPR) with advanced resuscitation skills and management of cardiac arrhythmias is a key dimension of code during cardiac arrest. It will decrease the chances of patient survival if the healthcare professionals are unable to initiate CPR timely. Moreover, traditional training will not prepare physicians and nurses at a competent level and their knowledge level declines over a period of time. In this regard, simulation training has been proven to be effective in promoting resuscitation skills. Simulation teaching learning strategy improves knowledge level, and skills performance during resuscitation through experiential learning without compromising patient safety in real clinical situations. The purpose of the study is to evaluate the effectiveness of simulation training in Advanced Cardiac Life Support Courses by using the selfefficacy tool. Methods: The study design is a quantitative research design and non-randomized quasi-experimental study design. The study examined the effectiveness of simulation through self-efficacy in two instructional methods; one is Medium Fidelity Simulation (MFS) and second is Traditional Training Method (TTM). The sample size was 220. Data was compiled by using the SPSS tool. The standardized simulation based training increases self-efficacy, knowledge, and skills and improves the management of patients in actual resuscitation. Results: 153 students participated in study; CG: n = 77 and EG: n = 77. The comparison was done between arms in pre and post-test. (F value was 1.69, p value is <0.195 and df was 1). There was no significant difference between arms in the pre and post-test. The interaction between arms was observed and there was no significant difference in interaction between arms in the pre and post-test. (F value was 0.298, p value is <0.586 and df is 1. However, the results showed self-efficacy scores were significantly higher within experimental group in post-test in advanced cardiac life support resuscitation courses as compared to Traditional Training Method (TTM) and had overall (p <0.0001) and F value was 143.316 (mean score was 45.01 and SD was 9.29) verses pre-test result showed (mean score was 31.15 and SD was 12.76) as compared to TTM in post-test (mean score was 29.68 and SD was 14.12) verses pre-test result showed (mean score was 42.33 and SD was 11.39). Conclusion: The standardized simulation-based training was conducted in the safe learning environment in Advanced Cardiac Life Suport Courses and physicians and nurses benefited from self-confidence, early identification of life-threatening scenarios, early initiation of CPR, and provides high-quality CPR, timely administration of medication and defibrillation, appropriate airway management, rhythm analysis and interpretation, and Return of Spontaneous Circulation (ROSC), team dynamics, debriefing, and teaching and learning strategies that will improve the patient survival in actual resuscitation.

Keywords: advanced cardiac life support, cardio pulmonary resuscitation, return of spontaneous circulation, simulation

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Authors: Kostas Philippopoulos, Chris G. Tzanis, Despina Deligiorgi

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Climate change adaptation requires the exploitation of renewable energy sources such as wind. However, climate variability can affect the regional wind energy potential and consequently the available wind power production. The goal of the research project is to examine the impact of atmospheric circulation on wind energy production over Greece. In the context of synoptic climatology, the proposed novel methodology employs Self-Organizing Maps for grouping and classifying the atmospheric circulation and nationally-aggregated capacity factor time series for a 30-year period. The results indicate the critical effect of atmospheric circulation on the national aggregated wind energy production values and therefore address the issue of optimum distribution of wind farms for a specific region.

Keywords: wind energy, atmospheric circulation, capacity factor, self-organizing maps

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Authors: Donna Erika E. De Jesus

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Introduction: Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7-10%. It is crucial that CPR be initiated within 4-6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes. Methods: This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Results: 43 were male patients, comprising the majority at 73.02%. Hypertension was identified as the top co-morbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival, which comprised only hands-only CPR. Twenty-three of which were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remains dismal, as a return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

Keywords: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, emergency medical services

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Authors: Weiwei Shan, Wenjing Ding, Juan Ning, Chao He, Zijuan Wang

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Gravity circulation loop for the cryopumps of the space simulator is introduced, and two phase mathematic model of flow heat transfer is analyzed as well. Based on this model, the liquid nitrogen (LN₂) gravity circulation loop including its equipment and layout is designed and has served as LN₂ feeding system for cryopumps in one large space simulator. With the help of control software and human machine interface, this system can be operated flexibly, simply, and automatically under four conditions. When running this system, the results show that the cryopumps can be cooled down and maintained under the required temperature, 120 K.

