Search results for: reliability improvement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6123

Search results for: reliability improvement

4923 Cephalometric Changes of Patient with Class II Division 1 [Malocclusion] Post Orthodontic Treatment with Growth Stimulation: A Case Report

Authors: Pricillia Priska Sianita

Abstract:

An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.

Keywords: cephalometric evaluation, class II division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems

Procedia PDF Downloads 249
4922 Evaluation of the Capabilities of Saccharomyces cerevisiae and Lactobacillus plantarum in Improvement of Total Phenolic Content and Antioxidant Activity in Carob Kibble

Authors: Thi Huong Vu, Vijay Jayasena, Zhongxiang Fang, Gary Dykes

Abstract:

Carob kibble has recently received attention due to the presence of high level of polyphenol antioxidants. The capacity of microorganisms to improve antioxidant activities and total phenolics in carob kibble was investigated in the study. Two types of microorganisms including lactic acid bacteria Lactobacillus plantarum (L. plantarum) and yeast Saccharomyces cerevisiae (S. cerevisiae) were used in single and in their combination as starters. The total phenolic content was determined by the Folin–Ciocalteu method. Antioxidant activities were assessed scavenging capacity using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS). The study found that S. cerevisiae alone considerably improved 55% total phenolics content at 15 h, while L. plantarum caused in a loss of 20% through the process. Antioxidant capacity of the yeast-fermented samples significantly increased by 43 % and 10 % in ABTS and DPPH assays, respectively. However, reduction of 13 % and 32 % inhibition were recorded in the carob treated with L. plantarum. In the combination of S. cerevisiae and L. plantarum (1:1), both total phenolic content and antioxidant activity of carob kibble were a similar trend as these of S. cerevisiae single, but a lower improvement. The antioxidant power of the extracts was linearly correlated to their total phenolic contents (R=0.75). The results suggested that S. cerevisiae alone was the better for enhancement of both total phenolic content and antioxidant activity in carob kibble using submerged fermentation. The efficiency of fermentation reached the highest at 15h. Thus submerged fermentation with S. cerevisiae offers a tool with simple and cost effective to further increase the bioactive potential of carob kibble, which is in use for food, cosmetic and pharmaceutical industries.

Keywords: antioxidant activity, carob kibble, lactobacillus plantarum, saccharomyces cerevisiae, total phenolics

Procedia PDF Downloads 290
4921 Characterization of Onboard Reliable Error Correction Code for SDRAM Controller

Authors: Pitcheswara Rao Nelapati

Abstract:

In the process of conveying the information there may be a chance of signal being corrupted which leads to the erroneous bits in the message. The message may consist of single, double and multiple bit errors. In high-reliability applications, memory can sustain multiple soft errors due to single or multiple event upsets caused by environmental factors. The traditional hamming code with SEC-DED capability cannot be address these types of errors. It is possible to use powerful non-binary BCH code such as Reed-Solomon code to address multiple errors. However, it could take at least a couple dozen cycles of latency to complete first correction and run at a relatively slow speed. In order to overcome this drawback i.e., to increase speed and latency we are using reed-Muller code.

Keywords: SEC-DED, BCH code, Reed-Solomon code, Reed-Muller code

Procedia PDF Downloads 429
4920 Assessing Professionalism, Communication, and Collaboration among Emergency Physicians by Implementing a 360-Degree Evaluation

Authors: Ahmed Al Ansari, Khalid Al Khalifa

Abstract:

Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.

Keywords: MSF system, emergency, validity, generalizability

Procedia PDF Downloads 357
4919 Insulation Properties of Rod-Plane Electrode Covered with ATH/SIR Nano-Composite in Dry-Air

Authors: Jae-Yong Sim, Jung-Hun Kwon, Ji-Sung Park, Kee-Joe Lim

Abstract:

One of the latest trends for insulation systems to improve the insulation performance is the use of eco-friendly hybrid insulation using compressed dry-air. Despite the excellent insulation performance of sulphurhexafluoride (SF6) gas, its use has been restricted due to the problems with significant global warming potential (GWP). Accordingly, lightning impulse performance of the hybrid insulation system covered with an aluminum trihydrate/silicone rubber (ATH/SIR) nanocomposite was examined in air at atmospheric pressure and in compressed air at pressures between 0.2 and 0.6 MPa. In the experiments, the most common breakdown path took place along the surface of the covered rod. The insulation reliability after several discharges should be guaranteed in hybrid insulation. On the other hand, the surface of the covered rod was carbonized after several discharges. Therefore, nanoscale ATH can be used as a reinforcement of covered dielectrics to inhibit carbonization on the surface of a covered rod. The results were analyzed in terms of the surface resistivity of the cover dielectrics.

