Search results for: friction surfaces of airport emergency plan

Authors: Bernardo C. P. Albuquerque, Darym J. F. Campos

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Increasing our ability to solve complex engineering problems is directly related to the processing capacity of computers. By means of such equipments, one is able to fast and accurately run numerical algorithms. Besides the increasing interest in numerical simulations, probabilistic approaches are also of great importance. This way, statistical tools have shown their relevance to the modelling of practical engineering problems. In general, statistical approaches to such problems consider that the random variables involved follow a normal distribution. This assumption tends to provide incorrect results when skew data is present since normal distributions are symmetric about their means. Thus, in order to visualize and quantify this aspect, 9 statistical distributions (symmetric and skew) have been considered to model a hypothetical slope stability problem. The data modeled is the friction angle of a superficial soil in Brasilia, Brazil. Despite the apparent universality, the normal distribution did not qualify as the best fit. In the present effort, data obtained in consolidated-drained triaxial tests and saturated direct shear tests have been modeled and used to analytically derive the probability density function (PDF) of the safety factor of a hypothetical slope based on Mohr-Coulomb rupture criterion. Therefore, based on this analysis, it is possible to explicitly derive the failure probability considering the friction angle as a random variable. Furthermore, it is possible to compare the stability analysis when the friction angle is modelled as a Dagum distribution (distribution that presented the best fit to the histogram) and as a Normal distribution. This comparison leads to relevant differences when analyzed in light of the risk management.

Keywords: statistical slope stability analysis, skew distributions, probability of failure, functions of random variables

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Authors: Jessie Fazel, Kristen Smith

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Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

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Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

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Describing clinical cases according to a clinical charting standard that enforces interoperability and enables connected care services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. This article presented a multi-tenant extension to the problem-oriented medical record that we have prototyped previously upon using the GraphQL Application Programming Interface to represent the notion of a problem list. Our implemented extension enables physicians and patients to collaboratively describe the patient case via using multi chatbots to collaboratively describe the patient case using the SOAP charting standard. Our extension also connects the described SOAP patient case with the HL7 FHIR (Health Interoperability Resources) medical record for connecting the patient case to the bench data.

Keywords: problem-oriented medical record, graphQL, chatbots, SOAP

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Authors: Aleksandr Kalinenko, Igor Vysotskiy, Sergey Malopheyev, Sergey Mironov, Rustam Kaibyshev

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From a thermo-mechanical standpoint, friction-stir welding (FSW) represents a unique combination of very large strains, high temperature and relatively high strain rate. The material behavior under such extreme deformation conditions is not studied well and thus, the microstructural examinations of the friction-stir welded materials represent an essential academic interest. Moreover, a clear understanding of the microstructural mechanisms operating during FSW should improve our understanding of the microstructure-properties relationship in the FSWed materials and thus enables us to optimize their service characteristics. Despite extensive research in this field, the microstructural behavior of some important structural materials remains not completely clear. In order to contribute to this important work, the present study was undertaken to examine the grain structure evolution during the FSW of 6061-T6 aluminum alloy. To provide an in-depth insight into this process, the electron backscatter diffraction (EBSD) technique was employed for this purpose. Microstructural observations were conducted by using an FEI Quanta 450 Nova field-emission-gun scanning electron microscope equipped with TSL OIMTM software. A suitable surface finish for EBSD was obtained by electro-polishing in a solution of 25% nitric acid in methanol. A 15° criterion was employed to differentiate low-angle boundaries (LABs) from high-angle boundaries (HABs). In the entire range of the studied FSW regimes, the grain structure evolved in the stir zone was found to be dominated by nearly-equiaxed grains with a relatively high fraction of low-angle boundaries and the moderate-strength B/-B {112}<110> simple-shear texture. In all cases, the grain-structure development was found to be dictated by an extensive formation of deformation-induced boundaries, their gradual transformation to the high-angle grain boundaries. Accordingly, the grain subdivision was concluded to the key microstructural mechanism. Remarkably, a gradual suppression of this mechanism has been observed at relatively high welding temperatures. This surprising result has been attributed to the reduction of dislocation density due to the annihilation phenomena.

