Search results for: virtual fracture clinic

Authors: Mohammad Hadi Khorashadi Zadeh

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Many new applications and internet services have been emerged since the innovation of mobile networks and devices. However, these applications have problems of security, management, and performance in business environments. Cloud systems provide information transfer, management facilities, and security for virtual environments. Therefore, an innovative internet service and a business model are proposed in the present study for creating a secure and consolidated environment for managing the mobile information of organizations based on cloud virtual phones (CVP) infrastructures. Using this method, users can run Android and web applications in the cloud which enhance performance by connecting to other CVP users and increases privacy. It is possible to combine the CVP with distributed protocols and central control which mimics the behavior of human societies. This mix helps in dealing with sensitive data in mobile devices and facilitates data management with less application overhead.

Keywords: BYOD, mobile cloud computing, mobile security, information management

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Authors: Rajendra Kumar Kanojia

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Background; Massive bone gaps are common following road side accidents and injury to the tibia, specially open grade three fractures. It has been seen that the diaphyseal fractures in the tibia are prone to non-union, there are certain reasons known very well, like less soft tissues around the lower third tibia, less vascularity, less options of fixation of the fractures after trauma and prolonged surgical time, operation theatre time and special surgical means. Aim of study; To know the suitability of the ilizarov ring fixators in staged treatment of the fracture of the both bones leg, including tibia, we wish to see the role of ilizarov in management of open grade three fractures which have been operated and debrided, for getting the length use of ilizaorv ring in a tertiary canter is the aim of the study.

Keywords: open fracture, staged management, ilizarov, bone grafting, lengthening

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Authors: Kenichiro Hida, Shin-Ichi Kuribayashi

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NFV-based network implements a variety of network functions with software on general-purpose servers, and this allows the network operator to select any capabilities and locations of network functions without any physical constraints. In this paper, we evaluate the influence of the maximum tolerable network delay on the virtual routing function deployment guidelines which the authors proposed previously. Our evaluation results have revealed the following: (1) the more the maximum tolerable network delay condition becomes severe, the more the number of areas where the route selection function is installed increases and the total network cost increases, (2) the higher the routing function cost relative to the circuit bandwidth cost, the increase ratio of total network cost becomes larger according to the maximum tolerable network delay condition.

Keywords: NFV (Network Functions Virtualization), resource allocation, virtual routing function, minimum total network cost

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Authors: Hanan A. Abdulhameed, Huda Y. Alyami

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The study presents a new international direction to conduct collaborative educational research. It follows a qualitative and quantitative methodology in investigating the main requirements to build an e-platform for Virtual Research Teams (VRTs). The e-platform considers three main components: First, the human and cultural structure, second, the institutional/organizational structure, and third, the technological structure. The study mainly focuses on the third component, the technological structure (the e-platform), and studies how to incorporate the other components: The human/cultural structure and the institutional/organizational structure in order to build an effective e-platform. The importance of the study is that it presents a comprehensive study about VRTs in terms of definition, types, structure, and main challenges. In addition, it suggests a practical way that benefits from the information and communication technology to conduct collaborative educational research by building and managing virtual research teams through an effective e-platform. The study draws the main framework to build an e-platform for collaborative educational research teams in Arab World. Thus, it tackles mainly the theoretical aspects, the framework of an effective e-platform. Then, it presents the evaluation of 18 Arab educational experts' to the proposed e-platform.

Keywords: collaborative research, educational science, E-platform, social research networks sites (SRNS), virtual research teams (VRTs)

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Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

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Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

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Authors: Adedeji W. Oyediran, Yekini N. Asafe

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Mechatronics is synergistic integration of mechanical engineering, with electronics and intelligent computer control in the design and manufacturing of industrial products and processes. Automobile (auto car, motor car or car is a wheeled motor vehicle used for transporting passengers, which also carries its own engine or motor) is a mechatronic system which served as major means of transportation around the world. Virtually all community has a need for automobile. This makes automobile issues as related to diagnostic and repair interesting to all communities. Consequent to the diversification of skill in diagnosing automobile faults and approaches in solving some problems and innovation in automobile industry. It is appropriate to say that repair and diagnostic of automobile will be better enhanced if community has opportunity of sharing knowledge and idea globally. This paper discussed the desirable elements in automobile as mechatronics system and present conceptual framework of virtual community model for automobile users.

