Search results for: quality of consumption

Authors: Masoud Mohammadpour, Blair Carlson, Radovan Kovacevic

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The quality of laser welded-brazed (LWB) joints were strongly dependent on the main process parameters, therefore the effect of laser power (3.2–4 kW), welding speed (60–80 mm/s) and wire feed rate (70–90 mm/s) on mechanical strength and surface roughness were investigated in this study. The comprehensive optimization process by means of response surface methodology (RSM) and desirability function was used for multi-criteria optimization. The experiments were planned based on Box– Behnken design implementing linear and quadratic polynomial equations for predicting the desired output properties. Finally, validation experiments were conducted on an optimized process condition which exhibited good agreement between the predicted and experimental results. AlSi3Mn1 was selected as the filler material for joining aluminum alloy 6022 and hot-dip galvanized steel in coach peel configuration. The high scanning speed could control the thickness of IMC as thin as 5 µm. The thermal simulations of joining process were conducted by the Finite Element Method (FEM), and results were validated through experimental data. The Fe/Al interfacial thermal history evidenced that the duration of critical temperature range (700–900 °C) in this high scanning speed process was less than 1 s. This short interaction time leads to the formation of reaction-control IMC layer instead of diffusion-control mechanisms.

Keywords: laser welding-brazing, finite element, response surface methodology (RSM), multi-response optimization, cross-beam laser

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Authors: Won Young Choi, Kwan Kyu Park

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Recently, the road depression happening in the urban area is different from the cause of the sink hole and the generation mechanism occurring in the limestone area. The main cause of sinkholes occurring in the city center is the loss of soil due to the damage of old underground buried materials and groundwater discharge due to large underground excavation works. The method of detecting the sinkhole in the urban area is mostly using the Ground Penetration Radar (GPR). However, it is challenging to implement compact system and detecting watery state since it is based on electromagnetic waves. Although many ultrasonic underground detection studies have been conducted, near-ground detection (several tens of cm to several meters) has been developed for bulk systems using geophones as a receiver. The goal of this work is to fabricate a miniaturized sinkhole detecting system based on low-cost ultrasonic transducers of 40 kHz resonant frequency with high transmission pressure and receiving sensitivity. Motived by biomedical ultrasonic imaging methods, we detect air layers below the ground such as asphalt through the pulse-echo method. To improve image quality using multi-channel, linear array system is implemented, and image is acquired by classical synthetic aperture imaging method. We present the successful feasibility test of multi-channel sinkhole detector based on ultrasonic transducer. In this work, we presented and analyzed image results which are imaged by single channel pulse-echo imaging, synthetic aperture imaging.

Keywords: road depression, sinkhole, synthetic aperture imaging, ultrasonic transducer

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Authors: Müberra Yüksel, Ömer Faruk Görçün

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The purpose of the present study is to investigate the role of strategic human resource management (SHRM) in constructing "employer branding" in logistics. Prior research does not focus on internal stakeholders, that is, employees. Despite the fact that logistic sector has become customer-oriented, the focus is solely on service quality as the unique aspect of logistic companies for competitive advantage. With an increasing interest lately in internal marketing of the employer brand, the emphasis is on the value that human capital brings to the firm which cannot be imitated. `Employer branding` has been the application of branding and relationship marketing principles for competitive advantage in SHRM. Employer branding is an organizing framework for human resource managers since it represents an organization’s efforts to promote, both within and outside, a coherent view of what makes the firm different and desirable as an employer, i.e., the distinct “employer brand personality” and "employee value propositions" (EVP) offered. The presumption of employer branding enhanced by internal marketing is to make customer-conscious employees to handle services better by being aligned with business mission and goals. Starting from internal customers and analyzing the gaps of EVP by using analytical hierarchy process methodology (AHP) and inquiring whether these brand values are communicated and conceived well may be the initial steps in our proposal for employer branding in logistics sector. This empirical study aims to fill this research gap within the context of an emergent market- Turkey, which is located at a hub of transportation and logistics.

Keywords: Strategic Human Resource Management (SHRM), employer branding, Employee Value Propositions (EVP), Analytical Hierarchy Process (AHP), logistics

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Authors: Sara Parker, Kay Standing

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This paper will share insights into how menstruators bodies in Nepal are viewed and controlled in Nepal due to the deeply held stigmas and taboos that exist that frame menstrual blood as impure and polluting. It draws on a British Academy Global Challenges Research (BA/GCRF) funded project, ‘Dignity Without Danger,’ that ran from December 2019 to 2022. In Nepal, beliefs and myths around menstrual related practices prevail and vary in accordance to time, generation, caste and class. Physical seclusion and/or restrictions include the consumption of certain foods, the ability to touch certain people and objects, and restricted access to water sources. These restrictions not only put women at risk of poor health outcomes, but they also promote discrimination and challenge fundamental human rights. Despite the pandemic, a wealth of field research and creative outputs have been generated to help break the silence that surrounds menstruation and also highlights the complexity of addressing the harms associated with the exclusion from sacred and profane spaces that menstruators face. Working with locally recruited female research assistants, NGOS and brining together academics from the UK and Nepal, we explore the intersecting factors that impact on menstrual experiences and how they vary throughout Nepal. WE concur with Tamang that there is no such thing as a ‘Nepali Woman’, and there is no one narrative that captures the experiences of menstruators in Nepal. These deeply held beliefs and practices mean that menstruators are denied their right to a dignified menstruation. By being excluded from public and private spaces, such as temples and religious sites, as well as from kitchens and your own bedroom in your own home, these beliefs impact on individuals in complex and interesting ways. Existing research in Nepal by academics and activists demonstrates current programmes and initiatives do not fully address the misconceptions that underpin the exclusionary practices impacting on sexual and reproductive health, a sense of well being and highlight more work is needed in this area. Research has been conducted in all 7 provinces and through exploring and connecting disparate stories, artefacts and narratives, we will deepen understanding of the complexity of menstrual practices enabling local stakeholders to challenge exclusionary practices. By using creative methods to engage with stakeholders and share our research findings as well as highlighting the wealth of activism in Nepal. We highlight the importance of working with local communities, leaders and cutting across disciplines and agencies to promote menstrual justice and dignity. Our research findings and creative outputs that we share on social media channels such as Dignity Without Danger Facebook, Instagram and you tube stress the value of employing a collaborative action research approach to generate material which helps local people take control of their own narrative and change social relations that lead to harmful practices.

