Search results for: medical record keeping

Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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Authors: Suresh Vidyasagar Chevuri, D. B. Karunakar Chevuri

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The main advantages of 'Metal Matrix Nano Composites (MMNCs)' include excellent mechanical performance, good wear resistance, low creep rate, etc. The method of fabrication of MMNCs is quite a challenge, which includes processing techniques like Spark Plasma Sintering (SPS), etc. The objective of the present work is to fabricate aluminum based MMNCs with the addition of small amounts of yttrium using Spark Plasma Sintering and to evaluate their mechanical and microstructure properties. Samples of 2024 AA with yttrium ranging from 0.1% to 0.5 wt% keeping 1 wt% TiB2 constant are fabricated by Spark Plasma Sintering (SPS). The mechanical property like hardness is determined using Vickers hardness testing machine. The metallurgical characterization of the samples is evaluated by Optical Microscopy (OM), Field Emission Scanning Electron Microscopy (FE-SEM) and X-Ray Diffraction (XRD). Unreinforced 2024 AA sample is also fabricated as a benchmark to compare its properties with that of the composite developed. It is found that the yttrium addition increases the above-mentioned properties to some extent and then decreases gradually when yttrium wt% increases beyond a point between 0.3 and 0.4 wt%. High density is achieved in the samples fabricated by spark plasma sintering when compared to any other fabrication route, and uniform distribution of yttrium is observed.

Keywords: spark plasma sintering, 2024 AA, yttrium addition, microstructure characterization, mechanical properties

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Authors: Khansa Hayat

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Organizational stress is one of the vital phenomena which is having its roots deep down in has deep roots in management, psychology, and organizational behavior research. In the meanwhile, keeping its focus on the positive strength of humans rather than the traditional negativity oriented research, positive psychology has emerged as a separate branch of organizational behavior. The current study investigates the interactive effects of Challenge and hindrance stressors and core Self Evaluations (CSE’s) of the individual on job performances including the in-role performance and extra role performances. The study also aims to investigate the supporting/buffering role of the human dispositions (i.e., self esteem, self efficacy, locus of control and emotional stability). The results show that Challenge stressors have a significant positive effect on in role performance and extra role performance of the individual. The findings of the study indicate that Core Self evaluations strengthen the relationship between challenge stressors and in role performance of the individual. In case of Hindrance Stressors the Core self Evaluations lessen the negative impact of Hindrance stressors and they let the individual perform at a better and normal position even when the Hindrance stressors are high. The relationship and implication of conservation of resource theory are also discussed. The limitations, future research directions and implications of the study are also discussed.

Keywords: challenge-hindrance stressors, core self evaluations, in-role performance, extra-role performance

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Authors: Linus O. Asuquo

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Mining in Nigeria and development effort of metallurgical technologies at National Metallurgical Development Centre Jos has been addressed in this paper. The paper has looked at the history of mining in Nigeria, the impact of mining on social and industrial development, and the contribution of the mining sector to Nigeria’s Gross Domestic Product (GDP). The paper clearly stated that Nigeria’s mining sector only contributes 0.5% to the nation’s GDP unlike Botswana that the mining sector contributes 38% to the nation’s GDP. Nigeria Bureau of Statistics has it on record that Nigeria has about 44 solid minerals awaiting to be exploited. Clearly highlighted by this paper is the abundant potentials that exist in the mining sector for investment. The paper made an exposition on the extensive efforts made at National Metallurgical Development Center (NMDC) to develop metallurgical technologies in various areas of the metals sector; like mineral processing, foundry development, nonferrous metals extraction, materials testing, lime calcination, ANO (Trade name for powder lubricant) wire drawing lubricant, refractories and many others. The paper went ahead to draw a conclusion that there is a need to develop the mining sector in Nigeria and to give a sustainable support to the efforts currently made at NMDC to develop metallurgical technologies which are capable of transforming the metals sector in Nigeria, which will lead to industrialization. Finally the paper made some recommendations which traverse the topic for the best expectation.

Keywords: mining, minerals, technologies, value addition

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Authors: Thimira Pasas P, Nirmala Priyadarshani M, Ishani R