Keywords: electron backscatter diffraction, friction-stir welding, heat-treatable aluminum alloys, microstructure

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Authors: N. S. Achour, M. Hamdaoui, S. Ben Nasrallah, A. Perwuelz

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The main idea of this work is to investigate the effect of knitted fabrics characteristics on moisture management properties. Wetting and transport properties of single jersey, Rib 1&1 and English Rib fabrics made out of cotton and blended Cotton/Polyester yarns were studied. The dynamic water sorption of fabrics was investigated under same isothermal and terrestrial conditions at 20±2°C-65±2% by using the Moisture Management Tester (MMT) which can be used to quantitatively measure liquid moisture transfer in one step in a fabric in multi directions: Absorption rate, moisture absorbing time of the fabric's inner and outer surfaces, one-way transportation capability, the spreading/drying rate, the speed of liquid moisture spreading on fabric's inner and outer surfaces are measured, recorded and discussed. The results show that fabric’s composition and knit’s structure have a significant influence on those phenomena.

Keywords: knitted fabrics characteristics, moisture management properties, multi directions, the moisture management tester

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Authors: Abbas Shafiee, Mohammad Taghi Ahmadian, Maryam Hoviattalab

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The biomechanical behavior of brain tissue is needed for predicting the traumatic brain injury (TBI). Each year over 1.5 million people sustain a TBI in the USA. The appropriate coefficients for injury prediction can be evaluated using experimental data. In this study, an experimental setup on brain soft tissue was developed to perform unconfined compression tests at quasistatic strain rates ∈0.0004 s-1 and 0.008 s-1 and 0.4 stress relaxation test under unconfined uniaxial compression with ∈ 0.67 s-1 ramp rate. The fitted visco-hyperelastic parameters were utilized by using obtained stress-strain curves. The experimental data was validated using finite element analysis (FEA) and previous findings. Also, influence of friction coefficient on unconfined compression and relaxation test and effect of ramp rate in relaxation test is investigated. Results of the findings are implemented on the analysis of a human brain under high acceleration due to impact.

Keywords: brain soft tissue, visco-hyperelastic, finite element analysis (FEA), friction, quasistatic strain rate

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Authors: Zhiyong Shan, Preethi Santhanam, Vinod Namboodiri, Rajiv Bagai

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In recent years, the emerging network worms and attacks have distributive characteristics, which can spread globally in a very short time. Security management crossing networks to co-defense network-wide attacks and improve the efficiency of security administration is urgently needed. We propose a hierarchical distributed network security management system (HD-NSMS), which can integrate security management across multiple networks. First, we describe the system in macrostructure and microstructure; then discuss three key problems when building HD-NSMS: device model, alert mechanism, and emergency response mechanism; lastly, we describe the implementation of HD-NSMS. The paper is valuable for implementing NSMS in that it derives from a practical network security management system (NSMS).

Keywords: network security management, device organization, emergency response, cross-network

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Authors: Manganyi Patricia Siphiwe

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Work environments are characterised by performance pressure and mechanisation, which lead to job stress and the dehumanisation of work spaces. The personnel’s competence to accomplish job responsibilities and high job demands lead to a substantial load of health. Therefore, providing employees with conducive working environments is essential. In order to attain it, the employer should ensure that responsive and institutional safe systems are in place. The employer’s responses to employees’ needs are of significance to a healthy and developmental work environment. Denying employees a developmental and flourishing workplace is to deprive a workplace of being humane. Stressors coming from various aspects in the workplace can yield undue pressure and undesired responses for the workforces. Against the profiled background, this paper examines the causes and consequences of workplace stress within the Emergency Medical sector. The paper utilised a qualitative methodology and in-depth interviews for data collection with the purposively sampled emergency medical personnel. The findings showed that workplace stress has been associated with high demands and lack of support which has an adverse effect on biopsychosocial wellbeing of employees. This paper, therefore, recommends an engaged involvement of social workers through work organisational initiatives, such as Employee Assistance Programmes (EAP) and related labour relations policy activities to promote positive and developmental working environments.

