Search results for: pulmonary delivery

Authors: Julian Donovan, Jessica Brealey, Matthew Bowker, Marianne Feghali, Gregory Smith, Lee Thompson, Deborah Henderson

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This article details the development of the X-ray response team (XRT), a service that utilises innovative technology to safely deliver acute and elective imaging and medical assessment service in the pre-hospital and community setting. This involves a partnership between Northumbria Healthcare NHS Foundation Trust’s Radiology and Emergency Medicine departments and the North East Ambulance Service to create a multidisciplinary prehospital team. The team committed to the delivery of a two-day acute service every week, alongside elective referrals, starting in November 2020. The service was originally made available to a 15-mile radius surrounding the Northumbria Hospital. Due to demand, this was expanded to include the North Tyneside and Northumberland regions. The target population was specified as frail and vulnerable patients, as well as those deemed to benefit from staying in their own environment. Within the first two months, thirty-six percent of patients assessed were able to stay at home due to the provision of off-site imaging. In the future, this service aims to allow patient transfer directly to an appropriate ward or clinic, bypassing the emergency department to improve the patient journey and reduce emergency care pressures.

Keywords: frailty, imaging, pre-hospital, X-ray

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Authors: Mohsen S. Sajadieha, Danyar Molavia

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In this paper, a truck scheduling problem is investigated at a two-touch cross-docking center with due dates for outbound trucks as a hard constraint. The objective is to minimize the total cost comprising penalty and delivery cost of delayed shipments. The sequence of unloading shipments is considered and is assumed that shipments are sent to shipping dock doors immediately after unloading and a First-In-First-Out (FIFO) policy is considered for loading the shipments. A mixed integer programming model is developed for the proposed model. Two meta-heuristic algorithms including genetic algorithm (GA) and variable neighborhood search (VNS) are developed to solve the problem in medium and large sized scales. The numerical results show that increase in due dates for outbound trucks has a crucial impact on the reduction of penalty costs of delayed shipments. In addition, by increase the due dates, the improvement in the objective function arises on average in comparison with the situation that the cross-dock is multi-touch and shipments are sent to shipping dock doors only after unloading the whole inbound truck.

Keywords: cross-docking, truck scheduling, fixed due date, door assignment

Procedia PDF Downloads 404

Authors: Ling-Lang Huang

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Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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Authors: Khaled Darwish, Islam El Madahh, Hoda Mohamed, Hadia El Hennawy

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Cloud computing has been one of the fastest growing parts in IT industry mainly in the context of the future of the web where computing, communication, and storage services are main services provided for Internet users. Mobile Cloud Computing (MCC) is gaining stream which can be used to extend cloud computing functions, services and results to the world of future mobile applications and enables delivery of a large variety of cloud application to billions of smartphones and wearable devices. This paper describes reliability for MCC by determining the ability of a system or component to function correctly under stated conditions for a specified period of time to be able to deal with the estimation and management of high levels of lifetime engineering uncertainty and risks of failure. The assessment procedures consists of determine Mean Time between Failures (MTBF), Mean Time to Failure (MTTF), and availability percentages for main components in both cloud computing and MCC structures applied on single node OpenStack installation to analyze its performance with different settings governing the behavior of participants. Additionally, we presented several factors have a significant impact on rates of change overall cloud system reliability should be taken into account in order to deliver highly available cloud computing services for mobile consumers.

Keywords: cloud computing, mobile cloud computing, reliability, availability, OpenStack

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Authors: M. Dakshayini, P. Jayarekha

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In traditional output-based education system, class room lecture and laboratory are the traditional delivery methods used during the course. Written examination and lab examination have been used as a conventional tool for evaluating student’s performance. Hence, there are certain apprehensions that the traditional education system may not efficiently prepare the students for competent professional life. This has led for the change from Traditional output-based education to Outcome-Based Education (OBE). OBE first sets the ideal programme learning outcome consecutively on increasing degree of complexity that students are expected to master. The core curriculum, teaching methodologies and assessment tools are then designed to achieve the proposed outcomes mainly focusing on what students can actually attain after they are taught. In this paper, we discuss a promising applications based learning and evaluation component involving industry collaboration to improve the quality of teaching and student learning process. Incorporation of this component definitely improves the quality of student learning in engineering education and helps the student to attain the competency as per the graduate attributes. This may also reduce the Industry-academia gap.