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Obesity is a global health issue. Early identification is essential to plan interventions and intervene than to reduce the worsening of obesity and its consequences on the health issues of the individual. Childhood obesity is multifactorial, with both modifiable and unmodifiable risk factors. A genetically susceptible individual (unmodifiable), when placed in an obesogenic environment (modifiable), is likely to become obese in onset and progression. The present study was conducted to identify the age of onset of childhood obesity and the influence of modifiable risk factors for childhood obesity among school children living in a suburban area of Sri Lanka. The study population was aged 11-12 years of Piliyandala Educational Zone. Data were collected from 11–12-year-old school children attending government schools in the Piliyandala Educational Zone. They were using a validated, pre-tested self-administered questionnaire. A stratified random sampling method was performed to select schools and to select a representative sample to include all 3 types of government schools of students due to the prevailing pandemic situation, information from the last school medical inspection on data from 2020used for this purpose. For each obese child identified, 2 non-obese children were selected as controls. A single representative from the area was selected by using a systematic random sampling method with a sampling interval of 3. Data was collected using a validated, pre-tested self-administered questionnaire and the Child Health Development Record of the child. An introduction, which included explanations and instructions for filing the questionnaire, was carried out as a group activity prior to distributing the questionnaire among the sample. The results of the present study aligned with the hypothesis that the age of onset of childhood obesity and prediction must be within the first two years of child life. A total of 130 children (66 males: 64 females) participated in the study. The age of onset of obesity was seen to be within the first two years of life. The risk of obesity at 11-12 years of age was Obesity risk was identified at 3-time s higher among females who underwent rapid weight gain within their infancy period. Consuming milk prior to breakfast emerged as a risk factor that increases the risk of obesity by three times. The current study found that the drink before breakfast tends to increase the obesity risk by 3-folds, especially among obese females. Proper monitoring must be carried out to identify the rapid weight gain, especially within the first 2 years of life. Consumption of mug milk before breakfast tends to increase the obesity risk by 3 times. Identification of the confounding factors, proper awareness of the mothers/guardians and effective proper interventions need to be carried out to reduce the obesity risk among school children in the future.

Keywords: childhood obesity, school children, age of onset, weight gain, feeding pattern, activity level

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Authors: Amri Yusoff, Shahrizuan Shafiril, Ashardi Abas, Norma Che Yusoff

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Nowadays, illegal logging has been causing much effect to our forest. Some of it causes a flash flood, avalanche, global warming, and etc. This comprehensibly makes us wonder why, what, and who has made it happened. Often, it already has been too late after we have known the cause of it. Even the Malaysian Royal Belum forest has not been spared from land clearing or illegal activity by the natives although this area has been gazetted as a protected area preserved for future generations. Furthermore, because of its sizeable and wide area, these illegal activities are difficult to monitor and to maintain. A critical action must be called upon to prevent all of these unhealthy activities from recurrence. Therefore, a remote monitoring device must be developed in order to capture critical real-time data such as temperature, humidity, gaseous, fire, and rain detection which indicates the current and preserved natural state and habitat in the forest. Besides, this device location can be detected via GPS by showing the latitudes and longitudes of its current location and then to be transmitted by SMS via GSM system. All of its readings will be sent in real-time for data management and analysis. This result will be benefited to the monitoring bodies or relevant authority in keeping the forest in the natural habitat. Furthermore, this research is to gather a unified data and then will be analysed for its comparison with an existing method.

Keywords: remote monitoring system, forest data, GSM, GPS, wireless sensor

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Authors: Pitsanu Poonpetpun

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This research paper consisted of three objectives: 1) to investigate actual perception of Suan Sunandha Rajabhat University’s members towards roles and performances of the Coordinating Council Office under the University Council; 2) to investigate expectation of Suan Sunandha Rajabhat University’s members towards roles and performances of the Coordinating Council Office under the University Council; and 3) to compare actual perception and expectation of Suan Sunandha Rajabhat University’s members towards roles and performances of the Coordinating Council Office under the University Council. A total of 316 samples from the population of the members of Suan Sunandha Rajabhat University were selected by use of the simple random sampling technique. Descriptive statistics and Dependent T- Test for paired samples were used, where the Dependent T- Test was for an analysis of a comparison of actual perception and expectation of Suan Sunandha Rajabhat University’s members towards roles and performances of the Coordinating Council Office under the University Council. The findings unveiled significantly high levels for the following roles: [i] appropriately circulating agendas and meeting files before time; [ii] preparing appropriate amount and quality of audio- visual equipment for meetings; [iii] compiling and keeping up-to-date documents; [iv] coordinating and working on linking all useful information to serve for the university uses for strategic policing; and [v] preparing appropriate meeting venues.

Keywords: coordinating council office of the university council, expected role, perceived role, performances of duties

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Authors: Atef Alaaeddine Sarraj, Brendan Jackman, Frank Walsh

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Tomorrow’s car will be more automated and increasingly connected. Innovative and intuitive interfaces are essential to accompany this functional enrichment. For that, today the automotive companies are competing to offer an advanced driver assistance system (ADAS) which will be able to provide enhanced navigation, collision avoidance, intersection support and lane keeping. These vision-based functions require an accurately calibrated camera. To achieve such differentiation in ADAS requires sophisticated sensors and efficient algorithms. This paper explores the different calibration methods applicable to vehicle-mounted fish-eye cameras with arbitrary fields of view and defines the first steps towards a self-calibration method that adequately addresses ADAS requirements. In particular, we present a self-calibration method after comparing different camera calibration algorithms in the context of ADAS requirements. Our method gathers data from unknown scenes while the car is moving, estimates the camera intrinsic and extrinsic parameters and corrects the wide-angle distortion. Our solution enables continuous and real-time detection of objects, pedestrians, road markings and other cars. In contrast, other camera calibration algorithms for ADAS need pre-calibration, while the presented method calibrates the camera without prior knowledge of the scene and in real-time.

