Search results for: the hospital residents problem

Authors: Asanka U. K. Godamunne

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Road traffic accidents (RTA) are a leading cause of death globally as well as in Sri Lanka and results in a large proportion of disability especially among young people. Ninety-percent of world’s road traffic deaths occur in low- and middle-income countries. The gross disparities in injury outcomes relate to immediate post-crash and hospital management. Emergency management, methods of patient transportation following road traffic accidents and safety measures are important factors to reduce mortality and morbidity. Studies in this area are limited in Sri Lanka. The main objective of this research was to assess the emergency management and proper method of transportation of road traffic accident victims. This offers the best way to explore the ways to reduce the mortality and morbidity and raise the public awareness. This study was conducted as a descriptive cross-sectional study. All the consecutive road traffic accident victims admitted to surgical wards at District General Hospital, Matale, Sri Lanka, over a period of three months were included in the study. Data from 387 victims were analyzed. The majority were in the 20-30 year age group. Seventy six percent of the patients were males. Motorcycles and trishaws were most affected. First-aid was given to only 2% of patients and it was given by non-medical persons. A significant proportion of patients (75%) were transported to the hospital by trishaws and only 1% transported by ambulance. About 86% of the patients were seated while transport and 14% were flat. Limbs and head were the most affected areas of the body. As per this study, immediate post-crash management and patient transportation were not satisfactory. There is a need to strengthen certain road safety laws and make sure people follow them.

Keywords: emergency management, patient transportation, road traffic accident victims, Sri Lanka

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Authors: Polly Parkinson, Emma Mecham, Fawn Groves, Amy Wilson-Lopez, Ivonne Santiago

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In the rush to meet electric vehicle (EV) adoption goals that address environmental and health concerns, engineering planners and community policy experts cannot separate the socioeconomic and equity factors from transportation needs. Two gaps are identified in existing research: concrete proposals that address affordable micromobility options and provide for needs of community members without cars, and community-engaged research that elevates the concerns and solutions brought forward by historically-marginalized community members. This data analysis from a recent case study in a vulnerable community indicates that because transportation decisions are inextricably linked to health, work, and housing, EV adoption must also address multifaceted human needs. Communities focused on building more electric vehicle charging stations must find ways for lower-income households to also benefit. This research engaged residents in the planning process and resulted in a template for charging stations to advance mobility justice with a range of options that purposefully benefit the whole community.

Keywords: community engagement, electric vehicle charging, environmental justice, participatory research, transportation equity

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Authors: Muhammad Shahbaz Akhtar

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Background; Tuberculosis remains a significant public health challenge in Pakistan, with high incidence and prevalence rates, particularly among vulnerable populations. Addressing the TB burden requires comprehensive efforts to improve healthcare infrastructure, increase access to quality diagnosis and treatment services, raise public awareness, and address socioeconomic determinants of health. Objective; To assess the knowledge and practices of healthcare workers and patients regarding prevention of tuberculosis at a tertiary care hospital of Southern Punjab.Material and methods; Data will be collected from 135 healthcare workers and 135 TB patients visiting Nishtar Hospital, Multan in this descriptive cross – sectional study using non – probability consecutive sampling technique. Proper approval will be taken from Hospital authorities to conduct this study. Study participants will be recruited after taking informed written consent, describing them objectives of this study. The study participants will be ensured of their confidentiality of the data and interviewed to assess their knowledge and practices regarding prevention of tuberculosis. Data Analysis Procedure; Data will be entered and analyzed by using SPSS version 25 to calculated mean and standard deviation for the numerical data such as age, duration of disease and duration of experience. Frequencies and percentages will be calculated for gender, age groups, level of knowledge, qualification, designation and practices. Impact of confounders like gender, age groups, duration of experience, disease duration, years of experience and designation will be assessed by stratification. Post stratification chi – square test will be applied at 0.05 level of significance at 95 % CI.

