Search results for: START triage system
18069 Improving the Management of Delirium of Surgical Inpatients
Authors: Shammael Selorfia
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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.Keywords: delirium, surgery, quality, improvement
Procedia PDF Downloads 7318068 Object Oriented Software Engineering Approach to Industrial Information System Design and Implementation
Authors: Issa Hussein Manita
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This paper presents an example of industrial information system design and implementation (IIDC), the most common software engineering design steps that are applied to the different design stages. We are going through the life cycle of software system development. We start by a study of system requirement and end with testing and delivering system, going by system design and coding, program integration and system integration step. The most modern software design tools available used in the design this includes, but not limited to, Unified Modeling Language (UML), system modeling, SQL server side application, uses case analysis, design and testing as applied to information processing systems. The system is designed to perform tasks specified by the client with real data. By the end of the implementation of the system, default or user defined acceptance policy to provide an overall score as an indication of the system performance is used. To test the reliability of he designed system, it is tested in different environment and different work burden such as multi-user environment.Keywords: software engineering, design, system requirement, integration, unified modeling language
Procedia PDF Downloads 56618067 Emergency Department Utilisation of Older People Presenting to Four Emergency Departments
Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis
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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.Keywords: chronic, older person, aged care, emergency department
Procedia PDF Downloads 22818066 Instrumentation for Engine Start Cycle Characterization at Cold Weather High Altitude Condition
Authors: Amit Kumar Gupta, Rohit Vashistha, G. P. Ravishankar, Mahesh P. Padwale
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A cold soaked gas turbine engine have known starting problems in high altitude and low temperature conditions. The high altitude results in lower ambient temperature, pressure, and density. Soaking at low temperature leads to higher oil viscosity, increasing the engine starter system torque requirement. Also, low temperature soaks results in a cold compressor rotor and casing. Since the thermal mass of rotor is higher than casing, casing expands faster, thereby, increasing the blade-casing tip clearance. The low pressure flow over the compressor blade coupled with the secondary flow through the compressor tip clearance during start result in stall inception. The present study discusses engine instrumentation required for capturing the stall inception event. The engine fan exit and combustion chamber were instrumented with dynamic pressure probes to capture the pressure characteristic and clamp-on current meter on primary igniter cable to capture ignition event during start cycle. The experiment was carried out at 10500 Ft. pressure altitude and -15°C ambient temperature. The high pressure compressor stall events were recorded during the starts.Keywords: compressor inlet, dynamic pressure probe, engine start cycle, flight test instrumentation
Procedia PDF Downloads 31318065 The Time for the World to Go Back to Forgotten "Values Pedagogy"
Authors: Sakineh Tashakori, Terrence Lovat
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With the start of war in every part of the world, from the war between Russia and Ukraine to the unbelievable start of the war between Israel and Palestine, the number of war refugees is increasing day by day. They are all homeless dads, moms, and kids looking for a safe place to go back to their ordinary lives without the fear of being mistreated and misunderstood by others. The significance of this study is to help the education system make life easier for refugees by going to values pedagogy inspired by Habermasian epistemology. The study employs a literature review methodology, which involves gathering relevant sources from academic journals and books to answer how values pedagogy is going to help the education system in this regard. The collected literature will be critically analyzed and synthesized to draw meaningful conclusions and support the argument for the implementation of values pedagogy. The findings of the study illustrate that values pedagogy can have a role in peace education and softening discourse to give students a better sense of mutual cultural and religious understanding and respect.Keywords: war, refugee, values pedagogy, Habermasian epistemology, peace education
Procedia PDF Downloads 4918064 A Software Product Engineering Process for Commercial Success in Start-Up and Cases
Authors: Javed Ahsan