Keywords: advanced driver assistance system (ADAS), fish-eye, real-time, self-calibration

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Authors: M. Ezati Kooshki, A. Abbaszadeh Shahri

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A number of devices used to control seismic structures have been developed during the past decades. One of the effective ways to reduce seismic forces transmitted to the buildings is through the base isolation systems, but the use of these devices is currently limited to large and expensive buildings. This study was an attempt to introduce an effective and low cost way to protect of structures against grand motions by a semi base isolation system. In this new way, structures were not completely decoupled of bases and the natural frequency of structures was changed due to earthquake by changing the horizontal stiffness; therefore, ground excitation energy was dissipated before entering the structures. For analyzing the dynamic behavior, the new method used finite element software (ABAQUS 6-10-1). This investigation introduced a new package of semi base isolation devices with a new material constitutive, but common in automobile industries, seeking to evaluate the effects of additional new devices on the seismic response when compared with structures without additional devises for different ground motions. The proposed semi base isolation devices were applied to a one story frame and the time history analysis was conducted on the record of Kobe earthquake (1995). The results showed that the efficiency reduced the floor acceleration and displacement, as well as velocity.

Keywords: semi base isolation system, finite element, natural frequency, horizontal stiffness

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Authors: Shu-Hui Jan, Shih-Ping Ho, Hui-Ping Tserng

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Construction knowledge can be referred to and reused among involved project managers and job-site engineers to alleviate problems on a construction job-site and reduce the time and cost of solving problems related to constructability. This paper proposes a new methodology to provide sharing of construction knowledge by using the Building Information Modeling (BIM) approach. The main characteristics of BIM include illustrating 3D CAD-based presentations and keeping information in a digital format, and facilitation of easy updating and transfer of information in the 3D BIM environment. Using the BIM approach, project managers and engineers can gain knowledge related to 3D BIM and obtain feedback provided by job-site engineers for future reference. This study addresses the application of knowledge sharing management in the construction phase of construction projects and proposes a BIM-based Knowledge Sharing Management (BIMKSM) system for project managers and engineers. The BIMKSM system is then applied in a selected case study of a construction project in Taiwan to verify the proposed methodology and demonstrate the effectiveness of sharing knowledge in the BIM environment. The combined results demonstrate that the BIMKSM system can be used as a visual BIM-based knowledge sharing management platform by utilizing the BIM approach and web technology.

Keywords: construction knowledge management, building information modeling, project management, web-based information system

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Authors: Mohammad Saleem, Neeta Kumar, Anita Sharma, Sazina Muzammil

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It is observed that some of the dental students in our setting take less interest in medical subjects. Various teaching methods are focus of research interest currently and being tried to generate interest among students. An approach of interactive integrated tutorial was used to assess its feasibility in teaching medical subjects to dental undergraduates. The aim was to generate interest and promote active self-learning among students. The objectives were to (1) introduce the integrated interactive learning method through two departments, (2) get feedback from the students and faculty on feasibility and effectiveness of this method. Second-year students in Bachelor of Dental Surgery course were divided into two groups. Each group was asked to study physiology and pathology of a common and important condition (anemia and hypertension) in a week’s time. During the tutorial, students asked questions on physiology and pathology of that condition from each other in the presence of teachers of both physiology and pathology departments. The teachers acted only as facilitators. After the session, the feedback from students and faculty on this alternative learning method was obtained. Results: Majority of the students felt that this method of learning is enjoyable, helped to develop reasoning skills and ability to correlate and integrate the knowledge from two related fields. Majority of the students felt that this kind of learning led to better understanding of the topic and motivated them towards deep learning. Teachers observed that the study promoted interdepartmental cross-discipline collaboration and better students’ linkages. Conclusion: Interactive integrated tutorial is effective in motivating dental students for better and deep learning of medical subjects.

