Search results for: emergency response team

Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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Authors: Ahmed Atef, Mohamed Alhasheem, Eman Beshr

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In this paper, an enhanced DC microgrid design is proposed using the DAB converter as a conversion unit in order to harvest the maximum power from the PV array. Each connected DAB converter is controlled with an enhanced control strategy. The controller is based on the artificial intelligence (AI) technique to regulate the terminal PV voltage through the phase shift angle of each DAB converter. In this manner, no need for a Maximum Power Point Tracking (MPPT) unit to set the reference of the PV terminal voltage. This strategy overcomes the stability issues of the DC microgrid as the response of converters is superior compared to the conventional strategies. The proposed PV interface system is modelled and simulated using MATLAB/SIMULINK. The simulation results reveal an accurate and fast response of the proposed design in case of irradiance changes.

Keywords: DC microgrid, DAB converter, parallel operation, artificial intelligence, fast response

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Authors: F. A. F. da Ponte, J. Q. Malveira, I. A. Maciel, M. C. G. Albuquerque

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In this work aviation, biofuel production was studied by fatty acids (C6 to C16) esterification. The process variables in heterogeneous catalysis were evaluated using an experimental design. Temperature and reaction time were the studied parameters, and the methyl esters content was the response of the experimental design. An ion exchange resin was used as a heterogeneous catalyst. The process optimization was carried out using response surface methodology (RSM) and polynomial model of second order. Results show that the most influential variables on the linear coefficient of each effect studied were temperature and reaction time. The best result of methyl esters conversion in the experimental design was under the conditions: 10% wt of catalyst; 100 °C and 4 hours of reaction. The best-achieved conversion was 96.5% wt of biofuel.

Keywords: esterification, ion-exchange resins, response surface methodology, biofuel

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Authors: Okan Cakir, Okan Tatli

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Acute motor and sensory axonal neuropathy (AMSAN) syndrome usually occurs following a postviral infection in two to four weeks and is a polyneuropathy characterized by axonal and sensorial degeneration as a rare variant of Gullian-Barre syndrome. In our case, we wanted to mention that a rare case of AMSAN Syndrome due to prior surgery. A 61-year-old male case admitted to emergency department with complaints of weakness in feet, numbness and incapability to walk. In his history, it was learned that endovascular aneurysm repair (EVAR) had applied for abdominal aort aneurysm two weeks ago before admission, his complaints had been for a couple of days increasingly and bilaterally, and there had been no infection disease history for four weeks. In physical examination, general status was good, vital signs were stable, and there was a mild paresis in dorsal flexion of feet in bilaterally lower extremities. No nuchal rigidity was determined. Other system examinations were normal. Urea:52 mg/dL (normal range: 15-44 mg/dL), creatinine: 1,05 mg/dL (normal range: 0,81-1,4 mg/dL), potassium: 3,68 mmol/L (normal range: 3,5-5,5 mmol/L), glycaemia: 142 mg/dL, calcium: 9,71 mg/dL (normal range: 8,5-10,5 mg/dL), erythrocyte sedimentation rate (ESR): 74 mm/h (normal range: 0-15 mm/h) were determined in biochemical tests. The case was consulted to neurology department and hospitalized. In performing electromyography, it was reported as a bilateral significant axonal degeneration with sensory-motor polyneuropathy. Normal ranges of glycaemia and protein levels were detected in lumbal punction. Viral markers and bucella, toxoplasma, and rubella markers were in normal range. Intravenous immunoglobulin (IVIG) was applied as a treatment, physical treatment programme was planned and the case discharged from neurology department. In our case, we mentioned that it should be considered polyneuropathy as an alternative diagnosis in cases admitting symptoms like weakness and numbness had a history of prior surgery.

Keywords: AMSAN Syndrome, emergency department, prior surgery, weakness

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Authors: Joshua Osondu

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This research explores how Artificial Intelligence (AI) can be utilized as a policy response to address teaching and learning (TL) issues in education in Ghana. The dual (AI and human) instructor model is used as a theoretical framework to examine how AI can be employed to improve teaching and learning processes and to equip learners with the necessary skills in the emerging AI society. A qualitative research design was employed to assess the impact of AI on various TL issues, such as teacher workloads, a lack of qualified educators, low academic performance, unequal access to education and educational resources, a lack of participation in learning, and poor access and participation based on gender, place of origin, and disability. The study concludes that AI can be an effective policy response to TL issues in Ghana, as it has the potential to increase students’ participation in learning, increase access to quality education, reduce teacher workloads, and provide more personalized instruction. The findings of this study are significant for filling in the gaps in AI research in Ghana and other developing countries and for motivating the government and educational institutions to implement AI in TL, as this would ensure quality, access, and participation in education and help Ghana industrialize.