Keywords: menstruation, Nepal, stigma, social norms

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Authors: Mostafa Mabrouk, Basma E. Abdel-Ghany, Mona Moaness, Bothaina M. Abdel-Hady, Hanan H. Beherei

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Tissue engineering became a promising field for bone repair and regenerative medicine in which cultured cells, scaffolds and osteogenic inductive signals are used to regenerate tissues. The annual cost of treating bone defects in Egypt has been estimated to be many billions, while enormous costs are spent on imported bone grafts for bone injuries, tumors, and other pathologies associated with defective fracture healing. The current study is aimed at developing a more strategic approach in order to speed-up recovery after bone damage. This will reduce the risk of fatal surgical complications and improve the quality of life of people affected with such fractures. 3D scaffolds loaded with cheap nano-particles that possess an osteogenic effect were prepared by nano-electrospinning. The Microstructure and morphology characterizations of the 3D scaffolds were monitored using scanning electron microscopy (SEM). The physicochemical characterization was investigated using X-ray diffractometry (XRD) and infrared spectroscopy (IR). The Physicomechanical properties of the 3D scaffold were determined by a universal testing machine. The in vitro bioactivity of the 3D scaffold was assessed in simulated body fluid (SBF). The bone-bonding ability of novel 3D scaffolds was also evaluated. The obtained nanofibrous scaffolds demonstrated promising microstructure, physicochemical and physicomechanical features appropriate for enhanced bone regeneration. Therefore, the utilized nanomaterials loaded with the drug are greatly recommended as cheap alternatives to growth factors.

Keywords: bone regeneration, cheap scaffolds, nanomaterials, active molecules

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Authors: Ridha Abdulla Al Hammam

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Purpose: to measure the extent of perceived structural empowerment and work commitment the intensive care unit in SMC have in their work place. Background: nurses’ access to power structures (information, recourses, opportunity, and support) directly influences their productivity, retention, and job satisfaction. Exploring nurses’ level and sources of work commitment (affective, normative, and continuance) is very essential to guide nursing leaders making decisions to improve work environment to facilitate effective nursing care. Both concepts (Structural Empowerment and Work Commitment) were never investigated in our critical care unit. Methods: a sample of 50 nurses attained from the Intensive Care Unit (Adult). Conditions for Workplace Effectiveness Questionnaire and Three-Component Model Employee Commitment Survey were used to measure the two concepts respectively. The study is quantitative, descriptive, and correlational in design. Results: the participants reported moderate structural empowerment provided by their work place (M=15 out of 20). The sample perceived high access to opportunity mainly through gaining more skills (M=4.45 out of 5) where the rest power structures were perceived with moderate accessibility. The participants’ affective commitment (M=5.6 out of 7) to work in the ICU overweighed their normative and continuance commitment (M=5.1, M=4.9 out of 7) implying a stronger emotional connection with their unit. Strong positive and significant correlations were observed between the participants’ structural empowerment scores and all work commitment sources. Conclusion: these results provided an insight on aspects of work environment that need to be fostered and improved in our intensive care unit which have a direct linkage to nurses’ work commitment and potentially to their quality of care they provide.

Keywords: structural empowerment, commitment, intensive care, nurses

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Authors: Syed Muzyan Shahzad, Liu Jianxin, Asim Shahzad, Muhammad Sharjeel Raza, Sun Ya, Fanidi Meryem

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Electrical resistivity investigation was conducted in vicinity of Tarbela Ghazi, in order to study the subsurface layer with a view of determining the depth to the aquifer and thickness of groundwater potential zones. Vertical Electrical Sounding (VES) using Schlumberger array was carried out at 16 VES stations. Well logging data at four tube wells have been used to mark the super saturated zones with great discharge rate. The present paper shows a geoelectrical identification of the lithology and an estimate of the relationship between the resistivity and Dar Zarrouk parameters (transverse unit resistance and longitudinal unit conductance). The VES results revealed both homogeneous and heterogeneous nature of the subsurface strata. Aquifer is unconfined to confine in nature, and at few locations though perched aquifer has been identified, groundwater potential zones are developed in unconsolidated deposits layers and more than seven geo-electric layers are observed at some VES locations. Saturated zones thickness ranges from 5 m to 150 m, whereas at few area aquifer is beyond 150 m thick. The average anisotropy, transvers resistance and longitudinal conductance values are 0.86 %, 35750.9821 Ω.m², 0.729 Siemens, respectively. The transverse unit resistance values fluctuate all over the aquifer system, whereas below at particular depth high values are observed, that significantly associated with the high transmissivity zones. The groundwater quality in all analyzed samples is below permissible limit according to World Health Standard (WHO).