Keywords: stress, employee, workplace, wellbeing

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Authors: Ahmad K. Samaila, Basant K. Jha

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This study is devoted to investigate the effect of transpiration on transient as well as steady-state natural convection flow of a reactive viscous fluid in a vertical channel formed by two infinite vertical parallel porous plates. The Boussinesq assumption is applied and the nonlinear governing equations of energy and momentum are developed. The problem is solved numerically using implicit finite difference method and analytically for steady-state case using perturbation method. Solutions are presented in graphical form for fluid temperature, velocity, and skin-friction and wall heat transfer rate for various parametric values. It is found that velocity, temperature, rate of heat transfer as well as skin-friction are strongly affected by mass leakage through the porous plates.

Keywords: transpiration, reactive viscous fluid, porous plates, natural convection, suction/injection

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Authors: Kariem Elhelow

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The task of optimizing teeth surface relations remains perplexing for many dental practitioners. The well-being of teeth, periodontium, and the musculoskeletal system is closely associated with occlusal stability. Dental occlusion is rather far beyond the simple contact of the occlusal surfaces of the opposite jaws, a fact that turned the word “Occlusion” into one of the most complicated puzzles in dentistry. The literature describing the pathological approaches made the practice of occlusion even more intimidating. Understanding the biomechanics of teeth and jaw movements makes the goals of occlusal rehabilitation very lively and simple to practice. The purpose of this article is to establish a path for understanding and practicing the fundamental occlusal principles in a simple yet in depth way. Relying of the evidence based core would deliver a context for showing that occlusion is not as complicated as literatures might reflect. Conclusion: Maintaining a well-defined picture of what a healthy occlusion should be like is very gratifying to both the operator and the patient, with added worth of predictability, esthetics, and function to the whole treatment.

Keywords: occlusal, temporomandibular joint, prosthetic, dentition

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Authors: Maher El-Masri, Jamie Crawley, Judy Bornais, Abeer Omar

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Background: Misuse of Emergency Department (ED) for non-urgent healthcare results in unnecessary crowdedness that can result in long ED waits and delays in treatment, diversion of ambulances to other hospitals, poor health outcomes for patients, and increased risk of death Objectives: The main purpose of this study was to explore the independent predictors of non-urgent ED visits in Erie St. Clair LHIN. Secondary purposes of the study include comparison of the rates of non-urgent ED visits between urban and rural hospitals Design: A secondary analysis of archived population-based data on 597,373 ED visits in southwestern Ontario Results The results suggest that older (OR = .992; 95% CI .992 – .993) and female patients (OR = .940; 95% CI .929 - .950) were less likely to visit ED for non-urgent causes. Non-urgent ED visits during the winter, spring, and fall were 13%, 5.8%, and 7.5%, respectively, lesser than they were during the summer time. The data further suggest that non-urgent visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts compared to the day shift. Non-urgent visits were 2.76 times more likely to present to small community hospitals than large community hospitals. Health care providers were 1.92 times more likely to refer patients with non-urgent health problem to the ED than the decision taken by patients, family member or caretakers. Conclusion: In conclusion, our study highlights a number of important factors that are associated with inappropriate use of ED visits for non-urgent health problems. Knowledge of these factors could be used to address the issue of unnecessary ED crowdedness.

Keywords: emergency department, non-urgent visits, predictors, logistic regression

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Authors: Ling Dai

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Surface-sensing devices such as atomic force microscope have been widely used to characterize the surface structure and properties of nanoscale polymer films. However, using molecular dynamics simulations, we show that there is intrinsic and unavoidable inelastic deformation at polymer surfaces induced by the sensing tip. For linear chain polymers like perfluoropolyether, such tip-induced deformation derives from the differences in the atomic interactions which are atomic specie-based Van der Waals interactions, and resulting in atomic shuffling and causing inelastic alternation in both molecular structures and mechanical properties at the regions of the polymer surface. For those aromatic chain polymers like epoxy, the intrinsic deformation is depicted as the intra-chain rotation of aromatic rings and kinking of linear atomic connections. The present work highlights the need to reinterpret the data obtained from surface-sensing tests by considering this intrinsic inelastic deformation occurring at polymer surfaces.