Keywords: nanocomposite, hybrid insulation, ATH, dry-air

Procedia PDF Downloads 450
4918 Neuron Point-of-Care Stem Cell Therapy: Intrathecal Transplant of Autologous Bone Marrow-Derived Stem Cells in Patients with Cerebral Palsy

Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia

Abstract:

Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.

Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders

Procedia PDF Downloads 414
4917 Access to Inclusive and Culturally Sensitive Mental Healthcare in Pharmacy Students and Residents

Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris

Abstract:

Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.

Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers

Procedia PDF Downloads 92
4916 Developing a Cybernetic Model of Interdepartmental Logistic Interactions in SME

Authors: Jonas Mayer, Kai-Frederic Seitz, Thorben Kuprat

Abstract:

In today’s competitive environment production’s logistic objectives such as ‘delivery reliability’ and ‘delivery time’ and distribution’s logistic objectives such as ‘service level’ and ‘delivery delay’ are attributed great importance. Especially for small and mid-sized enterprises (SME) attaining these objectives pose a key challenge. Within this context, one of the difficulties is that interactions between departments within the enterprise and their specific objectives are insufficiently taken into account and aligned. Interdepartmental independencies along with contradicting targets set within the different departments result in enterprises having sub-optimal logistic performance capability. This paper presents a research project which will systematically describe the interactions between departments and convert them into a quantifiable form.

Keywords: department-specific actuating and control variables, interdepartmental interactions, cybernetic model, logistic objectives

Procedia PDF Downloads 372
4915 Evaluation of the Grammar Questions at the Undergraduate Level

Authors: Preeti Gacche

Abstract:

A considerable part of undergraduate level English Examination papers is devoted to grammar. Hence the grammar questions in the question papers are evaluated and the opinions of both students and teachers about them are obtained and analyzed. A grammar test of 100 marks is administered to 43 students to check their performance. The question papers have been evaluated by 10 different teachers and their scores compared. The analysis of 38 University question papers reveals that on an average 20 percent marks are allotted to grammar. Almost all the grammar topics are tested. Abundant use of grammatical terminology is observed in the questions. Decontextualization, repetition, possibility of multiple correct answers and grammatical errors in framing the questions have been observed. Opinions of teachers and students about grammar questions vary in many respects. The students responses are analyzed medium-wise and sex-wise. The Medium at the School level and the sex of the students are found to play no role as far as interest in the study of grammar is concerned. English medium students solve grammar questions intuitively whereas non-English medium students are required to recollect the rules of grammar. Prepositions, Verbs, Articles and Model auxiliaries are found to be easy topics for most students whereas the use of conjunctions is the most difficult topic. Out of context items of grammar are difficult to answer in comparison with contextualized items of grammar. Hence contextualized texts to test grammar items are desirable. No formal training in setting questions is imparted to teachers by the competent authorities like the University. They need to be trained in testing. Statistically there is no significant change of score with the change in the rater in testing of grammar items. There is scope of future improvement. The question papers need to be evaluated and feedback needs to be obtained from students and teachers for future improvement.

Keywords: context, evaluation, grammar, tests

Procedia PDF Downloads 353
4914 Improving Self-Administered Medication Adherence for Older Adults: A Systematic Review

Authors: Mathumalar Loganathan, Lina Syazana, Bryony Dean Franklin

Abstract:

Background: The therapeutic benefit of self-administered medication for long-term use is limited by an average 50% non-adherence rate. Patient forgetfulness is a common factor in unintentional non-adherence. With a growing ageing population, strategies to improve self-administration of medication adherence are essential. Our aim was to review systematically the effects of interventions to optimise self-administration of medication. Method: Database searched were MEDLINE, EMBASE, PsynINFO, CINAHL from 1980 to 31 October 2013. Search terms included were ‘self-administration’, ‘self-care’, ‘medication adherence’, and ‘intervention’. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale. Results: The search strategy retrieved 6 studies that met the inclusion and exclusion criteria. Three intervention strategies were identified: self-administration medication programme (SAMP), nursing education and medication packaging (pill calendar). A nursing education programme focused on improving patients’ behavioural self-management of drug prescribing. This was the most studied area and three studies highlighting an improvement in self-administration of medication. Conclusion: Results are mixed and there is no one interventional strategy that has proved to be effective. Nevertheless, self-administration of medication programme seems to show most promise. A multi-faceted approach and clearer policy guideline are likely to be required to improve prescribing for these vulnerable patients. Mixed results were found for SAMP. Medication packaging (pill calendar) was evaluated in one study showing a significant improvement in self-administration of medication. A meta-analysis could not be performed due to heterogeneity in the outcome measures.