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Software engineers strive for technical sophistication with a dream of finding commercial success in their start-up business. But they may find their much technically sophisticated software products failing in industry in competition with lesser sophisticated products. This is because of not maintaining a clear focus on complimenting and leading commercial success through technical sophistication. This can be achieved through a software engineering specific product development process suggested in this paper. This process is about evolving a software product through specific phases and iterations until commercial triumph falls on software engineer’s feet.Keywords: software, product, engineering, commercialization, start-up, competitiveness, industry
Procedia PDF Downloads 35218063 Radio Frequency Energy Harvesting Friendly Self-Clocked Digital Low Drop-Out for System-On-Chip Internet of Things
Authors: Christos Konstantopoulos, Thomas Ussmueller
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Digital low drop-out regulators, in contrast to analog counterparts, provide an architecture of sub-1 V regulation with low power consumption, high power efficiency, and system integration. Towards an optimized integration in the ultra-low-power system-on-chip Internet of Things architecture that is operated through a radio frequency energy harvesting scheme, the D-LDO regulator should constitute the main regulator that operates the master-clock and rest loads of the SoC. In this context, we present a D-LDO with linear search coarse regulation and asynchronous fine regulation, which incorporates an in-regulator clock generation unit that provides an autonomous, self-start-up, and power-efficient D-LDO design. In contrast to contemporary D-LDO designs that employ ring-oscillator architecture which start-up time is dependent on the frequency, this work presents a fast start-up burst oscillator based on a high-gain stage with wake-up time independent of coarse regulation frequency. The design is implemented in a 55-nm Global Foundries CMOS process. With the purpose to validate the self-start-up capability of the presented D-LDO in the presence of ultra-low input power, an on-chip test-bench with an RF rectifier is implemented as well, which provides the RF to DC operation and feeds the D-LDO. Power efficiency and load regulation curves of the D-LDO are presented as extracted from the RF to regulated DC operation. The D-LDO regulator presents 83.6 % power efficiency during the RF to DC operation with a 3.65 uA load current and voltage regulator referred input power of -27 dBm. It succeeds 486 nA maximum quiescent current with CL 75 pF, the maximum current efficiency of 99.2%, and 1.16x power efficiency improvement compared to analog voltage regulator counterpart oriented to SoC IoT loads. Complementary, the transient performance of the D-LDO is evaluated under the transient droop test, and the achieved figure-of-merit is compared with state-of-art implementations.Keywords: D-LDO, Internet of Things, RF energy harvesting, voltage regulators
Procedia PDF Downloads 13318062 Control Configuration System as a Key Element in Distributed Control System
Authors: Goodarz Sabetian, Sajjad Moshfe
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Control system for hi-tech industries could be realized generally and deeply by a special document. Vast heavy industries such as power plants with a large number of I/O signals are controlled by a distributed control system (DCS). This system comprises of so many parts from field level to high control level, and junior instrument engineers may be confused by this enormous information. The key document which can solve this problem is “control configuration system diagram” for each type of DCS. This is a road map that covers all of activities respect to control system in each industrial plant and inevitable to be studied by whom corresponded. It plays an important role from designing control system start point until the end; deliver the system to operate. This should be inserted in bid documents, contracts, purchasing specification and used in different periods of project EPC (engineering, procurement, and construction). Separate parts of DCS are categorized here in order of importance and a brief description and some practical plan is offered. This article could be useful for all instrument and control engineers who worked is EPC projects.Keywords: control, configuration, DCS, power plant, bus
Procedia PDF Downloads 48418061 On the Combination of Patient-Generated Data with Data from a Secure Clinical Network Environment: A Practical Example
Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh
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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.Keywords: mobile health, data integration, expert systems, disease-related malnutrition
Procedia PDF Downloads 47318060 Fast Approximate Bayesian Contextual Cold Start Learning (FAB-COST)
Authors: Jack R. McKenzie, Peter A. Appleby, Thomas House, Neil Walton