Keywords: polymer, surface, nano, molecular dynamics

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Authors: Sameer Masood, Lucas Chartier

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Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.

Keywords: choosing wisely, emergency department, head injury, quality improvement

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Authors: Rhodine Hickman, Craig Wylie, Michael G. McCaul

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Introduction: The World Health Organisation has called on governments around the world to recognise emergency conditions as a global public health problem and respond with appropriate steps for effective preventative strategies. However, to understand the magnitude of the problem, good quality epidemiological data is required. This is especially challenging in low and middle-income countries, where routine data is scarce, specifically within the prehospital setting. Methods: We conducted a retrospective cross-sectional study of a national prehospital private sector EMS database. The database being the property of ER24 (private Emergency Medical Services (EMS) company in South Africa) contains claims submitted by the majority of ambulance services in South Africa during the period between 1 January 2008 to 28 March 2017. We used descriptive statistics and control charts to describe the data using STATA 14. Results: 299,257 calls were included in the analysis. The top clinical conditions requiring ambulance transport were transport accidents (10% of total call volume) and ischaemic heart disease (4.4%). The number of transport accidents consistently increased between 2009 and 2014 and reached beyond the limit for normal variation in 2015. Victims of transport accidents required basic life support services 60% of the time with 80% of injuries being minor to moderate. The frequency of ischaemic heart disease had a steady incline from 2011 to 2016. Advanced life support services were required about 50% of the time, with 60% of patients needing urgent care. Conclusion: Transport accidents, followed by ischaemic heart disease, are the most prevalent conditions in South African private EMS. There is a potential to address these conditions by developing the capacity of low and mid-level providers in trauma and advanced EMS providers in ischaemic heart disease.

Keywords: emergency care, emergency medicine, prehospital providers, South Africa

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Authors: Jinkoo Kim, Hyungoo Kang, Hyungjun Shin

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In this study, a hybrid energy dissipation device is developed by combining a steel slit plate and friction pads to be used for seismic retrofit of structures, and its effectiveness is investigated by comparing the life cycle costs of the structure before and after the retrofit. The seismic energy dissipation capability of the dampers is confirmed by cyclic loading tests. The probabilities of reaching various damage states are obtained by fragility analysis, and the life cycle costs of the model structures are computed using the PACT (Performance Assessment Calculation Tool) program based on FEMA P-58 methodology. The fragility analysis shows that the probabilities of reaching limit states are minimized by the seismic retrofit with hybrid dampers and increasing column size. The seismic retrofit with increasing column size and hybrid dampers results in the lowest repair cost and shortest repair time.

Keywords: slit dampers, friction dampers, seismic retrofit, life cycle cost, FEMA P-58, PACT

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Authors: Atefeh Omidkhah, Mohammadreza Bemanian

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The issue of way-finding earmarks a wide range of literature in architecture and despite the 50 year background of way-finding studies, it still lacks a comprehensive theory for indoor settings. Way-finding has a notable role in emergency evacuation as well. People in the panic situation of a fire emergency need to find the safe egress route correctly and in as minimum time as possible. In this regard the parameters of an appropriate way-finding are mentioned in the evacuation related researches albeit scattered. This study reviews the fire safety related literature to extract a way-finding related framework for architectural purposes of the design of a safe evacuation route. In this regard a research trend review in addition with applied methodological approaches review is conducted. Then by analyzing eight original researches related to way-finding parameters in fire evacuation, main parameters that affect way-finding in emergency situation of a fire incident are extracted and a framework was developed based on them. Results show that the issues related to exit route and emergency evacuation can be chased in task oriented studies of way-finding. This research trend aims to access a high-level framework and in the best condition a theory that has an explanatory capability to define differences in way-finding in indoor/outdoor settings, complex/simple buildings and different building types or transitional spaces. The methodological advances demonstrate the evacuation way-finding researches in line with three approaches that the latter one is the most up-to-date and precise method to research this subject: real actors and hypothetical stimuli as in evacuation experiments, hypothetical actors and stimuli as in agent-based simulations and real actors and semi-real stimuli as in virtual reality environment by adding multi-sensory simulation. Findings on data-mining of 8 sample of original researches in way-finding in evacuation indicate that emergency way-finding design of a building should consider two level of space cognition problems in the time of emergency and performance consequences of them in the built environment. So four major classes of problems in way-finding which are visual information deficiency, confusing layout configuration, improper navigating signage and demographic issues had been defined and discussed as the main parameters that should be provided with solutions in design and interior of a building. In the design phase of complex buildings, which face more reported problem in way-finding, it is important to consider the interior components regarding to the building type of occupancy and behavior of its occupants and determine components that tend to become landmarks and set the architectural features of egress route in line with the directions that they navigate people. Research on topological cognition of environmental and its effect on way-finding task in emergency evacuation is proposed for future.

