Does video feedback analysis improve CPR performance in phase 5 medical students?

Background The use of simulation in medical education is increasing, with students taught and assessed using simulated patients and manikins. Medical students at Queen’s University of Belfast are taught advanced life support cardiopulmonary resuscitation as part of the undergraduate curriculum. Teaching and feedback in these skills have been developed in Queen’s University with high-fidelity manikins. This study aimed to evaluate the effectiveness of video compared to verbal feedback in assessment of student cardiopulmonary resuscitation performance Methods Final year students participated in this study using a high-fidelity manikin, in the Clinical Skills Centre, Queen’s University Belfast. Cohort A received verbal feedback only on their performance and cohort B received video feedback only. Video analysis using ‘StudioCode’ software was distributed to students. Each group returned for a second scenario and evaluation 4 weeks later. An assessment tool was created for performance assessment, which included individual skill and global score evaluation. Results One hundred thirty eight final year medical students completed the study. 62 % were female and the mean age was 23.9 years. Students having video feedback had significantly greater improvement in overall scores compared to those receiving verbal feedback (p = 0.006, 95 % CI: 2.8–15.8). Individual skills, including ventilation quality and global score were significantly better with video feedback (p = 0.002 and p < 0.001, respectively) when compared with cohort A. There was a positive change in overall score for cohort B from session one to session two (p < 0.001, 95 % CI: 6.3–15.8) indicating video feedback significantly benefited skill retention. In addition, using video feedback showed a significant improvement in the global score (p < 0.001, 95 % CI: 3.3–7.2) and drug administration timing (p = 0.004, 95 % CI: 0.7–3.8) of cohort B participants, from session one to session two. Conclusions There is increased use of simulation in medicine but a paucity of published data comparing feedback methods in cardiopulmonary resuscitation training. Our study shows the use of video feedback when teaching cardiopulmonary resuscitation is more effective than verbal feedback, and enhances skill retention. This is one of the first studies to demonstrate the benefit of video feedback in cardiopulmonary resuscitation teaching.

TEST-ANALYSIS MODEL CORRELATION AND CALIBRATION OF A MULTI-COMPONENT PLASTIC PART

The goal of this project is to learn the necessary steps to create a finite element model, which can accurately predict the dynamic response of a Kohler Engines Heavy Duty Air Cleaner (HDAC). This air cleaner is composed of three glass reinforced plastic components and two air filters. Several uncertainties arose in the finite element (FE) model due to the HDAC’s component material properties and assembly conditions. To help understand and mitigate these uncertainties, analytical and experimental modal models were created concurrently to perform a model correlation and calibration. Over the course of the project simple and practical methods were found for future FE model creation. Similarly, an experimental method for the optimal acquisition of experimental modal data was arrived upon. After the model correlation and calibration was performed a validation experiment was used to confirm the FE models predictive capabilities.

A NEW DC UPS FOR DC POWER DISTRIBUTION SYSTEM IN DATA CENTER

In recent years, the 380V DC and 48V DC distribution systems have been extensively studied for the latest data centers. It is widely believed that the 380V DC system is a very promising candidate because of its lower cable cost compared to the 48V DC system. However, previous studies have not adequately addressed the low reliability issue with the 380V DC systems due to large amount of series connected batteries. In this thesis, a quantitative comparison for the two systems has been presented in terms of efficiency, reliability and cost. A new multi-port DC UPS with both high voltage output and low voltage output is proposed. When utility ac is available, it delivers power to the load through its high voltage output and charges the battery through its low voltage output. When utility ac is off, it boosts the low battery voltage and delivers power to the load form the battery. Thus, the advantages of both systems are combined and the disadvantages of them are avoided. High efficiency is also achieved as only one converter is working in either situation. Details about the design and analysis of the new UPS are presented. For the main AC-DC part of the new UPS, a novel bridgeless three-level single-stage AC-DC converter is proposed. It eliminates the auxiliary circuit for balancing the capacitor voltages and the two bridge rectifier diodes in previous topology. Zero voltage switching, high power factor, and low component stresses are achieved with this topology. Compared to previous topologies, the proposed converter has a lower cost, higher reliability, and higher efficiency. The steady state operation of the converter is analyzed and a decoupled model is proposed for the converter. For the battery side converter as a part of the new UPS, a ZVS bidirectional DC-DC converter based on self-sustained oscillation control is proposed. Frequency control is used to ensure the ZVS operation of all four switches and phase shift control is employed to regulate the converter output power. Detailed analysis of the steady state operation and design of the converter are presented. Theoretical, simulation, and experimental results are presented to verify the effectiveness of the proposed concepts.