Keywords: cryopumps, gravity circulation loop, liquid nitrogen, two-phase

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Authors: Zatil Afifah Omar, Siti Nur Izati Azmi, Kathi Swaran, Navin Kumar

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Lost circulation has always been one of the greatest problems faced by drilling companies during drilling operations due to excessive drilling Fluids losses. Loss of circulation leads to Huge cost and non-productive time. The objective of this study is to evaluate the sealing efficiency of a proprietary blend of synthetic rubber as loss circulation material in comparison with a conventional product such as calcium carbonate, graphite, cellulosic, and nutshells. Sand Bed Tester with a different proprietary blend of synthetic rubber compositions has been used to determine the effectiveness of the LCM in preventing drilling fluids losses in a lab scale. Test results show the proprietary blend of synthetic rubber have good bridging properties and sealing Off fractures of various sizes. The finish product is environmentally friendly with lower production lead time and lower production cost compared to current conventional loss circulation materials used in current drilling operations.

Keywords: loss circulation materials, drilling operation, sealing efficiency, LCM

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Authors: Ali Aghazadegan, Ali Shokri, Julia Mullarney

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River confluences are areas where there is a lot of mixing, which is often caused by the formation of shear layers and helical motions. The hydrodynamics of secondary circulation at river confluences with low flow discharge ratios and a 90° junction angle are investigated in this study. The analysis is based on Delft 3D modelling, which includes a three-dimensional time-averaged velocity field, turbulence, and water surface levels that have been validated using laboratory data. Confluence structure was characterized by shear layer, secondary circulation, and mixing at the junction and post confluence channel. This study analysis formation of the shear layer by generation of secondary circulations in variation discharge ratios. The values of streamwise, cross-wise, and vertical components are used to estimate the secondary circulation observed within and downstream of the tributary mouth. These variables are estimated for three horizontal planes at Z = [0.14; 0.07; 0.02] and for eight cross-sections at X = [-0.1; 0.00; 0.10; 0.2; 0.30; 0.4; 0.5; 0.6] within a range of 0.05 Y 0.30.

Keywords: river confluence, shear layer, secondary circulation, hydrodynamics

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Authors: Taikchan Lildar, Ayesha Samad, Suraj Sookhu

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Atrial fibrillation with rapid ventricular response results in the loss of atrial kick and shortened ventricular filling time, which often leads to decompensated heart failure. Pharmacologic rhythm control is the treatment of choice, and patients frequently benefit from the restoration of sinus rhythm. When pharmacologic treatment is unsuccessful or a patient declines hemodynamically, direct cardioversion is the treatment of choice. Torsades de pointes or “twisting of the points'' in French, is a rare but under-appreciated risk of cardioversion therapy and accounts for a significant number of sudden cardiac death each year. A 61-year-old female with no significant past medical history presented to the Emergency Department with worsening dyspnea. An electrocardiogram showed atrial fibrillation with rapid ventricular response, and a chest X-ray was significant for bilateral pulmonary vascular congestion. Full-dose anticoagulation and diuresis were initiated with moderate improvement in symptoms. A transthoracic echocardiogram revealed biventricular systolic dysfunction with a left ventricular ejection fraction of 30%. After consultation with an electrophysiologist, the consensus was to proceed with the restoration of sinus rhythm, which would likely improve the patient’s heart failure symptoms and possibly the ejection fraction. A transesophageal echocardiogram was negative for left atrial appendage thrombus; the patient was treated with a loading dose of amiodarone and underwent successful direct current cardioversion with 200 Joules. The patient was placed on telemetry monitoring for 24 hours and was noted to have frequent premature ventricular contractions with subsequent degeneration to torsades de pointes. The patient was found unresponsive and pulseless; cardiopulmonary resuscitation was initiated with cardioversion, and return of spontaneous circulation was achieved after four minutes to normal sinus rhythm. Post-cardiac arrest electrocardiogram showed sinus bradycardia with heart-rate corrected QT interval of 592 milliseconds. The patient continued to have frequent premature ventricular contractions and required two additional cardioversions to achieve a return of spontaneous circulation with intravenous magnesium and lidocaine. An automatic implantable cardioverter-defibrillator was subsequently implanted for secondary prevention of sudden cardiac death. The backup pacing rate of the automatic implantable cardioverter-defibrillator was set higher than usual in an attempt to prevent premature ventricular contractions-induced torsades de pointes. The patient did not have any further ventricular arrhythmias after implantation of the automatic implantable cardioverter-defibrillator. Overdrive pacing is a method utilized to treat premature ventricular contractions-induced torsades de pointes by preventing a patient’s susceptibility to R on T-wave-induced ventricular arrhythmias. Pacing at a rate of 90 beats per minute succeeded in controlling the arrhythmia without the need for traumatic cardiac defibrillation. In our patient, conversion of atrial fibrillation with rapid ventricular response to normal sinus rhythm resulted in a slower heart rate and an increased probability of premature ventricular contraction occurring on the T-wave and ensuing ventricular arrhythmia. This case highlights direct current cardioversion for atrial fibrillation with rapid ventricular response resulting in persistent ventricular arrhythmia requiring an automatic implantable cardioverter-defibrillator placement with overdrive pacing to prevent a recurrence.