Keywords: automobile, automobile users, knowledge sharing, mechatronics system, virtual community

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Authors: Daniel Azizyan, Marina Vardanyan, Astghik Dallakyan

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The objective of this literature review is to bring valuable and much-needed insight into Virtual Reality Exposure Therapy (VRET) for the treatment of Post-Traumatic Stress Disorder (PTSD) among military personnel. As the issues regarding war veterans who suffer from PTSD become more and more widespread, the task of finding possible solutions that would provide alternative approaches to existing methods being used today becomes more relevant than ever. By analyzing the previous applications of VRET, this literature review covers the state of the research done currently on the topic, reviews the known information while identifying the main problems, and aims to use missed opportunities and find potential solutions. It provides the answers to the most relevant questions concerning VRET and leads to important conclusions in the hope of making the technology more practical, widespread, and effective.

Keywords: military PTSD, post-traumatic stress disorder, prolonged exposure, virtual reality exposure therapy, VRE

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Authors: E. Olmos-Raya, A. Cascales Martínez, N. Minto de Sousa, M. Alcañiz Raya

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The late detection and subjectivity of the assessment of Autism Spectrum Disorder (ASD) imposed a difficulty for the children’s clinical and familiar environment. The results showed in this paper, are part of a research project about the assessment and training of social skills in children with ASD, whose overall goal is the use of virtual environments together with physiological measures in order to find a new model of objective ASD assessment based on implicit brain processes measures. In particular, this work tries to contribute by studying the differences and changes in the Skin Conductance Response (SCR) and Eye Tracking (ET) between a typical development group (TD group) and an ASD group (ASD group) after several combined stimuli using a low cost Immersive Virtual Environment (IVE). Subjects were exposed to a virtual environment that showed natural scenes that stimulated visual, auditory and olfactory perceptual system. By exposing them to the IVE, subjects showed natural behaviors while measuring SCR and ET. This study compared measures of subjects diagnosed with ASD (N = 18) with a control group of subjects with typical development (N=10) when exposed to three different conditions: only visual (V), visual and auditory (VA) and visual, auditory and olfactory (VAO) stimulation. Correlations between SCR and ET measures were also correlated with the Autism Diagnostic Observation Schedule (ADOS) test. SCR measures showed significant differences among the experimental condition between groups. The ASD group presented higher level of SCR while we did not find significant differences between groups regarding DF. We found high significant correlations among all the experimental conditions in SCR measures and the subscale of ADOS test of imagination and symbolic thinking. Regarding the correlation between ET measures and ADOS test, the results showed significant relationship between VA condition and communication scores.

Keywords: autism, electrodermal activity, eye tracking, immersive virtual environment, virtual reality

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Authors: Noawanit Songkram

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This paper is a report on the findings of a study conducted on e–learning system in virtual learning environment to develop problem solving ability and team learning for learners in higher education. The methodology of this study was R&D research. The subjects were 18 undergraduate students in Faculty of Education, Chulalongkorn University in the academic year of 2013. The research instruments were a problem solving ability assessment, a team learning evaluation form, and an attitude questionnaire. The data was statistically analyzed using mean, standard deviation, one way repeated measure ANOVA and t–test. The research findings discovered the e –learning system in virtual learning environment to develop problem solving ability and team learning for learners in higher education consisted of five components:(1) online collaborative tools, (2) active learning activities, (3) creative thinking, (4) knowledge sharing process, (5) evaluation and nine processes which were (1) preparing in group working, (2) identifying interested topic, (3) analysing interested topic, (4) collecting data, (5) concluding idea (6) proposing idea, (7) creating workings, (8) workings evaluation, (9) sharing knowledge from empirical experience.