Vibro-acoustic analysis of additively manufactured acoustic metamaterials

In the last decade it emerged the interest in new types of acoustic insulating materials, called acoustic metamaterials. These materials are composed by a host and inclusions and are arranged periodically or non-periodically in sub-wavelength elements called meta-atoms. Their inclusions and internal geometries can be manipulated to tailor the acoustic properties, reducing weight, and increasing at the same time their efficiency. Thanks to the high absorbing characteristics that they can achieve, their usage is of particularly interest as material of the core in sandwich panels of aerospace structures to reduce vibrations and noise inside passengers aircraft’s cabin. In addition, since the low frequency signals are difficult to be damped with conventional materials, their usage can guarantee a high transmission loss at low frequencies, obtaining a positive benefit on passengers’ comfort. The performances and efficiency of these materials are enhanced thanks to the new additive manufacturing techniques opposed to the conventional ones uncapable to pro- duce such complex internal geometries. The aim of this work is to study, produce and redesign micro-perforated sandwich panels of a literature case study to achieve high performances in the low frequency range, e.g., below 2000 Hz. Some geometrical parameters, such as perforation ratio and diameter of holes, were considered to realize different models and see the differences in the sound transmission loss. The models were produced by means of Fused Deposition Modelling using an Acrylonitrile Butadiene Styrene (ABS Plus p430) material on a commercial additive manufacturing system. Finally, the frequency response analysis was carried out with Mul2 software, based on the Carrera’s Unified Formulation (CUF) to understand the acoustic and structural properties of the material employed, analyzing the plates’ displacements and the TL results.

Analisi vibroacustica di un sistema di scarico per monoposto Formula SAE

Lo scopo del presente lavoro è quello di determinare una metodologia di analisi vibroacustica di validità generale applicabile a tutti i casi nei quali la forzante sia di tipo vibrazionale. Nello specifico si è analizzato il comportamento strutturale e acustico di un impianto di scarico di una monoposto Formula SAE. Ricorrendo all’analisi FEM (Finite Element Method) è possibile determinare e quantificare gli effetti dannosi causati dalle vibrazioni già nella fase di prototipazione permettendo una sostanziale riduzione dei tempi e costi. La determinazione del comportamento strutturale del modello alle vibrazioni è iniziata dall’analisi modale, grazie alla quale sono state determinate le frequenze naturali e i modi propri dell’impianto di scarico. Successivamente, l’analisi FRF (Frequency Response Function) ha permesso di conoscere la risposta del nostro sistema ad una forzante imposta mettendo in luce le diverse criticità strutturali. Con il presupposto di ottenere delle condizioni di carico che fossero il più vicine possibili alle normali condizioni operative si è impostata un’analisi PSD (Power Spectral Density). Per concludere la prima parte dell’analisi si è reso necessario indagare anche il comportamento a fatica vibrazionale, valutando in questo modo le zone soggette a vita finita e quindi le prime a cedere in fase di esercizio. La parte finale è stata dedicata all’analisi del rumore. Dall’analisi FRF si è determinata la SPL (Sound Pressure Level) ottenendo come output un valore di pressione sonora prodotto dall’effetto della propagazione delle onde di pressione generate dalla vibrazione strutturale dell’impianto di scarico. Infine, l’analisi di Transmission Loss ha permesso di valutare l’efficacia della geometria del silenziatore sulla riduzione del livello acustico generato dal transito dei gas di scarico alle diverse frequenze.