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Cold-start is a notoriously difficult problem which can occur in recommendation systems, and arises when there is insufficient information to draw inferences for users or items. To address this challenge, a contextual bandit algorithm – the Fast Approximate Bayesian Contextual Cold Start Learning algorithm (FAB-COST) – is proposed, which is designed to provide improved accuracy compared to the traditionally used Laplace approximation in the logistic contextual bandit, while controlling both algorithmic complexity and computational cost. To this end, FAB-COST uses a combination of two moment projection variational methods: Expectation Propagation (EP), which performs well at the cold start, but becomes slow as the amount of data increases; and Assumed Density Filtering (ADF), which has slower growth of computational cost with data size but requires more data to obtain an acceptable level of accuracy. By switching from EP to ADF when the dataset becomes large, it is able to exploit their complementary strengths. The empirical justification for FAB-COST is presented, and systematically compared to other approaches on simulated data. In a benchmark against the Laplace approximation on real data consisting of over 670, 000 impressions from autotrader.co.uk, FAB-COST demonstrates at one point increase of over 16% in user clicks. On the basis of these results, it is argued that FAB-COST is likely to be an attractive approach to cold-start recommendation systems in a variety of contexts.Keywords: cold-start learning, expectation propagation, multi-armed bandits, Thompson Sampling, variational inference
Procedia PDF Downloads 10318059 Early Childhood Teacher Turnover in an Early Head Start Setting: A Qualitative Examination
Authors: Jennifer Sturgeon
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Stable relationships provide a predictable and trusting environment and are essential for early development, but high teacher turnover rates in childcare settings make it challenging for infants and toddlers to form stable relationships with their teachers. This can have an adverse effect on development and learning. The qualitative study discussed in this article draws from the experiences of early Head Start teachers and administrators to describe both the impact of teacher turnover and the motivational factors that contribute to teacher retention. A case study approach was used and included classroom observations, a review of exit interviews, and perceptions from focus groups of early Head Start staff in an urban early Head Start childcare center. Emerging from the case study was the discovery that teacher turnover has an impact on the social-emotional development of toddlers, particularly in self-regulation. Additional key findings that emerged include teacher turnover leading to negative effects on learning, a decrease in preschool preparation, and increased chaos in the classroom and center. Motivational factors that contributed to teacher retention included positive leadership, the mission to make a difference, and fair compensation.Keywords: early childhood, teacher turnover, continuity of care, early head start
Procedia PDF Downloads 6618058 The Effect of Gender and Resources on Entrepreneurial Activity
Authors: Frederick Nyakudya
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In this paper, we examine the relationship between human capital, personal wealth and social capital to explain the differential start-up rates between female and male entrepreneurs. Since our dependent variable is dichotomous, we examine the determinants of these using a maximum likelihood logit estimator. We used the Global Entrepreneurship Monitor database covering the period 2006 to 2009 with 421 usable cases drawn from drawn from the Lower Layer Super Output Areas in the East Midlands in the United Kingdom. we found evidence that indicates that a female positively moderate the positive relationships between indicators of human capital, personal wealth and social capital with start-up activity. The findings have implications for programs, policies, and practices to encourage more females to engage in start-up activity.Keywords: entrepreneurship, star-up, gender, GEM
Procedia PDF Downloads 10318057 Diagnosis Of Static, Dynamic, And Mixed Eccentricity In Line Start Permanent Magnet Synchronous Motor By Using FEM
Authors: Mohamed Moustafa Mahmoud Sedky
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In line start permanent magnet synchronous motor, eccentricity is a common fault that can make it necessary to remove the motor from the production line. However, because the motor may be inaccessible, diagnosing the fault is not easy. This paper presents an FEM that identifies different models, static eccentricity, dynamic eccentricity, and mixed eccentricity, at no load and full load. The method overcomes the difficulty of applying FEMs to transient behavior. It simulates motor speed, torque and flux density distribution along the air gap for SE, DE, and ME. This paper represents the various effects of different eccentricities types on the transient performance.Keywords: line start permanent magnet, synchronous machine, static eccentricity, dynamic eccentricity, mixed eccentricity
Procedia PDF Downloads 37218056 GSM Based Smart Patient Monitoring System
Authors: Ayman M. Mansour
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In this paper, we propose an intelligent system that is used for monitoring the health conditions of Patients. Monitoring the health condition of Patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will Improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to Faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The propose system will provide an intelligent system that will generate initial diagnosing to the patient case. This will assist and advice clinicians at the point of care. The decision is based on demographic data and laboratory test results of patient data. Using such system with the ability of making medical decisions, the quality of medical care in Jordan and specifically in Tafial is expected to be improved. This will provide more accurate, effective, and reliable diagnoses and treatments especially if the physicians have insufficient knowledge.Keywords: GSM, SMS, patient, monitoring system, fuzzy logic, multi-agent system