Keywords: active learning, education, integrated, interactive, self-learning, tutorials

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Authors: Sérgio J. Teixeira, João J. Ferreira

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Tourism frequently gets identified as one of the sectors with the greatest potential for expansion on a global scale and hence conveying the importance of attempting to better understand the regional factors of competitiveness prevailing in this sector. This study’s objective essentially strives to provide a mapping of the scientific publications and the intellectual knowledge therein contained while conveying past research trends and identifying potential future lines of research in the fields of regional competitiveness and tourism innovation. This correspondingly deploys a systematic review of the literature in keeping with the bibliometric approach based upon VOSviewer software, with a particular focus on drafting maps for visualising the underlying intellectual structure. This type of analysis encapsulates the number of articles published and their annual number of citations for the period between 1900 and 2016 as registered by the Web of Science database. The results demonstrate how the intellectual structure on regional competitiveness divides essentially into three major categories: regional competitiveness, tourism innovation, and tourism clusters. Thus, the main contribution of this study arises out of identifying the main research trends in this field and the respective shortcomings and specific needs for future scientific research in the field of regional competitiveness and innovation in tourism.

Keywords: regional competitiveness, tourism cluster, bibliometric studies, tourism innovation, systematic review

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Authors: S. S. Adamu, H. S. Muhammad, D. S. Shuaibu

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Poor power quality in electrical power systems can lead to medical equipment at healthcare centres to malfunction and present wrong medical diagnosis. Equipment such as X-rays, computerized axial tomography, etc. can pollute the system due to their high level of harmonics production, which may cause a number of undesirable effects like heating, equipment damages and electromagnetic interferences. The conventional approach of mitigation uses passive inductor/capacitor (LC) filters, which has some drawbacks such as, large sizes, resonance problems and fixed compensation behaviours. The current trends of solutions generally employ active power filters using suitable control algorithms. This work focuses on assessing the level of Total Harmonic Distortion (THD) on medical facilities and various ways of mitigation, using radiology unit of an existing hospital as a case study. The measurement of the harmonics is conducted with a power quality analyzer at the point of common coupling (PCC). The levels of measured THD are found to be higher than the IEEE 519-1992 standard limits. The system is then modelled as a harmonic current source using MATLAB/SIMULINK. To mitigate the unwanted harmonic currents a shunt active filter is developed using synchronous detection algorithm to extract the fundamental component of the source currents. Fuzzy logic controller is then developed to control the filter. The THD without the active power filter are validated using the measured values. The THD with the developed filter show that the harmonics are now within the recommended limits.

Keywords: power quality, total harmonics distortion, shunt active filters, fuzzy logic

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Authors: S. Sharan Sundar, Nithish B. Moudhgalya, Nidhi Bhandari, Vineeth Vijayaraghavan

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Automatic Short Answer Grading is one of the prime applications of artificial intelligence in education. Several approaches involving the utilization of selective handcrafted features, graphical matching techniques, concept identification and mapping, complex deep frameworks, sentence embeddings, etc. have been explored over the years. However, keeping in mind the real-world application of the task, these solutions present a slight overhead in terms of computations and resources in achieving high performances. In this work, a simple and effective solution making use of elemental features based on statistical, linguistic properties, and word-based similarity measures in conjunction with tree-based classifiers and regressors is proposed. The results for classification tasks show improvements ranging from 1%-30%, while the regression task shows a stark improvement of 35%. The authors attribute these improvements to the addition of multiple similarity scores to provide ensemble of scoring criteria to the models. The authors also believe the work could reinstate that classical natural language processing techniques and simple machine learning models can be used to achieve high results for short answer grading.

Keywords: artificial intelligence, intelligent systems, natural language processing, text mining

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Authors: Ali H. Muhammad

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This paper investigates both instrumental and emotional family support on employee job satisfaction and perception of work-family conflict. Instrumental family support is manifested in family behavior that contributes to the reduction of employee’s family responsibilities and keeping the physical home environment in a proper shape. Emotional family support includes the encouragement and praise that the employee receives from his family and families for the employee’s work problem and their role in assisting the employees in dealing with these problems. The paper suggests that instrumental and emotional family support increases employee’s job satisfaction. Furthermore, the study proposes that family support decreases employee’s perception of work-family conflict. In addition, this study examines the reliability and validity of the family support index developed by Lynda King and her colleagues in 1995. Confirmatory factor analysis is used to test the validity of the instrument in an Arab business setting. A paper-pencil questionnaire was used to collect data from a random sample of 70 Kuwaiti employees working in the oil sector. Data were analyzed using factor analysis, reliability tests, and regression analysis. Results confirmed the research hypothesis. Family support had a positive effect on job satisfaction. Furthermore, family support significantly contributed to the reduction of employee perception of work-family conflict.