Keywords: refractory atrial fibrillation, atrial fibrillation, overdrive pacing, torsades de pointes

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Authors: Lur N. Dreier

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Spontaneous transformation in Ursus maritimus is generally considered to be seldom, albeit not, to this author's best knowledge, previously unpublished in the medical literature. However, no case series has to date described transformative spontaneous processes to filios hominum species. Norwegian public hospital system, is, however, especially the grounds of the specific climate in the Northern hemisphere, and because of a high suited to observe such transformations, both on income level. Hence, this paper describes, to our knowledge, the first case series of 25 patients undergoing treatment for spontaneous transformation in four Norwegian hospitals. The methodology was to include patients on a consecutive basis, identifying clinically and laboratory the typology in each of the four hospitals. The major findings were that the archetypes were heterogeneous, with coercive laboratory findings, with a high degree of redundancy of the process. This might potentially lead to many advances in the diagnostics.

Keywords: case series, transformation, hominum species, maritimus species

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Authors: Prashant Verma, Prafulla K. Swain, K. K. Singh, Mukti Khetan

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Objective: In India, around 20,000 women die every year due to abortion-related complications. In the modelling of count variables, there is sometimes a preponderance of zero counts. This article concerns the estimation of various count regression models to predict the average number of spontaneous abortion among women in the Punjab state of India. It also assesses the factors associated with the number of spontaneous abortions. Materials and methods: The study included 27,173 married women of Punjab obtained from the DLHS-4 survey (2012-13). Poisson regression (PR), Negative binomial (NB) regression, zero hurdle negative binomial (ZHNB), and zero-inflated negative binomial (ZINB) models were employed to predict the average number of spontaneous abortions and to identify the determinants affecting the number of spontaneous abortions. Results: Statistical comparisons among four estimation methods revealed that the ZINB model provides the best prediction for the number of spontaneous abortions. Antenatal care (ANC) place, place of residence, total children born to a woman, woman's education and economic status were found to be the most significant factors affecting the occurrence of spontaneous abortion. Conclusions: The study offers a practical demonstration of techniques designed to handle count variables. Statistical comparisons among four estimation models revealed that the ZINB model provided the best prediction for the number of spontaneous abortions and is recommended to be used to predict the number of spontaneous abortions. The study suggests that women receive institutional Antenatal care to attain limited parity. It also advocates promoting higher education among women in Punjab, India.

Keywords: count data, spontaneous abortion, Poisson model, negative binomial model, zero hurdle negative binomial, zero-inflated negative binomial, regression

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Authors: Inten Meutia, Emylia Yuniarti

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The objective of this study is to analyze the effects of interest rate, the rate of return of Islamic banks on the amount of mudarabah deposits in Islamic banks. In analyzing the effect of rate of return in the Islamic banks and interest rate risk in the conventional banks, the 1-month Islamic deposit rate of return and 1 month fixed deposit interest rate of a total Islamic deposit are considered. Using data covering the period from January 2010 to Sepember 2013, the study applies the regression analysis to analyze the effect between variable and independence t-test to analyze the mean difference between rate of return and rate of interest. Regression analysis shows that rate of return have significantly negative influence on mudarabah deposits, while interest rate have negative influence but not significant. The result of independent t test shows that the interest rate is not different from the rate of return in Islamic Bank. It supports the hyphotesis that rate of return in Islamic banking mimic rate of interest in conventional bank. The results of the study have important implications on the risk management practices of the Islamic banks in Indonesia.