Keywords: artificial intelligence, teacher, learner, students, policy response

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Authors: Ajay Das, Sandip Basu

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Introduction: There is increasing recognition that diverse streams of knowledge can often be recombined in novel ways to generate new knowledge. However, knowledge recombination theory has not been applied to examine the effects of collaborator diversity on the quality of knowledge such collaborators produce. This is surprising because one would expect that a collaborative team with certain aspects of diversity should be able to recombine process elements related to knowledge development, which are relatively tacit, but also complementary because of the collaborator’s varying backgrounds. Theory and Hypotheses: We propose to examine two aspects of diversity in the environments of collaborative teams to try and capture such potential recombinations of relatively tacit, process knowledge. The first aspect of diversity in team members’ environments is geographical. Collaborators with more geographical distance between them (perhaps working in different countries) often have more autonomy in the processes they adopt for knowledge development. In the absence of overt monitoring, such collaborators are likely to adopt differing approaches to knowledge development. The sharing of such varying approaches among collaborators is likely to result in greater quality of the common collaborative pursuit. The second aspect is diversity in the work backgrounds of team members. Such diversity can also increase the potential for knowledge recombination. For example, if one or more members are from a manufacturing center (versus all of them being from a purely R&D center), such members will provide unique perspectives on the implementation of innovative ideas. Again, knowledge that has been evaluated from these diverse perspectives is likely to be of a higher quality. In addition to the above aspects of environmental diversity among team members, we also plan to examine the extent to which individual collaborators are in different environments from the primary innovation center of their employing firms. Proposed Methods: We will test our model on a sample of firms in the semiconductor industry. Our level of analysis will be individual patents generated by these firms and the teams involved in the generation of these. Information on manufacturing activities of our sample firms will be obtained from SEMI, a proprietary database of the semiconductor industry, as well as company 10-K reports. Conclusion: We believe that our results will represent a preliminary attempt to understand how various forms of diversity in collaborative teams impact the knowledge development process. Our dependent variable of knowledge quality is important to study since higher values of this variable can not only drive firm performance but the broader development of regions and societies through spillover impacts on future innovation. The results of this study will, therefore, inform future research and practice in innovation, geographical location, and vertical integration.

Keywords: innovation, manufacturing strategy, knowledge, diversity

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Authors: Badache Messaoud

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Geothermal thermosyphons (GTs) are increasingly used in many heating and cooling geothermal applications owing to their high heat transfer performance. This paper proposes a response surface methodology (RSM) to investigate and optimize the performance of a CO2 geothermal thermosyphon. The filling ratio (FR), temperature, and flow rate of the heat transfer fluid are selected as the designing parameters, and heat transfer rate and effectiveness are adopted as response parameters (objective functions). First, a dedicated experimental GT test bench filled with CO2 was built and subjected to different test conditions. An RSM was used to establish corresponding models between the input parameters and responses. Various diagnostic tests were used to assess evaluate the quality and validity of the best-fit models, which explain respectively 98.9% and 99.2% of the output result’s variability. Overall, it is concluded from the RSM analysis that the heat transfer fluid inlet temperatures and the flow rate are the factors that have the greatest impact on heat transfer (Q) rate and effectiveness (εff), while the FR has only a slight effect on Q and no effect on εff. The maximal heat transfer rate and effectiveness achieved are 1.86 kW and 47.81%, respectively. Moreover, these optimal values are associated with different flow rate levels (mc level = 1 for Q and -1 for εff), indicating distinct operating regions for maximizing Q and εff within the GT system. Therefore, a multilevel optimization approach is necessary to optimize both the heat transfer rate and effectiveness simultaneously.

