Search results for: admission delay

Authors: Peri Harish Kumar, Rafique Umer Harvitkar

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Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

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Authors: Maha Hammami, Olfa Benouda Sioud

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This study investigates the reliability of management earnings forecasts with reference to these two ingredients: verifiability and neutrality. Specifically, we examine the biasedness (or accuracy) of management earnings forecasts and company specific characteristics that can be associated with accuracy. Based on sample of 102 IPO prospectuses published for admission on NYSE Euronext Paris from 2002 to 2010, we found that these forecasts are on average optimistic and two of the five test variables, earnings variability and financial leverage are significant in explaining ex post bias. Acknowledging the possibility that the bias is the result of the managers’ forecasting behavior, we then examine whether managers decide to under-predict, over-predict or forecast accurately for self-serving purposes. Explicitly, we examine the role of financial distress, operating performance, ownership by insiders and the economy state in influencing managers’ forecasting preferences. We find that managers of distressed firms seem to over-predict future earnings. We also find that when managers are given more stock options, they tend to under-predict future earnings. Finally, we conclude that the management earnings forecasts are affected by an intentional bias due to managers’ forecasting preferences.

Keywords: intentional bias, management earnings forecasts, neutrality, verifiability

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Authors: Yassine Meraihi, Dalila Acheli, Rabah Meraihi

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MANET for Mobile Ad hoc NETwork is a collection of wireless mobile nodes that communicates with each other without using any existing infrastructure, access point or centralized administration, due to the higher mobility and limited radio transmission range, routing is an important issue in ad hoc network, so in order to ensure reliable and efficient route between to communicating nodes quickly, an appropriate routing protocol is needed. In this paper, we present the performance analysis of two mobile ad hoc network routing protocols namely DSR and OLSR using NS2.34, the performance is determined on the basis of packet delivery ratio, throughput, average jitter and end to end delay with varying pause time.

Keywords: DSR, OLSR, quality of service, routing protocols, MANET

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Authors: Jonas Mayer, Kai-Frederic Seitz, Thorben Kuprat

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In today’s competitive environment production’s logistic objectives such as ‘delivery reliability’ and ‘delivery time’ and distribution’s logistic objectives such as ‘service level’ and ‘delivery delay’ are attributed great importance. Especially for small and mid-sized enterprises (SME) attaining these objectives pose a key challenge. Within this context, one of the difficulties is that interactions between departments within the enterprise and their specific objectives are insufficiently taken into account and aligned. Interdepartmental independencies along with contradicting targets set within the different departments result in enterprises having sub-optimal logistic performance capability. This paper presents a research project which will systematically describe the interactions between departments and convert them into a quantifiable form.

Keywords: department-specific actuating and control variables, interdepartmental interactions, cybernetic model, logistic objectives

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Authors: Mahmoud Abdelrazig Mahmoud Barakat

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Achievement tests administered at national level play a significant role in the lives of test-takers as well as the whole society. This paper aims to investigate the effect of giving students a choice between two optional questions on their overall performance in a high stake achievement test for university admission. It is hypothesized that questions targeting writing-based productive skills and language system necessitate display of abilities which are different from fact-based questions designed around story content. The two items are assumed to reflect different constructs that require different criteria of assessment. Consequently, the student’s overall score is affected by the item they choose to answer, which might not be reflective of their real language abilities. An open-ended interview was carried out with ten teachers working with grade 3 students in model secondary schools to investigate the nature of the two test items and their impact on the student’s performance. The data has proved that giving choice in an achievement test generates different performances that are assessed differently. It is recommended that in order to address the question of fairness, it is important to clearly define and balance the construct of the items that affect the student’s choice and performance.