Keywords: tuberculosis, data analysis, HIV/AIDS, preventable

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Authors: Syed Qasim Gilani, Muhammad Umair, Muhammad Noman, Syed Bilawal Shah, Aqib Abbasi, Muhammad Waheed

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Cardiovascular Diseases(CVD's) are the major cause of death in the world. The main reason for these deaths is the unavailability of first aid for heart failure. In many cases, patients die before reaching the hospital. We in this paper are presenting innovative online health service for Cardiac Patients. The proposed online health system has two ends. Users through device developed by us can communicate with their doctor through a mobile application. This interface provides them with first aid.Also by using this service, they have an easy interface with their doctors for attaining medical advice. According to the proposed system, we developed a device called Cardiac Care. Cardiac Care is a portable device which a patient can use at their home for monitoring heart condition. When a patient checks his/her heart condition, Electrocardiogram (ECG), Blood Pressure(BP), Temperature are sent to the central database. The severity of patients condition is checked using Artificial Intelligence Algorithm at the database. If the patient is suffering from the minor problem, our algorithm will suggest a prescription for patients. But if patient's condition is severe, patients record is sent to doctor through the mobile Android application. Doctor after reviewing patients condition suggests next step. If a doctor identifies the patient condition as critical, then the message is sent to the central database for sending an ambulance for the patient. Ambulance starts moving towards patient for bringing him/her to hospital. We have implemented this model at prototype level. This model will be life-saving for millions of people around the globe. According to this proposed model patients will be in contact with their doctors all the time.

Keywords: cardiovascular disease, classification, electrocardiogram, blood pressure

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Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

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Authors: Abdolsalam Ghaderi

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In this paper, the single-depot capacitated location-routing problem under uncertainty is presented. The problem aims to find the optimal location of a single depot and the routing of vehicles to serve the customers when the parameters may change under different circumstances. This problem has many applications, especially in the area of supply chain management and distribution systems. To get closer to real-world situations, travel time of vehicles, the fixed cost of vehicles usage and customers’ demand are considered as a source of uncertainty. A combined approach including robust optimization and stochastic programming was presented to deal with the uncertainty in the problem at hand. For this purpose, a mixed integer programming model is developed and a heuristic algorithm based on Variable Neighborhood Search(VNS) is presented to solve the model. Finally, the computational results are presented and future research directions are discussed.

Keywords: location-routing problem, robust optimization, stochastic programming, variable neighborhood search

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Authors: Elda Maraj, Shkelqim Kuka

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Coronary heart disease causes many deaths in the world. Unfortunately, this problem will continue to increase in the future. In this paper, a fuzzy logic model to predict coronary heart disease is presented. This model has been developed with seven input variables and one output variable that was implemented for 30 patients in Albania. Here fuzzy logic toolbox of MATLAB is used. Fuzzy model inputs are considered as cholesterol, blood pressure, physical activity, age, BMI, smoking, and diabetes, whereas the output is the disease classification. The fuzzy sets and membership functions are chosen in an appropriate manner. Centroid method is used for defuzzification. The database is taken from University Hospital Center "Mother Teresa" in Tirana, Albania.

Keywords: coronary heart disease, fuzzy logic toolbox, membership function, prediction model

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Authors: Liudmila A.Guzikova

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Being federative state Russia includes more than 80 subjects which are widely diverse by climatic conditions, demographic characteristics, cultural traditions, intensity of migration, economic development and investment attraction and other parameters. Now, in the regions of the country all forms of housing problem are present - housing mismatch to sanitary and hygienic standards, overcrowding, forced residence in financially burdensome housing, homelessness, -although the extent of these symptoms varies widely. Heterogeneity of regional conditions in combination with specifics of regional housing situation requires to concentrate the study of housing problem on the regional level. Traditionally housing market and mortgage are considered as the instruments of housing problem solving. The question arises how the housing market and mortgage market contribute to solving the housing problem in the regions of Russia. Though the purchase of dwelling in ownership should not be regarded as a universal method of the housing problem solving, the purchase of dwelling both by own funds or by use of mortgage can reduce the problem and enhance public satisfaction of living conditions. The aim of the study is to identify differences and similarities in the development of regional housing markets and mortgage lending in the regions of Russia and to evaluate their impact on the status of the housing problem. To achieve the aim of the study the methods of correlation and regression analysis are used. The data of federal statistics constitutes the information base of research. The results of the study contribute to better understanding of the interrelations in housing sphere and can be used to work out social and economic development programs in the regions.