Keywords: geothermal thermosiphon, co2, Response surface methodology, heat transfer performance

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Authors: Baluku Nathan

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Transferring critically ill patients from one health facility to another poses a major risk to the patient because of increased oxygen demands. transferring patients with critical COVID-19 from a rural health canter in a rural district to a national referral hospital over 350 km in 7 hours would require three size H oxygen cylinders for successful transfer. It was always difficult to arrange the three size cylinders in the ambulance as workspace was greatly compromised for the ambulance assistant. Purpose: The purpose of this study was to investigate the impact and effectiveness of transport ventilators on the transportation of the critically ill patients from rural health canters to national referral hospitals in Uganda. Methodology: This was a descriptive cross-sectional study conducted in sept 2022 among critical care nurses and ambulance assistants who had used both methods of transportation (ventilators and cylinders). A semi structured questionnaire was used to collect quantitative data after informed consent. Results: From the findings, distribution of transport ventilators to the regional referral hospitals by the Ministry of Health has gradually improved patient transfer as the team requires less than one size oxygen cylinder to successfully transfer a patient. We use two ambulance assistants (a critical care nurse and another nurse who has been trained on use of the ventilator) when transferring patients with critical COVID-19 as the teams have to interchange over the long distance. Conclusions: Transport ventilators are effective and efficient in transferring critically ill patients, therefore should be rolled out to lower levels coupled with user training to improve outcomes of patients transferred in ambulances in lower income countries.

Keywords: emergency medical technician, critically ill, COVID-19, transport ventilator

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Authors: Akshay A. Pandya, B. R. Parekh

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This paper presents how earth fault damage in the transformer can be detected by Sweep Frequency Response Analysis (SFRA). The test methods used by the authors for presenting the results are described. The power transformer of rating 10 KVA, 11000 V/440 V, 3-phase, 50 Hz, Dyn11 has been specially developed in-house for carrying out SFRA testing by practically simulated various transformer damages on it. Earth fault has been practically simulated on HV “U” phase winding and LV “W” phase winding separately. The result of these simulated faults are presented and discussed. The motivation of this presented work is to extend the guideline approach; there are ideas to organize database containing collected measurement results. Since the SFRA interpretation is based on experience, such databases are thought to be of great importance when interpreting SFRA response. The evaluation of the SFRA responses against guidelines and experience have to be performed and conclusions regarding usefulness of each simulation has been drawn and at last overall conclusion has also been drawn.

Keywords: earth fault damage, power transformer, practical simulation, SFRA traces, transformer damages

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Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

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Authors: Raida Zouari, Iness Ahriz, Rafik Zayani, Ali Dziri, Ridha Bouallegue

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This paper proposes a room level indoor localization algorithm based on the use Multi-Layer Neural Network (MLNN) classifiers and one versus one strategy. Seven parameters of the Channel Impulse Response (CIR) were used and Gram-Shmidt Orthogonalization was performed to study the relevance of the extracted parameters. Simulation results show that when relevant CIR parameters are used as position fingerprint and when optimal MLNN architecture is selected good room level localization score can be achieved. The current study showed also that some of the CIR parameters are not correlated to the location and can decrease the localization performance of the system.

Keywords: mobile indoor localization, multi-layer neural network (MLNN), channel impulse response (CIR), Gram-Shmidt orthogonalization

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Authors: Phatthara Surachon, Tosaphol Ratniyomchai, Thanatchai Kulworawanichpong

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This paper presents an aerodynamic brake study of reducing braking distance for high-speed trains (HST) using aerodynamic brakes as inspiration from the applications on the commercial aircraft wings. In case of emergency, both braking distance and stopping time are longer than the usual situation. Therefore, the passenger safety and the HST driving control management are definitely obtained by reducing the time and distance of train braking during emergency situation. Due to the limited study and implementation of the aerodynamic brake in HST, the possibility in use and the effectiveness of the aerodynamic brake to the train dynamic movement during braking are analyzed and considered. Regarding the aircraft’s flaps that applied in the HST, the areas of the aerodynamic brake acted as an additional drag force during train braking are able to vary depending on the operating angle and the required dynamic braking force. The HST with a varying speed of 200 km/h to 350 km/h is taken as a case study of this paper. The results show that the stopping time and the brake distance are effectively reduced by the aerodynamic brakes. The mechanical brake and its maintenance are effectively getting this benefit by extending its lifetime for longer use.