Keywords: outcome-based education, programme learning outcome, teaching-learning process, evaluation, industry collaboration

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Authors: Fredrick Olatunji Ajegbomogun, Clement Ola Adekoya

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Mathematics has, for ages, been an essential subject in the education curriculum across the globe. The word mathematics scares the majority of undergraduate students and even more library and information science (LIS) students who have not seen the pertinence of the subject to their academic pursuits. This study investigated mathematics anxiety and attitudes among LIS undergraduate students in Nigerian universities. The study adopted a descriptive survey research design. Multi-stage and convenient sampling techniques were used for the study. Data were collected using a questionnaire and analyzed using descriptive statistical tools. It was found that mathematics is important in LIS education. The students displayed a high level of anxiety toward mathematics. The students have a negative attitude toward mathematics. However, the hypotheses tested revealed that while the LIS female undergraduate students displayed low levels of anxiety and a positive attitude toward mathematics, the level of anxiety of the male undergraduate students was high, and their attitude toward mathematics was negative. It was recommended that LIS undergraduate students develop a positive attitude towards mathematics and appreciate that the paradigm shift in the practice of librarianship is towards mathematics as a way of developing technological tools (hardware and software) to facilitate the effective delivery of library services.

Keywords: anxiety, attitude, library and information science, mathematics anxiety, undergraduate students, Nigerian universities

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Authors: Ethelbert Chinedu Nwokorie

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This empirical study analyzes the impact of communication and networking functions of Nigerian and Ghanaian public sector managers’ on public sector effectiveness. The focus is on which of these management functions public sector managers’ in these countries perform most, why, how and how does it affect effectiveness of public sector organizations in the two countries. This qualitative analysis was done by interviewing middle and top level managers in some selected public sector organizations in the two countries on their practical experiences. Findings reveal that ineffectiveness of public sector organizations in Ghana persists because public sector managers perform more of networking functions to promote their individual carrier success and progression in their various organizations, rather than achieving the organizations goals and objectives. In Nigeria, though majority of the interviewed public sector managers perform more communication functions than networking, they do this mostly by treating files and correspondences, instead of face-to-face communication and interaction with employees’. Hence, they hardly relate directly with their employees’ to find out how they are performing their jobs, their challenges, where they are having problems and why. The findings and recommendations of this study will help in improving effectiveness, quality and service delivery in Nigerian and Ghanaian public sector organizations and beyond.

Keywords: effectiveness, communication, employees, management, networking, organization, public sector

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Authors: Lo Kar Yin, Law Ka Mei

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Architectural, engineering, construction and operations (AECO) industry practitioners have been well adapting to the dynamic construction market from the fundamental training of its discipline. As further triggered by the pandemic since 2019, great steps are taken in virtual environment and the best collaboration is strived with project teams without boundaries. With adoption of Building Information Modeling-based approach and qualitative analysis, this paper is to review quantity take-off and cost estimation process through modeling techniques in liaison with suppliers, fabricators, subcontractors, contractors, designers, consultants and services providers in the construction industry value chain for automatic project cost budgeting, project cost control and cost evaluation on design options of in-situ reinforced-concrete construction and Modular Integrated Construction (MiC) at design stage, variation of works and cash flow/spending analysis at construction stage as far as practicable, with a view to sharing the findings for enhancing mutual trust and co-operation among AECO industry practitioners. It is to foster development through a common prototype of design and build project delivery method in NEC Engineering and Construction Contract (ECC) Options A and C.