Keywords: housing market, housing problem, mortgage, regional economy

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Authors: S. Woźniak, J. Rybka, T. Paszkowski, P. Milart

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A 30-year-old patient, who was pregnant for her second 9 weeks, was admitted to the hospital due to a suspected incomplete miscarriage. A fetal egg was found in the uterine cavity near the mouth of the fallopian tube. The patient was qualified for dilatation and curettage. The histopathological examination revealed fragments of the trophoblast. Two months later, the patient was re-admitted to the hospital due to vaginal bleeding and elevated levels of beta-hCG. Additional tests were performed. An intramural pregnancy was suspected. The patient was qualified for embolization of the uterine arteries and then treatment with methotrexate. Three weeks later, during a routine gynecological examination, a detached tumor 4 cm in diameter was found in the vagina. The material was sent for histopathological examination, which showed the presence of trophoblastic cells.

Keywords: ectopic pregnancy, intramural pregnancy, uterine artery embolization, methotrexate

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Kaan Yamanturk, Cihan Dogruoz

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Seismic isolators have been utilized around the world to protect the structures, nonstructural components and contents from the damaging effects of earthquakes. In Structural Engineering, seismic isolation is used for protecting buildings and its vibration-sensitive contents from earthquakes. Seismic isolation is a passive control system that lowers effective earthquake forces by utilizing flexible bearings. One of the most significant isolation systems is seismic isolators. In this paper, double pendulum type Teflon coated seismic isolators utilized in a city hospital project by Guris Construction and Engineering Co. Inc, located in Kutahya, Turkey, have been investigated. Totally, 498 seismic isolators were applied in the project. These isolators are double friction pendulum type seismic isolation devices. The review of current practices is also examined in this study. The focus of this study is related to the application of passive seismic isolation systems for buildings as practiced in Kutahya City Hospital Project. Based on the study, the acceleration at the top floor will be 0.18 g and it will decrease 0.01 g in every floor. Therefore, seismic isolators are very important for buildings located in earthquake zones.

Keywords: maximum considered earthquake, moment resisting frame, seismic isolator, seismic design

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Authors: Malinda Sabrina, Khoerul Anwar

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Railway noise generated by pass-by train has been described as a form of environmental pollutants especially for the residential area near the railway. Many studies have shown, that environmental noise particularly transportation noise has negative effects on people which resulting in annoyance and specific health problems such as cardiovascular disease, cognitive impairment and sleep disturbance. Therefore, various attempts are made to reduce the noise. One method of reducing such noise to acceptable noise levels is to build acoustically barrier walls. The objective of this study was to review the method of reducing railway noise and obtain the preliminary design of the acoustics barrier on the edge of railway tracks close to the residential area. The design of this barrier is using the Maekawa's method. Measurements have been performed in residential areas around the railroads in the Karawang - Indonesia with the absence of an acoustical barrier. From the observation, it was found that the railway was passed by five trains within thirty minutes. With the limited distance between the railway tracks and the location of the residential area as well as the street of residents, then it was obtained that a reduction in sound pressure level is 25 dBA. Maximum sound pressure level obtained is 86.9 dBA then by setting the barrier as high as 4 m at a distance, 2.5 m from the railway, the noise level received by residents in the settlement around the railway line becomes 61.9 dBA.

Keywords: acoustics barrier, Maekawa's method, noise attenuation, railway noise

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Authors: Taehan Lee

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We consider a network design problem which has shortest routing restriction based on the values determined by the installed facilities on each arc. In conventional multicommodity network design problem, a commodity can be routed through any possible path when the capacity is available. But, we consider a problem in which the commodity between two nodes must be routed on a path which has shortest metric value and the link metric value is determined by the installed facilities on the link. By this routing restriction, the problem has a distinct characteristic. We present an integer programming formulation containing the primal-dual optimality conditions to the shortest path routing. We give some computational results for the model.

Keywords: integer programming, multicommodity network design, routing, shortest path

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Authors: Mohd Sarfaraz

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The objective of this study is to investigate the work-life balance and job satisfaction among women employees in a hospital in India. It is believed that balancing a successful career with a family life or personal life can be challenging. WLB impacts on persons' satisfaction in their work and personal life roles. For this purpose, a questionnaire is developed with 22 items. The data collected from women employees who are working in a hospital in Aligarh, India. The constructs considered in this study include WLB and job satisfaction. The demographic and organisational variables considered in the study are genders, age and tenure of the job. Factors of WLB are flexible working conditions, work-life balance programs, and employee intention to change/leave a job, work pressure/stress and long working hours. This paper examines the relationship between work-family conflict, policies, and job and life satisfaction. Appropriate statistical tool using SPSS will be applied to achieve the objective. The anxiety over work-life balance is progressively becoming a common talk, especially for female employees.Increasing demands from the work and family domains represent a high strain for employees which even lead to the health problems among employees. Although it is believed that work-family role strain is more common among women employees. Therefore, the study will focus on these issues of WLB and job satisfaction among female professionals.