Keywords: family support, job satisfaction, work-family conflict, Kuwait oil sector

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Authors: Arka Roy, Chandra Prakash Dubey

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Inverse problem generally used for recovering hidden information from outside available data. Vertical component of gravity field we will be going to use for underneath density structure calculation. Ill-posing nature is main obstacle for any inverse problem. Linear regularization using Tikhonov formulation are used for appropriate choice of SVD and GSVD components. For real time data handle, signal to noise ratios should have to be less for reliable solution. In our study, 2D and 3D synthetic model with rectangular grid are used for gravity field calculation and its corresponding inversion for density reconstruction. Fine grid also we have considered to hold any irregular structure. Keeping in mind of algebraic ambiguity factor number of observation point should be more than that of number of data point. Picard plot is represented here for choosing appropriate or main controlling Eigenvalues for a regularized solution. Another important study is depth resolution plot (DRP). DRP are generally used for studying how the inversion is influenced by regularizing or discretizing. Our further study involves real time gravity data inversion of Vredeforte Dome South Africa. We apply our method to this data. The results include density structure is in good agreement with known formation in that region, which puts an additional support of our method.

Keywords: depth resolution plot, gravity inversion, Picard plot, SVD, Tikhonov formulation

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Authors: M. Wajahat, M. Shoaib, A. Waheed

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As a result of increase in world energy demand as well as the demand for heating, refrigeration and air conditioning, energy engineers are now more inclined towards the renewable energy especially solar based thermal driven refrigeration and air conditioning systems. This research is emphasized on solar assisted adsorption refrigeration system to provide comfort conditions for a building in Islamabad. The adsorption chiller can be driven by low grade heat at low temperature range (50 -80 °C) which is lower than that required for generator in absorption refrigeration system which may be furnished with the help of common flat plate solar collectors (FPC). The aim is to offset the total energy required for building’s heating and cooling demand by using FPC’s thus reducing dependency on primary energy source hence saving energy. TRNSYS is a dynamic modeling and simulation tool which can be utilized to simulate the working of a complete solar based adsorption chiller to meet the desired cooling and heating demand during summer and winter seasons, respectively. Modeling and detailed parametric analysis of the whole system is to be carried out to determine the optimal system configuration keeping in view various design constraints. Main focus of the study is on solar thermal loop of the adsorption chiller to reduce the contribution from the auxiliary devices.

Keywords: flat plate collector, energy saving, solar assisted adsorption chiller, TRNSYS

Procedia PDF Downloads 653

Authors: Magdalena Chrabąszcz, Teresa Wolniewicz, Cezary Maciejewski, Joanna Czuwara

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BACKGROUND: Dermoscopy is a clinical tool known to improve the early detection of melanoma and other malignancies of the skin. Over the past few years melanoma has grown into a disease of socio-economic importance due to the increasing incidence and persistently high mortality rates. Early diagnosis remains the best method to reduce melanoma and non-melanoma skin cancer– related mortality and morbidity. Dermoscopy is a noninvasive technique that consists of viewing pigmented skin lesions through a hand-held lens. This simple procedure increases melanoma diagnostic accuracy by up to 35%. Dermoscopy is currently the standard for clinical differential diagnosis of cutaneous melanoma and for qualifying lesion for the excision biopsy. Like any clinical tool, training is required for effective use. The introduction of small and handy dermoscopes contributed significantly to the switch of dermatoscopy toward a first-level useful tool. Non-dermatologist physicians are well positioned for opportunistic melanoma detection; however, education in the skin cancer examination is limited during medical school and traditionally lecture-based. AIM: The aim of this randomized study was to determine whether the adjunct of dermoscopy to the standard fourth year medical curriculum improves the ability of medical students to distinguish between benign and malignant lesions and assess acceptability and satisfaction with the intervention. METHODS: We performed a prospective study in 2 cohorts of fourth-year medical students at Medical University of Warsaw. Groups having dermatology course, were randomly assigned to:  cohort A: with limited access to dermatoscopy from their teacher only – 1 dermatoscope for 15 people  Cohort B: with a full access to use dermatoscopy during their clinical classes:1 dermatoscope for 4 people available constantly plus 15-minute dermoscopy tutorial. Students in both study arms got an image-based test of 10 lesions to assess ability to differentiate benign from malignant lesions and postintervention survey collecting minimal background information, attitudes about the skin cancer examination and course satisfaction. RESULTS: The cohort B had higher scores than the cohort A in recognition of nonmelanocytic (P < 0.05) and melanocytic (P <0.05) lesions. Medical students who have a possibility to use dermatoscope by themselves have also a higher satisfaction rates after the dermatology course than the group with limited access to this diagnostic tool. Moreover according to our results they were more motivated to learn dermatoscopy and use it in their future everyday clinical practice. LIMITATIONS: There were limited participants. Further study of the application on clinical practice is still needed. CONCLUSION: Although the use of dermatoscope in dermatology as a specialty is widely accepted, sufficiently validated clinical tools for the examination of potentially malignant skin lesions are lacking in general practice. Introducing medical students to dermoscopy in their fourth year curricula of medical school may improve their ability to differentiate benign from malignant lesions. It can can also encourage students to use dermatoscopy in their future practice which can significantly improve early recognition of malignant lesions and thus decrease melanoma mortality.

