Search results for: robotic surgical instruments
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2107

Search results for: robotic surgical instruments

1717 The Influence of Training on the Special Aerial Gymnastics Instruments on Selected C-Reactive Proteins in Cadets’ Serum

Authors: Z. Wochyński, K. A. Sobiech, Z. Kobos

Abstract:

To C-Reactive Proteins include ferritin, transferrin, and ceruloplasmin- metalloproteins. The study aimed at assessing an effect of training on the Special Aerial Gymnastics Instruments (SAGI) on changes of serum ferritin, transferrin, and ceruloplasmin and cadets’ physical fitness in comparison with a control group. Fifty-five cadets in the mean age 20 years were included into this study. They were divided into two groups: Group A (N=41) trained on SAGI and Group B (N=14) trained according the standard program of physical education (control group). In both groups, blood was a material for assays. Samples were collected twice before and after training at the start of the program (training I), during (training II), and after education program completion (training III). Commercially available kits were used to assay blood serum ferritin, transferrin, and ceruloplasmin. Cadets’ physical fitness was evaluated with exercise tests before and after education program completion. In Group A, serum post-exercise ferritin decreased statistically insignificantly in training I and II and increased in training III in comparison with pre-exercise values. In Group B, post-exercise serum ferritin decreased statistically insignificantly in training I and III and significantly increased in training II in comparison with the pre-exercise values. In Group A, serum transferrin decreased statistically insignificantly in training I, and significantly increased in training II, whereas in training III it increased insignificantly in comparison with pre-exercise values. In Group B, post-exercise serum transferrin increased statistically significantly in training I, II, and III in comparison with pre-exercise values. I n Group A, serum ceruloplasmin decreased in all three series in comparison with pre-exercise values. In Group B, serum ceruloplasmin increased significantly in training II. It was showed that the training on SAGI significantly decreased serum ceruloplasmin in Group A in all three series of assays and did not produce significant changes in serum ferritin also was showed significant increase in serum transferrin.

Keywords: special aerial gymnastics instruments, ferritin, ceruloplasmin, transferrin

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1716 Human Rights Violation in Modern Society

Authors: Shenouda Salib Hosni Rofail

Abstract:

The interface between development and human rights has long been the subject of scholarly debate. As a result, a set of principles ranging from the right to development to a human rights-based approach to development has been adopted to understand the dynamics between the two concepts. Despite these attempts, the exact link between development and human rights is not yet fully understood. However, the inevitable interdependence between the two concepts and the idea that development efforts must be made while respecting human rights have gained prominence in recent years. On the other hand, the emergence of sustainable development as a widely accepted approach to development goals and policies further complicates this unresolved convergence. The place of sustainable development in the human rights discourse and its role in ensuring the sustainability of development programs require systematic research. The aim of this article is, therefore, to examine the relationship between development and human rights, with a particular focus on the place of the principles of sustainable development in international human rights law. It will continue to examine whether it recognizes the right to sustainable development. Thus, the Article states that the principles of sustainable development are recognized directly or implicitly in various human rights instruments, which is an affirmative answer to the question posed above. Accordingly, this document scrutinizes international and regional human rights instruments, as well as the case law and interpretations of human rights bodies, to support this hypothesis.

Keywords: sustainable development, human rights, the right to development, the human rights-based approach to development, environmental rights, economic development, social sustainability human rights protection, human rights violations, workers’ rights, justice, security.

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1715 Premature Menopause among Women in India: Evidence from National Family Health Survey-IV

Authors: Trupti Meher, Harihar Sahoo

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Premature menopause refers to the occurrence of menopause before the age of 40 years. Women who experience premature menopause either due to biological or induced reasons have a longer duration of exposure to severe symptoms and adverse health consequences when compared to those who undergo menopause at a later age, despite the fact that premature menopause has a profound effect on the health of women. This study attempted to determine the prevalence and predictors of premature menopause among women aged 25-39 years, using data from the National Family Health Survey (NFHS-4) conducted during 2015–16 in India. Descriptive statistics and multinomial logistic regression were used to carry out the result. The results revealed that the prevalence of premature menopause in India was 3.7 percent. Out of which, 2.1 percent of women had experienced natural premature menopause, whereas 1.7 percent had premature surgical menopause. The prevalence of premature menopause was highest in the southern region of India. Further, results of the multivariate model indicated that rural women, women with higher parity, early age at childbearing and women with smoking habits were at a greater risk of premature menopause. A sizeable proportion of women in India are attaining menopause prematurely. Unless due attention is given to this matter, it will emerge as a major problem in India in the future. The study also emphasized the need for further research to enhance knowledge on the problems of premature menopausal women in different socio-cultural settings in India.