Procedia PDF Downloads 55718055 Ignition Interlock Device for Motorcycles
Authors: Luisito L. Lacatan, Zacha Valerie G. Ancheta, Michelangelo A. Dorado, Lester Joseph M. Ochoa, Anthony Mark G. Tayabas
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Ignition Interlock Device or IID is a mechanism installed inside a vehicle which requires the driver to breathe into the device before starting the vehicle. If the IID detects that the alcohol level or blood alcohol content (BAC) is higher than the accepted value, the engine will not start. If the driver is not able to provide a clean breath sample, the IID will log the event, warn the driver, and then start up an alarm. The purpose of the IID is to prevent accidents due to driving under the influence (DUI). With the rise of the two-wheeled vehicle in the Philippines due to its mobility and purchasing power, IIDs are still mainly installed on four-wheeled vehicles. Even though riding the motorcycle when drunk is more dangerous, there are only a small number of installed devices on motorcycles and scooters. The general objective of this study was to develop a system with hardware and software components that would implement IID on motorcycles. The study employed a descriptive method of research. The study also concluded the following: the infrared must have a point-to-point communication, the breathalyzer on the helmet should react to ethanol, the microcontroller on the motorcycle should accept all IR signals from the helmet and interpret it and the GPS shield should have an unobstructed line-of-sight communication with the GPS satellites.Keywords: blood alcohol content, breathalyser, driving under the influence, global positioning system, global system for mobile communication
Procedia PDF Downloads 31618054 Critical Activity Effect on Project Duration in Precedence Diagram Method
Authors: Salman Ali Nisar, Koshi Suzuki
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Precedence Diagram Method (PDM) with its additional relationships i.e., start-to-start, finish-to-finish, and start-to-finish, between activities provides more flexible schedule than traditional Critical Path Method (CPM). But, changing the duration of critical activities in PDM network will have anomalous effect on critical path. Researchers have proposed some classification of critical activity effects. In this paper, we do further study on classifications of critical activity effect and provide more information in detailed. Furthermore, we determine the maximum amount of time for each class of critical activity effect by which the project managers can control the dynamic feature (shortening/lengthening) of critical activities and project duration more efficiently.Keywords: construction project management, critical path method, project scheduling, precedence diagram method
Procedia PDF Downloads 50618053 A 5-V to 30-V Current-Mode Boost Converter with Integrated Current Sensor and Power-on Protection
Authors: Jun Yu, Yat-Hei Lam, Boris Grinberg, Kevin Chai Tshun Chuan
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This paper presents a 5-V to 30-V current-mode boost converter for powering the drive circuit of a micro-electro-mechanical sensor. The design of a transconductance amplifier and an integrated current sensing circuit are presented. In addition, essential building blocks for power-on protection such as a soft-start and clamp block and supply and clock ready block are discussed in details. The chip is fabricated in a 0.18-μm CMOS process. Measurement results show that the soft-start and clamp block can effectively limit the inrush current during startup and protect the boost converter from startup failure.Keywords: boost converter, current sensing, power-on protection, step-up converter, soft-start
Procedia PDF Downloads 101018052 Impact of Serum Estrogen and Progesterone Levels in the Outcome Pregnancy Rate in Frozen Embryo Transfer Cycles. A Prospective Cohort Study
Authors: Sayantika Biswas, Dipanshu Sur, Amitoj Athwal, Ratnabali Chakravorty
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Title: Impact of serum estrogen and progesterone levels in the outcome pregnancy rate in frozen embryo transfer cycles. A prospective cohort study Objective: The aim of the current study was to evaluate the effect of serum estradiol (E2) and progesterone (P4) levels at different time points on pregnancy outcomes in frozen embryo transfer (FET) cycles. Materials & Method: A prospective cohort study was performed in patients undergoing frozen embryo transfer. Patients under age 37 years of age with at least one good blastocyst or three good day 3 embryos were included in the study. For endometrial preparation, 14 days of oral estradiol use (2X2 mg for 5 days. 3X2 mg for 4 days, and 4X2 mg for 5 days) was followed by vaginal progesterone twice a day and 50 mg intramuscular progesterone twice a day. Embryo transfer was scheduled 72-76 hrs or 116-120hrs after the initiation of progesterone. Serum E2 and P4 levels were examined at 4 times a) at the start of the menstrual cycle prior to the hormone supplementation. b) on the day of P4 