Keywords: aquifer, Dar Zarrouk parameters, geoelectric layers, Tarbela Ghazi

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Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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Authors: Raul Alexis Sanchez Cornejo, Elena Ivonne Mancera Andrade, Gibran Sidney Aleman Nava, Angel Josue Arteaga Garces, Roberto Parra Saldivar

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An unhealthy diet is one of the main factors for a wide range of chronical diseases such as diabetes, obesity, cancer, cardiovascular diseases, among others. Nowadays, there is a current need to provide innovate healthy products to people in order to decrease the number of people with unhealthy diet. This study focuses on the production of two food products based on two microalgae strains: Tortillas with powder of Haematococcus pluvialis and Spirulina platensis biomass and yogurt with microencapsulated biomass of the same strains. S. platensis has been used widely as food supplements in a form of powder and pills due to its high content in proteins and fatty acids. Haematococcus pluvialis has been recognized for its ability to produce high-added value products under stressful conditions such as antioxidants (astaxanthin). Despite the benefits that those microalgae have, few efforts have been done to use them in food products. The main objective of this work is to evaluate the nutritional properties such as protein content, lipid fraction, carbohydrates, antioxidants,, and vitamins, that these microalgae strains provide to the food product. Additionally, physicochemical, and sensory evaluation were assessed to evaluate the quality of the product. The results obtained will dictate the feasibility of the product to be commercialized. These novel products will have the ability to change the nutritional intake and strength the health of the consumers.

Keywords: functional food, Haematococcus pluvialis, microalgae, Spirulina platensis, tortilla, yogurt

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Authors: Anand R. Nair, Markus Trenker

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Lifting body concepts were conceived as early as 1917 and patented by Roy Scroggs. It was an idea of using the fuselage as a lift producing body with no or small wings. Many of these designs were developed and even flight tested between 1920’s to 1970’s, but it was not pursued further for commercial flight as at lower airspeeds, such a configuration was incapable to produce sufficient lift for the entire aircraft. The concept presented in this contribution is combining the lifting body design along with a fixed wing to maximise the lift produced by the aircraft. Conventional aircraft fuselages are designed to be aerodynamically efficient, which is to minimise the drag; however, these fuselages produce very minimal or negligible lift. For the design of an unmanned fixed wing transport aircraft, many of the restrictions which are present for commercial aircraft in terms of fuselage design can be excluded, such as windows for the passengers/pilots, cabin-environment systems, emergency exits, and pressurization systems. This gives new flexibility to design fuselages which are unconventionally shaped to contribute to the lift of the aircraft. The two lifting body concepts presented in this contribution are targeting different applications: For a fast cargo delivery drone, the fuselage is based on a scaled airfoil shape with a cargo capacity of 500 kg for euro pallets. The aircraft has a span of 14 m and reaches 1500 km at a cruising speed of 90 m/s. The aircraft could also easily be adapted to accommodate pilot and passengers with modifications to the internal structures, but pressurization is not included as the service ceiling envisioned for this type of aircraft is limited to 10,000 ft. The next concept to be investigated is called a multi-purpose drone, which incorporates a different type of lifting body and is a much more versatile aircraft as it will have a VTOL capability. The aircraft will have a wingspan of approximately 6 m and flight speeds of 60 m/s within the same service ceiling as the fast cargo delivery drone. The multi-purpose drone can be easily adapted for various applications such as firefighting, agricultural purposes, surveillance, and even passenger transport. Lifting body designs are not a new concept, but their effectiveness in terms of cargo transportation has not been widely investigated. Due to their enhanced lift producing capability, lifting body designs enable the reduction of the wing area and the overall weight of the aircraft. This will, in turn, reduce the thrust requirement and ultimately the fuel consumption. The various designs proposed in this contribution will be based on the general aviation category of aircrafts and will be focussed on unmanned methods of operation. These unmanned fixed-wing transport drones will feature appropriate cargo loading/unloading concepts which can accommodate large size cargo for efficient time management and ease of operation. The various designs will be compared in performance to their conventional counterpart to understand their benefits/shortcomings in terms of design, performance, complexity, and ease of operation. The majority of the performance analysis will be carried out using industry relevant standards in computational fluid dynamics software packages.

Keywords: lifting body concept, computational fluid dynamics, unmanned fixed-wing aircraft, cargo drone

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Authors: Pedro M. Velasco, Cecilia C. Alday, Oscar C. Avello, Ximena T. Faundez, Luis M. Velasco

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Anaerobic digestion (AD) plants of food waste (FW) produced by agro-industry, have been widely developed from last decade to nowadays, because of the advantages over aerobic active sludge systems. Despite several bioreactor configurations and operation modes have been successfully improved and implemented at industrial scale in a wide range of applications, effluent behavior, after AD, does not commonly meet requirements for direct disposal into the environment without further treatments. In addition, literature has rarely shown AD of food waste at psychrophilic range. This temperature range may be of interest for making AD plant operation easier and increasing the stability of digestion. In spite of literature shows several methods for post-treatment, such as the use of microalgae, these have not been cultivated on effluents from AD at psychrophilic range. Hence, with the aim of showing the potential use of AD of FW at the psychrophilic range (25ºC) and the viability of microalgae post-treatment, single batch reactors have been used for methane potential tests at laboratory scale. Afterwards, digestates, derived from this AD of FW sludge, were diluted with fresh water at different ratios (1:0, 1:1; 1:4) and used as culture media for photoautotrophic microalgae. Several parameters, such as pH, biogas production, and chemical oxygen demand, were measured periodically over several months. Results show that methane potential is 150 ml g-1 per volatile solid with up to 57.7 % of methane content. Moreover, microalgae has been successfully cultivated on all tested effluents and in case of 1:1 and 1:4 rates, the resulting effluents meet the quality levels required for irrigation water.