Keywords: India, natural menopause, premature menopause, surgical menopause

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1714 Systematic and Meta-Analysis of Navigation in Oral and Maxillofacial Trauma and Impact of Machine Learning and AI in Management

Authors: Shohreh Ghasemi

Abstract:

Introduction: Managing oral and maxillofacial trauma is a multifaceted challenge, as it can have life-threatening consequences and significant functional and aesthetic impact. Navigation techniques have been introduced to improve surgical precision to meet this challenge. A machine learning algorithm was also developed to support clinical decision-making regarding treating oral and maxillofacial trauma. Given these advances, this systematic meta-analysis aims to assess the efficacy of navigational techniques in treating oral and maxillofacial trauma and explore the impact of machine learning on their management. Methods: A detailed and comprehensive analysis of studies published between January 2010 and September 2021 was conducted through a systematic meta-analysis. This included performing a thorough search of Web of Science, Embase, and PubMed databases to identify studies evaluating the efficacy of navigational techniques and the impact of machine learning in managing oral and maxillofacial trauma. Studies that did not meet established entry criteria were excluded. In addition, the overall quality of studies included was evaluated using Cochrane risk of bias tool and the Newcastle-Ottawa scale. Results: Total of 12 studies, including 869 patients with oral and maxillofacial trauma, met the inclusion criteria. An analysis of studies revealed that navigation techniques effectively improve surgical accuracy and minimize the risk of complications. Additionally, machine learning algorithms have proven effective in predicting treatment outcomes and identifying patients at high risk for complications. Conclusion: The introduction of navigational technology has great potential to improve surgical precision in oral and maxillofacial trauma treatment. Furthermore, developing machine learning algorithms offers opportunities to improve clinical decision-making and patient outcomes. Still, further studies are necessary to corroborate these results and establish the optimal use of these technologies in managing oral and maxillofacial trauma

Keywords: trauma, machine learning, navigation, maxillofacial, management

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1713 Evaluation of Condyle Alterations after Orthognathic Surgery with a Digital Image Processing Technique

Authors: Livia Eisler, Cristiane C. B. Alves, Cristina L. F. Ortolani, Kurt Faltin Jr.

Abstract:

Purpose: This paper proposes a technically simple diagnosis method among orthodontists and maxillofacial surgeons in order to evaluate discrete bone alterations. The methodology consists of a protocol to optimize the diagnosis and minimize the possibility for orthodontic and ortho-surgical retreatment. Materials and Methods: A protocol of image processing and analysis, through ImageJ software and its plugins, was applied to 20 pairs of lateral cephalometric images obtained from cone beam computerized tomographies, before and 1 year after undergoing orthognathic surgery. The optical density of the images was analyzed in the condylar region to determine possible bone alteration after surgical correction. Results: Image density was shown to be altered in all image pairs, especially regarding the condyle contours. According to measures, condyle had a gender-related density reduction for p=0.05 and condylar contours had their alterations registered in mm. Conclusion: A simple, viable and cost-effective technique can be applied to achieve the more detailed image-based diagnosis, not depending on the human eye and therefore, offering more reliable, quantitative results.

Keywords: bone resorption, computer-assisted image processing, orthodontics, orthognathic surgery

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1712 Investigation of the Influence of Student’s Characteristics on Mathematics Achievement in Junior Secondary School in Ibadan, Nigeria

Authors: Babatunde Kasim Oladele

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This current study investigated students’ characteristics as factors that influence Mathematics Achievement of junior secondary school students. The study adopted a descriptive survey design. The population of the study was one hundred and twenty-three (123) JSS students of secondary schools in Ibadan North Local Government in Oyo State. A Mathematics achievement test and three questionnaires on student’s self-efficacy belief, attitude, and learning style were the instruments used. Prior to the administration of the constructed mathematics achievement test, 100-item mathematics was subjected to the expert review, and items analysis was carried out. Fifty items were retained. The Cronbach Alpha reliability coefficients of the instruments were 0.71, 0.76, and 0.83, respectively. Collected data were analysed using the frequency count, percentages, mean, standard deviation, and Path Analysis in Amos SPSS Version 20. Students characteristics: gender, age, self-efficacy, attitude and learning style had positive direct effects on students’ achievement in Mathematics as indicated by their respective beta weights (β = 0.36, 0.203, 0.92, 0.079, 0.69 p < 0.05). Consequently, the study concluded that student’s characteristics (Age, gender, and learning style) explained a significant part of the variability in students’ achievement in Mathematics.

Keywords: mathematics achievement, students’ characteristics, junior secondary school, Ibadan

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1711 Developing and Validating an Instrument for Measuring Mobile Government Adoption in Saudi Arabia

Authors: Sultan Alotaibi, Dmitri Roussinov

Abstract:

Many governments recently started to change the ways of providing their services by allowing their citizens to access services from anywhere without the need of visiting the location of the service provider. Mobile government (M-government) is one of the techniques that fulfill that goal. It has been adopted by many governments. M-government can be defined as an implementation of Electronic Government (E-Government) by using mobile technology with the aim of improving service delivery to citizens, businesses and all government agencies. There have been several research projects developing models to understand the behavior of individuals towards the adoption of m-government. This paper proposes a model for adoption of m-government services in Saudi Arabia by extending Technology Acceptance Model (TAM) by introducing external factors. This paper also reports on the development of a survey instrument designed to measure user perception of mobile government acceptance. A survey instrument has been developed by using existing scales from prior instruments and a pilot study has been conducted by distributing the survey to 33 participants. As a result, a survey instrument has been refined to retain 43 items. The results also showed that the reliabilities of all the scales in the survey instrument are above the levels acceptable in current academic research, thus the instruments developed by us are capable of analyzing the factors in M-government adoption.