Keywords: e-learning system, problem solving ability, team leaning, virtual learning environment

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Authors: Aboozar Aghaei

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In the present work, the dissimilar Monel400 and SS316 were joined by friction stir welding (FSW). The applied rotating speed was 400 rpm, whereas the traverse speed varied between 50 and 150 mm/min. At a constant rotating speed, the sound welds were obtained at the welding speeds of 50 and 100 mm/min. However, a groove-like defect was formed when the welding speed exceeded 100 mm/min. The mechanical properties of the joints were evaluated using tensile and fatigue tests. The fatigue strength of dissimilar FSWed specimen was higher than that of both Monel400 and SS316. To study the failure behavior of FSWed specimens, the fracture surfaces were analyzed using scanning electron microscope (SEM). The failure analysis indicates that different mechanisms may contribute to the fracture of welds. This was attributed to the dissimilar characteristics of dissimilar materials exhibiting different failure behaviors.

Keywords: mechanical properties, stainless steel, frictions, monel

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Mohammad Arshad Ikram

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We report three cases of challenging fractures in children treated by intramedullary fixation using the Metaizeau method and achieved anatomical reduction with excellent clinical results. Jean-Paul Metaizeau described the centromedullary fixation for the radial neck in 1980 using K-wires Radial neck fractures are uncommon in children. Treatment of severely displaced fractures is always challenging. Closed reduction techniques are more popular as compared to open reduction due to the low risk of complications. Metaizeau technique of closed reduction with centromedullary pinning is a commonly preferred method of treatment. We present two cases with a severely displaced radial neck fracture, treated by this method and achieved sound union; anatomical position of the radial head and full function were observed two months after surgery. Proximal humerus fractures are another uncommon injury in children accounting for less than 5% of all pediatric fractures. Most of these injuries occur through the growth plate because of its relative weakness. Salter-Harris type I is commonly seen in the younger age group, whereas type II & III occurs in older children and adolescents. In contrast to adults, traumatic glenohumeral dislocation is an infrequently observed condition among children. A combination of proximal humerus fracture and glenohumeral dislocation is extremely rare and occurs in less than 2% of the pediatric population. The management of this injury is always challenging. Treatment ranged from closed reduction with and without internal fixation and open reduction with internal fixation. The children who had closed reduction with centromedullary fixation by the Metaizeau method showed excellent results with the return of full movements at the shoulder in a short time without any complication. We present the case of a child with anterior dislocation of the shoulder associated with a complete displaced proximal humerus metaphyseal fracture. The fracture was managed by closed reduction and then fixation by two centromedullary K-wires using the Metaizeau method, achieving the anatomical reduction of the fracture and dislocation. This method of treatment enables us to achieve excellent radiological and clinical results in a short time.

Keywords: glenohumeral, Metaizeau method, pediatric fractures, radial neck

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Authors: Salsabeel F. M. Alfalah, Jannat F. Falah, Nadia Muhaidat, Amjad Hudaib, Diana Koshebye, Sawsan AlHourani

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Educational technology is changing the way how students engage and interact with learning materials. This improved the learning process amongst various subjects. Virtual Reality (VR) applications are considered one of the evolving methods that have contributed to enhancing medical education. This paper utilizes VR to provide a solution to improve the delivery of the subject of Embryology to medical students, and facilitate the teaching process by providing a useful aid to lecturers, whilst proving the effectiveness of this new technology in this particular area. After evaluating the current teaching methods and identifying students ‘needs, a VR system was designed that demonstrates in an interactive fashion the development of the human embryo from fertilization to week ten of intrauterine development. This system aims to overcome some of the problems faced by the students’ in the current educational methods, and to increase the efficacy of the learning process.

Keywords: virtual reality, student assessment, medical education, 3D, embryology

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Authors: Hsiu-Hua Cheng, Chi-Wei Chen

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Lurking behaviour is common in information-seeking oriented communities. Transferring users with lurking behaviour to be contributors can assist virtual communities to obtain competitive advantages. Based on the ecological cognition framework, this study proposes a model to examine the antecedents of lurking behaviour in information-seeking oriented virtual communities. This study argues desire for emotional support, desire for information support, desire for performance-approach, desire for performance -avoidance, desire for mastery-approach, desire for mastery-avoidance, desire for ability trust, desire for benevolence trust, and desire for integrity trust effect on lurking behaviour. This study offers an approach to understanding the determinants of lurking behaviour in online contexts.