Keywords: conventional bank, interest rate, Islamic bank, rate of return

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Authors: Landry Tchambou Tchouongsi, Appolinaire Derbetini Vondou

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This study describes the local Hadley circulation (HC) during the December-February (DJF) and June-August (JJA) seasons, respectively, in Central Africa (CA) from the divergent component of the mean meridional wind and also from a new method called the variation of the ψ vector. Historical data from the ERA5 reanalysis for the period 1983 to 2013 were used. The results show that the maximum of the upward branch of the local Hadley circulation in the DJF and JJA seasons is located under the Congo Basin (CB). However, seasonal and horizontal variations in the mean temperature gradient and thermodynamic properties are largely associated with the distribution of convection and large-scale upward motion. Thus, temperatures beneath the CB show a slight variation between the DJF and JJA seasons. Moreover, energy transport of the moist static energy (MSE) adequately captures the mean flow component of the HC over the tropics. By the way, the divergence under the CB is enhanced by the presence of the low pressure of western Cameroon and the contribution of the warm and dry air currents coming from the Sahara.

Keywords: Circulation, reanalysis, thermodynamic, local Hadley.

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Authors: Lucie Cote, Sonia McFadden

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Mental health problems in the workplace are currently one of the main causes of absences. Research work has highlighted the importance of a collaborative process involving the stakeholders in the return-to-work process and has established the best management practices to ensure a successful return-to-work. However, very few studies have specifically explored the combination of various management models and determined whether they could satisfy the needs of the stakeholders. The objective of this study is to analyze two models for managing the return to work: the ‘medical-administrative’ and the ‘support of the worker’ in order to understand the actions and actors involved in these models. The study also aims to explore whether these models meet the needs of the actors involved in the management of the return to work. A qualitative case study was conducted in a Canadian federal organization. An abundant internal documentation and semi-directed interviews with six managers, six workers and four human resources professionals involved in the management of records of employees returning to work after a mental health problem resulted in a complete picture of the return to work management practices used in this organization. The triangulation of this data facilitated the examination of the benefits and limitations of each approach. The results suggest that the actions of management for employee return to work from both models of management ‘support of the worker’ and ‘medical-administrative’ are compatible and can meet the needs of the actors involved in the return to work. More research is needed to develop a structured model integrating best practices of the two approaches to ensure the success of the return to work.

Keywords: return to work, mental health, management models, organizations

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Authors: Jian Wang, Lu Yang, Jiong Peng

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Internal circulation two-platen clamping system for injection molding machine (IMM) has many potential advantages on energy-saving. In order to estimate its properties, experiments in this paper were carried out. Displacement and pressure of the components were measured. In comparison, the model of hydraulic clamping system was established by using AMESim. The related parameters as well as the energy consumption could be calculated. According to the analysis, the hydraulic system was optimized in order to reduce the energy consumption.

Keywords: AMESim, energy-saving, injection molding machine, internal circulation

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Authors: Fatin Fadhilah Hasib, Puji Sucia Sukmaningrum, Imron Mawardi, Achsania Hendratmi

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Murabaha is the most popular contract by the Islamic banks in Indonesia, since there is opinion stating that the risk level of mudharaba and musyaraka are higher and the return is uncertain. This research aims to analyze the difference of return, risk, and variation coefficient between profit sharing-based and trading-based financing in Islamic bank. This research uses quantitative approach using Wilcoxon signed rank test with data sampled from 13 Indonesian Islamic banks, collected from their quarterly financial reports from 2011 to 2015. The result shows the significant difference in return, while risk and variation coefficient are almost same. From the analysis, it can be concluded that profit sharing-based financing is less desirable not because of its risk. Trading-based financing is more desirable than the profit sharing because of its return.