Keywords: TAM, m-government, e-government, model, acceptance, mobile government

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1710 The Orthodontic Management of Multiple Tooth Agenesis with Macroglossia in Adult Patient: Case Report

Authors: Yanuarti Retnaningrum, Cendrawasih A. Farmasyanti, Kuswahyuning

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Orthodontists find challenges in treating patients who have cases of macroglossia and multiple tooth agenesis because difficulties in determining the causes, formulating a diagnosis and the potential for relapse after treatment. Definition of macroglossia is a tongue enlargement due to muscle hypertrophy, tumor or an endocrine disturbance. Macroglossia may cause many problems such as anterior proclination of upper and lower incisors, development of general diastema and anterior and/ or posterior open bite. Treatment for such patients with multiple tooth agenesis and macroglossia can be complex and must consider orthodontic and/or surgical interventions. This article discusses an orthodontic non surgical approach to a patient with a general diastema in both maxilla and mandible associated with multiple tooth agenesis and macroglossia. Fixed orthodontic therapy with straightwire appliance was used for space closure in anterior region of maxilla and mandible, also to create a space suitable for future prosthetic restoration. After 12 months treatment, stable and functional occlusal relationships was achieved, although still have edentulous area in both maxilla and mandible. At the end of the orthodontic treatment was obtained with correct overbite and overjet values. After removal of the brackets, a maxillary and mandibular removable retainer combine with artificial tooth were placed for retention.

Keywords: general diastema, macroglossia, space closure, tooth agenesis

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1709 Strategies For Management Of Massive Intraoperative Airway Haemorrhage Complicating Surgical Pulmonary Embolectomy

Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

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1708 Impact of 99mTc-MDP Bone SPECT/CT Imaging in Failed Back Surgery Syndrome

Authors: Ching-Yuan Chen, Lung-Kwang Pan

Abstract:

Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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1707 The Effect of Teaching Science Strategies Curriculum and Evaluating on Developing the Efficiency of Academic Self in Science and the Teaching Motivation for the Student Teachers of the Primary Years

Authors: Amani M. Al-Hussan

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The current study aimed to explore the effects of science teaching strategies course (CURR422) on developing academic self efficacy and motivation towards teaching it in female primary classroom teachers in College of Education in Princess Nora Bint AbdulRahman University. The study sample consisted (48) female student teachers. To achieve the study aims, the researcher designed two instruments: Academic Self Efficacy Scale & Motivation towards Teaching Science Scale while maintaining the validity and reliability of these instruments.. Several statistical procedures were conducted i.e. Independent Sample T-test, Eta Square, Cohen D effect size. The results reveal that there were statistically significant differences between means of pre and post test for the sample in favor of post test. For academic self efficacy scale, Eta square was 0.99 and the effect size was 27.26. While for the motivation towards teaching science scale, Eta was 0.99 and the effect size was 51.72. These results indicated high effects of independent variable on the dependent variable.

Keywords: academic self efficiency, achievement, motivation, primary classroom teacher, science teaching strategies course, evaluation

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1706 It Is Time to Perform Total Laparoscopic Hysterectomy (TLH) without the Use of Uterine Manipulator: Kamran's TLH

Authors: Ahmed Gendia, Waseem Kamran

Abstract:

Objective: Total Laparoscopic hysterectomy (TLH) remains a common approach among laparoscopic surgeons. However, this approach depends on the use of uterine manipulator to facilitate the surgery. Although many studies reported the effectiveness of TLH with uterine manipulator, only few reported TLH without the use of any uterine or vaginal manipulation. the aim of this report is to demonstrate our Technique (kamran's TLH) in performing TLH without the use of any uterine or vaginal manipulation in benign conditions and report our intra- and post-operative outcomes. Methodology : surgical technique will be demonstrated through a short video highlighting the easy and safe to learn surgical steps. Additionally, the data of 86 patients who underwent KTLH for benign condition were retrospectively analyzed. the data included intra- and postoperative finding and complications. Results : A total of 86 hysterectomies were performed utilizing the Kamran's TLH ( KTHL). Mean age was 52.2 (±11) years old and BMI was 28.2(±7). Mean operative time was 64.7(±27.9) minutes and estimated bloods loss was 46.2(±54.6) ml. No intraoperative complications were recorded and there was no conversion to open surgery. Only one patient required readmission and surgery for vaginal vault dehiscence. Conclusion & Significance: Uterine manipulator is a key component in performing laparoscopic hysterectomy. However, our approach demonstrated that TLH can be safely performed without the use of any uterine or vaginal manipulation.