Keywords: dermatoscopy, early detection of melanoma, medical education, skin cancer

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Authors: Yi Jin, Xu Tang, Cuiyang Feng

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The ‘11th five-year’ and ‘12th five-year’ plans have clearly put forward to strictly control the total amount and intensity of energy and water consumption. The synergy effect of energy and water has rarely been considered in the process of energy and water saving in China, where its contribution cannot be maximized. Energy sectors consume large amounts of energy and water when producing massive energy, which makes them both energy and water intensive. Therefore, the synergy effect in these sectors is significant. This paper assesses and optimizes the synergy effect in three energy sectors under the background of promoting energy and water saving. Results show that: From the perspective of critical path, chemical industry, mining and processing of non-metal ores and smelting and pressing of metals are coupling points in the process of energy and water flowing to energy sectors, in which the implementation of energy and water saving policies can bring significant synergy effect. Multi-objective optimization shows that increasing efforts on input restructuring can effectively improve synergy effects; relatively large synergetic energy saving and little water saving are obtained after solely reducing the energy and water intensity of coupling sectors. By optimizing the input structure of sectors, especially the coupling sectors, the synergy effect of energy and water saving can be improved in energy sectors under the premise of keeping economy running stably.

Keywords: critical path, energy sector, multi-objective optimization, synergy effect, water

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Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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Authors: Sudhir K. Gupta

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Introduction: When a forensic doctor determines that a suspicious death is a suicide, homicide, or accident, the decision virtually becomes incontestable by the investigating police officer, and it becomes an issue whether the medical opinion was created with necessary checks and balances on the other probabilities of the case. It is suggested that the opinion of Forensic Medical experts is conventional, mutable, and shifting from one expert to another. The determination of suicide, accident, or homicide is mandatorily required, which is the Gold Standard for conducting death investigations. Forensic investigations serve many audiences, but the court is by far the most critical. The likely questions on direct and cross-examination determine how forensic doctors gather and handle evidence and what conclusions they reach. Methodology: The author interacted with the investigative authority, and a crime scene visit was also done along with the perusal of the Postmortem report, subsequent opinion, and crime scene photographs and statements of the witness and accused. Further analysis of all relevant scientific documents and opinions of other forensic doctors, forensic scientists, and ballistic experts involved in these cases was done to arrive at an opinion with scientific justification. Findings: The opinions arrived at by the author and how they helped the judiciary in delivering justice in these cases have been discussed in this article. This can help the readers to understand the process involved in formulating a credible forensic medical expert opinion for investigators and the judiciary. Conclusion: A criminal case might be won or lost over doubt cast on the chain of custody. Medically trained forensic doctors, therefore, learn to practice their profession in legally appropriate ways, and opinions must be based on medical justifications with credible references.

Keywords: forensic doctor, professional credibility, investigation, expert opinion

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Authors: Z. Razi, S. M. J. Mortazavi, N. Shokrpour, Z. Shayan, F. Amiri

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Long-term exposure to low doses of ionizing radiation occurs in radiation health care workplaces. Although doses in health professions are generally very low, there are still matters of concern. The radiation safety program promotes occupational radiation safety through accurate and reliable monitoring of radiation workers in order to effectively manage radiation protection. To achieve this goal, it has become mandatory to implement health examination periodically. As a result, based on the hematological alterations, working populations with a common occupational radiation history are screened. This paper calls into question the effectiveness of blood component analysis as a screening program which is mandatory for medical radiation workers in some countries. This study details the distribution and trends of changes in blood components, including white blood cells (WBCs), red blood cells (RBCs) and platelets as well as received cumulative doses from occupational radiation exposure. This study was conducted among 199 participants and 100 control subjects at the medical imaging departments at the central hospital of Shiraz University of Medical Sciences during the years 2006–2010. Descriptive and analytical statistics, considering the P-value<0.05 as statistically significance was used for data analysis. The results of this study show that there is no significant difference between the radiation workers and controls regarding WBCs and platelet count during 4 years. Also, we have found no statistically significant difference between the two groups with respect to RBCs. Besides, no statistically significant difference was observed with respect to RBCs with regards to gender, which has been analyzed separately because of the lower reference range for normal RBCs levels in women compared to men and. Moreover, the findings confirm that in a separate evaluation between WBCs count and the personnel’s working experience and their annual exposure dose, results showed no linear correlation between the three variables. Since the hematological findings were within the range of control levels, it can be concluded that the radiation dosage (which was not more than 7.58 mSv in this study) had been too small to stimulate any quantifiable change in medical radiation worker’s blood count. Thus, use of more accurate method for screening program based on the working profile of the radiation workers and their accumulated dose is suggested. In addition, complexity of radiation-induced functions and the influence of various factors on blood count alteration should be taken into account.