Keywords: achievement test, assessment, choice, fairness performance

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Authors: Ambra Giovannelli, Erika Maria Archilei

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The amount of the electrical power required by refrigeration systems is relevant worldwide. It is evaluated in the order of 15% of the total electricity production taking refrigeration and air-conditioning into consideration. For this reason, in the last years several energy saving techniques have been proposed to reduce the power demand of such plants. The paper deals with the development of an innovative internal recovery system for cryogenic cooling plants. Such a system consists in a Compressor-Expander Group (CEG) designed on the basis of the automotive turbocharging technology. In particular, the paper is focused on the design of the expander, the critical component of the CEG system. Due to the low volumetric flow entering the expander and the high expansion ratio, a commercial turbocharger expander wheel was strongly modified. It was equipped with a transonic nozzle, designed to have a radially inflow full admission. To verify the performance of such a machine and suggest improvements, two different set of nozzles have been designed and modelled by means of the commercial Ansys-CFX software. steady-state 3D CFD simulations of the second-generation prototype are presented and compared with the initial ones.

Keywords: vapour cCompression systems, energy saving, refrigeration plant, organic fluids, radial turbine

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Authors: Divya Sisodiya, Deepika Sipal

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Optical wireless communication (OWC) is a relatively new technology in optical communication systems that allows for high-speed wireless optical communication. This research focuses on developing a cost-effective OWC system using a hybrid configuration of optical amplifiers. In addition to using EDFA amplifiers, a comparison study was conducted to determine which modulation technique is more effective for communication. This research examines the performance of an OWC system based on ASK and PSK modulation techniques by varying OWC parameters under various atmospheric conditions such as rain, mist, haze, and snow. Finally, the simulation results are discussed and analyzed.

Keywords: OWC, bit error rate, amplitude shift keying, phase shift keying, attenuation, amplifiers

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Authors: Muhammad Zaman Shakir, Mingfa Yao, Zohaib Iqbal

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This study proposed four Jet fuel surrogate (S1, S2 S3, and 4) with careful selection of seven large hydrocarbon fuel components, ranging from C₉-C₁₆ of higher molecular weight and higher boiling point, adapting the standard molecular distribution size of the actual jet fuel. The surrogate was composed of seven components, including n-propyl cyclohexane (C₉H₁₈), n- propylbenzene (C₉H₁₂), n-undecane (C₁₁H₂₄), n- dodecane (C₁₂H₂₆), n-tetradecane (C₁₄H₃₀), n-hexadecane (C₁₆H₃₄) and iso-cetane (iC₁₆H₃₄). The skeletal jet fuel surrogate reaction mechanism was developed by two approaches, firstly based on a decoupling methodology by describing the C₄ -C₁₆ skeletal mechanism for the oxidation of heavy hydrocarbons and a detailed H₂ /CO/C₁ mechanism for prediction of oxidation of small hydrocarbons. The combined skeletal jet fuel surrogate mechanism was compressed into 128 species, and 355 reactions and thereby can be used in computational fluid dynamics (CFD) simulation. The extensive validation was performed for individual single-component including ignition delay time, species concentrations profile and laminar flame speed based on various fundamental experiments under wide operating conditions, and for their blended mixture, among all the surrogate, S1 has been extensively validated against the experimental data in a shock tube, rapid compression machine, jet-stirred reactor, counterflow flame, and premixed laminar flame over wide ranges of temperature (700-1700 K), pressure (8-50 atm), and equivalence ratio (0.5-2.0) to capture the properties target fuel Jet-A, while the rest of three surrogate S2, S3 and S4 has been validated for Shock Tube ignition delay time only to capture the ignition characteristic of target fuel S-8 & GTL, IPK and RP-3 respectively. Based on the newly proposed HyChem model, another four surrogate with similar components and composition, was developed and parallel validations data was used as followed for previously developed surrogate but at high-temperature condition only. After testing the mechanism prediction performance of surrogates developed by the decoupling methodology, the comparison was done with the results of surrogates developed by the HyChem model. It was observed that all of four proposed surrogates in this study showed good agreement with the experimental measurements and the study comes to this conclusion that like the decoupling methodology HyChem model also has a great potential for the development of oxidation mechanism for heavy alkanes because of applicability, simplicity, and compactness.