Keywords: anaerobic digestion, biogas, food waste, microalgae, psychrophilic range

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Authors: Iftikhar A. Tayubi, Tabrej Khan, Mansoor M. Alsubei, Fahad A. Alsaferi

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LIZTOXD provides a single source of high-quality information about proteinaceous lizard toxins that will be an invaluable resource for pharmacologists, neuroscientists, toxicologists, medicinal chemists, ion channel scientists, clinicians, and structural biologists. We will provide an intuitive, well-organized and user-friendly web interface that allows users to explore the detail information of Lizard and toxin proteins. It includes common name, scientific name, entry id, entry name, protein name and length of the protein sequence. The utility of this database is that it can provide a user-friendly interface for users to retrieve the information about Lizard, toxin and toxin protein of different Lizard species. These interfaces created in this database will satisfy the demands of the scientific community by providing in-depth knowledge about Lizard and its toxin. In the next phase of our project we will adopt methodology and by using A MySQL and Hypertext Preprocessor (PHP) which and for designing Smart Draw. A database is a wonderful piece of equipment for storing large quantities of data efficiently. The users can thus navigate from one section to another, depending on the field of interest of the user. This database contains a wealth of information on species, toxins, toxins, clinical data etc. LIZTOXD resource that provides comprehensive information about protein toxins from lizard toxins. The combination of specific classification schemes and a rich user interface allows researchers to easily locate and view information on the sequence, structure, and biological activity of these toxins. This manually curated database will be a valuable resource for both basic researchers as well as those interested in potential pharmaceutical and agricultural applications of lizard toxins.

Keywords: LIZTOXD, MySQL, PHP, smart draw

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Authors: Rebeca V. Tholen, Elaine Bundy

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Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

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Authors: Ilana Margalith, Yaron Niv

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One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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Authors: Samira K. Al-Nasser, Siamak Noroozi, Roya Haratian, Adrian Harvey

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A total knee replacement (TKR) is a surgical procedure necessary when there is severe pain and/or loss of function in the knee. Surgeons balance the load in the knee and the surrounding soft tissue by feeling the tension at different ranges of motion. This method can be unreliable and lead to early failure of the joint. The ideal kinematics and load distribution have been debated significantly based on previous biomechanical studies surrounding both TKRs and normal knees. Intraoperative sensors like VERASENSE and eLibra have provided a method for the quantification of the load indicating a balanced knee. A review of the literature written about intraoperative sensors and tension/stability of the knee was done. Studies currently debate the quantification of the load in medial and lateral compartments specifically. However, most research reported that following a TKR the medial compartment was loaded more heavily than the lateral compartment. In several cases, these results were shown to increase the success of the surgery because they mimic the normal kinematics of the knee. In conclusion, most research agrees that an intercompartmental load differential of between 10 and 20 pounds, where the medial load was higher than the lateral, and an absolute load of less than 70 pounds was ideal. However, further intraoperative sensor development could help improve the accuracy and understanding of the load distribution on the surgical outcomes in a TKR. A reduction in early revision surgeries for TKRs would provide an improved quality of life for patients and reduce the economic burden placed on both the National Health Service (NHS) and the patient.

Keywords: intraoperative sensors, joint load forces, kinematics, load balancing, and total knee replacement

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Authors: Lobna Ahmed Galal

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Modal integration has given minimal consideration in cities of developing countries, as well as the declining dominance of public transport, and predominance of informal transport, the modal share of informal taxis in greater Cairo has increased from 6% in 1987 to 37% in 2001 and this has since risen even higher, informal and non-motorized modes of transport acting as a gap filler by feeding other modes of transport, not by design or choice, but often by lack of accessible and affordable public transport. Yet non-motorized transport is peripheral, with minimal priority in urban planning and investments, lacking of strong polices to support non-motorized transport, for authorities development is associated with technology and motorized transport, and promotion of non-motorized transport may be considered corresponding to development, as well as social stigma against non-motorized transport, as it is seen a travel mode for the poor. Cairo as a city of a developing country, has poor quality infrastructure for non-motorized transport, suffering from absence of dedicated corridors, and when existing they are often encroached for commercial purposes, widening traffic lanes at the expense of sidewalks, absence of footpaths, or being overcrowded, poor lighting, making walking unsafe and yet, lack of financial supply to such facilities as it is often considered beyond city capabilities. This paper will deal with the objective measuring of the built environment relating to walking, in some neighborhoods of new cities around Cairo, In addition to comparing the results of the objective measures of the built environment with the level of self-reported survey. The first paper's objective is to show how the index ‘walkability of community neighborhoods’ works in the contexts in neighborhoods of new cities around Cairo. The procedure of objective measuring is of a high potential to be carried out by using GIS.