start. c) on the day of ET. d) on the third day after ET. Result: A total 41 women were included in this study (mean age 31.8; SD 2.8). Clinical pregnancy rate was 65.55%. Serum E2 levels on at the start of the menstrual cycle prior to the hormone supplementation and on the day of P4 start were high in patients who achieved pregnancy compared to who did not (P=0.005 and P=0.019 respectively). P4 levels on on the day of ET were also high in patients with clinical pregnancy. On the day of P4 start, a serum E2 threshold of 186.4 pg/ml had a sensitivity of 82%, and P4 had a sensitivity of 71% for the prediction of clinical pregnancy at the threshold value 16.00 ng/ml. Conclusion: In women undergoing FET with hormone replacement, serum E2 level >186.4 pg/ml on the day of the start of progesterone and serum P4 levels >16.00 ng/ml on embryo transfer day are associated with clinical pregnancy.Keywords: serum estradiol, serum progesterone, clinical pregnancy, frozen embryo transfer
Procedia PDF Downloads 7118051 The Influence of Emotional Intelligence Skills on Innovative Start-Ups Coaching: A Neuro-Management Approach
Authors: Alina Parincu, Giuseppe Empoli, Alexandru Capatina
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The purpose of this paper is to identify the most influential predictors of emotional intelligence skills, in the case of 20 business innovation coaches, on the co-creation of knowledge through coaching services delivered to innovative start-ups from Europe, funded through Horizon 2020 – SME Instrument. We considered the emotional intelligence skills (self-awareness, self-regulation, motivation, empathy and social skills) as antecedent conditions of the outcome: the quality of coaching services, perceived by the entrepreneurs who received funding within SME instrument, using fuzzy-sets qualitative comparative analysis (fsQCA) approach. The findings reveal that emotional intelligence skills, trained with neuro-management techniques, were associated with increased goal-focused business coaching skills.Keywords: neuro-management, innovative start-ups, business coaching, fsQCA
Procedia PDF Downloads 16418050 Comparing the ‘Urgent Community Care Team’ Clinical Referrals in the Community with Suggestions from the Clinical Decision Support Software Dem DX
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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage
Procedia PDF Downloads 14518049 Reliability Analysis of a Fuel Supply System in Automobile Engine
Authors: Chitaranjan Sharma
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The present paper deals with the analysis of a fuel supply system in an automobile engine of a four wheeler which is having both the option of fuel i.e. PETROL and CNG. Since CNG is cheaper than petrol so the priority is given to consume CNG as compared to petrol. An automatic switch is used to start petrol supply at the time of failure of CNG supply. Using regenerative point technique with Markov renewal process, the reliability characteristics which are useful to system designers are obtained.Keywords: reliability, redundancy, repair time, transition, probability, regenerative points, markov renewal, process
Procedia PDF Downloads 54418048 A Single Stage Rocket Using Solid Fuels in Conventional Propulsion Systems
Authors: John R Evans, Sook-Ying Ho, Rey Chin
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This paper describes the research investigations orientated to the starting and propelling of a solid fuel rocket engine which operates as combined cycle propulsion system using three thrust pulses. The vehicle has been designed to minimise the cost of launching small number of Nano/Cube satellites into low earth orbits (LEO). A technology described in this paper is a ground-based launch propulsion system which starts the rocket vertical motion immediately causing air flow to enter the ramjet’s intake. Current technology has a ramjet operation predicted to be able to start high subsonic speed of 280 m/s using a liquid fuel ramjet (LFRJ). The combined cycle engine configuration is in many ways fundamentally different from the LFRJ. A much lower subsonic start speed is highly desirable since the use of a mortar to obtain the latter speed for rocket means a shorter launcher length can be utilized. This paper examines the means and has some performance calculations, including Computational Fluid Dynamics analysis of air-intake at suitable operational conditions, 3-DOF point mass trajectory analysis of multi-pulse propulsion system (where pulse ignition time and thrust magnitude can be controlled), etc. of getting a combined cycle rocket engine use in a single stage vehicle.Keywords: combine cycle propulsion system, low earth orbit launch vehicle, computational fluid dynamics analysis, 3dof trajectory analysis
Procedia PDF Downloads 18618047 Cooperative Learning Mechanism in Intelligent Multi-Agent System
Authors: Ayman M. Mansour, Bilal Hawashin, Mohammed A. Mansour