Keywords: high-speed train, aerodynamic brake, brake distance, drag force

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Authors: Alaaeddeen M. Seufi

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Many have been published on therapeutic derivatives from living organisms including insects. In addition to traditional maggot therapy, more than 900 therapeutic products were isolated from insects. Most people look at insects as enemies and others believe that insects are friends. Many beneficial insects rather than Honey Bees, Silk Worms and Shellac insect could insure human-insect friendship. In addition, insects could be MicroFactories, Biosensors or Bioreactors. InsectFarm is an amazing example of the applied research that transfers insects from laboratory to market by Prof Mircea Ciuhrii and co-workers. They worked for 18 years to derive therapeutics from insects. Their research resulted in production of more than 30 commercial medications derived from insects (e.g. Imunomax, Noblesse, etc.). Two general approaches were followed to discover drugs from living organisms. Some laboratories preferred biochemical approach to purify components of the innate immune system of insects and insect metabolites as well. Then the purified components could be tested for many therapeutic trials. Other researchers preferred molecular approach based on proteomic studies. Components of the innate immune system of insects were then tested for their medical activities. Our Laboratory team preferred to induce insect immune system (using oral, topical and injection routes of administration), then a transcriptomic study was done to discover the induced genes and to identify specific biomarkers that can help in drug discovery. Biomarkers play an important role in medicine and in drug discovery and development as well. Optimum biomarker development and application will require a team approach because of the multifaceted nature of biomarker selection, validation, and application. This team uses several techniques such as pharmacoepidemiology, pharmacogenomics, and functional proteomics; bioanalytical development and validation; modeling and simulation to improve and refine drug development. Our Achievements included the discovery of four components of the innate immune system of Spodoptera littoralis and Musca domestica. These components were designated as SpliDef (defesin), SpliLec (lectin), SpliCec (cecropin) and MdAtt (attacin). SpliDef, SpliLec and MdAtt were confirmed as antimicrobial peptides, while SpliCec was additionally confirmed as anticancer peptide. Our current research is going on to achieve something in antioxidants and anticoagulants from insects. Our perspective is to achieve something in the mass production of prototypes of our products and to reach it to the commercial level. These achievements are the integrated contributions of everybody in our team staff.

Keywords: AMPs, insect, innate immunitty, therappeutics

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Authors: Steven J. Singer, Julianna F. Kamenakis, Allison R. Shapiro, Kimberly M. Cacciato

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Communication and language are topics frequently studied among deaf children. However, there is limited research that focuses specifically on the communication and language experiences of Deaf-Disabled children. In this ethnography, researchers investigated the language experiences of six sets of parents with Deaf-Disabled children who chose American Sign Language (ASL) as the preferred mode of communication for their child. Specifically, the researchers were interested in the factors that influenced the parents’ decisions regarding their child’s communication options, educational placements, and social experiences. Data collection in this research included 18 hours of semi-structured interviews, 20 hours of participant observations, over 150 pages of reflexive journals and field notes, and a 2-hour focus group. The team conducted constant comparison qualitative analysis using NVivo software and an inductive coding procedure. The four researchers each read the data several times until they were able to chunk it into broad categories about communication and social influences. The team compared the various categories they developed, selecting ones that were consistent among researchers and redefining categories that differed. Continuing to use open inductive coding, the research team refined the categories until they were able to develop distinct themes. Two team members developed each theme through a process of independent coding, comparison, discussion, and resolution. The research team developed three themes: 1) early medical needs provided time for the parents to explore various communication options for their Deaf-Disabled child, 2) without intervention from medical professionals or educators, ASL emerged as a prioritized mode of communication for the family, 3) atypical gender roles affected familial communication dynamics. While managing the significant health issues of their Deaf-Disabled child at birth, families and medical professionals were so fixated on tending to the medical needs of the child that the typical pressures of determining a mode of communication were deprioritized. This allowed the families to meticulously research various methods of communication, resulting in an informed, rational, and well-considered decision to use ASL as the primary mode of communication with their Deaf-Disabled child. It was evident that having a Deaf-Disabled child meant an increased amount of labor and responsibilities for parents. This led to a shift in the roles of the family members. During the child’s development, the mother transformed from fulfilling the stereotypical roles of nurturer and administrator to that of administrator and champion. The mother facilitated medical proceedings and educational arrangements while the father became the caretaker and nurturer of their Deaf-Disabled child in addition to the traditional role of earning the family’s primary income. Ultimately, this research led to a deeper understanding of the critical role that time plays in parents’ decision-making process regarding communication methods with their Deaf-Disabled child.