Keywords: laparoscopic hystrectomy, TLH, uterine manipulator, surgery

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1705 Beyond the 'Human Rights and Development' Discourse: A Quest for a Right to Sustainable Development in International Human Rights Law

Authors: Roman Girma Teshome

Abstract:

The intersection between development and human rights has been the point of scholarly debate for a long time. Consequently, a number of principles, which extend from the right to development to the human rights-based approach to development, have been adopted to understand the dynamics between the two concepts. Despite these attempts, the exact relationship between development and human rights has not been fully discovered yet. However, the inevitable interdependence between the two notions and the idea that development efforts must be undertaken by giving due regard to human rights guarantees has gained momentum in recent years. On the other hand, the emergence of sustainable development as a widely accepted approach in development goals and policies makes this unsettled convergence even more complicated. The place of sustainable development in human rights law discourse and the role of the latter in ensuring the sustainability of development programs call for a systematic study. Hence, this article seeks to explore the relationship between development and human rights, particularly focusing on the place given to sustainable development principles in international human right law. It will further quest whether there is a right to sustainable development recognized therein. Accordingly, the article asserts that the principles of sustainable development are directly or indirectly recognized in various human rights instruments, which provides an affirmative response to the question raised hereinabove. This work, therefore, will make expeditions through international and regional human rights instruments as well as case laws and interpretative guidelines of human rights bodies to prove this hypothesis.

Keywords: sustainable development, human rights, the right to development, the human rights-based approach to development, environmental rights, economic development, social sustainability

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1704 Clinical Empathy: The Opportunity to Offer Optimal Treatment to People with Serious Illness

Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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1703 Analytical Technique for Definition of Internal Forces in Links of Robotic Systems and Mechanisms with Statically Indeterminate and Determinate Structures Taking into Account the Distributed Dynamical Loads and Concentrated Forces

Authors: Saltanat Zhilkibayeva, Muratulla Utenov, Nurzhan Utenov

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The distributed inertia forces of complex nature appear in links of rod mechanisms within the motion process. Such loads raise a number of problems, as the problems of destruction caused by a large force of inertia; elastic deformation of the mechanism can be considerable, that can bring the mechanism out of action. In this work, a new analytical approach for the definition of internal forces in links of robotic systems and mechanisms with statically indeterminate and determinate structures taking into account the distributed inertial and concentrated forces is proposed. The relations between the intensity of distributed inertia forces and link weight with geometrical, physical and kinematic characteristics are determined in this work. The distribution laws of inertia forces and dead weight make it possible at each position of links to deduce the laws of distribution of internal forces along the axis of the link, in which loads are found at any point of the link. The approximation matrixes of forces of an element under the action of distributed inertia loads with the trapezoidal intensity are defined. The obtained approximation matrixes establish the dependence between the force vector in any cross-section of the element and the force vector in calculated cross-sections, as well as allow defining the physical characteristics of the element, i.e., compliance matrix of discrete elements. Hence, the compliance matrixes of an element under the action of distributed inertial loads of trapezoidal shape along the axis of the element are determined. The internal loads of each continual link are unambiguously determined by a set of internal loads in its separate cross-sections and by the approximation matrixes. Therefore, the task is reduced to the calculation of internal forces in a final number of cross-sections of elements. Consequently, it leads to a discrete model of elastic calculation of links of rod mechanisms. The discrete model of the elements of mechanisms and robotic systems and their discrete model as a whole are constructed. The dynamic equilibrium equations for the discrete model of the elements are also received in this work as well as the equilibrium equations of the pin and rigid joints expressed through required parameters of internal forces. Obtained systems of dynamic equilibrium equations are sufficient for the definition of internal forces in links of mechanisms, which structure is statically definable. For determination of internal forces of statically indeterminate mechanisms (in the way of determination of internal forces), it is necessary to build a compliance matrix for the entire discrete model of the rod mechanism, that is reached in this work. As a result by means of developed technique the programs in the MAPLE18 system are made and animations of the motion of the fourth class mechanisms of statically determinate and statically indeterminate structures with construction on links the intensity of cross and axial distributed inertial loads, the bending moments, cross and axial forces, depending on kinematic characteristics of links are obtained.

Keywords: distributed inertial forces, internal forces, statically determinate mechanisms, statically indeterminate mechanisms

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1702 Activity-Based Costing of Medical Intensive Care Unit 240

Authors: Suppawan Lertpongpakpoom, Anongnat Boonrat, Kunya BoontummoSuppawan

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This descriptive cost analysis aimed to analyze the unit cost of patients in medical intensive care unit. Purposive sampling was used to select 20 nurses, 6 practical nurses, 5 nurses aid and select samples 30 patients. Data were collected from both primary source (activity and average time of nursing care) and secondary source Z bill of payment and patient record). Instruments were cost recording form, activity observation form, and service recording form. Content validity of all instruments were evaluated by three experts (CVI = 0.87). Descriptive statistics was employed for data analysis. The results of the Activity-Based Costing Analysis showed that total activity cost of 4 service types for the patients was 14,776.92 Bath. The highest cost was nursing record was 5,674.78 Bath, followed direct nursing activity was 5,176.18 Bath, medical treatment was 1,976.6 Bath. The lowest cost was management activity was 1,003.64 Bath per visit. The result suggested that Activity-Base Costing Analysis could be applied to give better understanding of cost structure, enabling better consideration wasted expense and non-value-added activity, and improvement of effective utilization.