Keywords: financing, Islamic bank, return, risk

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Authors: Nkongho Ayuketang Arreyndip, Ebobenow Joseph

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In this paper, temperature extremes are forecast by employing the block maxima method of the generalized extreme value (GEV) distribution to analyse temperature data from the Cameroon Development Corporation (CDC). By considering two sets of data (raw data and simulated data) and two (stationary and non-stationary) models of the GEV distribution, return levels analysis is carried out and it was found that in the stationary model, the return values are constant over time with the raw data, while in the simulated data the return values show an increasing trend with an upper bound. In the non-stationary model, the return levels of both the raw data and simulated data show an increasing trend with an upper bound. This clearly shows that although temperatures in the tropics show a sign of increase in the future, there is a maximum temperature at which there is no exceedance. The results of this paper are very vital in agricultural and environmental research.

Keywords: forecasting, generalized extreme value (GEV), meteorology, return level

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Authors: K. Bhojnadh, M. Fiddler, D. Cheshire

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An investigation into the Kutta effect on the trailing edge of a subsonic aerofoil was conducted which led to an analysis using Ansys Fluent to determine the effect of flow separation over a NACA 0012 aerofoil. This aerofoil was subjected to oscillations to create an unsteady flow over the aerofoil, therefore, creating turbulence, with unsteady aerodynamics playing a key role to determine the flow regimes when the aerofoil is subjected to different angles of attack along with varying Reynolds numbers. Many theories were evolved to determine the flow parameters of a 2-D aerofoil in these unsteady conditions because they behave unpredictably at the trailing edge when subjected to a different angle of attack. The shear area observed in the boundary layer at the trailing edge tends towards an unsteady turbulent flow even at small angles of attack, creating drag as the flow separates, reducing the aerodynamic performance of aerofoil. In this paper, research was conducted to determine the effect of Kutta circulation over the aerofoil and the effect of that circulation in reducing the effect of pressure and boundary layer distribution over the aerofoil. The effect of circulation is observed by using Ansys Fluent by using varying flow parameters and differential schemes to observe the flow behaviour on the aerofoil. Initially, steady flow analysis was conducted on the aerofoil to determine the effect of circulation, and it was noticed that the effect of circulation could only be properly observed when the aerofoil is subjected to oscillations. Therefore, that was modelled by using Ansys user-defined functions, which define the motion of the aerofoil by creating a dynamic mesh on the aerofoil. Initial results were observed, and further development of the dynamic mesh functions in Ansys is taking place. This research will determine the overall basic principles of unsteady flow aerodynamics applied to the investigation of Kutta related circulation, and gives an indication regarding the generation of vortices which is discussed further in this paper.

Keywords: circulation, flow seperation, turbulence modelling, vortices

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Authors: Dawood Al Chanti, Alice Caplier

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Sparse representations of signals have received a great deal of attention in recent years. In this paper, the interest of using sparse representation as a mean for performing sparse discriminative analysis between spontaneous facial expressions is demonstrated. An automatic facial expressions recognition system is presented. It uses a KSVD-SVM approach which is made of three main stages: A pre-processing and feature extraction stage, which solves the problem of shared subspace distribution based on the random projection theory, to obtain low dimensional discriminative and reconstructive features; A dictionary learning and sparse coding stage, which uses the KSVD model to learn discriminative under or over dictionaries for sparse coding; Finally a classification stage, which uses a SVM classifier for facial expressions recognition. Our main concern is to be able to recognize non-basic affective states and non-acted expressions. Extensive experiments on the JAFFE static acted facial expressions database but also on the DynEmo dynamic spontaneous facial expressions database exhibit very good recognition rates.

Keywords: dictionary learning, random projection, pose and spontaneous facial expression, sparse representation

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

Procedia PDF Downloads 126

Authors: Smrity Dwivedi

Abstract:

The present paper has revealed the effect of double substrates over a bandwidth performance for planar antennas. The used material has its own importance to get minimum return loss and improved directivity. The author has taken double substrates to enhance the efficiency in terms of gain of antenna. Metamaterial based antenna has its own specific structure which increased the performance of antenna. Improved return loss is -20 dB, and the voltage standing wave ratio (VSWR) is 1.2, which is better than single substrate having return loss of -15 dB and VSWR of 1.4. Complete results are obtained using commercial software CST microwave studio.