Keywords: American Sign Language, deaf-disabled, ethnography, sociolinguistics

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Authors: Z. Arabshahi, I. Afara, A. Oloyede, H. Moody, J. Kashani, T. Klein

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Articular cartilage is a fluid-swollen tissue of synovial joints that functions by providing a lubricated surface for articulation and to facilitate the load transmission. The biomechanical function of this tissue is highly dependent on the integrity of its ultrastructural matrix. Any alteration of articular cartilage matrix, either by injury or degenerative conditions such as osteoarthritis (OA), compromises its functional behaviour. Therefore, the assessment of articular cartilage is important in early stages of degenerative process to prevent or reduce further joint damage with associated socio-economic impact. Therefore, there has been increasing research interest into the functional assessment of articular cartilage. This study developed a characterization parameter for articular cartilage assessment based on the response of cartilage surface to loading/unloading. This is because the response of articular cartilage to compressive loading is significantly depth-dependent, where the superficial zone and underlying matrix respond differently to deformation. In addition, the alteration of cartilage matrix in the early stages of degeneration is often characterized by PG loss in the superficial layer. In this study, it is hypothesized that the response of superficial layer is different in normal and proteoglycan depleted tissue. To establish the viability of this hypothesis, samples of visually intact and artificially proteoglycan-depleted bovine cartilage were subjected to compression at a constant rate to 30 percent strain using a ring-shaped indenter with an integrated ultrasound probe and then unloaded. The response of articular surface which was indirectly loaded was monitored using ultrasound during the time of loading/unloading (deformation/recovery). It was observed that the rate of cartilage surface response to loading/unloading was different for normal and PG-depleted cartilage samples. Principal Component Analysis was performed to identify the capability of the cartilage surface response to loading/unloading, to distinguish between normal and artificially degenerated cartilage samples. The classification analysis of this parameter showed an overlap between normal and degenerated samples during loading. While there was a clear distinction between normal and degenerated samples during unloading. This study showed that the cartilage surface response to loading/unloading has the potential to be used as a parameter for cartilage assessment.

Keywords: cartilage integrity parameter, cartilage deformation/recovery, cartilage functional assessment, ultrasound

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Authors: A. Yacob, N. Hj. Ali, M. H. Yusoff, M. Y. MohdSaman, W. M. A. F. W. Hamzah

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Personalized learning becomes increasingly popular which not is restricted by time, place or any other barriers. This study proposes an analysis of Personalized Learning using Item Response Theory which considers course material difficulty and learner ability. The study investigates twenty undergraduate students at TATI University College, who are taking programming subject. By using the IRT, it was found that, finding the most appropriate problem levels to each student include high and low level test items together is not a problem. Thus, the student abilities can be asses more accurately and fairly. Learners who experience more anxiety will affect a heavier cognitive load and receive lower test scores. Instructors are encouraged to provide a supportive learning environment to enhance learning effectiveness because Cognitive Load Theory concerns the limited capacity of the brain to absorb new information.

Keywords: assessment, item response theory, cognitive load theory, learning, motivation, performance

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Authors: Nahid Tavakoli, Asghar Ehteshami, Akbar Hassanzadeh, Fatemeh Amini

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Introduction: The Information security incident management guidelines was been developed to help hospitals to meet their information security event and incident management requirements. The purpose of this Study was to investigate on Information Security Incident Management in Isfahan’s educational hospitals in accordance to ISO/IEC 27002 standards. Methods: This was a cross-sectional study to investigate on Information Security Incident Management of educational hospitals in 2014. Based on ISO/IEC 27002 standards, two checklists were applied to check the compliance with standards on Reporting Information Security Events and Weakness and Management of Information Security Incidents and Improvements. One inspector was trained to carry out the assessments in the hospitals. The data was analyzed by SPSS. Findings: In general the score of compliance Information Security Incident Management requirements in two steps; Reporting Information Security Events and Weakness and Management of Information Security Incidents and Improvements was %60. There was the significant difference in various compliance levels among the hospitals (p-valueKeywords: information security incident management, information security management, standards, hospitals

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Authors: Peter Boyes, Sarah Sharples, Paul Tennent, Gary Priestnall, Jeremy Morley