Keywords: architectural design, egress route, way-finding, fire safety, evacuation

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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Authors: Taweechai Nuntawisuttiwong, Natasha Dejdumrong

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Geometric modeling plays an important role in the constructions and manufacturing of curve, surface and solid modeling. Their algorithms are critically important not only in the automobile, ship and aircraft manufacturing business, but are also absolutely necessary in a wide variety of modern applications, e.g., robotics, optimization, computer vision, data analytics and visualization. The calculation and display of geometric objects can be accomplished by these six techniques: Polynomial basis, Recursive, Iterative, Coefficient matrix, Polar form approach and Pyramidal algorithms. In this research, the coefficient matrix (simply called monomial form approach) will be used to model polynomial rectangular patches, i.e., Said-Ball, Wang-Ball, DP, Dejdumrong and NB1 surfaces. Some examples of the monomial forms for these surface modeling are illustrated in many aspects, e.g., construction, derivatives, model transformation, degree elevation and degress reduction.

Keywords: monomial forms, rectangular surfaces, CAGD curves, monomial matrix applications

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Authors: Dana Mohammed, Fatemah Abdullah, Hawraa Ali, Najat Al-Shaer, Rawan Al-Awadhi, , Magdy Helal

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We study the patient service performance at the emergency department of a major Kuwaiti public hospital, using discrete simulation and lean concepts. In addition to the common problems in such health care systems (over crowdedness, facilities planning and usage, scheduling and staffing, capacity planning) the emergency department suffered from several cultural and patient behavioural issues. Those contributed significantly to the system problems and constituted major obstacles in maintaining the performance in control. This led to overly long waiting times and the potential of delaying providing help to critical cases. We utilized the visual management tools to mitigate the impact of the patients’ behaviours and attitudes and improve the logistics inside the system. In addition a proposal is made to automate the date collection and communication within the department using RFID-based barcoding system. Discrete event simulation models were developed as decision support systems; to study the operational problems and assess achieved improvements. The simulation analysis resulted in cutting the patient delays to about 35% of their current values by reallocating and rescheduling the medical staff. Combined with the application of the visual management concepts, this provided the basis to improving patient service without any major investments.

Keywords: simulation, visual management, health care system, patient

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Authors: Petar Kurecic, Josipa Penic

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The paper represents a product of mentor-graduate student cooperation, developed at the graduate study of Business Economics, major Tourism. The analysis was made through the anonymous questionnaire filled by the respondents from Croatia. Following the latest threatening events and having in mind those yet to come, it can be concluded that no country can benefit from the tourism industry if at the same time does not develop its security system as an integral part of the standard tourist offer. Analyzing the trends in contemporary tourism, the safety and security issues became the decisive factors for the choice of a certain destination. Consequently, countries must not perceive security systems and measures as an unnecessary expense but as an essential element in organizing their tourist services. All hotels and respectable tourist agencies should have a crisis management, with detailed, thoroughly elaborated procedures for emergency situations. Tourists should be timely informed about the potential dangers and risks and the measures taken to prevent them, as well as on procedures for emergency situations. Additionally, it would be good to have mobile applications that would enable tourists to make direct emergency calls with instructions on behavior in crisis situations. It is also essential to implement and put into effect sophisticated security measures such as using surveillance cameras, controlling access to buildings, information exchange with colleagues and neighbors, reporting the suspicious occurrences to the security services, and training staff for crisis management. The security issue is definitely one of the crucial factors in the development of tourism in a certain country.