Keywords: assessing, built environment, Cairo, walkability

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Authors: Seema Singh, Puja Anand, Alok Bhasin

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The interior design profession aims to create aesthetically pleasing design solutions for human habitats but of late, growing awareness about depleting environmental resources, both tangible and intangible, and damages to the eco-system led to the quest for creating healthy and sustainable interior environments. The paper proposes adapting traditionally produced organic wool textiles for the mainstream interior design industry. This can create sustainable livelihoods whereby eco-friendly bridges can be built between Interior designers and consumers and pastoral communities. This study focuses on traditional textiles produced by two pastoral communities from India that use organic wool from indigenous sheep varieties. The Gaddi communities of Himachal Pradesh use wool from the Gaddi sheep breed to create Pattu (a multi-purpose textile). The Kurumas of Telangana weave a blanket called the Gongadi, using wool from the Black Deccani variety of sheep. These communities have traditionally reared indigenous sheep breeds for their wool and produce hand-spun and hand-woven textiles for their own consumption, using traditional processes that are chemical free. Based on data collected personally from field visits and documentation of traditional crafts of these pastoral communities, and using traditionally produced indigenous organic wool, the authors have developed innovative textile samples by including design interventions and exploring dyeing and weaving techniques. As part of the secondary research, the role of pastoralism in sustaining the eco-systems of Himachal Pradesh and Telangana was studied, and also the role of organic wool in creating healthy interior environments. The authors found that natural wool from indigenous sheep breeds can be used to create interior textiles that have the potential to be marketed to an urban audience, and this will help create earnings for pastoral communities. Literature studies have shown that organic & sustainable wool can reduce indoor pollution & toxicity levels in interiors and further help in creating healthier interior environments. Revival of indigenous breeds of sheep can further help in rejuvenating dying crafts, and promotion of these indigenous textiles can help in sustaining traditional eco-systems and the pastoral communities whose way of life is endangered today. Based on research and findings, the authors propose that adapting traditional textiles can have potential for application in Interiors, creating eco-friendly spaces. Interior textiles produced through such sustainable processes can help reduce indoor pollution, give livelihood opportunities to traditional economies, and leave almost zero carbon foot-print while being in sync with available natural resources, hence ultimately benefiting the society. The win-win situation for all the stakeholders in this eco-friendly model makes it pertinent to re-think how we design lifestyle textiles for interiors. This study illustrates a specific example from the two pastoral communities and can be used as a model that can work equally well in any community, regardless of geography.

Keywords: design intervention, eco- friendly, healthy interiors, indigenous, organic wool, pastoralism, sustainability

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Authors: Thanakorn Thanawat, Nomjit Nualnetr

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Background and Purpose: In Thailand, rice farmers have the most prevalence of low back pain when compared with other manual workers. Exercises have been suggested to be a principal part of treatment programs for low back pain. However, the programs should be tailored to an individual’s readiness to change categorized by a behavioral approach. This study aimed to evaluate a difference between the responses of rice farmers with chronic low back pain who received an exercise program integrated with the transtheoretical model of behavior change (TTM) and those of the comparison group regarding severity of pain and trunk muscle endurance. Materials and Methods: An 8-week exercise program was conducted to rice farmers with chronic low back pain who were randomized to either the TTM (n=62, 52 woman and 10 men, mean age ± SD 45.0±5.4 years) or non-TTM (n=64, 53 woman and 11 men, mean age ± SD 44.7±5.4 years) groups. All participants were tested for their severity of pain and trunk (abdominal and back) muscle endurance at baseline (week 0) and immediately after termination of the program (week 8). Data were analysed by using descriptive statistics and student’s t-tests. The results revealed that both TTM and non-TTM groups could decrease their severity of pain and improve trunk muscle endurance after participating in the 8-week exercise program. When compared with the non-TTM group, however, the TTM showed a significantly greater increase in abdominal muscle endurance than did the non-TTM (P=0.004, 95% CI -12.4 to -2.3). Conclusions and Clinical Relevance: An exercise program integrated with the TTM could provide benefits to rice farmers with chronic low back pain. Future studies with a longitudinal design and more outcome measures such as physical performance and quality of life are suggested to reveal further benefits of the program.

Keywords: chronic low back pain, transtheoretical model, rice farmers, exercise program

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Authors: Faisal Islam, J. Ramkumar

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The applications of composite materials in aerospace, sporting and automotive industries need high quality machined surfaces and dimensional accuracy. Some studies have been done to understand the fiber failure mechanisms encountered during milling machining of CFRP composites but none are capable of explaining the exact nature of the orientation-based fiber failure mechanisms encountered in the milling machining process. The objective of this work is to gain a better understanding of the orientation-based fiber failure mechanisms occurring on the slot edges during CFRP milling machining processes. The occurrence of damage is predicted by a schematic explanation based on the mechanisms of material removal which in turn depends upon fiber cutting angles. A geometric model based on fiber cutting angle and fiber orientation angle is proposed that defines the critical and safe zone during machining and predicts the occurrence of delamination. Milling machining experiments were performed on composite samples of varying fiber orientations to verify the proposed theory. Mean fiber pulled out length was measured from the microscopic images of the damaged area to quantify the amount of damage produced. By observing the damage occurring for different fiber orientation angles and fiber cutting angles for up-milling and down-milling edges and correlating it with the material removal mechanisms as described earlier, it can be concluded that the damage/delamination mainly depends on the portion of the fiber cutting angles that lies within the critical cutting angle zone.