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Significant long-term investment projects can involve complex decisions. These are often described as capital projects, and the factors that contribute to their complexity include budgets, motivating reasons for investment, stakeholder involvement, interdependent projects, and the delivery phases required. The complexity of these projects often requires management groups to be established involving stakeholder representatives; these teams are inherently multidisciplinary. This study uses two university campus capital projects as case studies for this type of management group. Due to the interaction of projects with wider campus infrastructure and users, decisions are made at varying spatial granularity throughout the project lifespan. This spatial-related context brings complexity to the group decisions. Sensemaking is the process used to achieve group situational awareness of a complex situation, enabling the team to arrive at a consensus and make a decision. The purpose of this study is to understand the role of people and data in the complex spatial related long-term decision and sensemaking processes. The paper aims to identify and present issues experienced in practical settings of these types of decision. A series of exploratory semi-structured interviews with members of the two projects elicit an understanding of their operation. From two stages of thematic analysis, inductive and deductive, emergent themes are identified around the group structure, the data usage, and the decision making within these groups. When data were made available to the group, there were commonly issues with the perception of veracity and validity of the data presented; this impacted the ability of group to reach consensus and, therefore, for decisions to be made. Similarly, there were different responses to forecasted or modelled data, shaped by the experience and occupation of the individuals within the multidisciplinary management group. This paper provides an understanding of further support required for team sensemaking and decision making in complex capital projects. The paper also discusses the barriers found to effective decision making in this setting and suggests opportunities to develop decision support systems in this team strategic decision-making process. Recommendations are made for further research into the sensemaking and decision-making process of this complex spatial-related setting.

Keywords: decision making, decisions under uncertainty, real decisions, sensemaking, spatial, team decision making

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Muhammad Rizwan, Naveed Ahmad, Akhtar Naeem Khan

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Seismic behavior factors are evaluated for the performance assessment of low rise reinforced concrete RC frame structures based on experimental study of unidirectional dynamic shake table testing of two 1/3rd reduced scaled two storey frames, with a code confirming special moment resisting frame (SMRF) model and a noncompliant model of similar characteristics but built in low strength concrete .The models were subjected to a scaled accelerogram record of 1994 Northridge earthquake to deformed the test models to final collapse stage in order to obtain the structural response parameters. The fully compliant model was observed with more stable beam-sway response, experiencing beam flexure yielding and ground-storey column base yielding upon subjecting to 100% of the record. The response modification factor - R factor obtained for the code complaint and deficient prototype structures were 7.5 and 4.5 respectively, which is about 10% and 40% less than the UBC-97 specified value for special moment resisting reinforced concrete frame structures.

Keywords: Northridge 1994 earthquake, reinforced concrete frame, response modification factor, shake table testing

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Authors: Mahacine Amrani

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This paper aims at reviewing some Moroccan industrial applications of wavelet especially in the dynamic identification of a process model using Haar wavelet mother response. Two recent Moroccan study cases are described using dynamic data originated by a distillation column and an industrial polyethylene process plant. The purpose of the wavelet scheme is to build on-line dynamic models. In both case studies, a comparison is carried out between the Haar wavelet mother response model and a linear difference equation model. Finally it concludes, on the base of the comparison of the process performances and the best responses, which may be useful to create an estimated on-line internal model control and its application towards model-predictive controllers (MPC). All calculations were implemented using AutoSignal Software.

Keywords: process performance, model, wavelets, Haar, Moroccan

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Authors: Reem Al-Garni

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Malnutrition is a global epidemic, but the under-weight or Failure-To-Thrive risk is increasing in rehabilitation setting and considered one of the contribution factor for developmental delay. Beside the consequences of malnutrition on children growth and development, there are other side-effects that might delay or hold the progress of rehabilitation. The awareness for malnutrition must be raised and discussed by the rehabilitation team, to promote the treatment and to optimize the client care. The solution can start from food supplements intake and / or Enteral Nutrition plan, depending on the malnutrition level and to reach the goal, the medical team should to work together in order to provide comprehensive treatment and to help the family to be able to manage their child condition. We have explore the outcomes of rehabilitation between the children with CP whose diagnosed with malnutrition and children with normal body Wight Over a period of 4 months who received 4-6 weeks of rehabilitation two hours daily by using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings reported that children with normal body Wight has better outcomes and improvement comparing with children with malnutrition for the entire study sample.

Keywords: Cerebral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, malnutrition

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Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

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Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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Authors: Daniel E. Martin, Chenghai Yang

Abstract:

Variable-rate aerial application systems are becoming more readily available; however, aerial applicators typically only use the systems for constant-rate application of materials, allowing the systems to compensate for upwind and downwind ground speed variations. Much of the resistance to variable-rate aerial application system adoption in the U.S. pertains to applicator’s trust in the systems to turn on and off automatically as desired. The objectives of this study were to evaluate a commercially available variable-rate aerial application system under field conditions to demonstrate both the response and accuracy of the system to desired application rate inputs. This study involved planting oats in a 35-acre fallow field during the winter months to establish a uniform green backdrop in early spring. A binary (on/off) prescription application map was generated and a variable-rate aerial application of glyphosate was made to the field. Airborne multispectral imagery taken before and two weeks after the application documented actual field deposition and efficacy of the glyphosate. When compared to the prescription application map, these data provided application system response and accuracy information. The results of this study will be useful for quantifying and documenting the response and accuracy of a commercially available variable-rate aerial application system so that aerial applicators can be more confident in their capabilities and the use of these systems can increase, taking advantage of all that aerial variable-rate technologies have to offer.