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In this paper, we propose a cooperative learning mechanism in a multi-agent intelligent system. The basic idea is that intelligent agents are capable of collaborating with one another by sharing their knowledge. The agents will start collaboration by providing their knowledge rules to the other agents. This will allow the most important and insightful detection rules produced by the most experienced agent to bubble up for the benefit of the entire agent community. The updated rules will lead to improving the agents’ decision performance. To evaluate our approach, we designed a five–agent system and implemented it using JADE and FuzzyJess software packages. The agents will work with each other to make a decision about a suspicious medical case. This system provides quick response rate and the decision is faster than the manual methods. This will save patients life.Keywords: intelligent, multi-agent system, cooperative, fuzzy, learning
Procedia PDF Downloads 67618046 A Design of Anisotropic Wet Etching System to Reduce Hillocks on Etched Surface of Silicon Substrate
Authors: Alonggot Limcharoen Kaeochotchuangkul, Pathomporn Sawatchai
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This research aims to design and build a wet etching system, which is suitable for anisotropic wet etching, in order to reduce etching time, to reduce hillocks on the etched surface (to reduce roughness), and to create a 45-degree wall angle (micro-mirror). This study would start by designing a wet etching system. There are four main components in this system: an ultrasonic cleaning, a condenser, a motor and a substrate holder. After that, an ultrasonic machine was modified by applying a condenser to maintain the consistency of the solution concentration during the etching process and installing a motor for improving the roughness. This effect on the etch rate and the roughness showed that the etch rate increased and the roughness was reduced.Keywords: anisotropic wet etching, wet etching system, hillocks, ultrasonic cleaning
Procedia PDF Downloads 11218045 Income Analysis of Beef Cattle Breeders for Traditional Profit-Sharing System, Tesang, in South Sulawesi Province
Authors: Sitti Nurani Sirajuddin, Muh. Aminawar, Siti Nurlaelah, Amidah Amrawaty
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This study aimed to determine the income of beef cattle breeders from the traditional profit-sharing system named Tesang. This study was conducted in the province of South Sulawesi start from April to July 2014, used quantitative methods and data analysis is of income. The population is all beef cattle breeders who perform for the traditional profit-sharing system (Tesang) in Barru Regency and Bone Regency, province of South Sulawesi. Samples are beef cattle breeders who breeding the cattle with the traditional profit-sharing system (Tesang) in Barru Regency and Bone Regency using breeding system and cattle enlargement system (expense) by fifty breeders. The results showed beef cattle breeder’s income from the profit-sharing system (Tesang) where enlargement system (expense) at6th month maintenance periods higher than the profit-sharing system (Tesang) with using breeding the cattle.Keywords: income, beef cattle, profit-sharing system, Teseng
Procedia PDF Downloads 27418044 Converting Scheduling Time into Calendar Date Considering Non-Interruptible Construction Tasks
Authors: Salman Ali Nisar, Suzuki Koji
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In this paper we developed a new algorithm to convert the project scheduling time into calendar date in order to handle non-interruptible activities not to be split by non-working days (such as weekend and holidays). In a construction project some activities might require not to be interrupted even on non-working days, or to be finished on the end day of business days. For example, concrete placing work might be required to be completed by the end day of weekdays i.e. Friday, and curing in the weekend. This research provides an algorithm that imposes time constraint for start and finish times of non-interruptible activities. The algorithm converts working days, which is obtained by Critical Path Method (CPM), to calendar date with consideration of the start date of a project. After determining the interruption by non-working days, the start time of a certain activity should be postponed, if there is enough total float value. Otherwise, the duration is shortened by hiring additional resources capacity or/and using overtime work execution. Then, time constraints are imposed to start time and finish time of the activity. The algorithm is developed in Excel Spreadsheet for microcomputer and therefore we can easily get a feasible, calendared construction schedule for such a construction project with some non-interruptible activities.Keywords: project management, scheduling, critical path method, time constraint, non-interruptible tasks
Procedia PDF Downloads 49618043 Wall Heat Flux Mapping in Liquid Rocket Combustion Chamber with Different Jet Impingement Angles
Authors: O. S. Pradeep, S. Vigneshwaran, K. Praveen Kumar, K. Jeyendran, V. R. Sanal Kumar