Keywords: unidirectional composites, milling, machining damage, delamination, carbon fiber reinforced plastics (CFRPs)

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Authors: Fatima Achouri, Kaddour Chouicha, Abdelwahab Khatir

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It is clear that concrete of quality must be made with selected materials chosen in optimum proportions that remain after implementation, a minimum of voids in the material produced. The different methods of formulations what we use, are based for the most part on a granular curve which describes an ‘optimal granularity’. Many authors have engaged in fundamental research on granular arrangements. A comparison of mathematical models reproducing these granular arrangements with experimental measurements of compactness have to verify that the minimum porosity P according to the following extent granular exactly a power law. So the best compactness in the finite medium are obtained with power laws, such as Furnas, Fuller or Talbot, each preferring a particular setting between 0.20 and 0.50. These considerations converge on the assumption that the optimal granularity Caquot approximates by a power law. By analogy, it can then be analyzed as a granular structure of fractal-type since the properties that characterize the internal similarity fractal objects are reflected also by a power law. Optimized mixtures may be described as a series of installments falling granular stuff to better the tank on a regular hierarchical distribution which would give at different scales, by cascading effects, the same structure to the mix. Likely this model may be appropriate for the entire extent of the size distribution of the components, since the cement particles (and silica fume) correctly deflocculated, micrometric dimensions, to chippings sometimes several tens of millimeters. As part of this research, the aim is to give an illustration of the application of fractal analysis to characterize the granular concrete mixtures optimized for a so-called fractal dimension where different concretes were studying that we proved a fractal structure of their granular mixtures regardless of the method of formulation or the type of concrete.

Keywords: concrete formulation, fractal character, granular packing, method of formulation

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Authors: Reuben Kinyuru Njuguna, Martin Mabuya Njuguna

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Digital platforms, such as The Internet, and the advent of digital marketing strategies, have led to many changes in the marketing of goods and services. These have resulted in improved service quality, enhanced customer relations, productivity gains, marketing transaction cost reductions, improved customer service and flexibility in fulfilling customers’ changing needs and lifestyles. Consequently, the purpose of this study was to determine the effect of digital marketing practices on the financial performance of mobile network operators in the telecommunications industry in Kenya. The objectives of the study were to establish how digital customer relationship management strategies on performance of mobile network operators in Kenya. The study used an explanatory cross-sectional survey research design, while the target population was made up of from the 4 major mobile network operators in Kenya, namely Safaricom Limited, Airtel Networks Kenya Limited, Finserve Africa Limited and Telkom Kenya Limited. Sampling strategy was stratified sampling with a sample size of 97 respondents. Digital customer relationship strategies were seen to influence firm performance, through enhancing convenience, building trust, encouraging growth in market share through creating sustainable relationships, building commitment with customers, enhancing customer retention and customer satisfaction. Digital customer relationship management were seen to maximize gross profits by increasing customer satisfaction, loyalty and retention. The study recommended upscaling the use of digital customer relationship management strategies to further enhance firm performance, given their great potential in this regard.

Keywords: customer relationship management, customer service delivery, performance, customer satisfaction

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Authors: Merve Gücen

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One of the aims of education is to educate individuals who have embraced universal moral principles and transform universal moral principles into moral values. Character education aims to educate behaviors of individuals in their mental activities to transform moral principles into moral values in their lives. As the result of this education, individuals are expected to develop positive character traits and become morally indifferent individuals. What are the characteristics of the factors that influence character education at this stage? How should character education help individuals develop positive character traits? Which methods are more effective? These questions come to mind when studying character education. Our research was developed within the framework of these questions. The aim of our study is to provide the most effective use of the education factor that affects character. In this context, we tried to explain character definition, character development, character education and the factors affecting character education using qualitative research methods. At this stage, character education programs applied in various countries were examined and a character education program consisting of Islamic values was prepared and implemented in an International Imam Hatip High School in Istanbul. Our application was carried out with the collaboration of school and families. Various seminars were organized in the school and participation of families was ensured. In the last phase of our study, we worked with the students and their families on the effectiveness of the events held during the program. In this study, it was found that activities such as storytelling and theater in character education programs were effective in recognizing wrong behaviors in individuals. It was determined that our program had a positive effect on the quality of education. It was seen that applications of this educational program affected the behavior of the employees in the educational institution.

Keywords: character development, family activities, values education, education program

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Authors: A. Rong, P. B. Luh, R. Lahdelma

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High penetration of intermittent renewable energy sources (RES) such as solar power and wind power into the energy system has caused temporal and spatial imbalance between electric power supply and demand for some countries and regions. This brings about the critical need for coordinating power production and power exchange for different regions. As compared with the power-only systems, the combined heat and power (CHP) systems can provide additional flexibility of utilizing RES by exploiting the interdependence of power and heat production in the CHP plant. In the CHP system, power production can be influenced by adjusting heat production level and electric power can be used to satisfy heat demand by electric boiler or heat pump in conjunction with heat storage, which is much cheaper than electric storage. This paper addresses multi-site CHP systems without considering RES, which lay foundation for handling penetration of RES. The problem under study is the unit commitment (UC) of the transmission-constrained multi-site CHP systems. We solve the problem by combining linear relaxation of ON/OFF states and sequential dynamic programming (DP) techniques, where relaxed states are used to reduce the dimension of the UC problem and DP for improving the solution quality. Numerical results for daily scheduling with realistic models and data show that DP-based algorithm is from a few to a few hundred times faster than CPLEX (standard commercial optimization software) with good solution accuracy (less than 1% relative gap from the optimal solution on the average).