Keywords: computational fluid dynamics, decoupling methodology Hychem, jet fuel, surrogate, skeletal mechanism

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Authors: Chau-Kuang Chen, John Hughes, Jr., A. Dexter Samuels

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The prediction models for the United States Medical Licensure Examination (USMLE) Steps 1 and 2 performances were constructed by the Monte Carlo simulation modeling approach via linear regression. The purpose of this study was to build robust simulation models to accurately identify the most important predictors and yield the valid range estimations of the Steps 1 and 2 scores. The application of simulation modeling approach was deemed an effective way in predicting student performances on licensure examinations. Also, sensitivity analysis (a/k/a what-if analysis) in the simulation models was used to predict the magnitudes of Steps 1 and 2 affected by changes in the National Board of Medical Examiners (NBME) Basic Science Subject Board scores. In addition, the study results indicated that the Medical College Admission Test (MCAT) Verbal Reasoning score and Step 1 score were significant predictors of the Step 2 performance. Hence, institutions could screen qualified student applicants for interviews and document the effectiveness of basic science education program based on the simulation results.

Keywords: prediction model, sensitivity analysis, simulation method, USMLE

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Authors: Siriporn Sikkaphun

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Food is essential for living, and receiving correct, suitable, and adequate food is advantageous to the body, especially for patients because it can enable good recovery. Feeding through a gastrostomy tube is one useful way that is widely used because it is easy, convenient, and economical.To compare the effectiveness of using the clinical guidelines for feeding through a gastrostomy tube in critically ill surgical patients.This is a pre-post quasi-experimental study on 15 critically ill surgical or accident patients who needed intubation and the gastrostomy tube from August 2011 to November 2012. The data were collected using the guidelines, and an evaluation form for effectiveness of guidelines for feeding through a gastrostomy tube in critically ill surgical patients. After using the guidelines for feeding through a gastrostomy tube in critically ill surgical patients, it was found that The average number of days from the admission date to the day the patients received food through the G-tube significantly reduced at the level .05. The number of personnel who practiced nursing activities correctly and suitably for patients with complications during feeding significantly increased at the level .05.The number of patients receiving energy to the target level significantly increased at the level .05. The results of this study indicated that the use of the guidelines for feeding through a gastrostomy tube in critically ill surgical patients was feasible in practice, and the outcomes were beneficial to the patients.

Keywords: clinical guidelines, feeding, gastrostomy tube, critically ill, surgical patients

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Authors: Nikolaos Mavropoulos

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Imperialism and colonialism had and still have a predominantly negative nuisance. In many ways the two terms are synonyms of racist behavior, exploitation, and oppression, imposed by the supposedly civilized West at Africa’s and Asia’s expense. Paradoxically enough, imperialism was not thoroughly negative for some Marxist scholars. For them, in reality, it served a historical necessity as the only mean to liberate the backward societies from their millennial stagnation and to introduce them to industrialization and progress. To Marx as immoral and cruel the imposition of imperial rule and the eradication of traditional structures may have been, the process is still a progressive step towards the formation of class consciousness, global revolution and socialism in a world scale. Overlooking the fact that imperialism could actually delay and put an end to capitalist development, some Marxists proponents considered it as a positive development for the colonized peoples.

Keywords: Colonialism, , Marxist theory, Modern history, , 19th century Imperialism,

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Pelin Onelcin, Yalcin Alver

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This paper investigates the walking speed and delays of pedestrians at two signalized intersections where the vehicle speed limits are different. Data was collected during afternoon and evening peak hours on November 15, 2013 and on December 6, 2013. Observational surveys were conducted by video recording technique. Pedestrians were categorized according to their gender, group size, stuff carrying condition and age. Results showed that individuals walked fastest when the group size is taken into consideration. The smallest 15th percentile walking speed was seen in the oldest age group (over 60 years old). Pedestrians experienced high delays both at roadsides and at medians. Factors affecting the pedestrian walking speed were analyzed by ANOVA.