Keywords: work-life balance, job satisfaction, work- family conflict, health

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Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: skeletal scintigraphy, SPECT/CT, imaging, procedure

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Authors: Mohamed H. Kosba, Heba A. Ibrahim, H. Rozita

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Statement of the Problem: The life expectancy for transfusion-dependent thalassemia patients has increased dramatically with iron-chelation therapy and other modern management modalities. In these patients, the most dominant maxillofacial manifestations are protrusion of zygomatic bones and premaxilla due to the hyperplasia of bone marrow. The purpose of this study is to determine the prevalence of malocclusion and orthodontic treatment needs according to the Dental Aesthetic Index (DAI) among Malay transfusion-dependent thalassemia patients. Orientation: This is a cross-sectional study consist of 43 Malay transfusion-dependent thalassemia patients, 22 males, and 19 females with the mean age of 15.9 years old (SD 3.58). The subjects were selected randomly from patients attending Paediatrics and Internal Medicine Clinic at Hospital USM and Hospital Sultana Bahiyah. The subjects were assessed for malocclusion according to Angle’s classification, and orthodontic treatment needs using DAI. The results show that 22 of the subjects (51.1%) have class II malocclusion, 12 subjects (28%) have class І, while 9 subjects (20.9%) have class Ⅲ. The assessment of orthodontic treatment needs to reveal 22 cases (51.1%) fall in the normal/minor needs category, 12 subjects (28%) fall in the severe and very severe category, while 9 subjects (20.9%) fall in the definite category. Conclusion & Significance: Half of Malay transfusion-dependent thalassemia patients have Class Ⅱmalocclusion. About 28% had malocclusion and required orthodontic treatment. This research shows that Malay transfusion-dependent thalassemia may require orthodontic management; earlier intervention to reduce the complexity of the treatment later, suggesting functional appliance as a suitable treatment option for them, a twin block appliance together with headgear to restrict maxillary growth suggested for management. The current protocol implemented by the Malaysian Ministry of Health for the management of these patients seems to be sufficient since the result shows that about 28% require orthodontic treatment need, according to DAI.

Keywords: prevalence, DAI, thalassaemia, angle classification

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Authors: Hsin-Yi Lo, Chia-Yu Hsu

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This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

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Authors: Zichun Chu

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The issue of tribal poverty has always attracted attentions. Due to social and economic difficulties, the indigenous people's personal development and tribal development have been greatly restricted. Past studies have pointed out that poverty may come from a lack of education. The United Nations Sustainable Development Goals (SDGs) also stated that if we are to solve the poverty problem, providing education widely is an important key. According to the theory of intellectual capital adaptation, “being capable” and “willing to do” are the keys of development. Therefore, we can say that the "ability" and "will" of tribal residents for their tribal development is the core concern of the tribal development. This research was designed to investigate the career choice development model of indigenous tribe people by investigating the current status of human capital, social capital, and cultural capital of tribal residents. This study collected 327 questionnaires (70% of total households) from Truku tribe to answer the research question: Did education help them for job choosing decisions from the aspects of human capital, social capital, and cultural capital in tribal status. This project highlighted the ‘single tribal research approach’ to gain an in-depth understanding of the human capital formed under the unique culture of the tribe (Truku tribe). The results show that the education level of most research participants was high school, very few high school graduates chose to further their education to college level; due to the lack of education of their parents, the social capital was limited to support them for jobs choice, most of them work for labor and service industries; however, their culture capital was comparably rich for works, the sharing culture of Taiwanese indigenous people made their work status stable. The results suggested that we should emphasize more on the development of vocational education based on the tribe’s location and resources. The self-advocacy of indigenous people should be developed so that they would gain more power on making career decisions. This research project is part of a pilot project called “INDIGENOUS PEOPLES, POVERTY, AND DEVELOPMENT,” sponsored by the National Science and Technology Council of Taiwan. If this paper were accepted to present in the 2023 ICIP, it would be lovely if a panel is formed for me and other co-researchers (Chuanju Cheng, Chih-Yuan Weng, and YiXuan Chen), for the audience will be able to get a full picture of this pilot project.