Keywords: blood cell count, mandatory testing, occupational exposure, radiation

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Authors: Hatice Yildirim

Abstract:

This study was an investigation into the role of teaching assistants (TAs) for deaf pupils in an English primary school. This study aimed to provide knowledge about how TAs support deaf pupils in mainstream schools in England. It is accepted that TAs have an important role in the inclusion of students with disabilities in mainstream schools. However, there has been a lack of attention paid to the role of TAs for deaf pupils in the literature. A qualitative case study approach was used to address the research questions. Twelve semi-structured classroom observations and six semi-structured interviews were carried out with four TAs and two teachers in one English mainstream primary school. The data analysis followed a thematic analysis framework. The results indicated that TAs are utilised based on a one-on-one support model and are deployed under the class teachers in the classroom. The classroom activities are carried out in small groups with the TAs and the class teacher’s agreement, as per the school’s policy. Findings show that TAs carried out seven different roles in the education of deaf pupils in an English mainstream primary school. Supporting the academic and social development of deaf pupils is TA`s main role. Also, they record pupils’ progress, communicate with pupils’ parents, take on a pastoral care role, tutor pupils in additional support lessons and raise awareness of deaf pupils’ issues.

Keywords: deaf, mainstream primary school, teaching assistant, teaching assistant`s roles

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Authors: Helder Shelton Abel Manguene, Giovanna Buonocore, Herminio Francisco Muiambo

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Paved roads are designed for 10-15 years of life. However, many asphalted roads suffer degradation before reaching their lifetime due to aging caused by load conditions and climatic factors. Oxidation is the main asphalt aging mechanism, which leads to a reduced bond between aggregate particles, increasing the potential for stripping and moisture damage, decreasing fatigue lifetime and reducing resistance to thermal cracking. To improve the performance of asphalt and mitigate these problems, modifiers such as polymers, oils and certain residues have been used. This work aims to study the influence of the addition of high-density polyethylene (HDPE) and engine oil on the thermal stability of asphalt in an oxidizing atmosphere. For the study, compositions containing asphalt, motor oil and HDPE were prepared, varying the concentration of the motor oil by 2.5%, 5%, 7.5% and 10% and keeping the HDPE concentration fixed at 5%. The results show that the pure asphalt sample is degraded in a single step that starts at approximately 311 ºC; All samples of modified asphalt except the one that contains 5% of motor oil have three degradation steps that start below the starting temperature of degradation of pure asphalt (about 250-300 ºC); The temperature of onset of degradation of the modified asphalt is shown to decrease as the concentration of the motor oil increases, suggesting a slight loss of thermal stability of the asphalt as the quantity of the motor oil increases.

Keywords: Asphalt, DTG, engine oil, HDPE, TGA

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Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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Authors: Deepak Chaudhary

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This paper attempts to analyze the leadership phenomena, its challenges, and prospects in Nepal. Literature is reviewed rigorously to explain the theoretical and empirical aspects of leadership. Besides, In-depth interviews with three national leaders were interviewed to know the challenges regarding polity and leadership. Similarly, a survey among 434 households in Katahari rural municipality and Godavari municipality was carried out to assess people’s perceptions of leaders. Leadership is normally pronounced in the wake of the success of the country’s development or crisis management. Real leaders are those who can avert any crisis successfully and proceed with the country in a progressive and normal way. Leadership’s working style can create a favorable institutional environment in the public institution that can lead development programs successfully. However, the literature suggests that Nepal is still struggling towards modernization in comparison to some East-Asian countries whose socio-economic situation was more similar in the 1950s. Similarly, Nepal has been facing several social movements after the 1990s, which resulted in a new political system, though the performance of the public institution has been a question and it goes to the leadership’s role. The poor tackling of natural disasters like earthquakes flooding, and pandemics raises the questions of the leadership’s role to some extent. The government of Nepal's record of developmental expenditures is dismal. However, leadership has been the central part of people, community, and country, and hence, the study of leadership phenomena in relation to a country’s well-being is intrinsic.