Keywords: security, security measures in tourism, tourism, tourist destinations

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Authors: H. Niranjan, S. Sivasankaran, Zailan Siri

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This study investigates mixed convection heat transfer about a thin vertical plate in the presence of magnetohydrodynamic (MHD) and heat transfer effects in the porous medium. The fluid is assumed to be steady, laminar, incompressible and in two-dimensional flow. The nonlinear coupled parabolic partial differential equations governing the flow are transformed into the non-similar boundary layer equations, which are then solved numerically using the shooting method. The effects of the conjugate heat transfer parameter, the porous medium parameter, the permeability parameter, the mixed convection parameter, the magnetic parameter, and the thermal radiation on the velocity and temperature profiles as well as on the local skin friction and local heat transfer are presented and analyzed. The validity of the methodology and analysis is checked by comparing the results obtained for some specific cases with those available in the literature. The various parameters on local skin friction, heat and mass transfer rates are presented in tabular form.

Keywords: MHD, porous medium, soret/dufour, stagnation-point

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Authors: Rachit Marwaha, Rahul Dev Gupta, Vivek Jain, Krishan Kant Sharma

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Metal matrix hybrid composites (MMHCs) are now gaining their usage in aerospace, automotive and other industries because of their inherent properties like high strength to weight ratio, hardness and wear resistance, good creep behaviour, light weight, design flexibility and low wear rate etc. Al alloy base matrix reinforced with silicon carbide (10%) and graphite (5%) particles was fabricated by stir casting process. The wear and frictional properties of metal matrix hybrid composites were studied by performing dry sliding wear test using pin on disc wear test apparatus. Experiments were conducted based on the plan of experiments generated through Taguchi’s technique. A L9 Orthogonal array was selected for analysis of data. Investigation to find the influence of applied load, sliding speed and track diameter on wear rate as well as coefficient of friction during wearing process was carried out using ANOVA. Objective of the model was chosen as smaller the better characteristics to analyse the dry sliding wear resistance. Results show that track diameter has highest influence followed by load and sliding speed.

Keywords: Taguchi method, orthogonal array, ANOVA, metal matrix hybrid composites

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Authors: Diobein C. Flores

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The populace in Municipality of Talaingod is composed of Ata-Manobo. The said lumads enrich their culture, orientation and self because the place is a hive of their tribe. In lieu, the study would analyze the participation of the Ata-Manobo in the making of school improvement plan (SIP). Thus, it recommends alternative policy options that would help strengthen their involvement. The school stakeholders-Ata Manobo representatives from students, parent-teacher association, alumni, basic sector, municipal/barangay government unit, civic/social organizations and other government various agencies are the key participants in this study. The research used descriptive design. The responses of the representatives were analyzed through the criteria involved in employing Rational Model. The technical dimension, administrative, political acceptability and economic are the criteria in revealing decision. The policy alternative option 3- recommends to formulate policy for the purpose of capacitating stakeholders or governing council members in the making of SIP was pointed out as the most preferred option. This could strengthen the participation among Ata-Manobo as stakeholders in planning. Hence, the formulation alternative policy- capacitating stakeholders in the crafting of school improvement plan is recommended. The suggested initiative would assist the Department of Education in forging consensus across neighborhoods during the making of SIP. The appropriation of the definite budget to be used during the conduct of capability building activities is also suggested. Training-workshops are identified as possible intervention to ensure that the stakeholders are equipped with necessary knowledge and skills needed in the making of SIP. Indeed, the equal opportunities for all stakeholders regardless of their life circumstances must be noted. With the belief, people must be empowered to take advantage and spearhead progress in the making of SIP.