Keywords: pedestrian delay, pedestrian walking speed, signalized crosswalk, ANOVA

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Authors: Saurav Dhawan, Sanchit Bansal

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Background T-MACS is a computer-based decision aid that ‘rules in’ and ‘rules out’ ACS using a combination of the presence or absence of six clinical features with only one biomarker measured on arrival: hs-cTnT. T-MACS had 99.3% negative predictive value and 98.7% sensitivity for ACS, ‘ruling out’ ACS in 40% of patients while ‘ruling in’ 5% at the highest risk. We aim at benchmarking the use of T-MACS which could help to conserve healthcare resources, facilitate early discharges, and ensure safe practice. Methodology Randomized retrospective data collection (n=300) was done from ED electronic records across 3 hospital sites within MFT over a period of 2 months. Data was analysed and compared by percentage for the usage of T-MACS, number of admissions/discharges, and in days for length of stay in hospital. Results MRI A&E had the maximum compliance with the use of T-MACS in the trust at 66%, with minimum admissions (44%) and an average length of stay of 1.825 days. NMG A&E had an extremely low compliance rate (8 %), with 75% admission and 3.387 days as the average length of stay. WYT A&E had no TMACS recorded, with a maximum of 79% admissions and the longest average length of stay at 5.07 days. Conclusion All three hospital sites had a RAG rating of ‘RED’ as per the compliance levels. The assurance level was calculated as ‘Very Limited’ across all sites. There was a positive correlation observed between compliance with TMACS and direct discharges from ED, thereby reducing the average length of stay for patients in the hospital.

Keywords: ACS, discharges, ED, T-MACS

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Authors: Hanan M. Taleb

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Energy consumption associated with buildings has a significant impact on the environment. To that end, and as a transaction between the inside and outside and between the building and urban space, the building skin plays an especially important role. It provides protection from the elements; demarcates private property and creates privacy. More importantly, it controls the admission of solar radiation. Therefore, designing the building skin sustainably will help to achieve optimal performance in terms of both energy consumption and thermal comfort. Unfortunately, with accelerating construction expansion, many recent buildings do not pay attention to the importance of the envelope design. This piece of research will highlight the importance of this part of the creation of buildings by providing evidence of a significant reduction in energy consumption if the envelopes are redesigned. Consequently, the aim of this paper is to enhance the performance of the hospital envelope in order to achieve sustainable performance. A hospital building sited in Abu Dhabi, in the UAE, has been chosen to act as a case study. A detailed analysis of the annual energy performance of the case study will be performed with the use of a computerised simulation; this is in order to explore their energy performance shortcomings. The energy consumption of the base case will then be compared with that resulting from the new proposed building skin. The results will inform architects and designers of the savings potential from various strategies.

Keywords: ASHREA, building skin, building envelopes, hospitals, Abu Dhabi, UAE, IES software

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Authors: Sabiha Sahin, Kursad Bora Carman, Coskun Yarar

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Introduction: Measuring the diameter of the optic nerve sheath is a noninvasive and easy to use imaging technique to predict intracranial pressure in children and adults. The aim was to measure the diameter of the optic nerve sheath in pediatric head trauma. Methods: The study group consisted of 40 children with healthy and 40 patients with head trauma. Transorbital sonographic measurement of the optic nerve sheath diameter was performed. Conclusion: The mean diameters of the optic nerve sheath of right and left eyes were 0.408 ± 0.064 mm and 0.417 ± 0.065 mm, respectively, in the trauma group. These results were higher in patients than in control group. There was a negative correlation between optic nerve sheath diameters and Glasgow Coma Scales in patients with head trauma (p < 0.05). There was a positive correlation between optic nerve sheath diameters and positive CT findings, systolic blood pressure in patients with head trauma. The clinical status of the patients at admission, blood pH and lactate level were related to the optic nerve sheath diameter. Conclusion: Measuring the diameter of the optic nerve sheath is not an invasive technique and can be easily used to predict increased intracranial pressure and to prevent secondary brain injury.