Keywords: variable-rate, aerial application, remote sensing, precision application

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Authors: Afolakemi Helen Olaleye, Ogunjobi A. O

Abstract:

Since coronavirus disease 2019 (COVID-19) was first reported in Nigeria, the virus has spread to virtually all sub-Saharan Africa (SSA) countries. In Nigeria, government agencies came together to create a goal-driven taskforce in improving our response against the virus. As COVID-19 international spread has been curtailed, community spread became rampant locally, leading to many health authorities raising concerns over the scarcity of medical consumables and supplies. Here at Lagos university teaching Hospital (LUTH), we present data analysis of COVID-19 infections offered at our Hospital (LUTH) and the surrounding communities. In addition, the adopted innovative solution to control the spread of infection, methods used in filling shortages of consumables, personal protective equipment (PPE), and use of mobile video technology in patient’s consultation. The management style and strategy adopted has led to a decline in infection rates in our community and among our front line staff. The current COVID -19 crisis has created an opportunity to test and demonstrate our pandemic response and control of infectious disease along with the revealed unknown potential in our community.

Keywords: COVID-19, preparedness, response, Lagos university teaching hospital

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Authors: Robyn Jackaman

Abstract:

This research explores the characterization of leadership, self-awareness, and gender identity within a higher educational institution. This is in response to the widely researched area of gender in relation to senior management levels and the contemporary reflection of this issue in leadership, where gender diversity is lacking. Through organizational platforms, the University has self-identified issues relating to gender, equality, and representation. With equality being central to the core of the project, a Community Participatory Action Research approach was implemented. This approach was chosen as it is recognized for facilitating change within community contexts which complements the University Campus culture. Seventeen semi-structured interviews gave qualitative insight into working habitus (from both professional and academic services), leadership attributions and qualities and gender significance within the workplace. The research team (cross-disciplinary) used framework analysis to code and categorized the data. Key findings presented categories in gender significance to personal/work identity, organizational change and positive reflections on leadership characteristics and roles. This research has helped support the creation of tools to better assist the organization in gender equality, inclusion, and leadership development.

Keywords: gendered work, gender equality, leadership, university organization

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Authors: Harun Rashid, Keerthi S. S. Atapaththu, Takashi Asaeda

Abstract:

Cesium (Cs) induced growth and stress response of Nitella were studied after exposure to four concentration of the metal; i.e. 0 (control), 0.001, 0.01, and 0.1 ppm Cs in growth media. Each treatment with three replicates were randomly allocated to 12 glass beakers in a complete randomize design and the experiment was continued for 30 days. At the end of the experiment, shoot length, cesium content, total chlorophyll, and plant stress response were compared. Anti-oxidant enzyme activities (peroxidase, catalase, and ascorbic peroxidase) and the concentration of H2O2 were measured to check plant stress. The longest shoot was found in control treatment (0 ppm Cs) and the shoot length of plants exposed to 0.001 ppm was statistically similar to that of control. Concentration of cesium in plants grown at 0.001, 0.01, and 0.1 ppm were significantly higher than those in control treatments. The antioxidant enzymes activities of plants exposed to cesium were significantly higher than those grown without any Cs (control). An elevated level of H2O2 concentration was also observed in former groups of plants. Further, the reduction in chlorophyll concentration and chlorophyll fluorescence in response to cesium exposure indicated the chronically damaged photosynthetic efficiency in cesium stressed Nitella.