Keywords: lurking behaviour, the ecological cognition framework, Information-seeking oriented virtual communities, desire

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Authors: Grandmother Roberta Oshkawbewisens, Elder Isabelle Meawasige, Lynne Groulx, Chloë Hamilton, Lee Allison Clark, Dana Hickey, Wansu Qiu, Jared Leedham, Nishanthini Mahendran, Cameron Maclaine

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In March of 2020, the world suddenly shifted with the onset of the COVID-19 pandemic; in-person programs and services were unavailable and a scramble to shift to virtual service delivery began. The Native Women’s Association of Canada (NWAC) established virtual programming through the Resiliency Lodge model and connected with Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people across Turtle Island and Inuit Nunangat through programs that provide a safe space to slow down and reflect on their lives, environment, and well-being. To continue to grow the virtual Resiliency Lodge model, NWAC needed to develop an understanding of three questions: how COVID-19 affects Elder-led support services, how Elder-led support services have adapted during the pandemic, and what Wise Practices need to be implemented to continue to develop, refine, and evaluate virtual Elder-led support services specifically for Indigenous women, girls, two-Spirit, transgender, and gender-diverse people. Through funding from the Canadian Institute of Health Research (CIHR), NWAC gained deeper insight into these questions and developed a series of key findings and recommendations that are outlined throughout this report. The goals of this project are to contribute to a more robust participatory analysis that reflects the complexities of Elder-led virtual cultural responses and the impacts of COVID-19 on Elder-led support services; develop culturally and contextually meaningful virtual protocols and wise practices for virtual Indigenous-led support; and develop an Evaluation Strategy to improve the capacity of the Resiliency Lodge model. Significant findings from the project include Resiliency Lodge programs, especially crafting and business sessions, have provided participants with a sense of community and contributed to healing and wellness; Elder-led support services need greater and more stable funding to offer more workshops to more Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people; and Elder- and Indigenous-led programs play a significant role in healing and building a sense of purpose and belonging among Indigenous people. Ultimately, the findings and recommendations outlined in this research project help to guide future Elder-led virtual support services and emphasize the critical need to increase access to Elder-led programming for Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people.

Keywords: indigenous women, traditional healing, virtual programs, covid-19

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Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

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Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: myofascial, quality Improvement, PDSA, TMD

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Authors: John Paul Q. Tomas, Mark Wilson L. de los Reyes, Kirsten Joyce P. Vasquez

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The most frequent type of fracture is a wrist fracture, which often makes it difficult for medical professionals to find and locate. In this study, fractures in wrist x-ray pictures were located and identified using deep learning and computer vision. The researchers used image filtering, masking, morphological operations, and data augmentation for the image preprocessing and trained the RetinaNet and Faster R-CNN models with ResNet50 backbones and Adam optimizers separately for each image filtering technique and projection. The RetinaNet model with Anisotropic Diffusion Smoothing filter trained with 50 epochs has obtained the greatest accuracy of 99.14%, precision of 100%, sensitivity/recall of 98.41%, specificity of 100%, and an IoU score of 56.44% for the Posteroanterior projection utilizing augmented data. For the Lateral projection using augmented data, the RetinaNet model with an Anisotropic Diffusion filter trained with 50 epochs has produced the highest accuracy of 98.40%, precision of 98.36%, sensitivity/recall of 98.36%, specificity of 98.43%, and an IoU score of 58.69%. When comparing the test results of the different individual projections, models, and image filtering techniques, the Anisotropic Diffusion filter trained with 50 epochs has produced the best classification and regression scores for both projections.