Keywords: head trauma, intracranial pressure, optic nerve, sonography

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Authors: Chun-Chuan Yang, Jeng-Yueng Chen, Yi-Ting Mai, Hsieh-Hua Liu

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By introduction of Relay Nodes (RNs), LTE-Advanced can provide enhanced coverage and capacity at cell edges and hot-spot areas. The authors have been researching the issue of power saving in mobile communications technology such as WiMax and LTE for some years. Based on the idea of Load-Based Power Saving (LBPS), three efficient power saving schemes for the user equipment (UE) were proposed in the authors’ previous work. In this paper, three revised schemes of the previous work in order to integrate RN and UE in power saving are proposed. Simulation study shows the proposed schemes can achieve significantly better power saving efficiency than the standard based scheme at the cost of moderately increased delay.

Keywords: DRX, LTE-A, power saving, RN

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Authors: Seung-Jun Yu, Yeong-Seop Ahn, Young-Min Ko, Hyoung-Kyu Song

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In order to achieve high data rate and increase the spectral efficiency, multiple input multiple output (MIMO) system has been proposed. However, multiple antennas are limited by size and cost. Therefore, recently developed cooperative diversity scheme, which profits the transmit diversity only with the existing hardware by constituting a virtual antenna array, can be a solution. However, most of the introduced cooperative techniques have a common fault of decreased transmission rate because the destination should receive the decodable compositions of symbols from the source and the relay. In this paper, we propose a cooperative cyclic delay diversity (CDD) scheme that uses hierarchical modulation. This scheme is free from the rate loss and allows seamless cooperative communication.

Keywords: MIMO, cooperative communication, CDD, hierarchical modulation

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Authors: Hamida Qumber Ali, Waseem Muhammad Arain, Shama Siddiqui, Sayeed Ghani

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We present an implementing of RMAC in TinyOS 1.x. RMAC is a cross layer and Duty-cycle MAC protocols that was proposed to provide energy efficient transmission services for wireless sensor networks. The protocol has a unique and efficient packet transmission scheduling mechanism that enables it to overcome delivery latency and overcome traffic congestion. Design details and implementation challenges are divulged. Experiments are conducted to show the correctness of our implementation with numerous assumptions. Simulations are performed to compare the performance of RMAC and SMAC. Our results show that RMAC outperforms SMAC in energy efficiency and delay.

Keywords: MAC protocol, performance, RMAC, wireless sensor networks

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Authors: Ibraheem A. K. Mahameed

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The aim of this study is to identify the risks affecting time performance of building construction projects in the West Bank in Palestine from contractors’ viewpoint. 38 risks that might affect time performance of building construction projects were defined through a detailed literature review. These risks have been classified into 6 groups: project, managerial, consultant, financial, external, and construction items. A questionnaire survey was performed to rank the considered risks in terms of severity and frequency. The analysis of the survey indicated that the top five risks affecting time performance of building construction projects in Palestine are: award project to the lowest price, political situation, poor communication and coordination between construction parties, change orders, and financial status of contractor.