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The influence of injector attitude on wall heat flux plays an important role in predicting the start-up transient and also determining the combustion chamber wall durability of liquid rockets. In this paper comprehensive numerical studies have been carried out on an idealized liquid rocket combustion chamber to examine the transient wall heat flux during its start-up transient at different injector attitude. Numerical simulations have been carried out with the help of a validated 2d axisymmetric, double precision, pressure-based, transient, species transport, SST k-omega model with laminar finite rate model for governing turbulent-chemistry interaction for four cases with different jet intersection angles, viz., 0o, 30o, 45o, and 60o. We concluded that the jets intersection angle is having a bearing on the time and location of the maximum wall-heat flux zone of the liquid rocket combustion chamber during the start-up transient. We also concluded that the wall heat flux mapping in liquid rocket combustion chamber during the start-up transient is a meaningful objective for the chamber wall material selection and the lucrative design optimization of the combustion chamber for improving the payload capability of the rocket.Keywords: combustion chamber, injector, liquid rocket, rocket engine wall heat flux
Procedia PDF Downloads 48118042 Developing Social Responsibility Values in Nascent Entrepreneurs through Role-Play: An Explorative Study of University Students in the United Kingdom
Authors: David W. Taylor, Fernando Lourenço, Carolyn Branston, Paul Tucker
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There are an increasing number of students at Universities in the United Kingdom engaging in entrepreneurship role-play to explore business start-up as a career alternative to employment. These role-play activities have been shown to have a positive influence on students’ entrepreneurial intentions. Universities also play a role in developing graduates’ awareness of social responsibility. However, social responsibility is often missing from these entrepreneurship role-plays. It is important that these role-play activities include the development of values that support social responsibility, in-line with those running hybrid, humane and sustainable enterprises, and not simply focus on profit. The Young Enterprise (YE) Start-Up programme is an example of a role-play activity that is gaining in popularity amongst United Kingdom Universities seeking ways to give students insight into a business start-up. A Post-92 University in the North-West of England has adapted the traditional YE Directorship roles (e.g., Marketing Director, Sales Director) by including a Corporate Social Responsibility (CSR) Director in all of the team-based YE Start-Up businesses. The aim for introducing this Directorship was to observe if such a role would help create a more socially responsible value-system within each company and in turn shape business decisions. This paper investigates role-play as a tool to help enterprise educators develop socially responsible attitudes and values in nascent entrepreneurs. A mixed qualitative methodology approach has been used, which includes interviews, role-play, and reflection, to help students develop positive value characteristics through the exploration of unethical and selfish behaviors. The initial findings indicate that role-play helped CSR Directors learn and gain insights into the importance of corporate social responsibility, influenced the values and actions of their YE Start-Ups, and increased the likelihood that if the participants were to launch a business post-graduation, that the intent would be for the business to be socially responsible. These findings help inform educators on how to develop socially responsible nascent entrepreneurs within a traditionally profit orientated business model.Keywords: student entrepreneurship, young enterprise, social responsibility, role-play, values
Procedia PDF Downloads 14418041 Development of Electroencephalograph Collection System in Language-Learning Self-Study System That Can Detect Learning State of the Learner
Authors: Katsuyuki Umezawa, Makoto Nakazawa, Manabu Kobayashi, Yutaka Ishii, Michiko Nakano, Shigeichi Hirasawa
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This research aims to develop a self-study system equipped with an artificial teacher who gives advice to students by detecting the learners and to evaluate language learning in a unified framework. 'Detecting the learners' means that the system understands the learners' learning conditions, such as each learner’s degree of understanding, the difference in each learner’s thinking process, the degree of concentration or boredom in learning, and problem solving for each learner, which can be interpreted from learning behavior. In this paper, we propose a system to efficiently collect brain waves from learners by focusing on only the brain waves among the biological information for 'detecting the learners'. The conventional Electroencephalograph (EEG) measurement method during learning using a simple EEG has the following disadvantages. (1) The start and end of EEG measurement must be done manually by the experiment participant or staff. (2) Even when the EEG signal is weak, it may not be noticed, and the data may not be obtained. (3) Since the acquired EEG data is stored in each PC, there is a possibility that the time of data acquisition will be different in each PC. This time, we developed a system to collect brain wave data on the server side. This system overcame the above disadvantages.Keywords: artificial teacher, e-learning, self-study system, simple EEG
Procedia PDF Downloads 13618040 A Perspective on Emergency Care of Gunshot Injuries in Northern Taiwan
Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang
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Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.Keywords: gunshot, length of stay, trauma, mortality
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