Keywords: self-administered medication, intervention, prescribing, older patients

Procedia PDF Downloads 323
4913 Gait Analysis in Total Knee Arthroplasty

Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

Abstract:

Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

Procedia PDF Downloads 94
4912 Intelligent IT Infrastructure in the Gas and Oil Industry

Authors: Ahmad Fahad Alotaibi, Khalid Hamed Hajri, Humoud Hudiban Rashidi

Abstract:

Intelligent information technology infrastructure is considered one of the enablers to enhance digital transformation in the gas and oil fields to optimize IT infrastructure reliability by supporting operations and maintenance in a safe and secure method to optimize resources. Smart IT buildings, communication rooms and shelters with intelligent technologies can strengthen the performance and profitability of gas and oil companies by ensuring business continuity. This paper describes the advantages of deploying intelligent IT infrastructure in the oil and gas industry by illustrating its positive impacts on some development aspects, for instance, operations, maintenance, safety, security and resource optimization. Moreover, it highlights the challenges and difficulties of providing smart IT services in a remote area and proposes solutions to overcome such difficulties.

Keywords: intelligent IT infrastructure, remote areas, oil and gas field, digitalization

Procedia PDF Downloads 60
4911 Artificial Intelligence-Aided Extended Kalman Filter for Magnetometer-Based Orbit Determination

Authors: Gilberto Goracci, Fabio Curti

Abstract:

This work presents a robust, light, and inexpensive algorithm to perform autonomous orbit determination using onboard magnetometer data in real-time. Magnetometers are low-cost and reliable sensors typically available on a spacecraft for attitude determination purposes, thus representing an interesting choice to perform real-time orbit determination without the need to add additional sensors to the spacecraft itself. Magnetic field measurements can be exploited by Extended/Unscented Kalman Filters (EKF/UKF) for orbit determination purposes to make up for GPS outages, yielding errors of a few kilometers and tens of meters per second in the position and velocity of a spacecraft, respectively. While this level of accuracy shows that Kalman filtering represents a solid baseline for autonomous orbit determination, it is not enough to provide a reliable state estimation in the absence of GPS signals. This work combines the solidity and reliability of the EKF with the versatility of a Recurrent Neural Network (RNN) architecture to further increase the precision of the state estimation. Deep learning models, in fact, can grasp nonlinear relations between the inputs, in this case, the magnetometer data and the EKF state estimations, and the targets, namely the true position, and velocity of the spacecraft. The model has been pre-trained on Sun-Synchronous orbits (SSO) up to 2126 kilometers of altitude with different initial conditions and levels of noise to cover a wide range of possible real-case scenarios. The orbits have been propagated considering J2-level dynamics, and the geomagnetic field has been modeled using the International Geomagnetic Reference Field (IGRF) coefficients up to the 13th order. The training of the module can be completed offline using the expected orbit of the spacecraft to heavily reduce the onboard computational burden. Once the spacecraft is launched, the model can use the GPS signal, if available, to fine-tune the parameters on the actual orbit onboard in real-time and work autonomously during GPS outages. In this way, the provided module shows versatility, as it can be applied to any mission operating in SSO, but at the same time, the training is completed and eventually fine-tuned, on the specific orbit, increasing performances and reliability. The results provided by this study show an increase of one order of magnitude in the precision of state estimate with respect to the use of the EKF alone. Tests on simulated and real data will be shown.

Keywords: artificial intelligence, extended Kalman filter, orbit determination, magnetic field

Procedia PDF Downloads 105
4910 Work Related Musculoskeletal Disorder: A Case Study of Office Computer Users in Nigerian Content Development and Monitoring Board, Yenagoa, Bayelsa State, Nigeria

Authors: Tamadu Perry Egedegu

Abstract:

Rapid growth in the use of electronic data has affected both the employee and work place. Our experience shows that jobs that have multiple risk factors have a greater likelihood of causing Work Related Musculoskeletal Disorder (WRMSDs), depending on the duration, frequency and/or magnitude of exposure to each. The study investigated musculoskeletal disorder among office workers. Thus, it is important that ergonomic risk factors be considered in light of their combined effect in causing or contributing to WRMSDs. Fast technological growth in the use of electronic system; have affected both workers and the work environment. Awkward posture and long hours in front of these visual display terminals can result in work-related musculoskeletal disorders (WRMSD). The study shall contribute to the awareness creation on the causes and consequences of WRMSDs due to lack of ergonomics training. The study was conducted using an observational cross-sectional design. A sample of 109 respondents was drawn from the target population through purposive sampling method. The sources of data were both primary and secondary. Primary data were collected through questionnaires and secondary data were sourced from journals, textbooks, and internet materials. Questionnaires were the main instrument for data collection and were designed in a YES or NO format according to the study objectives. Content validity approval was used to ensure that the variables were adequately covered. The reliability of the instrument was done through test-retest method, yielding a reliability index at 0.84. The data collected from the field were analyzed with a descriptive statistics of chart, percentage and mean. The study found that the most affected body regions were the upper back, followed by the lower back, neck, wrist, shoulder and eyes, while the least affected body parts were the knee calf and the ankle. Furthermore, the prevalence of work-related 'musculoskeletal' malfunctioning was linked with long working hours (6 - 8 hrs.) per day, lack of back support on their seats, glare on the monitor, inadequate regular break, repetitive motion of the upper limbs, and wrist when using the computer. Finally, based on these findings some recommendations were made to reduce the prevalent of WRMSDs among office workers.

Keywords: work related musculoskeletal disorder, Nigeria, office computer users, ergonomic risk factor

Procedia PDF Downloads 241
4909 Reducing Ambulance Offload Delay: A Quality Improvement Project at Princess Royal University Hospital

Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

Abstract:

Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

Procedia PDF Downloads 106
4908 A New Method Presentation for Locating Fault in Power Distribution Feeders Considering DG

Authors: Rahman Dashti, Ehsan Gord

Abstract:

In this paper, an improved impedance based fault location method is proposed. In this method, online fault locating is performed using voltage and current information at the beginning of the feeder. Determining precise fault location in a short time increases reliability and efficiency of the system. The proposed method utilizes information about main component of voltage and current at the beginning of the feeder and distributed generation unit (DGU) in order to precisely locate different faults in acceptable time. To evaluate precision and accuracy of the proposed method, a 13-node is simulated and tested using MATLAB.

Keywords: distribution network, fault section determination, distributed generation units, distribution protection equipment

Procedia PDF Downloads 401
4907 Parasagittal Approach to Lumbar Epidural Steroid Injections: A Cost-Effectiveness Analysis

Authors: K. D. Candido, A. Lissounov, I. Knezevic, N. Knezevic

Abstract:

Background: The most commonly performed pain procedures in the USA is Lumbar Epidural Steroid Injections (LESI). There are three main types of these procedures: transforaminal (TF), interlaminar (IL) and caudal injections. It is expected for TF injections to have better outcomes than IL injections, based on the recently published systematic review. The studies presented in that review used a midline IL approach, but those with parasagittal IL approach were not taken into consideration. Our aim is to emphasize the efficacy of the lateral parasagittal (paramedian) IL approach in this review. Methods: We included five studies in this systematic review, which compared Parasagittal-IL (PIL) with either Midline-IL (MIL) or TF LESI. Total of 296 patients who had undergone different types of LESI were observed across the five studies, and the average pain and functional improvements were calculated and compared among groups. Results: Pain and function improvements with PIL approach is superior on 12 months follow up to MIL approach (53.4% vs. 14.7%) and (55% vs. 27.7%), respectively. A 12 months follow-up results between PIL and TF shows a near equivalent effectiveness for pain (58.9% vs. 63.2%) and function improvement (47.3% vs. 48.1%). An average follow-up of 17.1 days have shown better short-term pain relief for PIL than TF approach (45.8% vs. 19.2%), respectively. Number of repeated injections is lower for PIL injections than MIL. Number of weeks between 1st and 2nd injections: PIL averaged 15.8 weeks and MIL averaged 9.7 weeks. Third LESI injection is more common in TF group (30%) than PIL group (18.8%). Conclusion: Higher complication rates are associated with TF injections for which FDA7 issued an official warning. We have recorded better outcomes in pain and function improvement of Parasagittal-IL LESI as compared to midline-IL injection, in the presented systematic review. Parasagittal and TF injections have equivalent efficacy in Pain and Function improvements thus we advocate for Parasagittal-IL approach consideration as an alternative for TF injections.

Keywords: parasagital approach, lumbar, back pain, epidural steroid injection

Procedia PDF Downloads 174
4906 A Monitoring System to Detect Vegetation Growth along the Route of Power Overhead Lines

Authors: Eugene Eduful

Abstract:

This paper introduces an approach that utilizes a Wireless Sensor Network (WSN) to detect vegetation encroachment between segments of distribution lines. The WSN was designed and implemented, involving the seamless integration of Arduino Uno and Mega systems. This integration demonstrates a method for addressing the challenges posed by vegetation interference. The primary aim of the study is to improve the reliability of power supply in areas characterized by forested terrain, specifically targeting overhead powerlines. The experimental results validate the effectiveness of the proposed system, revealing its ability to accurately identify and locate instances of vegetation encroachment with a remarkably high degree of precision.