Keywords: delay, time performance, construction, building

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Authors: Mário Ernesto Sitoe, Orlando Zacarias

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University education is influenced by several factors that range from the adoption of strategies to strengthen the whole process to the academic performance improvement of the students themselves. This work uses data mining techniques to develop a predictive model to identify students with a tendency to evasion and retention. To this end, a database of real students’ data from the Department of University Admission (DAU) and the Department of Mathematics and Informatics (DMI) was used. The data comprised 388 undergraduate students admitted in the years 2009 to 2014. The Weka tool was used for model building, using three different techniques, namely: K-nearest neighbor, random forest, and logistic regression. To allow for training on multiple train-test splits, a cross-validation approach was employed with a varying number of folds. To reduce bias variance and improve the performance of the models, ensemble methods of Bagging and Stacking were used. After comparing the results obtained by the three classifiers, Logistic Regression using Bagging with seven folds obtained the best performance, showing results above 90% in all evaluated metrics: accuracy, rate of true positives, and precision. Retention is the most common tendency.

Keywords: evasion and retention, cross-validation, bagging, stacking

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Authors: Afif Saleh Abugharsa

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The IEEE 802.15.4 standard is designed for low-rate wireless personal area networks (LR-WPAN) with focus on enabling wireless sensor networks. It aims to give a low data rate, low power consumption, and low cost wireless networking on the device-level communication. The objective of this study is to investigate the performance of IEEE 802.15.4 based networks using simulation tool. In this project the network simulator 2 NS2 was used to several performance measures of wireless sensor networks. Three scenarios were considered, multi hop network with a single coordinator, star topology, and an ad hoc on demand distance vector AODV. Results such as packet delivery ratio, hop delay, and number of collisions are obtained from these scenarios.

Keywords: ZigBee, wireless sensor networks, IEEE 802.15.4, low power, low data rate

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Authors: H. L. M. Fawzan

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Undoubtedly, learning English as a second language (ESL) is considered a challenging task. It is more difficult for students in far-away districts when compared with the students in the capital cities, where learning resources are easily available and where the environment is conducive to learning. Thus, this study is an analysis of the challenges faced by learners in learning English as the second language within kurunegala district in Sri Lanka. Even though various efforts have been taken by the Sri Lankan Educationalists for improving the situation of English language teaching for the past few decades, a disappointing situation still exist in the achievements of English learning among Sri Lankan students. So, it is necessary to explore real reasons behind the poor achievements of the students in the English Language. It is also an attempt to highlight what can be done to improve the situation significantly. Kurunegala is far away from the capital city of Sri Lanka and is a densely populated district. In the year 2020, state university admission was 45.87% from the Kurunegala district (Department of Examinations). The researcher strived to examine some of the likely challenges faced when teaching English in secondary schools in Kurunegala. The data was collected using a questionnaire from 35 students from schools within the Kurunegala education division. The result of the study reveals that students were highly motivated to learn English for their prospects and expectations such as local and international communication, academic advancement, and employment prospects.

Keywords: english, teaching, Kurunegala, Sri Lanka, challenges

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Authors: Mohammad J. Mortazavi, Arvin Najafi, Pejman Mansouri

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Hemophilia A is simply described as deficiency of factor VIII(FVIII) and patients with this disorder have bleeding complications in different organs. By using the recombinant factor VIII in these patients, elective orthopedic surgeries have been done approximately in 40 last years. About 10-30 % of these patients have bleeding complications in their surgeries even by using recombinant factor VIII because of their inhibitor against FVIII molecule. Preoperative haemostatic management in these patients is challenging. We treated a 28-year-old male patient with hemophilia A with FVIII inhibitor which had been detected when he was14 years old (with the titer 54 Bethesda unit(BU)) scheduled for total knee arthroplasty (TKA). We use 90 µg/kg rFVIIa just before the surgery and every 2 hours during surgery. The patient did not have any significant hemorrhage during the surgery and after that. For the 2 days after surgery, the rFVIIa repeated every 2 hours as the same as preoperative dosage(90 µg/kg) and for another 2 days of postoperative admission it continued every 4 hours. After 4th day, the rFVIIa continued every 6 hours with the same dosage until the sixth day from the surgery, and finally the patient were discharged about two weeks after surgery. Seven days after the discharge, he came back for the follow up visit. On the follow up examination, the site of the surgery had neither infection hemarthroses signs.