Keywords: challenges, leadership, institutionalization, effectiveness

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Authors: Johannes Atug, Andreas Radke, Mitchell Tseng, Gunther Reinhart

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In modern supply chains, large numbers of SKU (Stock-Keeping-Unit) need to be timely managed, and any delays in noticing disruptions of items often limit the ability to defer the impact on customer order fulfillment. However, in supply chains of IoT-connected enterprises, the ERP (Enterprise-Resource-Planning), the MES (Manufacturing-Execution-System) and the SCADA (Supervisory-Control-and-Data-Acquisition) systems generate large amounts of data, which generally glean much earlier notice of deviations in the business process steps. That is, analyzing these streams of data with process mining techniques allows the monitoring of the supply chain business processes and thus identification of items that deviate from the standard order fulfillment process. In this paper, a framework to enable event-based SCM (Supply-Chain-Management) processes including an overview of core enabling technologies are presented, which is based on the RAMI (Reference-Architecture-Model for Industrie 4.0) architecture. The application of this framework in the industry is presented, and implications for SCM in industry 4.0 and further research are outlined.

Keywords: cyber-physical production systems, event-based monitoring, supply chain management, RAMI (Reference-Architecture-Model for Industrie 4.0)

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Authors: Balamurali Gunji, B. B. V. L. Deepak, B. B. Biswal, Amrutha Rout, Golak Bihari Mohanta

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Robots play an important role in the operations like pick and place, assembly, spot welding and much more in manufacturing industries. Out of those, assembly is a very important process in manufacturing, where 20% of manufacturing cost is wholly occupied by the assembly process. To do the assembly task effectively, Assembly Sequences Planning (ASP) is required. ASP is one of the multi-objective non-deterministic optimization problems, achieving the optimal assembly sequence involves huge search space and highly complex in nature. Many researchers have followed different algorithms to solve ASP problem, which they have several limitations like the local optimal solution, huge search space, and execution time is more, complexity in applying the algorithm, etc. By keeping the above limitations in mind, in this paper, a new automated optimal robotic assembly sequence planning using Artificial Bee Colony (ABC) Algorithm is proposed. In this algorithm, automatic extraction of assembly predicates is done using Computer Aided Design (CAD) interface instead of extracting the assembly predicates manually. Due to this, the time of extraction of assembly predicates to obtain the feasible assembly sequence is reduced. The fitness evaluation of the obtained feasible sequence is carried out using ABC algorithm to generate the optimal assembly sequence. The proposed methodology is applied to different industrial products and compared the results with past literature.

Keywords: assembly sequence planning, CAD, artificial Bee colony algorithm, assembly predicates

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Authors: Raman Kumar, Jasgurpreet Singh Chohan, Chander Shekhar Verma

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Today, the manufacturing industries respond rapidly to new demands and compete in this continuously changing environment, thus seeking out new methods allowing them to remain competitive and flexible simultaneously. The aim of the manufacturing organizations is to reduce manufacturing costs and wastes through system simplification, organizational potential, and proper infrastructural planning by using modern techniques like lean manufacturing. In India, large number of medium and large scale manufacturing industries has successfully implemented lean manufacturing techniques. Keeping in view the above-mentioned facts, different tools will be involved in the successful implementation of the lean approach. The present work is focused on the auto part manufacturing industry to improve the performance of the recliner assembly line. There is a number of lean manufacturing tools available, but the experience and complete knowledge of manufacturing processes are required to select an appropriate tool for a specific process. Fishbone diagrams (scrap, inventory, and waiting) have been drawn to identify the root cause of different. Effect of cycle time reduction on scrap and inventory is analyzed thoroughly in the case company. Results have shown that there is a decrease in inventory cost by 7 percent after the successful implementation of the lean tool.

Keywords: lean tool, fish-bone diagram, cycle time reduction, case study

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Authors: D. L. David, J. A. Wahedi, Q. T. Zaku

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A study was conducted at River Mayo Ranewo and River Lau, Taraba State Nigeria. The two rivers empty into the Upper Benue Basin. A visual encounter survey was conducted within the two wetlands from June to August, 2014. The fish record was based entirely on landings of fishermen, number of canoes that land fish was counted, types of nets and baits used on each sampling day. Fish were sorted into taxonomic groups, identified to family/species level, counted and weighed in groups. The relative species abundance was determined by dividing the number of species from a site by the total number of species from all tributaries/sites. Fish was preserved in 2% formaldehyde solution and taken to the laboratory, where they were identified. Shannon-Weiner index of species diversity indicated that the diversity was highest at River Mayo Ranewo than River Lau. In the result showed at River Mayo Ranewo, the family Mochokidae recorded the highest (23.15%), followed by Mormyridae (2.64%) and the least was the family Lepidosirenidae (0.04%). While at River Lau the family Mochokidae recorded the highest occurrence of (24.1%), followed by Bagridae (20.20%), and then Mormyridae, which also was the second highest in River Lau, with 18.46% occurrence. There was no occurrence of Malapteruridae and Osteoglossidae (0%) in River Lau, but the least occurrence was the family Gymnarchidae (0.04%). These results indicated that the fish composition were not significantly (p ≤ 0.05) different based on t-test.

Keywords: conservation, diversity index, Lau, Mayo Ranewo, wetlands

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