Keywords: wireless sensor network, vegetation encroachment, line of sight, Arduino Uno, XBEE

Procedia PDF Downloads 72
4905 Investigating the Relationship between Bank and Cloud Provider

Authors: Hatim Elhag

Abstract:

Banking and Financial Service Institutions are possibly the most advanced in terms of technology adoption and use it as a key differentiator. With high levels of business process automation, maturity in the functional portfolio, straight through processing and proven technology outsourcing benefits, Banking sector stand to benefit significantly from Cloud computing capabilities. Additionally, with complex Compliance and Regulatory policies, combined with expansive products and geography coverage, the business impact is even greater. While the benefits are exponential, there are also significant challenges in adopting this model– including Legal, Security, Performance, Reliability, Transformation complexity, Operating control and Governance and most importantly proof for the promised cost benefits. However, new architecture designed should be implemented to align this approach.

Keywords: security, cloud, banking sector, cloud computing

Procedia PDF Downloads 499
4904 The Role of Bone Marrow Stem Cells Transplantation in the Repair of Damaged Inner Ear in Albino Rats

Authors: Ahmed Gaber Abdel Raheem, Nashwa Ahmed Mohamed

Abstract:

Introduction: Sensorineural hearing loss (SNHL) is largely caused by the degeneration of the cochlea. Therapeutic options for SNHL are limited to hearing aids and cochlear implants. The cell transplantation approach to the regeneration of hair cells has gained considerable attention because stem cells are believed to accumulate in the damaged sites and have the potential for the repair of damaged tissues. The aim of the work: was to assess the use of bone marrow transplantation in repair of damaged inner ear hair cells in rats after the damage had been inflicted by Amikacin injection. Material and Methods: Thirty albino rats were used in this study. They were divided into three groups. Each group ten rats. Group I: used as control. Group II: Were given Amikacin- intratympanic injection till complete loss of hearing function. This could be assessed by Distortion product Otoacoustic Emission (DPOAEs) and / or auditory brain stem evoked potential (ABR). GroupIII: were given intra-peritoneal injection of bone marrow stem cell after complete loss of hearing caused by Amikacin. Clinical assessment was done using DPOAEs and / or auditory brain stem evoked potential (ABR), before and after bone marrow injection. Histological assessment of the inner ear was done by light and electron microscope. Also, Detection of stem cells in the inner ear by immunohistochemistry. Results: Histological examination of the specimens showed promising improvement in the structure of cochlea that may be responsible for the improvement of hearing function in rats detected by DPOAEs and / or ABR. Conclusion: Bone marrow stem cells transplantation might be useful for the treatment of SNHL.

Keywords: amikacin, hair cells, sensorineural hearing loss, stem cells

Procedia PDF Downloads 449
4903 Measurements of Service Quality vs Customer Satisfaction in Government Owned Retail Store at Kochi

Authors: N. S. Ajisha

Abstract:

In today’s competitive world the quality of the service you deliver is one of the important factor that determine customer satisfaction. Service quality is considered to be one important determinant to evaluate customer satisfaction and the relationship between service quality and customer satisfaction is considered as the foundation in researches on customer satisfaction. This research examines to do a gap analysis between the perception and expectation of the services delivered and find relation between the service quality and customer satisfaction. Service quality is found out here using the SERVQUAL model. And it finds out the dimension of service quality which is more important to measure customer satisfaction. The dimensions which we measure using SERVQUAL include the tangibles, reliability, responsiveness, assurance, and empathy. This study involves primary data collection like market survey.

Keywords: customer satisfaction, service quality, retail service quality, Kochi

Procedia PDF Downloads 555
4902 Elite Child Athletes Are Our Future: Cardiac Adaptation to Monofin Training in Prepubertal Egyptian Athletes

Authors: Magdy Abouzeid, Nancy Abouzeid, Afaf Salem

Abstract:

Background: The elite child athletes are one who has superior athletic talent. Monofin (a single surface swim fin) swimming already proved to be the most efficient method of swimming for human being. This is a novel descriptive study examining myocardial function indices in prepubertal monofin children. The aim of the present study was to determine the influence of long-term monofin training (LTMT), 36 weeks, 6 times per week, 90 min per unit on Myocardial function adaptation in elite child monofin athletes. Methods: 14 elite monofin children aged 11.95 years (± 1.09 yr) took part for (LTMT). All subjects underwent two-dimension, M-mode, and Doppler echocardiography before and after training to evaluate cardiac dimensions and function; septal and posterior wall thickness. Statistical methods of SPSS, means ± SD and paired t test, % of improvement were used. Findings: There was significant difference (p<0.01) and % improvement for all echocardiography parameter after (LTMT). Inter ventricular septal thickness in diastole and in systole increased by 27.9 % and 42.75 %. Left ventricular end systolic dimension and diastole increased by 16.81 % and 42.7 % respectively. Posterior wall thickness in systole very highly increased by 283.3 % and in diastole increased by 51.78 %. Left ventricular mass in diastole and in systole increased by 44.8 % and 40.1 % respectively. Stroke volume (SV) and resting heart rate (HR) significant changed (sv) 25 %, (HR) 14.7 %. Interpretation: the unique swim fin tool and create propulsion and overcome resistance. Further researches are needed to determine the effects of monofin training on right ventricular in child athletes.

Keywords: prepubertal, monofin training, heart athlete's, elite child athlete, echocardiography

Procedia PDF Downloads 339
4901 Smart Grids Cyber Security Issues and Challenges

Authors: Imen Aouini, Lamia Ben Azzouz

Abstract:

The energy need is growing rapidly due to the population growth and the large new usage of power. Several works put considerable efforts to make the electricity grid more intelligent to reduce essentially energy consumption and provide efficiency and reliability of power systems. The Smart Grid is a complex architecture that covers critical devices and systems vulnerable to significant attacks. Hence, security is a crucial factor for the success and the wide deployment of Smart Grids. In this paper, we present security issues of the Smart Grid architecture and we highlight open issues that will make the Smart Grid security a challenging research area in the future.

Keywords: smart grids, smart meters, home area network, neighbor area network

Procedia PDF Downloads 424
4900 On-Chip Aging Sensor Circuit Based on Phase Locked Loop Circuit

Authors: Ararat Khachatryan, Davit Mirzoyan

Abstract:

In sub micrometer technology, the aging phenomenon starts to have a significant impact on the reliability of integrated circuits by bringing performance degradation. For that reason, it is important to have a capability to evaluate the aging effects accurately. This paper presents an accurate aging measurement approach based on phase-locked loop (PLL) and voltage-controlled oscillator (VCO) circuit. The architecture is rejecting the circuit self-aging effect from the characteristics of PLL, which is generating the frequency without any aging phenomena affects. The aging monitor is implemented in low power 32 nm CMOS technology, and occupies a pretty small area. Aging simulation results show that the proposed aging measurement circuit improves accuracy by about 2.8% at high temperature and 19.6% at high voltage.

Keywords: aging effect, HCI, NBTI, nanoscale

Procedia PDF Downloads 359
4899 Correlation of SPT N-Value and Equipment Drilling Parameters in Deep Soil Mixing

Authors: John Eric C. Bargas, Maria Cecilia M. Marcos

Abstract:

One of the most common ground improvement techniques is Deep Soil Mixing (DSM). As the technique progresses, there is still lack in the development when it comes to depth control. This was the issue experienced during the installation of DSM in one of the National projects in the Philippines. This study assesses the feasibility of using equipment drilling parameters such as hydraulic pressure, drilling speed and rotational speed in determining the Standard Penetration Test N-value of a specific soil. Hydraulic pressure and drilling speed with a constant rotational speed of 30 rpm have a positive correlation with SPT N-value for cohesive soil and sand. A linear trend was observed for cohesive soil. The correlation of SPT N-value and hydraulic pressure yielded a R²=0.5377 while the correlation of SPT N-value and drilling speed has a R²=0.6355. While the best fitted model for sand is polynomial trend. The correlation of SPT N-value and hydraulic pressure yielded a R²=0.7088 while the correlation of SPT N-value and drilling speed has a R²=0.4354. The low correlation may be attributed to the behavior of sand when the auger penetrates. Sand tends to follow the rotation of the auger rather than resisting which was observed for very loose to medium dense sand. Specific Energy and the product of hydraulic pressure and drilling speed yielded same R² with a positive correlation. Linear trend was observed for cohesive soil while polynomial trend for sand. Cohesive soil yielded a R²=0.7320 which has a strong relationship. Sand also yielded a strong relationship having a coefficient of determination, R²=0.7203. It is feasible to use hydraulic pressure and drilling speed to estimate the SPT N-value of the soil. Also, the product of hydraulic pressure and drilling speed can be a substitute to specific energy when estimating the SPT N-value of a soil. However, additional considerations are necessary to account for other influencing factors like ground water and physical and mechanical properties of soil.