Keywords: hemophilia, factor VIII inhibitor, total knee replacement, rFVIIa

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Authors: Youru Zhou

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This paper seeks to unveil the quality assurance practices in the Chinese translation industry. Since China’s reform and opening up, the Chinese language service industry has enjoyed impressively rapid growth. However, while still in its early stage of professionalization, the Chinese translation industry is also facing many challenges, such as the lack of clear admission requirements, a powerful regulation authority and a great number of qualified professionals. ‘How quality is assured’ means a great deal to translation in China at this stage. In order to examine the mechanisms in which quality is assured, this paper studied four international and national standards that have gained widespread adoption by Chinese translation companies and examined the content that is relevant to translation quality assurance. Case studies with six selected Chinese translation companies of different sizes were conducted to confirm and exemplify the descriptions on the standards. It has been found that quality in the industry is a relative concept which is mainly determined by the demand of clients. Furthermore, the procedures of translation can vary from task to task dependent on the agreement made between the service provider and clients. Finally, there are companies relying on expert-oriented mechanisms to assure the quality of translation, while other companies and standards insist on process-oriented ones.

Keywords: case study, Chinese translation industry, professional practice, translation quality assurance, translation standards

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Authors: Sadek A. Makhlouf, Hassan M. Nouh

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Bone hydatidosis is an infection in worldwide distribution. Although there is no evidence in literature on Bone Hydatid disease in Libya, we tried to present the first epidemiological study of this disease in Eastern Libya through retrospective study from 1995 to 2013. Our data were collected from 3 hospitals in Eastern Libya particularly the sheep-raising areas with total number of musculoskeletal infection cases of two thousand one hundred ninety-four (2,194). There were five (5) five cases of bone infection, four (4) of it have been diagnosed after more than three (3) months. Our study is comparable to other international study but this type of bone infection need further studies for effective control strategies for all dogs to avoid serious complications that might happened from the delay in diagnosing this type of disease.

Keywords: bone infection, hydatidosis, Eastern Libya, sheep-raising areas

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Authors: Asmamaw Yehun

Abstract:

The name “TANA” is one of International Geodetic Service (IGS) Global Positioning System (GPS) station which is found in Bahir Dar University in Institute of Land Administration. The station name taken from one of big Lakes in Africa ,Lake Tana. The Institute of Land Administration (ILA) is part of Bahir Dar University, located in the capital of the Amhara National Regional State, Bahir Dar. The institute is the first of its kind in East Africa. The station is installed by cooperation of ILA and Sweden International Development Agency (SIDA) fund support. The Continues Operating Reference Station (CORS) is a network of stations that provide global satellite system navigation data to help three dimensional positioning, meteorology, space, weather, and geophysical applications throughout the globe. TANA station was as CORS since 2013 and sites are independently owned and operated by governments, research and education facilities and others. The data collected by the reference station is downloadable through Internet for post processing purpose by interested parties who carry out GNSS measurements and want to achieve a higher accuracy. We made a first observation on TANA, monitor stations on May 29th 2013. We used Leica 1200 receivers and AX1202GG antennas and made observations from 11:30 until 15:20 for about 3h 50minutes. Processing of data was done in an automatic post processing service CSRS-PPP by Natural Resources Canada (NRCan) . Post processing was done June 27th 2013 so precise ephemeris was used 30 days after observation. We found Latitude (ITRF08): 11 34 08.6573 (dms) / 0.008 (m), Longitude (ITRF08): 37 19 44.7811 (dms) / 0.018 (m) and Ellipsoidal Height (ITRF08): 1850.958 (m) / 0.037 (m). We were compared this result with GAMIT/GLOBK processed data and it was very closed and accurate. TANA station is one of the second IGS station for Ethiopia since 2015 up to now. It provides data for any civilian users, researchers, governmental and nongovernmental users. TANA station is installed with very advanced choke ring antenna and GR25 Leica receiver and also the site is very good for satellite accessibility. In order to test hydrostatic and wet zenith delay for positional data quality, we used GAMIT/GLOBK and we found that TANA station is the most accurate IGS station in East Africa. Due to lower tropospheric zenith and ionospheric delay, TANA and ADIS IGS stations has 2 and 1.9 meters 3D positional accuracy respectively.