Power Secant Method applied to natural frequency extraction of Timoshenko beam structures

This work deals with an improved plane frame formulation whose exact dynamic stiffness matrix (DSM) presents, uniquely, null determinant for the natural frequencies. In comparison with the classical DSM, the formulation herein presented has some major advantages: local mode shapes are preserved in the formulation so that, for any positive frequency, the DSM will never be ill-conditioned; in the absence of poles, it is possible to employ the secant method in order to have a more computationally efficient eigenvalue extraction procedure. Applying the procedure to the more general case of Timoshenko beams, we introduce a new technique, named ""power deflation"", that makes the secant method suitable for the transcendental nonlinear eigenvalue problems based on the improved DSM. In order to avoid overflow occurrences that can hinder the secant method iterations, limiting frequencies are formulated, with scaling also applied to the eigenvalue problem. Comparisons with results available in the literature demonstrate the strength of the proposed method. Computational efficiency is compared with solutions obtained both by FEM and by the Wittrick-Williams algorithm.

Acoustic Simulation of a Special Switched Reluctance Drive by Means of Field-Circuit Coupling and Multiphysics Simulation

The approach presented in this paper consists of an energy-based field-circuit coupling in combination with multi-physics simulation of the acoustic radiation of electrical machines. The proposed method is applied to a special switched reluctance motor with asymmetric pole geometry to improve the start-up torque. The pole shape has been optimized, subject to low torque ripple, in a previous study. The proposed approach here is used to analyze the impact of the optimization on the overall acoustic behavior. The field-circuit coupling is based on a temporary lumped-parameter model of the magnetic part incorporated into a circuit simulation based on the modified nodal analysis. The harmonic force excitation is calculated by means of stress tensor computation, and it is transformed to a mechanical mesh by mapping techniques. The structural dynamic problem is solved in the frequency domain using a finite-element modal analysis and superposition. The radiation characteristic is obtained from boundary element acoustic simulation. Simulation results of both rotor types are compared, and measurements of the drive are presented.

Plant availability of phosphorus in four superphosphate fertilizers varying in water-insoluble phosphate compounds

There is concern that the use of lower quality phosphate rock can result in elevated amounts of Fe-Al-P water-insoluble compounds in fertilizers and, consequently, low agronomic effectiveness. Therefore, studies were conducted to evaluate the effect of some of these compounds on plant growth. Four commercial superphosphates varying in chemical composition (two single and two triple superphosphates) were selected for the study. Fertilizer impurities were collected as water-insoluble residues by washing each P source with deionized water. A modal analysis, based primarily on elemental chemical analysis and x-ray diffractometry, was used to estimate the chemical composition of each P source. Water-soluble monocalcium phosphate (MCP) and the water-leached fertilizer residues were prepared to give a range of fertilizers in terms of water-soluble phosphorus (WSP) (0-100% of the available P as MCP). The water-leached fractions, MCP, and the mixtures of MCP with water-leached fractions were applied to supply 40 mg available P kg(1) to a thermic Rhodic Kanhapludult with pH values of 5.2 +/- 0.05 (unlimed) and 6.4 +/- 0.08 (limed). Wheat (Triticum aestivum L.) grown in a greenhouse for 101 d served as the test crop. The requirement for WSP was source and pH dependent. At a soil pH of 5.2, the fertilizers required 73 to 95% WSP to reach the maximum dry-matter yield, while they required 60 to 86% WSP at pH 6.4. To reach 90% of the maximum yield, all superphosphate fertilizers required <50% WSP. These results show that it is not always necessary to have high water solubility as required by legislation in many countries.