Keywords: career choices, career model, indegenous career development, indigenous education, tribe

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Authors: Busaba Phurksaphanrat

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This research proposes a pre-emptive fuzzy goal programming model for multi-objective multi-mode resource constrained project scheduling problem. The objectives of the problem are minimization of the total time and the total cost of the project. Objective in a multi-mode resource-constrained project scheduling problem is often a minimization of make-span. However, both time and cost should be considered at the same time with different level of important priorities. Moreover, all elements of cost functions in a project are not included in the conventional cost objective function. Incomplete total project cost causes an error in finding the project scheduling time. In this research, pre-emptive fuzzy goal programming is presented to solve the multi-objective multi-mode resource constrained project scheduling problem. It can find the compromise solution of the problem. Moreover, it is also flexible in adjusting to find a variety of alternative solutions.

Keywords: multi-mode resource constrained project scheduling problem, fuzzy set, goal programming, pre-emptive fuzzy goal programming

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Authors: Sharon-Yasotha Veerayah-Mcgregor, Valipuram Manoranjan

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A backward or inverse problem is known to be an ill-posed problem due to its instability that easily emerges with any slight change within the conditions of the problem. Therefore, only a limited number of numerical approaches are available to solve a backward problem. This paper considers the Nagumo equation, an equation that describes impulse propagation in nerve axons, which also models population growth with the Allee effect. A creative operator splitting numerical scheme is constructed to solve the inverse Nagumo equation. Computational simulations are used to verify that this scheme is stable, accurate, and efficient.

Keywords: inverse/backward equation, operator-splitting, Nagumo equation, ill-posed, finite-difference

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Authors: Steve Apell

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Transit-oriented development (TOD) is a popular intervention for local governments endeavoring to reduce auto-dependency and the adverse effects of sprawl. At the same time, American households such as the millennial generation, are shifting their residential preferences from the suburbs to the central city. These changes have intensified demand for TOD housing which generates high rents. This leads to displacement of low-income, transit-dependent households by more affluent middle class families. Critics argue that, the effectiveness of TOD might be compromised as newer affluent residents drive more and use transit less. However, there has not been a comprehensive study to test this hypothesis. Using census data ( 1990 – 2012) from six metropolitans areas, this research investigated if block groups within one-mile radius of TOD are gentrifying. Our findings reveal that the price of housing and number of college graduates, increased more in TODs compared to the metropolitan area. Similarly, the percentage of immigrants increased in TOD, while those of blacks and whites declined. Most importantly, TOD residents generally commuted less by car, while transit use increased in some metropolitan areas. TOD in the south of the United States registered higher cost of housing and less transit use. These findings have significant implications for the future of equitable and sustainable transportation policy.

Keywords: commuting, equity, gentrification, mode choice, transit oriented development

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Authors: Selvia Arokiya Mary

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Introduction: Worldwide, breast cancer comprises 10.4% of all cancer incidence among women. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Many women who undergo breast surgery suffer from ill-defined pain syndromes. STATEMENT OF THE PROBLEM: A study to assess the effectiveness of twin therapeutic approaches on certain bio-physiological parameters in breast cancer patients after breast surgery at selected hospital, Chennai. Objectives: This study is to 1. assess the level of certain biophysiological parameters in women after mastectomy. 2. assess the effectiveness of twin therapeutic approaches on certain biophysiological parameters in women after mastectomy. 3. correlate the practice of twin therapeutic approaches with certain biophysiological parameters. 4. associate the selected demographic variables with certain biophysiological parameters in women after mastectomy Research Design and Method: Pre experimental research design was used. Fifty women were selected by using convenient sampling technique at government general hospital, Chennai. Results: The Level of pain shows, in the study group 49(98%) of them had moderate in the pre test and after the intervention all of them had mild pain in the post test. In relation to level of shoulder function before the intervention shows that in the study group 49(98%) of them had movement towards gravity and after intervention 24 (48%) of them had movement against gravity maximum resistance. There was a significant reduction in pain and shoulder stiffness level at a ‘P’ level of < 0.001. There was a negative correlation between the pranayama practice and the level of pain, there was a positive correlation between the arm exercise practice and the level of shoulder function. There was no significant association between demographic and clinical variables with the level of pain and shoulder function in the study. Hypothesis: There is a significant difference in level of pain and shoulder function among women following breast surgery who receive pranayama & arm exercise programme. The pranayama had effect in terms of reduction of pain, arm exercise programme had effect in prevention of arm stiffness among post operative women following breast surgery. Thus the stated hypothesis was accepted. Conclusion: On the basis of the findings of the present study there was Advancing age related to increasing risk of breast cancer, level of pain also the type of surgery was associated with level of pain and shoulder function, There fore it is to be concluded that the study participants may get benefited by practice of pranayama and arm exercise program.