Keywords: Artificial Intelligence, Computer Vision, Wrist Fracture, Deep Learning

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Authors: Okunola Oluseye Ademola

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The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

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Authors: B. L. Avanthi Isaka, P. G. Ranjith

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The development of technically-sound enhanced geothermal systems (EGSs) is identified as a viable solution for world growing energy demand with immense potential, low carbon dioxide emission and importantly, as an environmentally friendly option for renewable energy production. The use of supercritical carbon dioxide (ScCO₂) as the working fluid in EGSs by replacing traditional water-based method is promising due to multiple advantages prevail in ScCO₂-injection for underground reservoir stimulation. The evolution of reservoir stimulation using ScCO₂ and the understanding of the flow behavior of a ScCO₂-stimulated geothermal reservoir is vital in applying ScCO₂-EGSs as a replacement for water-based EGSs. The study is therefore aimed to investigate the flow behavior of a ScCO₂-fractured rock medium at in-situ stress and temperature conditions. A series of permeability tests were conducted for ScCO₂ fractured Harcourt granite rock specimens at 90ºC, under varying confining pressures from 5–60 MPa using the high-pressure and high-temperature tri-axial set up which can simulate deep geological conditions. The permeability of the ScCO₂-fractured rock specimens was compared with that of water-fractured rock specimens. The results show that the permeability of the ScCO₂-fractured rock specimens is one order higher than that of water-fractured rock specimens and the permeability exhibits a non-linear reduction with increasing confining pressure due to the stress-induced fracture closure. Further, the enhanced permeability of the ScCO₂-induced fracture with multiple secondary branches was explained by exploring the CT images of the rock specimens. However, a single plain fracture was induced under water-based fracturing.

Keywords: supercritical carbon dioxide, fracture permeability, granite, enhanced geothermal systems

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Authors: Mohammad Reza Zamani Kouhpanji

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Characterizing the fatigue and fracture properties of nanostructures is one of the most challenging tasks in nanoscience and nanotechnology due to lack of a MEMS/NEMS device for generating uniform cyclic loadings at high frequencies. Here, the dynamic response of a recently proposed MEMS/NEMS device under different inputs signals is completely investigated. This MEMS/NEMS device is designed and modeled based on the electromagnetic force induced between paired parallel wires carrying electrical currents, known as Ampere’s Force Law (AFL). Since this MEMS/NEMS device only uses two paired wires for actuation part and sensing part, it represents highly sensitive and linear response for nanostructures with any stiffness and shapes (single or arrays of nanowires, nanotubes, nanosheets or nanowalls). In addition to studying the maximum gains at different resonance frequencies of the MEMS/NEMS device, its dynamical responses are investigated for different inputs and nanostructure properties to demonstrate the capability, usability, and reliability of the device for wide range of nanostructures. This MEMS/NEMS device can be readily integrated into SEM/TEM instruments to provide real time study of the fatigue and fracture properties of nanostructures as well as their softening or hardening behaviors, and initiation and/or propagation of nanocracks in them.

Keywords: MEMS/NEMS devices, paired wire actuators and sensors, dynamical response, fatigue and fracture characterization, Ampere’s force law

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Authors: N. Lebga, Kh. Bouamama, K. Kassali

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We report first-principles calculation results on the structural and elastic properties of ZnS x Se1−x alloy for which we employed the virtual crystal approximation provided with the ABINIT program. The calculations done using density functional theory within the local density approximation and employing the virtual-crystal approximation, we made a comparative study between the numerical results obtained from ab-initio calculation using ABINIT or Wien2k within the Density Functional Theory framework with either Local Density Approximation or Generalized Gradient approximation and the pseudo-potential plane-wave method with the Hartwigzen Goedecker Hutter scheme potentials. It is found that the lattice parameter, the phase transition pressure, and the elastic constants (and their derivative with respect to the pressure) follow a quadratic law in x. The variation of the elastic constants is also numerically studied and the phase transformations are discussed in relation to the mechanical stability criteria.