Keywords: building information modeling, cost estimation, quantity take-off, modeling techniques

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Authors: Kittipong Tissayakorn, Fumio Akagi, Yu Song

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Manufacturers have been exploring innovative strategies to achieve and sustain competitive advantages as they face a new era of intensive global competition. Such strategy is known as Supply Chain Management (SCM), which has gained a tremendous amount of attention from both researchers and practitioners over the last decade. Supply chain management (SCM) is considered as the most popular operating strategy for improving organizational competitiveness in the twenty-first century. It has attracted a lot of attention recently due to its role involving all of the activities in industrial organizations, ranging from raw material procurement to final product delivery to customers. Well-designed supply chain systems can substantially improve efficiency and product quality, and eventually enhance customer satisfaction and profitability. In this paper, a manufacturing engineering perspective on supply chain integration is presented. Research issues discussed include the product and process design for the supply chain, design evaluation of manufacturing in the supply chain, agent-based techniques for supply chain integration, intelligent information for sharing across the supply chain, and a development of standards for product, process, and production data exchange to facilitate electronic commerce. The objective is to provide guidelines and references for manufacturing engineers and researchers interested in supply chain integration.

Keywords: supply chain, supply chain management, supply chain integration, manufacturing industries

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Authors: Van-Dycke Sarpong Asare, Vincent Adongo

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Field measurement of subsurface seismic p-wave velocities was undertaken through seismic refraction tomography. The aim of this work is to obtain a model of the shallow subsurface material elastic properties relevant for geotechnical site characterization. The survey area is at Pwalugu in Northern Ghana, where a multipurpose dam, for electricity generation, irrigation, and potable water delivery, is being planned. A 24-channel seismograph and 24, 10 Hz electromagnetic geophones, deployed 5 m apart constituted the acquisition hardware. Eleven (2-D) seismic refraction profiles, nine of which ran almost perpendicular and two parallel to the White Volta at Pwalugu, were acquired. The refraction tomograms of the thirteen profiles revealed a subsurface model consisting of one minor and one major acoustic impedance boundaries – the top dry/loose sand and the variably weathered sandstone contact, and the overburden-sandstones bedrock contact respectively. The p-wave velocities and by inference, with a priori values of poison ratios, the s-wave velocities, assisted in characterizing the geotechnical conditions of the proposed site and also in evaluating the dynamic properties such as the maximum shear modulus, the bulk modulus, and the Young modulus.

Keywords: tomography, characterization, consolidated, Pwalugu and seismograph

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Authors: Swapnila V. Vanshiv, Hemant P. Joshi, Atul B. Aware

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Current study illustrates the formulation of floating microspheres for purpose of gastroretention of Dipyridamole which shows pH dependent solubility, with the highest solubility in acidic pH. The formulation involved hollow microsphere preparation by using solvent evaporation technique. Concentrations of rate controlling polymer, hydrophilic polymer, internal phase ratio, stirring speed were optimized to get desired responses, namely release of Dipyridamole, buoyancy of microspheres, entrapment efficiency of microspheres. In the formulation, the floating microspheres were prepared by using ethyl cellulose as release retardant and HPMC as a low density hydrophilic swellable polymer. Formulated microspheres were evaluated for their physical properties such as particle size and surface morphology by optical microscopy and SEM. Entrapment efficiency, floating behavior and drug release study as well the formulation was evaluated for in vivo gastroretention in rabbits using gamma scintigraphy. Formulation showed 75% drug release up to 10 hr with entrapment efficiency of 91% and 88% buoyancy till 10 hr. Gamma scintigraphic studies revealed that the optimized system was retained in the gastric region (stomach) for a prolonged period i.e. more than 5 hr.