Keywords: Ata-Manobo Tribe, stakeholders, school improvement plan, Municipality of Talaingod, Philippines

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Authors: Theo Welch

Abstract:

Background: Gamma-hydroxybutyrate (GHB) is a depressant of the central nervous system with euphoric effects. It is being increasingly used recreationally in the United Kingdom (UK) despite associated morbidity and mortality. Due to the lack of evidence, healthcare professionals remain unsure as to the optimum management of GHB acute toxicity. Methods: A literature review was undertaken of its pharmacology and the emergency management of its acute toxicity.Findings: GHB is inexpensive and readily available over the Internet. Treatment of GHB acute toxicity is supportive. Clinicians should pay particular attention to the airway as emesis is common. Intubation is required in a minority of cases. Polydrug use is common and worsens prognosis. Conclusion: An inexpensive and readily available drug, GHB acute toxicity can be difficult to identify and treat. GHB acute toxicity is generally treated conservatively. Further research is needed to ascertain the indications, benefits, and risks of intubating patients with GHB acute toxicity. instructions give you guidelines for preparing papers for the conference.

Keywords: GHB, gamma-hydroxybutyrate, prehospital, emergency, toxicity, management

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Authors: Sergio Luiz da Costa Junior, Carolina Fofonka Palomino, Paulo Cesar Lodi

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The use of light landfills is an effective solution for road works in soft ground sites, such as Rio de Janeiro (RJ) and Santos (SP) - the Southeastern Brazilian coast. The technique consists in replacing the topsoil by expandable polystyrene (EPS) geofoam, lined with geomembrane to prevent the attack of chemical products.Thus, knowing the interface shear strength of those materials is important in projects to avoid rupturing the system. The purpose of this paper is to compare the shear strength in the geomembrane-EPS interfaces by the direct shear test. The tests were performed under the dry and saturated condition, and four kind of high-density polyethylene (HDPE) 2,00mm geomembranes were used, smooth and texturized - manufactured in the flat die and blown film process. It was found that the shear strength is directly influenced by the roughness of the geomembrane, showed higher friction angle in the textured geomembrane. The direct shear test, in the saturated condition, also showed smaller friction angle than the now-wetted test.

Keywords: geofoam, geomembrane, soft ground, strength shear

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Authors: Zaid A. Janjua, Barbara Turnbull, Kwing-So Choi

Abstract:

The adhesion of glaze ice on power infrastructure, ships and aerofoils cause monetary and structural damage. Here we investigate the influence of temperature as an important parameter affecting adhesion strength of ice. Two terms are defined to investigate this: 'freezing temperature', the temperature at which glaze ice forms; and 'ambient temperature', the temperature of the surrounding during the test. Using three metal surfaces, the adhesion strength of ice has been calculated as a value of shear stress at the point of detachment on a spinning centrifuge. Findings show that the ambient temperature has a greater influence than the freezing temperature on the adhesion strength of ice. This is because there exists an amorphous liquid-like layer at the ice-surface interface, whose bond with the surface increases in strength at lower ambient temperatures when the substrate conducts heat much faster than the ice and acts as a heat sink. The results will help us to measure the actual adhesion strength of ice to metal surfaces based on data from weather monitoring devices. Future tests envisaged focus on thermally non-conducting substrates and their influence on adhesion strength.

Keywords: ice adhesion, centrifuge, glaze ice, freezing temperature, ambient temperature

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Authors: An-Yi Wang, Wei-Fong Kao, Shin-Han Tsai

Abstract:

Introduction: Information as patient characteristics, resuscitation scene, resuscitation provider perspectives and families wish affects on resuscitation decision-making for out-of-hospital cardiac arrest (OHCA). There is no consistency consensus on how families and emergency physicians approach this decision. The main purpose of our study is to evaluate the characteristics of withholding resuscitation efforts arrival at the hospital. Methods: We retrospectively analyzed patients with OHCA without pre-hospital return-of-spontaneous circulation (ROSC) who was sent to our emergency department (ED) between January 2014 and December 2015. Baseline characteristics, pre-hospital course, and causes of the cardiopulmonary arrest among patients were compared. Results: In 2 years, total 155 arrest patients without pre-hospital ROSC was included. 33(21.3%) patients withhold the resuscitation efforts in ED with mean resuscitation duration 4.45 ± 7.04 minutes after ED arrival. In withholding group, the initial rhythm of arrests was all non-shockable. 9 of them received endotracheal intubation before decision-making. None of the patients in withhold resuscitation group survived to discharge. There was no significant difference among gender, underlying cardiovascular disease, malignancy, chronic renal disease, nor witness collapse between withhold and continue resuscitation groups. Univariate analysis showed there was lower percentage of bystander resuscitation (32.3% vs. 50.4%, p=0.071), and the lower percentage of transport via emergency medical service (EMS) (78.8% vs. 91.8%, p=0.054) in withholding group. Multivariate analysis showed old age (adjusted odds ratio=1.06, 95% C.I.=[1.02-1.11], p<0.05), with underlying respiratory insufficiency (adjusted odds ratio=12.16, 95% C.I.=[3.34-44.29], p<0.05), living at home compared with nursing home (adjusted odds ratio=37.75, 95% C.I.=[1.09-1110.70], p<0.05) were more likely to withhold resuscitation. Transport via EMS was more likely to continue resuscitation (adjusted odds ratio=0.11, 95% C.I.=[0.02-0.71], p<0.05). Conclusion: The decision-making for families and emergency physicians to withhold or continue resuscitation for out-of-hospital cardiac arrest is complex and multi-factorial. Continue resuscitation efforts in nursing home residents is high, and further study among this population is warranted.

Keywords: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, termination resuscitation, withhold resuscitation

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Authors: Hadjer Didouh, Izzaddine Sameut Bouhaik, Mohammed Hadj Meliani

Abstract:

This research delves into the intricate dynamics of biofilm adhesion on surfaces, particularly focusing on the widely employed X52 surface in oil and gas industry pipelines. Biofilms, characterized by microorganisms within a self-produced matrix, pose significant challenges due to their detrimental impact on surfaces. Our study integrates advanced molecular techniques and cutting-edge microscopy, such as scanning electron microscopy (SEM), to identify microbial communities and visually assess biofilm adhesion. Simultaneously, we concentrate on the X52 surface, utilizing impedance spectroscopy and potentiodynamic polarization to gather electrochemical responses under various conditions. In conjunction with the broader investigation, we propose a novel approach to mitigate biofilm-induced corrosion challenges. This involves environmentally friendly inhibitors derived from plants, offering a sustainable alternative to conventional chemical treatments. Our inquiry screens and selects inhibitors based on their efficacy in hindering biofilm formation and reducing corrosion rates on the X52 surface. This study contributes valuable insights into the interplay between electrochemical processes and biofilm attachment on the X52 surface. Furthermore, the outcomes of this research have broader implications for the oil and gas industry, where biofilm-related corrosion is a persistent concern. The exploration of eco-friendly inhibitors not only holds promise for corrosion control but also aligns with environmental considerations and sustainability goals. The comprehensive nature of this research aims to enhance our understanding of biofilm dynamics, provide effective strategies for corrosion mitigation, and contribute to sustainable practices in pipeline management within the oil and gas sector.

Keywords: bio-corrosion, biofilm, attachment, X52, metal/bacteria interface

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Authors: Anuruddha Jagoda, Samiddhi Samarakoon, Anil Jasinghe

Abstract:

In an emergency department ‘where every second count for patient’s management’ timely availability of X- rays play a vital role in early diagnosis and management of patients. Trauma care centers rely heavily on timely radiologic imaging for patient care and radiology plays a crucial role in the emergency department (ED) operations. A research study was carried out to assess timeliness of availability of X-rays and total turnaround time at the Accident Service of National Hospital of Sri Lanka which is the premier trauma center in the country. Digital Radiology system was implemented as an intervention to improve the timeliness of availability of X-rays. Post-implementation assessment was carried out to assess the effectiveness of the intervention. Reduction in all three aspects of waiting times namely waiting for initial examination by doctors, waiting until X –ray is performed and waiting for image availability was observed after implementation of the intervention. However, the most significant improvement was seen in waiting time for image availability and reduction in time for image availability had indirect impact on reducing waiting time for initial examination by doctors and waiting until X –ray is performed. The most significant reduction in time for image availability was observed when performing 4-5 X rays with DR system. The least improvement in timeliness was seen in patients who are categorized as critical.

Keywords: emergency department, digital radilogy, timeliness, trauma care

Procedia PDF Downloads 255