Keywords: CST microwave studio, metamaterial, return loss, VSWR

Procedia PDF Downloads 366

Authors: K. Touafek, A. Khelifa, I. Tabet, H. Haloui, H. Bencheikh El Houcine, M. Adouane

Abstract:

Hybrid photovoltaic thermal (PVT) collectors allow simultaneous production of electrical energy thus heat energy. There are several configurations of hybrid collectors (to produce water or air). For hybrids water collectors, there are several configurations that differ by the nature of the absorber (serpentine, tubes...). In this paper, an absorber tank is studied. The circulation of the coolant is natural (we do not use the pump). We present the obtained results in our experimental study and we analyzed the data, and then we compare the results with the theory practices. The electrical performances of the hybrid collector are compared with those of conventional photovoltaic module mounted on the same structure and measured under the same conditions. We conducted experiments with natural circulation of the coolant (Thermosyphon), for a flow rate of 0.025kg/m².

Keywords: experimental, photovoltaic, solar, temperature, tank

Procedia PDF Downloads 294

Authors: Sunghyoun Lee, Byeongkee Yu, Chanjung Lee, Yeongtaek Lim

Abstract:

Oyster mushrooms are one of the ingredients that Koreans prefer. The oyster mushroom cultivation house has multiple layers in order to increase the mushroom production per unit area. However, the growing shelves in the house act as obstacles and hinder the circulation of the interior air, which leads to the difference of cultivation environment between the upper part and lower part of the growing shelves. Due to this difference of environments, growth distinction occurs according to the area of the growing shelves. It is known that minute air circulation around the mushroom cap facilitates the metabolism of mushrooms and improves its quality. This study has utilized the computational fluid dynamics (CFD) program, that is, FLUENT R16, in order to analyze the improvement of the internal environment uniformity of the oyster mushroom cultivation house. The analyzed factors are velocity distribution, temperature distribution, and humidity distribution. In order to maintain the internal environment uniformity of the oyster mushroom cultivation house, it appeared that installing circulation fan at the upper part of the working passage towards the ceiling is effective. When all the environmental control equipment – unit cooler, inlet fan, outlet fan, air circulation fan, and humidifier - operated simultaneously, the RMS figure on the growing shelves appeared as follows: velocity 28.23%, temperature 30.47%, humidity 7.88%. However, when only unit cooler and air circulation fan operated, the RMS figure on the growing shelves appeared as follows: velocity 22.28%, temperature 0.87%, humidity 0.82%. Therefore, in order to maintain the internal environment uniformity of the mushroom cultivation house, reducing the overall operating time of inlet fan, outlet fan, and humidifier is needed, and managing the internal environment with unit cooler and air circulation fan appropriately is essential.

Keywords: air circulation fan, computational fluid dynamics, multi-layered shelves cultivation, oyster mushroom cultivation house

Procedia PDF Downloads 169

Authors: Yogi Sirodz Gaos, Irvan Wiradinata

Abstract:

In the 500 kW Organic Rankine Cycle (ORC) power plant in Indonesia, an AFT (according to the Tubular Exchanger Manufacturers Association – TEMA) type shell and tube heat exchanger device is used as a pre-heating system for the ORC’s hot water circulation system. The pre-heating source is a waste heat recovery of the brine water, which is tapped from a geothermal power plant. The brine water itself has 5 MWₜₕ capacities, with average temperature of 170ᵒC, and 7 barg working pressure. The aim of this research is to examine the performance of the heat exchanger in the ORC system in a 500 kW ORC power plant. The data for this research were collected during the commissioning on the middle of December 2016. During the commissioning, the inlet temperature and working pressure of the brine water to the shell and tube type heat exchanger was 149ᵒC, and 4.4 barg respectively. Furthermore, the ΔT for the hot water circulation of the ORC system to the heat exchanger was 27ᵒC, with the inlet temperature of 140ᵒC. The pressure in the hot circulation system was dropped slightly from 7.4ᵒC to 7.1ᵒC. The flow rate of the hot water circulation was 80.5 m³/h. The presentation and discussion of a case study on the performance of the heat exchanger on the 500 kW ORC system is presented as follows: (1) the heat exchange duty is 2,572 kW; (2) log mean temperature of the heat exchanger is 13.2ᵒC; (3) the actual overall thermal conductivity is 1,020.6 W/m².K (4) the required overall thermal conductivity is 316.76 W/m².K; and (5) the over design for this heat exchange performance is 222.2%. An analysis of the heat exchanger detailed engineering design (DED) is briefly discussed. To sum up, this research concludes that the shell and tube heat exchangers technology demonstrated a good performance as pre-heating system for the ORC’s hot water circulation system. Further research need to be conducted to examine the performance of heat exchanger system on the ORC’s hot water circulation system.