Keywords: activity-based costing, medical intensive care, nursing care, cost analysis

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1701 Conceptual Design of Suction Cup Lifting System

Authors: Mohammed Aijaz

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In industries, to transfer fragile materials like glasses, a holding, lifting, and manipulation system are required. In this report, we designed and analysed a suction cup holding, lifting, and manipulation system that is attached to a head plate and must be able to grip/hold securely, the largest glass panel with 3m x 2.5m x 20mm thick with a mass of 115 kg. The system is able to rotate the panel through 180 degrees in the X, Y, and Z axis in any direction from the outer reach of the robotic arm. The structural analysis is performed to verify the structural strength of the suction cup’s head plate system.

Keywords: designing, mechanical, engineering, suction

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1700 Nose Macroneedling Tie Suture Hidden Technique

Authors: Mohamed Ghoz, Hala Alsabeh

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Context: Macroscopic Nose Macroneedling (MNM) is a new non-surgical procedure for lifting and tightening the nose. It is a tissue-non-invasive technique that uses a needle to create micro-injuries in the skin. These injuries stimulate the production of collagen and elastin, which results in the tightening and lifting of the skin. Research Aim: The research aim of this study was to investigate the efficacy and safety of MNM for the treatment of nasal deformities. Methodology A total of 100 patients with nasal deformities were included in this study. The patients were randomly assigned to either the MNM group or the control group. The MNM group received a single treatment of MNM, while the control group received no treatment. The patients were evaluated at baseline, 6 months, and 12 months after treatment. Findings: The results of this study showed that MNM was effective in improving the appearance of the nose in patients with nasal deformities. At 6 months after treatment, the patients in the MNM group had significantly improved nasal tip projection, nasal bridge height, and nasal width compared to the patients in the control group. The improvements in nasal appearance were maintained at 12 months after treatment. Theoretical Importance: The findings of this study provide support for the use of MNM as a safe and effective treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities. Data Collection: Data was collected from the patients using a variety of methods, including clinical assessments, photographic assessments, and patient-reported outcome measures. Analysis Procedures: The data was analyzed using a variety of statistical methods, including descriptive statistics, inferential statistics, and meta-analysis. Question Addressed: The research question addressed in this study was whether MNM is an effective and safe treatment for nasal deformities. Conclusion: The findings of this study suggest that MNM is an effective and safe treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities.

Keywords: nose, surgery, tie, suture

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1699 Modeling and Control of an Acrobot Using MATLAB and Simulink

Authors: Dong Sang Yoo

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The problem of finding control laws for underactuated systems has attracted growing attention since these systems are characterized by the fact that they have fewer actuators than the degrees of freedom to be controlled. The acrobot, which is a planar two-link robotic arm in the vertical plane with an actuator at the elbow but no actuator at the shoulder, is a representative of underactuated systems. In this paper, the dynamic model of the acrobot is implemented using Mathworks’ Simscape. And the sliding mode control is constructed using MATLAB and Simulink.

Keywords: acrobot, MATLAB and simulink, sliding mode control, underactuated system

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1698 Applying Risk Taking in Islamic Finance: A Fiqhī Viewpoint

Authors: Mohamed Fairooz Abdul Khir

Abstract:

The linkage between liability for risk and legitimacy of reward is a governing principle that must be fully observed in financial transactions. It is the cornerstone of any Islamic business or financial deal. The absence of risk taking principle may give rise to numerous prohibited elements such as ribā, gharar and gambling that violate the objectives of financial transactions. However, fiqhī domains from which it emanates have not been clearly spelled out by the scholars. In addition, the concept of risk taking in relation to contemporary risks associated with financial contracts, such as credit risk, liquidity risk, reputational risk and market risk, needs further scrutiny as regard their Sharīʿah bases. Hence, this study is imperatively significant to prove that absence of risk taking concept in Islamic financial instruments give rise to prohibited elements particularly ribā. This study is primarily intended to clarify the concept of risk in Islamic financial transactions from the fiqhī perspective and evaluate analytically the selected issues involving risk taking based on the established concept of risk taking from fiqhī viewpoint. The selected issues are amongst others charging cost of fund on defaulting customers, holding the lessee liable for total loss of leased asset under ijārah thumma al-bayʿ and capital guarantee under mushārakah based instruments. This is a library research in which data has been collected from various materials such as classical fiqh books, regulators’ policy guidelines and journal articles. This study employed deductive and inductive methods to analyze the data critically in search for conclusive findings. It suggests that business risks have to be evaluated based on their subjects namely (i) property (māl) and (ii) work (ʿamal) to ensure that Islamic financial instruments structured based on certain Sharīʿah principles are not diverted from the risk taking concept embedded in them. Analysis of the above selected cases substantiates that when risk taking principle is breached, the prohibited elements such as ribā, gharar and maysir do arise and that they impede the realization of the maqāṣid al-Sharīʿah intended from Islamic financial contracts.