Keywords: antioxidant enzymes, cesium, growth, Nitella, oxidative stress

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Authors: Eduardo Kanagushiku Pereira, Frank Gregory Cavalcante da Silva, Barbara Soares Gonçalves, Ana Lúcia Bergamasco Galastri, Ronei Luciano Mamoni

Abstract:

The inflammatory response initiates after the recognition of pathogens by receptors expressed by innate immune cells. Among these receptors, the NLRP3 was associated with the recognition of pathogenic fungi in experimental models. NLRP3 operates forming a multiproteic complex called inflammasome, which actives caspase-1, responsible for the production of the inflammatory cytokines IL-1beta and IL-18. In this study, we aimed to investigate the involvement of NLRP3 in the inflammatory response elicited in macrophages against Paracoccidioides brasiliensis (Pb), the etiologic agent of PCM. Macrophages were differentiated from THP-1 cells by treatment with phorbol-myristate-acetate. Following differentiation, macrophages were stimulated by Pb yeast cells for 24 hours, after previous treatment with specific NLRP3 (3,4-methylenedioxy-beta-nitrostyrene) and/or caspase-1 (VX-765) inhibitors, or specific inhibitors of pathways involved in NLRP3 activation such as: Reactive Oxigen Species (ROS) production (N-Acetyl-L-cysteine), K+ efflux (Glibenclamide) or phagossome acidification (Bafilomycin). Quantification of IL-1beta and IL-18 in supernatants was performed by ELISA. Our results showed that the production of IL-1beta and IL-18 by THP-1-derived-macrophages stimulated with Pb yeast cells was dependent on NLRP3 and caspase-1 activation, once the presence of their specific inhibitors diminished the production of these cytokines. Furthermore, we found that the major pathways involved in NLRP3 activation, after Pb recognition, were dependent on ROS production and K+ efflux. In conclusion, our results showed that NLRP3 participates in the recognition of Pb yeast cells by macrophages, leading to the activation of the NLRP3-inflammasome and production of IL-1beta and IL-18. Together, these cytokines can induce an inflammatory response against P. brasiliensis, essential for the establishment of the initial inflammatory response and for the development of the subsequent acquired immune response.

Keywords: inflammation, IL-1beta, IL-18, NLRP3, Paracoccidioidomycosis

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Authors: Fouad Inel, Lakhdar Khochemane

Abstract:

This article presents a comparative response specification performance between two controllers of three and four cable based robots for various applications. The main objective of this work is: the first is to use the direct and inverse geometric model to study and simulate the end effector position of the robot with three and four cables. A graphical user interface has been implemented in order to visualizing the position of the robot. Secondly, we present the determination of static and dynamic tensions and lengths of cables required to flow different trajectories. At the end, we study the response of our systems in closed loop with a Proportional-IntegratedDerivative (PID) and Proportional-Integrated (PD) controllers then this last are compared the results of the same examples using MATLAB/Simulink; we found that the PID method gives the better performance, such as rapidly speed response, settling time, compared to PD controller.

Keywords: dynamic modeling, geometric modeling, graphical user interface, open loop, parallel cable-based robots, PID/PD controllers

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Authors: Eakarat Boonreang, Anothai Harasarn

Abstract:

The objectives of this study are to investigate the flood disaster management capacity of communities in Ubon Ratchathani province, Thailand, and to recommend the sustainable flood management approaches of communities in Ubon Ratchathani province, Thailand. The selected population consisted of the community leaders and committees, the executives of local administrative organizations, and the head of Ubon Ratchathani provincial office of disaster prevention and mitigation. The data was collected by in-depth interview, focus group, and observation. The data was analyzed and classified in order to determine the communities’ capacity in flood disaster management. The results revealed that communities’ capacity were as follows, before flood disaster, the community leaders held a meeting with the community committees in order to plan disaster response and determined evacuation routes, and the villagers moved their belongings to higher places and prepared vehicles for evacuation. During flood disaster, the communities arranged motorboats for transportation and villagers evacuated to a temporary evacuation center. Moreover, the communities asked for survival bags, motorboats, emergency toilets, and drinking water from the local administrative organizations and the 22nd Military Circle. After flood disaster, the villagers cleaned and fixed their houses and also collaborated in cleaning the temple, school, and other places in the community. The recommendation approaches for sustainable flood disaster management consisted of structural measures, such as the establishment of reservoirs and building higher houses, and non-structural measures such as raising awareness and fostering self-reliance, establishing disaster management plans, rehearsal of disaster response procedures every year, and transferring disaster knowledge among younger generations. Moreover, local administrative organizations should formulate strategic plans that focus on disaster management capacity building at the community level, particularly regarding non-structural measures. Ubon Ratchathani provincial offices of disaster prevention and mitigation should continually monitor and evaluate the outcomes of community based disaster risk management program, including allocating more flood disaster management-related resources among local administrative organizations and communities.

Keywords: capacity building, community based disaster risk management, flood disaster management, Thailand

Procedia PDF Downloads 152