Keywords: density functional theory, elastic properties, ZnS, ZnSe,

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Authors: Eugene Y. C. Wong, Daniel Y. W. Mo, Cosmo T. Y. Ng, Jessica K. Y. Chan, Leith K. Y. Chan, Henry Y. K. Lau

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The real-time planning visualisation, precise allocation and loading optimisation in air cargo load planning operations are increasingly important as more considerations are needed on dangerous cargo loading, locations of lithium batteries, weight declaration and limited aircraft capacity. The planning of the unit load devices (ULD) can often be carried out only in a limited number of hours before flight departure. A dynamic air cargo load planning system is proposed with the optimisation of cargo load plan and visualisation of planning results in virtual reality systems. The system aims to optimise the cargo load planning and visualise the simulated loading planning decision on air cargo terminal operations. Adopting simulation tools, Cave Automatic Virtual Environment (CAVE) and virtual reality technologies, the results of planning with reference to weight and balance, Unit Load Device (ULD) dimensions, gateway, cargo nature and aircraft capacity are optimised and presented. The virtual reality system facilities planning, operations, education and training. Staff in terminals are usually trained in a traditional push-approach demonstration with enormous manual paperwork. With the support of newly customized immersive visualization environment, users can master the complex air cargo load planning techniques in a problem based training with the instant result being immersively visualised. The virtual reality system is developed with three-dimensional (3D) projectors, screens, workstations, truss system, 3D glasses, and demonstration platform and software. The content will be focused on the cargo planning and loading operations in an air cargo terminal. The system can assist decision-making process during cargo load planning in the complex operations of air cargo terminal operations. The processes of cargo loading, cargo build-up, security screening, and system monitoring can be further visualised. Scenarios are designed to support and demonstrate the daily operations of the air cargo terminal, including dangerous goods, pets and animals, and some special cargos.

Keywords: air cargo load planning, optimisation, virtual reality, weight and balance, unit load device

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Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles

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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.

Keywords: general surgery, telemedicine, patient satisfaction, patient safety

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Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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Authors: Suleyman Karabal, Timothy L. Burnett, Egemen Avcu, Andrew H. Sherry, Philip J. Withers

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SA508 Grade 3 steel is widely used in the construction of nuclear pressure vessels, where its fracture toughness plays a critical role in ensuring operational safety and reliability. Understanding the ductile failure mechanisms in this steel grade is crucial for designing robust pressure vessels that can withstand severe nuclear environment conditions. In the present study, round bar specimens of SA508 Grade 3 steel with four distinct notch geometries were subjected to tensile loading while capturing continuous 2D images at 5-second intervals in order to monitor any alterations in their geometries to construct true stress-strain curves of the specimens. 3D reconstructions of X-ray computed tomography (CT) images at high-resolution (a spatial resolution of 0.82 μm) allowed for a comprehensive assessment of the influences of second-phase particles (i.e., manganese sulfide inclusions and cementite particles) on ductile failure initiation as a function of applied plastic strain. Additionally, based on 2D and 3D images, plasticity modeling was executed, and the results were compared to experimental data. A specific ‘two-parameter criterion’ was established and calibrated based on the correlation between stress triaxiality and equivalent plastic strain at failure initiation. The proposed criterion demonstrated substantial agreement with the experimental results, thus enhancing our knowledge of ductile fracture behavior in this steel grade. The implementation of X-ray CT and fractography analysis provided new insights into the diverse roles played by different populations of second-phase particles in fracture initiation under varying stress triaxiality conditions.

Keywords: ductile fracture, two-parameter criterion, x-ray computed tomography, stress triaxiality

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Authors: Ali Asgary, Haopeng Zhou, Ghassem Tofighi