Keywords: biophysiological parameters breast surgery, lumpectomy , mastectomy, radical mastectomy, twin therapeutic approach, pranayama, arm exercise

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Authors: Mourad Hrizi

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In this paper, we study the inverse problem of reconstructing an interior interface D appearing in the elliptic partial differential equation: Δu+χ(D)u=0 from the knowledge of the boundary measurements. This problem arises from a semiconductor transistor model. We propose a new shape reconstruction procedure that is based on the Kohn-Vogelius formulation and the topological sensitivity method. The inverse problem is formulated as a topology optimization one. A topological sensitivity analysis is derived from a function. The unknown subdomain D is reconstructed using a level-set curve of the topological gradient. Finally, we give several examples to show the viability of our proposed method.

Keywords: inverse problem, topological optimization, topological gradient, Kohn-Vogelius formulation

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Authors: Sie Long Kek, Wah June Leong, Kok Lay Teo

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Linear quadratic Gaussian model is a standard mathematical model for the stochastic optimal control problem. The combination of the linear quadratic estimation and the linear quadratic regulator allows the state estimation and the optimal control policy to be designed separately. This is known as the separation principle. In this paper, an efficient computational method is proposed to solve the linear quadratic Gaussian problem. In our approach, the Hamiltonian function is defined, and the necessary conditions are derived. In addition to this, the output error is defined and the least-square optimization problem is introduced. By determining the first-order necessary condition, the gradient of the sum squares of output error is established. On this point of view, the stochastic approximation approach is employed such that the optimal control policy is updated. Within a given tolerance, the iteration procedure would be stopped and the optimal solution of the linear-quadratic Gaussian problem is obtained. For illustration, an example of the linear-quadratic Gaussian problem is studied. The result shows the efficiency of the approach proposed. In conclusion, the applicability of the approach proposed for solving the linear quadratic Gaussian problem is highly demonstrated.

Keywords: iteration procedure, least squares solution, linear quadratic Gaussian, output error, stochastic approximation

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Authors: Wuthichai Wongthatsanekorn, Nuntana Matheekrieangkrai

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This research proposes Bee Algorithm (BA) to optimize Ready Mixed Concrete (RMC) truck scheduling problem from single batch plant to multiple construction sites. This problem is considered as an NP-hard constrained combinatorial optimization problem. This paper provides the details of the RMC dispatching process and its related constraints. BA was then developed to minimize total waiting time of RMC trucks while satisfying all constraints. The performance of BA is then evaluated on two benchmark problems (3 and 5construction sites) according to previous researchers. The simulation results of BA are compared in term of efficiency and accuracy with Genetic Algorithm (GA) and all problems show that BA approach outperforms GA in term of efficiency and accuracy to obtain optimal solution. Hence, BA approach could be practically implemented to obtain the best schedule.

Keywords: bee colony optimization, ready mixed concrete problem, ruck scheduling, multiple construction sites

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Authors: Diab Z., Hamad A., Dixit A., Al-Rikabi M., Keshaverzi F.

Abstract:

Introduction: According to the NICE guidelines, 2020Prasugrel is the recommended first line treatment in adults with acute coronary syndromes (ACS) in patients with ST-segment-elevation myocardial infarction (STEMI), defined as ST elevation or new left bundle branch block on ECG , that cardiologists intend to treat with primary percutaneous coronary intervention (PCI). The current literature suggests that this is largely due to safety and efficacy, and cost effectiveness. We wanted to do an audit to examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI. AIM: To examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI Methods: We looked at the patients presented to MRI during1^st of January 2022 to 28th February 2022. We included all the people who were above 18 and were brought to the hospital through the PPCI pathway and diagnosed as ACS and underwent PPCI. We excluded Patients who were brought to the hospital through the PPCI pathway and underwent coronary angiography and their diagnosis was found other than STEMI or if the outcome was death before discharge or they were above age >75 (as per guideline increase bleeding risk of prasugrel in a person aged 75 or older). Results: The total number of patients was 100. There were a total of seventy patients who had STEMI and fit the criteria for inclusion. Out of these, only 72.9% (51) were given Prasugrel as a first line. Seventeen (17) 24.3% STEMI patients were candidates for prasugrel as first-line therapy but were instead offered (clopidogrel/ticagrelor). Two 2 (2.9%) STEMI patients were not given prasugrel as first-line therapy because of C/I (CVA) or the use of anticoagulant Nine 9 (9%) of them died before discharge. Eleven 11 (11%) were above the age of 75. Ten 10 (10%) of patients had a diagnosis other than STEMI. Conclusions and recommendations: Our audit has shown the need to increase awareness amongst staff re: the first line use of Prasugrel as per NICE guidelines. We aim to arrange awareness sessions for staff and increase visibility of the guidelines for the staff to encourage them to adhere to the guideline. Further research is needed to find the optimum treatment in patients above 75.

Keywords: pasurgrel, PCI, NICE, STEMI

Procedia PDF Downloads 73

Authors: Alaka Padhye, S. P. Kane

Abstract:

The following study considers some variations made to the secretary problem (SP). In a multiple criteria secretary problem (MCSP), the selection of a unit is based on two independent characteristics. The units that appear before an observer are known say N, the best rank of a unit being N. A unit is selected, if it is better with respect to either first or second or both the characteristics. When the number of units is large and due to constraints like time and cost, the observer might want to stop earlier instead of inspecting all the available units. Let the process terminate at r2th unit where r1Keywords: joint distribution, marginal distribution, real ranks, secretary problem, selection criterion, two tailed secretary problem

Procedia PDF Downloads 270

Authors: Farajallah Adibhashemi

Abstract:

A retrospective study on causes, surgery findings, results and the follow up of 30 horses with colic in Tehran, Iran. Colic is the main problem horse industry.The causes of colic are related to management like food, sport and medical care. In this study that has been done between 2012-2015 for 30 horses referred to teaching hospital of veterinary medicine faculty of the University of Tehran. Seventy percent of causes was related to management of feeding and twenty percent was for malsporting. The rest of causes was from the anti parasite in bad root. The surgery findings were as follows: 60% displacement of dorsal right and left colon, 20% in impaction of pelvic flexure,10% impaction of the cecum, and 10% impaction of the stomach.

Keywords: horse, colic, Tehran, Iran

Procedia PDF Downloads 365

Authors: Thorsten Herrmann, Alexander Laukemann, Hansgeorg Binz, Daniel Roth

Abstract:

For the analysis of already identified and existing problems, the pertinent literature provides a comprehensive collection of approaches as well as methods in order to analyze the problems in detail. But coming up with problems, which are assets worth pursuing further, is often challenging. However, the importance of well-formulated problem ideas and their influence of subsequent creative processes are incontestable and proven. In order to meet the covered challenges, the Institute for Engineering Design and Industrial Design (IKTD) developed the Emoji Method. This paper presents the Emoji Method, which support designers to generate problem ideas in a structured way. Considering research findings from knowledge management and innovation management, research into emojis and emoticons reveal insights by means of identifying and formulating problem ideas within the early design phase. The simple application and the huge supporting potential of the Emoji Method within the early design phase are only few of the many successful results of the conducted evaluation. The Emoji Method encourages designers to identify problem ideas and describe them in a structured way in order to start focused with generating solution ideas for the revealed problem ideas.

Keywords: emojis, problem ideas, innovation management, knowledge management

Procedia PDF Downloads 142

Authors: J. Kaabi, Y. Harrath

Abstract:

This paper studied the flow shop scheduling problem under machine availability constraints. The machines are subject to flexible preventive maintenance activities. The nonresumable scenario for the jobs was considered. That is, when a job is interrupted by an unavailability period of a machine it should be restarted from the beginning. The objective is to minimize the total tardiness time for the jobs and the advance/tardiness for the maintenance activities. To solve the problem, a genetic algorithm was developed and successfully tested and validated on many problem instances. The computational results showed that the new genetic algorithm outperforms another earlier proposed algorithm.

Keywords: flow shop scheduling, genetic algorithm, maintenance, priority rules

Procedia PDF Downloads 470