Keywords: Dipyridamole microspheres, gastroretention, HPMC, optimization method

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Authors: Indu Verma, Santanu Kumar Pal

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Interactions between DNA and adsorbed Poly (L-lysine) (PLL) on liquid crystal (LC) droplets were investigated using polarizing optical microcopy (POM) and epi-fluorescence microscopy. Earlier, we demonstrated that adsorption of PLL to the LC/aqueous interface resulted in homeotropic orientation of the LC and thus exhibited a radial configuration of the LC confined within the droplets. Subsequent adsorption of DNA (single stranded DNA/double stranded DNA) at PLL coated LC droplets was found to trigger a LC reorientation within the droplets leading to pre-radial/bipolar configuration of those droplets. To our surprise, subsequent exposure of complementary ssDNA (c-ssDNA) to ssDNA/ adsorbed PLL modified LC droplets did not cause the LC reorientation. This is likely due to the formation of polyplexes (DNA-PLL complex) as confirmed by fluorescence microscopy and atomic force microscopy. In addition, dsDNA adsorbed PLL droplets have been found to be effectively used to displace (controlled release) propidium iodide (a model drug) encapsulated within dsDNA over time. These observations suggest the potential for a label free droplet based LC detection system that can respond to DNA and may provide a simple method to develop DNA-based drug nano-carriers.

Keywords: DNA biosensor, drug delivery, interfaces, liquid crystal droplets

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Authors: Sulafah Basahel

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Nowadays, Higher Education Institutions (HEIs) around the world are attempting to utilize Information and Communication Technologies (ICTs) to enhance learning process and strategies of knowledge delivery for students through Distance Education (DE) system. Stakeholders in DE system face a complex situation of different ill-defined and related issues that influence decision making process. In this study system thinking as a body of knowledge is used to explore the emergent properties that produced from these connections between issues and could have either positive or negative outcomes for the DE development. Checkland Soft System Methodology (SSM) - Mode 2 is employed in a cultural context of Saudi Arabia for more knowledge acquisition purposes among multiple stakeholders in DE rather than solving problems to achieve an overall development of DE system. This paper will discuss some political, cultural issues and connections between them that impact on effectiveness of stakeholders’ activities and relations. This study will significantly contribute to both system thinking and education fields by leading decision makers in DE to reconsider future plans, strategies and right actions for more successful educational practices.

Keywords: distance education, higher education institutions, ill-defined issues, soft system methodology-Mode 2

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Authors: Ashley L. Freeman, Jessica D. Watkins

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TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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Authors: Cyrus Addy, Venkata Sriram Siddhardh Nadendla, Kwame Awuah-Offei

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Surface robots in modern underground mine rescue operations suffer from several limitations in enabling a prompt self-rescue. Therefore, the possibility of designing and deploying in-mine robots to expedite miner self-rescue can have a transformative impact on miner safety. These in-mine robots for miner self-rescue can be envisioned to carry out diverse tasks such as object detection, autonomous navigation, and payload delivery. Specifically, this paper investigates the challenges in the design of object detection algorithms for in-mine robots using thermal images, especially to detect people in real-time. A total of 125 thermal images were collected in the Missouri S&T Experimental Mine with the help of student volunteers using the FLIR TG 297 infrared camera, which were pre-processed into training and validation datasets with 100 and 25 images, respectively. Three state-of-the-art, pre-trained real-time object detection models, namely YOLOv5, YOLO-FIRI, and YOLOv8, were considered and re-trained using transfer learning techniques on the training dataset. On the validation dataset, the re-trained YOLOv8 outperforms the re-trained versions of both YOLOv5, and YOLO-FIRI.

Keywords: miner self-rescue, object detection, underground mine, YOLO

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Authors: R. N. Astya, E. S. Nugraha, S. P. Nurheni, Hoerudin