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Use of virtual (VR), augmented reality (AR), and extended reality technologies for training and education has increased in recent years as more hardware and software tools have become available and accessible to larger groups of users. Similarly, the applications of these technologies in earthquake related training and education are on the rise. Several studies have reported promising results for the use of VR and AR for evacuation behaviour and training under earthquake situations. They simulate the impacts that earthquake has on buildings, buildings’ contents, and how building occupants and users can find safe spots or open paths to outside. Considering that considerable number of earthquake injuries and fatalities are linked to the behaviour, our goal is to use these technologies to reduce the impacts of building contents on people. Building on our artificial intelligence (AI) based indoor earthquake risk assessment application that enables users to use their mobile device to assess the risks associated with building contents during earthquakes, we develop a virtual reality application to demonstrate the behavior of different building contents during earthquakes, their associate moving, spreading, falling, and collapsing risks, and their risk mitigation methods. We integrate realistic seismic models, building contents behavior with and without risk mitigation measures in virtual reality environment. The application can be used for training of architects, interior design experts, and building users to enhance indoor safety of the buildings that can sustain earthquakes. This paper describes and demonstrates the application development background, structure, components, and usage.

Keywords: virtual reality, earthquake damage, building content, indoor risks, earthquake risk mitigation, interior design, unity game engine, oculus

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Authors: Kulachai Kultawanich, Prakob Koraneekij, Jaitip Na-Songkhla

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The way of learning has been changed into a new paradigm since the improvement of network and communication technology, so learners have to interact with massive amount of the information. Thus, information literacy has become a critical set of abilities required by every college and university in the world. Connectivism is considered to be an alternative way to design information literacy course in online learning environment, such as Virtual Classroom (VC). With the change of learning pedagogy, VC is employed to improve the social capability by integrating cloud-based technology. This paper aims to study the use of Cloud-based Virtual Classroom (CBVC) in Connectivism learning process to enhance information literacy and self-efficacy of twenty-one undergraduate students who registered in an e-publishing course at Chulalongkorn University. The data were gathered during 6 weeks of the study by using the following instruments: (1) Information literacy test (2) Information literacy rubrics (3) Information Literacy Self-Efficacy (ILSE) Scales and (4) Questionnaire. The result indicated that students have information literacy and self-efficacy posttest mean scores higher than pretest mean scores at .05 level of significant after using CBVC in Connectivism learning process. Additionally, the study identified that the Connectivism learning process proved useful for developing information rich environment and a sense of community, and the CBVC proved useful for developing social connection.

Keywords: cloud-based, virtual classroom, connectivism, information literacy

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Authors: Hygreeva Kiran Namburi, Anna Hojna, Edita Lecianova, Fencl Zdenek

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Irradiation Assisted Stress Corrosion Cracking [IASCC] is one of the most significant environmental degradation in the internal components made from Austenitic stainless steel. This mechanism is still not fully understood and there are no suitable criteria for prediction of the damage during operation. In this work, core basket material 08Ch18N10T austenitic stainless steel acquired from decommissioned NPP Nord / Greifswald Unit 1, VVER 440-230 type, operated for 15 years and irradiated at 5.2 dpa is studied. This material was tensile tested at two different test temperatures and strain rates in air and at the elevated temperature under the water environment. SEM observations of the fracture surface documented ductile fracture of the samples tested in air, but areas of IASCC tested in water. This paper emphasizes on the microscopic examination results from the mechanically tested samples to determine the underlying IASCC physical damage process. TEM observations of thin foils made from the gauge sections that are closer to the fractured surface of the specimen aimed to find variances in interaction of dislocations and grain boundaries owing to different test conditions.

Keywords: irradiation assisted stress corrosion cracking, core basket material, SEM observations of the fracture surface, microscopic examination results

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Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

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Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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Authors: Farid Saeidi, Serkan Dag

Abstract:

In this study, fracture analysis of a fibrous composite laminate with variable fiber spacing is carried out using Jk-integral method. The laminate is assumed to be under thermal loading. Jk-integral is formulated by using the constitutive relations of plane orthotropic thermoelasticity. Developed domain independent form of the Jk-integral is then integrated into the general purpose finite element analysis software ANSYS. Numerical results are generated so as to assess the influence of variable fiber spacing on mode I and II stress intensity factors, energy release rate, and T-stress. For verification, some of the results are compared to those obtained using displacement correlation technique (DCT).

Keywords: Jk-integral, Variable Fiber Spacing, Thermoelasticity, T-stress, Finite Element Method, Fibrous Composite.

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