Keywords: ground improvement, equipment drilling parameters, standard penetration test, deep soil mixing

Procedia PDF Downloads 48
4898 A Study on Development Strategies of Marine Leisure Tourism Using AHP

Authors: Da-Hye Jang, Woo-Jeong Cho

Abstract:

Marine leisure tourism contributes greatly to the national economy in which the sea is located nearby and many countries are using marine tourism to create value added. The interest and investment of government and local governments on marine leisure tourism growing as a major trend of marine tourism is steadily increasing. But indiscriminate investment in marine leisure tourism such as duplicated business wastes limited resources. In other words, government and local governments need to select and concentrate on the goal they pursue by drawing priority on maritime leisure tourism policies. The purpose of this study is to analyze development strategies on supplier for marine leisure tourism and thus provide a comprehensive and rational framework for developing marine leisure tourism. In order to achieve the purpose, this study is to analyze priorities for each evaluation criterion of marine leisure tourism development policies using Analytic Hierarchy Process. In this study, a questionnaire was used as the survey tool and was developed based on the previous studies, government report, regional report, related thesis and literature for marine leisure tourism. The questionnaire was constructed by verifying the validity of contents from the expert group related to marine leisure tourism after conducting the first and second preliminary surveys. The AHP survey was conducted to experts (university professors, researchers, field specialists and related public officials) from April 6, 2018 to April 30, 2018 by visiting in person or e-mail. This study distributed 123 questionnaires and 68 valid questionnaires were used for data analysis. As a result, 4 factors with 12 detail strategies were analyzed using Excel. Extracted factors of development strategies of marine leisure tourism are consist of 4 factors such as infrastructure, popularization, law & system improvement and advancement. In conclusion, the results of the pairwise comparison of the four major factor on the first class were infrastructure, popularization, law & system improvement and advancement in order. Second, marine water front space maintenance had higher priority than marina facilities expansion and the establishment of marine leisure education center. Third, marine leisure safety·culture improvement had higher priority than strengthening experience·education program and the upkeep and open promotion event. Fourth, specialization·cluster of marine leisure tourism had higher priority than business support system of marine leisure tourism. Fifth, the revision of water-related leisure activities safety act had higher priority than an enactment of marine tourism promotion act and the foster of marina service industry. Finally, marine water front space maintenance was the most important development plan to boost marine leisure tourism.

Keywords: marine leisure tourism, marine leisure, marine tourism, analytic hierarchy process

Procedia PDF Downloads 165
4897 Environmental Impact of a New-Build Educational Building in England: Life-Cycle Assessment as a Method to Calculate Whole Life Carbon Emissions

Authors: Monkiz Khasreen

Abstract:

In the context of the global trend towards reducing new buildings carbon footprint, the design team is required to make early decisions that have a major influence on embodied and operational carbon. Sustainability strategies should be clear during early stages of building design process, as changes made later can be extremely costly. Life-Cycle Assessment (LCA) could be used as the vehicle to carry other tools and processes towards achieving the requested improvement. Although LCA is the ‘golden standard’ to evaluate buildings from 'cradle to grave', lack of details available on the concept design makes LCA very difficult, if not impossible, to be used as an estimation tool at early stages. Issues related to transparency and accessibility of information in the building industry are affecting the credibility of LCA studies. A verified database derived from LCA case studies is required to be accessible to researchers, design professionals, and decision makers in order to offer guidance on specific areas of significant impact. This database could be the build-up of data from multiple sources within a pool of research held in this context. One of the most important factors that affects the reliability of such data is the temporal factor as building materials, components, and systems are rapidly changing with the advancement of technology making production more efficient and less environmentally harmful. Recent LCA studies on different building functions, types, and structures are always needed to update databases derived from research and to form case bases for comparison studies. There is also a need to make these studies transparent and accessible to designers. The work in this paper sets out to address this need. This paper also presents life-cycle case study of a new-build educational building in England. The building utilised very current construction methods and technologies and is rated as BREEAM excellent. Carbon emissions of different life-cycle stages and different building materials and components were modelled. Scenario and sensitivity analyses were used to estimate the future of new educational buildings in England. The study attempts to form an indicator during the early design stages of similar buildings. Carbon dioxide emissions of this case study building, when normalised according to floor area, lie towards the lower end of the range of worldwide data reported in the literature. Sensitivity analysis shows that life cycle assessment results are highly sensitive to future assumptions made at the design stage, such as future changes in electricity generation structure over time, refurbishment processes and recycling. The analyses also prove that large savings in carbon dioxide emissions can result from very small changes at the design stage.