Keywords: dynamic programming, multi-site combined heat and power system, relaxed states, transmission-constrained generation unit commitment

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Authors: Mukesh Khadka, Alexander Paz, Hanns de la Fuente-Mella

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Typically, pavement performance models are developed in two steps: (i) pavement segments with similar characteristics are grouped together to form a cluster, and (ii) the corresponding performance models are developed using statistical techniques. A challenge is to select the characteristics that define clusters and the segments associated with them. If inappropriate characteristics are used, clusters may include homogeneous segments with different performance behavior or heterogeneous segments with similar performance behavior. Prediction accuracy of performance models can be improved by grouping the pavement segments into more uniform clusters by including both characteristics and a performance measure. This grouping is not always possible due to limited information. It is impractical to include all the potential significant factors because some of them are potentially unobserved or difficult to measure. Historical performance of pavement segments could be used as a proxy to incorporate the effect of the missing potential significant factors in clustering process. The current state-of-the-art proposes Clusterwise Linear Regression (CLR) to determine the pavement clusters and the associated performance models simultaneously. CLR incorporates the effect of significant factors as well as a performance measure. In this study, a mathematical program was formulated for CLR models including multiple explanatory variables. Pavement data collected recently over the entire state of Nevada were used. International Roughness Index (IRI) was used as a pavement performance measure because it serves as a unified standard that is widely accepted for evaluating pavement performance, especially in terms of riding quality. Results illustrate the advantage of the using CLR. Previous studies have used CLR along with experimental data. This study uses actual field data collected across a variety of environmental, traffic, design, and construction and maintenance conditions.

Keywords: clusterwise regression, pavement management system, performance model, optimization

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Authors: Vivian Correa

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Hypothesis There are typical patterns - phenotypes - of sleep behaviors by age and biological sex groups of parasomnia patients where wearable devices could avoid injuries. Materials and methods We analyzed public video records on sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating,” “sleep sex”, and “aggression in sleep” in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified the videos into estimated sex and age (children, adults, elderly) groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus the groups by STATA package providing 95% confidence interval and the probability of statistical significance. Results 224 videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Elderly males had 40-fold odds compared to adults and children to perform aggressive movements and 70-fold odds of complex movements in the bed compared to adults. Conclusion Unlike other groups, the high chances of adults being sleepwalkers and elderly males performing intense and violent movements in bed showed us the importance of developing wearable parasomnia devices to prevent injuries.

Keywords: parasomnia, wearable devices, sleepwalking, RBD

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Authors: Ema Vitória Fonseca Lavrador

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In this work, we intend to explore the impact that the film "Lightyear" (2022) had on the social context of its production, distribution, and reception. This film, produced by Walt Disney Animation Studios and Pixar Animation Studios, depicts the story of Buzz Lightyear, a Space Ranger from which the character of the same name in the "Toy Story" film franchise is based. This prequel was predicted to be the blockbuster of the year, but it was a financial fiasco and the subject of numerous controversies, which also caused it to be drowned out by the film "Minions: The Rise of Gru" (2022). The reason for its failure is not based on the film's narrative or quality but on its controversial context for being a commitment to LGBTQIA+ representation in an unexpected way, by featuring a same-sex couple and showing a kiss shared by them. This representation cost Disney distribution in countries against LGBTQIA+ representation in media and involved Disney in major disagreements with fans and politicians, especially for being a direct opposition to the Florida House Bill 1557, also called the “Don't Say Gay” bill. Many major companies have taken a stand against this law because it jeopardizes the safety of the LGBTQIA+ community, and, although Disney initially cut the kiss off the film, pressure from the staff and audience resulted in unprecedented progress. For featuring a brief homosexual kiss, its exhibition was banned in several countries and discouraged by the same public that was previously the focus of Disney's attention, as this is a conservative “family-friendly” branded company. We believe it is relevant to study the case of "Lightyear" because it is a work that raises awareness and promotes representation of communities affected during the dark times while less legislation is being approved to protect the rights and safety of queer people.

Keywords: Don’t Say Gay” bill, gender stereotypes, LGBTQIA+ representation, lightyear, Disney/Pixar

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Authors: Hazrat Salman Sidique, Muhammad Tahir Khan, Haq Aman Ullah, Muhammad Mobashar, Muhammad Ishtiaq Sohail Mehmood

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The poor quality conventional feed for the livestock production in Pakistan are wheat straw, tops of sugar cane and tree leaves. To enhance the nutritive value of feed, this study focused on investigating the effects of fibrolytic enzyme (Fibrozyme®, Alltech Inc. Company, USA) at different levels i.e. 0, 5, 10, and 15g/kg of total mix ration on feed intake, digestibility, milk yield and composition, and economics of the ration in Holstein Friesians cows. Twelve Holstein Friesians cows of almost the same age, and lactation stage were randomly allocated into 4 equal groups i.e. A, B, C, and D. Four experimental rations supplemented with Fibrozyme® 0g, 5g, 10g, and 15g/Kg of total mix ration were assigned to these sets correspondingly. The dry matter intake was linearly and significantly (P<0.05) improved. A significant effect of Fibrozyme® was observed for organic matter digestibility, ether extract digestibility, crude fiber digestibility, nitrogen free extract digestibility, and acid detergent fiber digestibility while the results were statistically non-significant for crude protein digestibility, neutral detergent fiber digestibility, and ash digestibility. Milk yield and composition except fat were significantly (P<0.05) increased in all Fibrozyme® treated groups. This study concludes that supplementation of Fibrozyme® at the rate of 15g/Kg total mix ration improved the dry matter intake, nutrients digestibility, and milk production and constituents like protein, lactose, and solid not fat. Therefore, treatment of total mix ration with Fibrozyme® was desirably reasonable and profitable.