Keywords: shell and tube, heat exchanger, organic Rankine cycle, performance, commissioning

Procedia PDF Downloads 118

Authors: Liang Wang, Beste F. Yuksel, David Guy Brizan

Abstract:

A computational model of affect that can distinguish between spontaneous and posed smiles with no errors on a large, popular data set using deep learning techniques is presented in this paper. A Long Short-Term Memory (LSTM) classifier, a type of Recurrent Neural Network, is utilized and compared to human classification. Results showed that while human classification (mean of 0.7133) was above chance, the LSTM model was more accurate than human classification and other comparable state-of-the-art systems. Additionally, a high accuracy rate was maintained with small amounts of training videos (70 instances). The derivation of important features to further understand the success of our computational model were analyzed, and it was inferred that thousands of pairs of points within the eyes and mouth are important throughout all time segments in a smile. This suggests that distinguishing between a posed and spontaneous smile is a complex task, one which may account for the difficulty and lower accuracy of human classification compared to machine learning models.

Keywords: affective computing, affect detection, computer vision, deep learning, human-computer interaction, machine learning, posed smile detection, spontaneous smile detection

Procedia PDF Downloads 99

Authors: Hyun Kyu Lee, Won Zin Oh, June Hyun Kim, Jin Hee Kim, Sang June Choi, Hak Soo Kim

Abstract:

The oxidative dissolution of chromium oxide by manganese oxides including permanganate have been widely studied not only for the chemical decontamination of nuclear power plant, but also for the environmental control of the toxic chromate caused by naturally occurring manganese dioxide. However, little attention has been made for the spontaneous reductive decomposition of permanganate in the water, which is a competing reaction with the oxidation of the chromium oxide by permanganate. The objective of this study is to investigate the spontaneous reductive decomposition behavior of permanganate in the water, depending on the variation of acidity, temperature and concentration. Results of the experiments showed that the permanganate reductive decomposition product is manganese dioxide, and this reaction accompanies with the same molar amount of hydrogen ion consumption. Therefore, at the neutral condition (ex. potassium permanganate solution without acidic chemicals), the permanganate do not reduce by itself at any condition of temperature, concentration within the experimental range. From the results, we confirmed that the oxidation reaction for the permanganate reduction is the water oxidation that is accompanying the oxygen evolution. The experimental results on the reductive decomposition behavior of permanganate in the water also showed that the degree and rate of permanganate reduction increases with the temperature, acidity and concentration. The spontaneous decomposition of the permanganates obtained in the studies would become a good reference to select the operational condition, such as temperature, acidity and concentration, for the chemical decontamination of nuclear power plants.

Keywords: permanganate reduction, spontaneous decomposition, water oxidation, acidity, temperature, permanganate concentration, chemical decontamination, nuclear power plant

Procedia PDF Downloads 314

Authors: A. N. Dagang, E. I. Ismail, Z. Zakaria

Abstract:

This paper presents the analysis on the performance of monopole antenna with fluorescent tubes. In this research, the simulation and experimental approach is conducted. The fluorescent tube with different length and size is designed using Computer Simulation Technology (CST) software and the characteristics of antenna parameter are simulated throughout the software. CST was used to simulate antenna parameters such as return loss, resonant frequency, gain and directivity. Vector Network Analyzer (VNA) was used to measure the return loss of plasma antenna in order to validate the simulation results. In the simulation and experiment, the supply frequency is set starting from 1 GHz to 10 GHz. The results show that the return loss of plasma antenna changes when size of fluorescent tubes is varied, correspond to the different plasma properties. It shows that different values of plasma properties such as plasma frequency and collision frequency gives difference result of return loss, gain and directivity. For the gain, the values range from 2.14 dB to 2.36 dB. The return loss of plasma antenna offers higher value range from -22.187 dB to -32.903 dB. The higher the values of plasma frequency and collision frequency, the higher return loss can be obtained. The values obtained are comparative to the conventional type of metal antenna.

Keywords: plasma antenna, fluorescent tube, CST, plasma parameters

Procedia PDF Downloads 358