Keywords: atmosphere, GNSS, neutral atmosphere, precipitable water vapour

Procedia PDF Downloads 49

Authors: Puntarikorn Rungrattanakasin

Abstract:

Objectives: To develop the trigger tool to warn about the risk of bleeding as an adverse event from warfarin drug usage during admission in Medical Wards of Chumphae Hospital. Methods: A retrospective study was performed by reviewing the medical records for the patients admitted between June 1st,2020- May 31st, 2021. ADEs were evaluated by Naranjo’s algorithm. The international normalized ratio (INR) and events of bleeding during admissions were collected. Statistical analyses, including Chi-square test and Reciever Operating Characteristic (ROC) curve for optimal INR threshold, were used for the study. Results: Among the 139 admissions, the INR range was found to vary between 0.86-14.91, there was a total of 15 bleeding events, out of which 9 were mild, and 6 were severe. The occurrence of bleeding started whenever the INR was greater than 2.5 and reached the statistical significance (p <0.05), which was in concordance with the ROC curve and yielded 100 % sensitivity and 60% specificity in the detection of a bleeding event. In this regard, the INR greater than 2.5 was considered to be an optimal threshold to alert promptly for bleeding tendency. Conclusions: The INR value of greater than 2.5 (>2.5) would be an appropriate trigger tool to warn of the risk of bleeding for patients taking warfarin in Chumphae Hospital.

Keywords: trigger tool, warfarin, risk of bleeding, medical wards

Procedia PDF Downloads 124

Authors: Nazri Kama, Sufyan Basri, Roslina Ibrahim

Abstract:

It is important to manage the changes in the software to meet the evolving needs of the customer. Accepting too many changes causes delay in the completion and it incurs additional cost. One type of information that helps to make the decision is through change impact analysis. Current impact analysis approaches assume that all classes in the class artifact are completely developed and the class artifact is used as a source of analysis. However, these assumptions are impractical for impact analysis in the software development phase as some classes in the class artifact are still under development or partially developed that leads to inaccuracy. This paper presents a novel impact analysis approach to be used in the software development phase. The significant achievements of the approach are demonstrated through an extensive experimental validation using three case studies.

Keywords: software development, impact analysis, traceability, static analysis.

Procedia PDF Downloads 585

Authors: Eunhwa Jun

Abstract:

This case report describes the misdiagnosis of a patient who presented with right arm pain as cervical disc herniation. The patient had several underlying conditions, including hypertension, diabetes mellitus, liver cirrhosis, a history of lung cancer with left lower lobe lobectomy, and adjuvant chemoradiotherapy. An external cervical spine MRI revealed central protruding discs at the C4-5-6-7 levels. Despite treatment with medication and epidural blocks, the patient's pain persisted. A C-RACZ procedure was planned, but the patient's pain had worsened before admission. Using ultrasound, a brachial plexus block was attempted, but the brachial plexus eluded clear visualization, hinting at underlying neurological complexities. Chest CT revealed a new, large soft tissue mass in the right supraclavicular region with adjacent right axillary lymphadenopathy, leading to the diagnosis of metastatic squamous cell carcinoma. Palliative radiation therapy and chemotherapy were initiated as part of the treatment plan, and the patient's pain score decreased to 3 out of 10 on the Numeric Rating Scale (NRS), revealing the pain was due to metastatic lung cancer.

Keywords: supraclavicula brachial plexus metastasis, cervical disc herniation, brachial plexus block, metastatic lung cancer

Procedia PDF Downloads 20