Keywords: digestibility, fibrozyme, TMR, digestibility, lactating cow

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Authors: Mokhlisur Rahman

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Ocean inhibits one of the most complex ecosystems on the planet that regulates the earth's climate and weather by providing us with compatible weather to live. Ocean provides food by extending various ways of lifestyles that are dependent on it, transportation by accommodating the world's biggest carriers, recreation by offering its beauty in many moods, and home to countless species. At the essence of receiving various forms of entertainment, consumers choose to be close to the ocean while performing many fun activities. Which, at some point, upsets the stomach of the ocean by threatening marine life and the environment. Consumers throw the waste into the ocean after using it. Most of them are plastics that float over the ocean and turn into thousands of micro pieces that are hard to observe with the naked eye but easily eaten by the sea species. Eventually, that conflicts with the natural consumption process of any living species, making them sick. This information is not known by most consumers who go to the sea or seashores occasionally to spend time, nor is it widely discussed, which creates an information gap among consumers. However, advertising is a powerful tool to educate people about ocean pollution. This abstract analyzes three major ocean-saving advertisement campaigns that use innovative and advanced technology to get maximum exposure. The study collects data from the selected campaigns' websites and retrieves all available content related to messages, videos, and images. First, the SeaLegacy campaign uses stunning images to create awareness among the people; they use social media content, videos, and other educational content. They create content and strategies to build an emotional connection among the consumers that encourage them to move on an action. All the messages in their campaign empower consumers by using powerful words. Second, Ocean Conservancy Campaign uses social media marketing, events, and educational content to protect the ocean from various pollutants, including plastics, climate change, and overfishing. They use powerful images and videos of marine life. Their mission is to create evidence-based solutions toward a healthy ocean. Their message includes the message regarding the local communities along with the sea species. Third, ocean clean-up is a campaign that applies strategies using innovative technologies to remove plastic waste from the ocean. They use social media, digital, and email marketing to reach people and raise awareness. They also use images and videos to evoke an emotional response to take action. These tree advertisements use realistic images, powerful words, and the presence of living species in the imagery presentation, which are eye-catching and can grow emotional connection among the consumers. Identifying the effectiveness of the messages these advertisements carry and their strategies highlights the knowledge gap of mass people between real pollution and its consequences, making the message more accessible to the mass of people. This study aims to provide insights into the effectiveness of ocean-saving advertisement campaigns and their impact on the public's awareness of ocean conservation. The findings from this study help shape future campaigns.

Keywords: advertising-campaign, content-creation, images ocean-saving technology, videos

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Authors: Raed Alsufyani, Hissam Tawfik, Victor Chang, Muthu Ramachandran

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This study investigates the factors that influence the decision by players in the healthcare sector to embrace Cloud Business Intelligence Technology with a focus on healthcare organizations in Saudi Arabia. To bring this matter into perspective, this study primarily considers the Technology-Organization-Environment (TOE) framework and the Human Organization-Technology (HOT) fit model. A survey was hypothetically designed based on literature review and was carried out online. Quantitative data obtained was processed from descriptive and one-way frequency statistics to inferential and regression analysis. Data were analysed to establish factors that influence the decision to adopt Cloud Business intelligence technology in the healthcare sector. The implication of the identified factors was measured, and all assumptions were tested. 66.70% of participants in healthcare organization backed the intention to adopt cloud business intelligence system. 99.4% of these participants considered security concerns and privacy risk have been the most significant factors in the adoption of cloud Business Intelligence (CBI) system. Through regression analysis hypothesis testing point that usefulness, service quality, relative advantage, IT infrastructure preparedness, organization structure; vendor support, perceived technical competence, government support, and top management support positively and significantly influence the adoption of (CBI) system. The paper presents quantitative phase that is a part of an on-going project. The project will be based on the consequences learned from this study.

Keywords: cloud computing, business intelligence, HOT-fit model, TOE, healthcare and innovation adoption

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Authors: Albert Suryaprawira

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The Nasion-Sella Line (NSL) has been used for several years as a reference line in longitudinal growth study. Therefore this line is considered to be stable not only to evaluate treatment outcome and to predict relapse possibility but also to manage prognosis. This is a radiographic superimposition of an adult male aged 19 years who complained of difficulty in aesthetic, talking and chewing. Patient has a midface hypoplasia profile (concave). He was diagnosed to have a severe Skeletal Class III with Class III malocclusion, increased lower vertical height, and an anterior open bite. A pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. A panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, a pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, a post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition using NSL as a reference line between those radiographs was performed to analyse the outcome. It is important to describe the amount of hard and soft tissue movement and to predict the possibility of relapse after the surgery. The patient also needs to understand all the surgical plan, outcome and relapse prevention. The surgical management included maxillary impaction and advancement of Le Fort I osteotomy. The evaluation using NSL as a reference was a very useful method in determining the outcome and prognosis.

Keywords: Nasion-Sella Line, midface hypoplasia, Le Fort 1, maxillary advancement

Procedia PDF Downloads 142