Keywords: architecture, building, carbon dioxide, construction, educational buildings, England, environmental impact, life-cycle assessment

Procedia PDF Downloads 113
4896 Application of Multilinear Regression Analysis for Prediction of Synthetic Shear Wave Velocity Logs in Upper Assam Basin

Authors: Triveni Gogoi, Rima Chatterjee

Abstract:

Shear wave velocity (Vs) estimation is an important approach in the seismic exploration and characterization of a hydrocarbon reservoir. There are varying methods for prediction of S-wave velocity, if recorded S-wave log is not available. But all the available methods for Vs prediction are empirical mathematical models. Shear wave velocity can be estimated using P-wave velocity by applying Castagna’s equation, which is the most common approach. The constants used in Castagna’s equation vary for different lithologies and geological set-ups. In this study, multiple regression analysis has been used for estimation of S-wave velocity. The EMERGE module from Hampson-Russel software has been used here for generation of S-wave log. Both single attribute and multi attributes analysis have been carried out for generation of synthetic S-wave log in Upper Assam basin. Upper Assam basin situated in North Eastern India is one of the most important petroleum provinces of India. The present study was carried out using four wells of the study area. Out of these wells, S-wave velocity was available for three wells. The main objective of the present study is a prediction of shear wave velocities for wells where S-wave velocity information is not available. The three wells having S-wave velocity were first used to test the reliability of the method and the generated S-wave log was compared with actual S-wave log. Single attribute analysis has been carried out for these three wells within the depth range 1700-2100m, which corresponds to Barail group of Oligocene age. The Barail Group is the main target zone in this study, which is the primary producing reservoir of the basin. A system generated list of attributes with varying degrees of correlation appeared and the attribute with the highest correlation was concerned for the single attribute analysis. Crossplot between the attributes shows the variation of points from line of best fit. The final result of the analysis was compared with the available S-wave log, which shows a good visual fit with a correlation of 72%. Next multi-attribute analysis has been carried out for the same data using all the wells within the same analysis window. A high correlation of 85% has been observed between the output log from the analysis and the recorded S-wave. The almost perfect fit between the synthetic S-wave and the recorded S-wave log validates the reliability of the method. For further authentication, the generated S-wave data from the wells have been tied to the seismic and correlated them. Synthetic share wave log has been generated for the well M2 where S-wave is not available and it shows a good correlation with the seismic. Neutron porosity, density, AI and P-wave velocity are proved to be the most significant variables in this statistical method for S-wave generation. Multilinear regression method thus can be considered as a reliable technique for generation of shear wave velocity log in this study.

Keywords: Castagna's equation, multi linear regression, multi attribute analysis, shear wave logs

Procedia PDF Downloads 229
4895 Comparison Analysis of CFD Turbulence Fluid Numerical Study for Quick Coupling

Authors: JoonHo Lee, KyoJin An, JunSu Kim, Young-Chul Park

Abstract:

In this study, the fluid flow characteristics and performance numerical study through CFD model of the Non-split quick coupling for flow control in hydraulic system equipment for the aerospace business group focused to predict. In this study, we considered turbulence models for the application of Computational Fluid Dynamics for the CFD model of the Non-split Quick Coupling for aerospace business. In addition to this, the adequacy of the CFD model were verified by comparing with standard value. Based on this analysis, accurate the fluid flow characteristics can be predicted. It is, therefore, the design of the fluid flow characteristic contribute the reliability for the Quick Coupling which is required in industries on the basis of research results.

Keywords: CFD, FEM, quick coupling, turbulence

Procedia PDF Downloads 384
4894 Reliability of Intra-Logistics Systems – Simulating Performance Availability

Authors: Steffen Schieweck, Johannes Dregger, Sascha Kaczmarek, Michael ten Hompel

Abstract:

Logistics distributors face the issue of having to provide increasing service levels while being forced to reduce costs at the same time. Same-day delivery, quick order processing and rapidly growing ranges of articles are only some of the prevailing challenges. One key aspect of the performance of an intra-logistics system is how often and in which amplitude congestions and dysfunctions affect the processing operations. By gaining knowledge of the so called ‘performance availability’ of such a system during the planning stage, oversizing and wasting can be reduced whereas planning transparency is increased. State of the art for the determination of this KPI are simulation studies. However, their structure and therefore their results may vary unforeseeably. This article proposes a concept for the establishment of ‘certified’ and hence reliable and comparable simulation models.

Keywords: intra-logistics, performance availability, simulation, warehousing

Procedia PDF Downloads 454