Keywords: Islamic finance, ownership risk, ribā, risk taking

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1697 Innovation Management in State-Owned-Enterprises in the Digital Transformation: An Empirical Case Study of Swiss Post

Authors: Jiayun Shen, Lorenz Wyss, Thierry Golliard, Matthias Finger

Abstract:

Innovation is widely recognized as the key for private enterprises to win the market competition. The state-owned-enterprises need to be innovative to compete in the market after the privatization as well. However, it is a lack of research to study how state-owned-enterprises manage innovation to create new products and services. Swiss Post, a Swiss state-owned-enterprises, has established a department to transform the corporate culture and foster innovation to achieve digital transformation. This paper describes the innovation management process at the Swiss Post and analyzes the impacts of the instruments, the organizational structure, and explores the barriers of innovation. This study used qualitative methods based on a review of the literature on innovation management and semi-structured interviews. Being established for over five years, the Swiss Post’s innovation management department has established a software-assisted modularized platform with systematic instruments to help the internal employees with the different innovation processes. It guides the innovators from idea creation to piloting in markets and supports with a separate financing source, with knowledge inputs and coaching, as well as with connections to external partners through the open innovation and venturing team. The platform also adapts to different business units within the corporate with a customized tailor for the various operational business units. The separate financing instruments enabled the creation and further development of new ideas; the coaching services contribute greatly to the transformation of teams’ innovation culture by providing new knowledge, thinking methods, and use cases for inspiration. It also facilitates organizational learning to help the whole corporate with the digital transformation. However, it is also confronted with a big challenge in twofold. Internally, the disruptive projects often hardly overcome the obstacles of long-established operational processes in the traditional business units; externally, the expectations of the public and restrictions from the federal government have become high hurdles for the company to stay and compete in the innovation track.

Keywords: empirical case study, innovation management, state-owned-enterprise, Swiss Post

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1696 The Contribution of the Lomé Charter to Combating Trafficking in Persons at Sea: Nigerian and South African Legal Perspective

Authors: Obinna Emmanuel Nkomadu

Abstract:

A major maritime problem in the African continent is the widespread proliferation of threats to maritime security, and one of which is the traffic in persons (TIP) at sea, which victims are sometimes assaulted, injured, killed, and in many cases go missing. The South African and Nigerian law on TIP at sea is the Prevention and Combating of Trafficking in Persons Act and the Trafficking in Persons (Prohibition) Enforcement and Administration Act, respectively. These legislation prohibits TIP at sea but does not provides effective and efficient national coordination structures and international cooperation measures against traffickers who engage on human trafficking on the African maritime domain. As a result of the limitations on the maritime security laws of most African States and the maritime security threats on the continent, the African Union in 2016 adopted the African Charter on Maritime Security and Safety and Development in Africa (Lome Charter). The Lomé Charter provides mechanisms for national and international cooperation on maritime security threats, including TIP at sea. However, the Charter is yet to come into force due to the number of States required to accede or ratify the Charter. This paper identifies gaps on existing instruments on TIP at sea by those States and justify on South Africa and Nigeria should adopt the Charter. The justification flow from analysing relevant international law instruments, as well as legislation on human trafficking.

Keywords: cooperation against trafficking in persons at sea, lomé charter, maritime security, Nigerian legislation on trafficking in persons, South African legislation on trafficking in person, and trafficking in persons at sea

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1695 Disabled Young People’s Hopes and Dreams in a Rapidly Changing Society: Co-Production Peer Research

Authors: Tillie Curran

Abstract:

This co-production project aimed for an expansive exploration of disabled young people’s hopes and dreams in the context of unprecedented societal changes. The research questions developed with disabled young people acting as peer researchers, ask ‘what does a good life look like now, and, what are your hopes and dreams for the future?’ Disabled children’s childhood studies and an asset-based approach placed the voice of disabled young people at the centre of the research process and inviting participants to ‘think big’! Over 18 months, academics, members of a Centre for Independent Living and peer researchers, came together to facilitate knowledge cafes with fifty disabled young people aged between 14 and 25 in a college and youth club setting. Methods used included trigger questions, photos voice, video, and cartooning. The peer researchers also investigated how house robots and connected autonomous vehicles might support their future aspirations and sense of freedom in this new era with a trip to the university robotic laboratory. Key themes arising from participants’ hopes and dream were about ‘being responsible’, ‘loving’, ‘freedom and happiness’ and a ‘strong sense of self and togetherness’ and suggest alternative narratives and rich visions of the future possibilities for disabled young people. The five key messages peer researchers produced for the report emphasised freedom to define their futures, desires to make the world a better place, to belong and have the chance of their own family life. Thematic analysis, production of the report and impact activities were all co-produced and as the project progressed peer researchers increasingly demonstrated a role as ‘change makers’ and have formed a young people’s co-production group going on into the future. Discussion of the project highlights the factors that made these processes successful and the ethical dilemmas encountered in the context of normalcy. Finally, we consider the implications for all involved as we rethink ‘the future’, not in terms of normative ideals or trajectories, or seeing service ‘transition’ as an end, but in terms of disabled young people’s contribution, participation, freedoms, and possibilities.