Risk factors for metabolic bone disease in Crohn's disease patients

Background: The aim was to evaluate the presence of metabolic bone disease (MBD) in patients with Crohn’s disease (CD) and to identify potential etiologic factors. Methods: The case–control study included 99 patients with CD and 56 controls with a similar age and gender distribution. Both groups had dual-energy x-ray absorptionmetry and a nutritional evaluation. Single nucleotide polymorphisms at the IL1, TNF-a, LTa, and IL-6 genes were analyzed in patients only. Statistical analysis was performed using SPSS software. Results: The prevalence of MBD was significantly higher in patients (P ¼ 0.006). CD patients with osteoporosis were older (P < 0.005), small bowel involvement and surgical resections were more frequent (P < 0.005), they more often exhibited a penetrating or stricturing phenotype (P < 0.05), duration of disease over 15 years (P < 0.005), and body mass index (BMI) under 18.5 kg/m2 (P < 0.01) were more often found. No association was found with steroid use. Patients with a Z-score < 2.0 more frequently had chronic active disease (P < 0.05). With regard to diet, low vitamin K intake was more frequent (P ¼ 0.03) and intake of total, monounsaturated, and polyunsaturated fat was higher in patients with Z-score < 2.0 (P < 0.05). With respect to genetics, carriage of the polymorphic allele for LTa252 A/G was associated with a higher risk of osteoporosis (P ¼ 0.02). Regression analysis showed that age over 40 years, chronic active disease, and previous colonic resections were independently associated with the risk of developing MBD. Conclusions: The prevalence of MBD was significantly higher in CD patients. Besides the usual risk factors, we observed that factors related to chronic active and long-lasting disease increased the risk of MBD.

Estudo numérico e experimental sobre o comportamento dinâmico de um edifício

Dissertação para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização em Estruturas

Consciencialização dos operadores turísticos para a consulta do viajante

Partindo de uma hipótese que se veio a demonstrar válida, de que os Operadores Turísticos em Portugal têm muito pouca informação sobre a consulta do viajante e o seu papel em responsabilidade na promoção da saúde dos seus clientes, apresenta-se neste trabalho não só uma análise da situação anteriormente referida como uma estratégia de comunicação visando consciencializar os Operadores Turísticos para a necessidade de fomentarem a adesão dos seus clientes à consulta do viajante. Dois temas emergem como centrais, nomeadamente a questão do turismo na nossa contemporaneidade e a saúde dos que viajem essencialmente para fora da Europa em turismo. Transversal a todo o trabalho encontra-se a noção de comunicação e saúde, especialmente na sua vertente de comunicação para a saúde. Defende-se que a comunicação para a saúde pode ser pensada como um fator competitivo para os Operadores Turísticos e apresenta-se uma estratégia de comunicação subordinada ao título: “Projeto de Consciencialização dos Operadores para a Consulta do Viajante”. Na primeira parte apresenta-se uma revisão da literatura e de outras fontes sobre os temas: Turismo, Consulta do Viajante e Comunicação para a Saúde, e na segunda parte o projeto que já referi. Partindo da hipótese inicialmente formulada, para uma análise completa da situação utilizaram-se metodologias de análise qualitativa e quantitativa junto dos principais públicos envolvidos a saber os Operadores Turísticos.

Projeto de fundações e estrutura de colégio em Ponta Delgada utilizando os eurocódigos estruturais

Trabalho de Projeto para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização em Estruturas

Projeto de fundações e estrutura de um hotel em Lisboa

Trabalho de Projeto para obtenção do grau de mestre em Engenharia Civil na Área de Especialização em Estruturas

Projeto de fundações e estrutura de um edifício em Lisboa

Trabalho de Projeto para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização em Estruturas

Chagas disease: What is known and what should be improved: a systemic review

This study consists of a broad review on what is known and what should be improved regarding knowledge of Chagas disease, not only through analysis on the main studies published on the topics discussed, but to a large extent based on experience of this subject, acquired over the past 50 years (1961-2011). Among the subjects covered, we highlight the pathogenesis and evolution of infection by Trypanosoma cruzi, drugs in use and new strategies for treating Chagas disease; the serological tests for the diagnosis and the controls of cure the infection; the regional variations in prevalence, morbidity and response to treatment of the disease; the importance of metacyclogenesis of T. cruzi in different species of triatomines and its capacity to transmit Chagas infection; the risks of adaptation of wild triatomines to human dwellings; the morbidity and need for a surveillance and control program for Chagas disease in the Amazon region and the need to prioritize initiatives for controlling Chagas disease in Latin America and Mexico and in non-endemic countries, which is today a major international dilemma. Finally, we raise the need for to create a new initiative for controlling Chagas disease in the Gran Chaco, which involves parts of Argentina, Bolivia and Paraguay.