Keywords: co-production, disability, robotic, youth

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1694 The Relationship between Organizational Culture and Application of Management Accounting Innovation: Evidence from Iran

Authors: Zohreh Hajiha

Abstract:

Culture affects the ability of the organization in expressing and achieving the goals. Organizational culture influences the selection of instruments applied in the management of organizations. All the instruments applied in organizations to control, promote and create innovations are influenced by organizational culture. This research studies organizational culture based on the cultural model of Muijen and its relationship with applying management accounting innovations in Iranian listed firms. Management accounting innovations of this study include activity-based costing, activity-based management, balanced scorecard, target costing, standard costing, quality costing, Kaizen costing and dimensions of organizational culture include support orientation, innovation orientation, rules orientation and goal orientation. 105 questionnaires were sent to financial executives of production companies and 73 questionnaires were returned. The findings show that there is a significant difference between organizational culture of firms that have applied management accounting innovations and those which have used these innovations less. Also, dimensions of support orientation and culture goal orientation are the highest in groups that apply management accounting innovations. The findings suggest that proper organization culture could promote the use od management accounting tools in Iranian firms.

Keywords: organizational culture, innovation, management accounting, muijen model

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1693 Pre-Malignant Breast Lesions, Methods of Treatment and Outcome

Authors: Ahmed Mostafa, Mohamed Mahmoud, Nesreen H. Hafez, Mohamed Fahim

Abstract:

This retrospective study includes 60 patients with pre-invasive breast cancer. Aim of the study: Evaluation of premalignant lesions of the breast (DCIS), different treatment methods and outcome. Patients and methods: 60 patients with DCIS were studied from the period between 2005 to 2012, for 38 patients the primary surgical method was wide local resection (WLE) (63.3%) and the other cases (22 patients, 36.7%) had mastectomy, fourteen cases from those who underwent local excision received radiotherapy, while no adjuvant radiotherapy was given for those who underwent mastectomy. In case of hormonal receptor positive DCIS lesions hormonal treatment (Tamoxifen) was given after local control. Results: No difference in overall survival between mastectomy & breast conserving therapy (wide local excision and adjuvant radiotherapy), however local recurrence rate is higher in case of breast conserving therapy, also no role of Axillary evacuation in case of DCIS. The use of hormonal therapy decreases the incidence of local recurrence by about 98%. Conclusion: The main management of DCIS is local treatment (wide local excision and radiotherapy) with hormonal treatment in case of hormone receptor positive lesions.

Keywords: ductal carcinoma in situ, surgical treatment, radiotherapy, breast conserving therapy, hormonal treatment

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1692 Outcome of Anastomosis of Mechanically Prepared vs Mechanically Unprepared Bowel in Laparoscopic Anterior Resection in Surgical Units of Teaching Hospital Karapitiya ,Sri Lanka

Authors: K. P. v. R. de Silva, R. W. Senevirathna, M. M. A. J. Kumara, J. P. M. Kumarasinghe, R. L. Gunawardana, S. M. Uluwitiya, G. C. P. Jayawickrama, W. K. T. I. Madushani

Abstract:

Introduction: The limited literature supporting the utilization of mechanical bowel preparation (MBP) for patients undergoing laparoscopic anterior resection (LAR) remains a notable issue. This study was conducted to examine the clinical consequences of anastomosis in colorectal surgery with MBP compared to cases where MBP was not utilized (no-MBP) in the context of LAR. Methods: This was a retrospective comparative study conducted in the professorial surgical wards of the teaching hospital karapitiya (THK). Colorectal cancer patients(n=306) participated in the study, including 151 MBP patients and 155 no-MBP patients, where the postoperative complications and mortality rates were compared. Results: The anastomotic leakage rate was 2.6%(n=4) in the no-MBP group and 6.0%(n=9) in the MBP group (p=0.143). The postoperative paralytic ileus rate was 18.5%(n=28) and 5.8%(n=9) in the MBP group and no-MBP group, respectively, displaying a statistically significant difference (p=0.001). Wound infection, pneumonia, urinary tract infection, and cardiac complication rates also were higher in the MBP group. The overall mortality rate was 1.3%(n=3) in the no-MBP group and 2.0%(n=2) in the MBP group. Conclusions: The evidence concludes that MBP increases post-operative complications. Therefore, prophylactic MBP in LAR has not been proven to benefit patients. However, further research is necessary to understand the comparative effects of MBP versus no preparation comprehensively.

Keywords: MBP, anastomosis, LAR, paralytic ileus

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1691 Influence of Some Psychological Factors on the Learning Gains of Distance Learners in Mathematics in Ibadan, Nigeria

Authors: Adeola Adejumo, Oluwole David Adebayo, Muraina Kamilu Olanrewaju

Abstract:

The purpose of this study was to investigate the influence of some psychological factors (i.e, school climate, parental involvement and classroom interaction) on the learning gains of university undergraduates in Mathematics in Ibadan, Nigeria. Three hundred undergraduates who are on open distance learning education programme in the University of Ibadan and thirty mathematics lecturers constituted the study’s sample. Both the independent and dependent variables were measured with relevant standardized instruments and the data obtained was analyzed using multiple regression statistical method. The instruments used were school climate scale, parental involvement scale and classroom interaction scale. Three research questions were answered in the study. The result showed that there was significant relationship between the three independent variables (school climate, parental involvement and classroom interaction) on the students’ learning gain in mathematics and that the independent variables both jointly and relatively contributed significantly to the prediction of students’ learning gain in mathematics. On the strength of these findings, the need to enhance the school climate, improve the parents’ involvement in the student’s education and encourage students’ classroom interaction were stressed and advocated.

Keywords: school climate, parental involvement, ODL, learning gains, mathematics

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1690 Rhythmic Sound: Presence and Significance: A Study of the Yue Drum Used in the Han Chinese Shigong Ritual in Guangxi, China

Authors: Li-Jun Zheng

Abstract:

The use of drums as an accompanying instrument is a common phenomenon in traditional Chinese folk rituals and musical culture. Especially, some folk rituals construct ritual-related sounds and give them ritual-specific symbolic and meaningful systems through the combination and use of multiple percussion instruments. The Yue drum(岳鼓), an asymmetrically shaped thin waist drum, is currently used in Han Chinese Shigong(师公)rituals in Guangxi, China, and is an important ritual instrument in Shigong rituals. This paper examines the use of the Yue drum and other percussion instruments in Han Chinese Shigong rituals in Guangxi, China, and shows the current status of combining instrumental accompaniment forms with human voices in Shigong rituals. Through further analysis of the musical and dance forms of Han Chinese Shigong rituals, this paper shows how Han Chinese Shigong ritual performers construct the ritual field through "sound-human-dance" and further explains the relationship between the existing and fictitious performance fields in the rituals. In addition, this paper demonstrates the relationship between Han Chinese Shigong rituals and the religious beliefs they involve, such as Taoism and Buddhism. And it further explores how performers in Han Chinese Shigong rituals use Yue drums for the dual purpose of "entertaining the gods" and "entertaining the people".

Keywords: sound research, the Han Chinese Shigong ritual, the thin waist drum, folk beliefs, ritual music

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1689 Robust Control of a Parallel 3-RRR Robotic Manipulator via μ-Synthesis Method

Authors: A. Abbasi Moshaii, M. Soltan Rezaee, M. Mohammadi Moghaddam

Abstract:

Control of some mechanisms is hard because of their complex dynamic equations. If part of the complexity is resulting from uncertainties, an efficient way for solving that is robust control. By this way, the control procedure could be simple and fast and finally, a simple controller can be designed. One kind of these mechanisms is 3-RRR which is a parallel mechanism and has three revolute joints. This paper aims to robust control a 3-RRR planner mechanism and it presents that this could be used for other mechanisms. So, a significant problem in mechanisms control could be solved. The relevant diagrams are drawn and they show the correctness of control process.

Keywords: 3-RRR, dynamic equations, mechanisms control, structural uncertainty

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1688 Apollo Quality Program: The Essential Framework for Implementing Patient Safety

Authors: Anupam Sibal

Abstract:

Apollo Quality Program(AQP) was launched across the Apollo Group of Hospitals to address the four patient safety areas; Safety during Clinical Handovers, Medication Safety, Surgical Safety and the six International Patient Safety Goals(IPSGs) of JCI. A measurable, online, quality dashboard covering 20 process and outcome parameters was devised for monthly monitoring. The expected outcomes were also defined and categorized into green, yellow and red ranges. An audit methodology was also devised to check the processes for the measurable dashboard. Documented clinical handovers were introduced for the first time at many locations for in-house patient transfer, nursing-handover, and physician-handover. Prototype forms using the SBAR format were made. Patient-identifiers, read-back for verbal orders, safety of high-alert medications, site marking and time-outs and falls risk-assessment were introduced for all hospitals irrespective of accreditation status. Measurement of Surgical-Site-Infection (SSI) for 30 days postoperatively, was done. All hospitals now tracked the time of administration of antimicrobial prophylaxis before surgery. Situations with high risk of retention of foreign body were delineated and precautionary measures instituted. Audit of medications prescribed in the discharge summaries was made uniform. Formularies, prescription-audits and other means for reduction of medication errors were implemented. There is a marked increase in the compliance to processes and patient safety outcomes. Compliance to read-back for verbal orders rose from 86.83% in April’11 to 96.95% in June’15, to policy for high alert medications from 87.83% to 98.82%, to use of measures to prevent wrong-site, wrong-patient, wrong procedure surgery from 85.75% to 97.66%, to hand-washing from 69.18% to 92.54%, to antimicrobial prophylaxis within one hour before incision from 79.43% to 93.46%. Percentage of patients excluded from SSI calculation due to lack of follow-up for the requisite time frame decreased from 21.25% to 10.25%. The average AQP scores for all Apollo Hospitals improved from 62 in April’11 to 87.7 in Jun’15.

Keywords: clinical handovers, international patient safety goals, medication safety, surgical safety

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