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Vitamin A deficiency remains to be among the major malnutrition problems in Indonesia. Vitamin A is a fat-soluble vitamin which renders it difficult to be fortified in water-based foods and beverages. Furthermore, its low solubility and stability in aqueous system may limit its bioaccessibility in the gastrointestinal tract. Nanoemulsification of vitamin A may solve these problems. The objective of this study was to investigate bioaccessibility of vitamin A (retinyl palmitate/RP) nanoemulsion as influenced by two types of carrier oil (Virgin Coconut Oil/VCO and corn oil/CO) and surfactant concentrations (polysorbate 20/Tween 20 3% and 6%). Oil in water (o/w) nanoemulsions of vitamin A was produced through a combination of high shear-high pressure homogenization technique. The results showed that RP-VCO nanoemulsions were 121.62 nm (3%) and 115.40 (6%) nm in particle size, whereas RP-CO nanoemulsions were 154.72 nm (3%) and 134.00 nm (6%) in particle size. As for VCO nanoemulsions, the bioaccessibility of vitamin A was shown to be 89.84% and 55.32%, respectively. On the other hand, CO nanoemulsions produced vitamin A bioaccessibility of 53.66% and 44.85%, respectively. In general, VCO nanoemulsions showed better bioaccessibility of vitamin A than CO nanoemulsions. In this study, RP-VCO nanoemulsion with 3% Tween 20 had the highest ζ-potential value (-26.5 mV) and produced the highest bioaccessibility of vitamin A (89.84%, P<0.05). Additionally, the vitamin A nanoemulsion was stable even for after a week of freeze and thaw treatment. Following the freeze and thaw treatment, the vitamin A nanoemulsion showed good stability without aggregation and separation. These results would be useful for designing effective vitamin A delivery systems for food and beverage applications.

Keywords: bioaccessibility, carrier oil, surfactant, vitamin A nanoemulsion

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Authors: Anna K. Wood, Terri Friedline

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In April and May 2020, the private banking industry approved over 1.7 million emergency small business loans, totaling over $650 billion in federal relief funds as part of the Paycheck Protection Program (PPP). Since the program’s rollout, the extensive evidence of discriminatory lending and misuse of funds has been revealed by investigative journalism and academic studies. This study is based on 41 interviews with frontline banking industry professionals conducted during the days and weeks of the PPP rollout, presenting a real-time narrative of the program rollout through the eyes of those in the role of a street-level bureaucrat. We present two themes from this data about the conditions under which these frontline workers experienced the PPP: Exigent Timelines and Defaulting to Existing Workplace Norms and Practices. We analyze these themes using literature on street-level organizations, bureaucratic discretion, and the differences between public and private sector logic. The results of this study present new directions for theorizing sector-level differences in street-level bureaucratic discretion in the context of mixed-sector collaboration on public service delivery, particularly under conditions of crisis and urgency.

Keywords: street level bureaucracy, social policy, bureaucratic discretion, public private partnerships

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Authors: Kwok Tak Kit

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The construction industry plays an important role in environmental and carbon emissions as it consumes a huge amount of natural resources and energy. Sustainable engineering involves the process of planning, design, procurement, construction and delivery in which the whole building and construction process resulting from building and construction can be effectively and sustainability managed to achieve the use of natural resources. Implementation of sustainable technology development and innovation, adoption of the advanced construction process and facilitate the facilities management to implement the energy and waste control more accurately and effectively. Study and research in the relationship of BIM and environment assessment tools lack a clear discussion. In this paper, we will focus on the synergy of BIM technology and sustainable engineering in the AEC industry and outline the key factors which enhance the use of advanced innovation, technology and method and define the role of stakeholders to achieve zero-carbon emission toward the Paris Agreement to limit global warming to well below 2ᵒC above pre-industrial levels. A case study of the adoption of Building Information Modeling (BIM) and environmental assessment tools in Hong Kong will be discussed in this paper.

Keywords: sustainability, sustainable engineering, BIM, LEED

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Authors: K. C. Iyer, Yogita Manan Bindal, Sumit Kumar Bakshi

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The construction industry is plagued with disputes and litigation in India with many stalled projects seeking dispute resolution. This has an adverse effect on the performance and overall project delivery and impacts future investments within the industry. While construction industry is the major driver of growth, there has not been major reforms in the government construction contracts. The study is aimed at identifying the proactive means of dispute avoidance, focusing on reforms required within the construction contracts, by studying 49 arbitration awards of construction disputes. The claims presented in the awards are aggregated to study the causes linked to the contract document and are referred against the prospective recommendation and practices as surveyed from literature review of research papers. Within contract administration, record keeping has been a major concern as they are required by the parties to substantiate the claims or the counterclaims and therefore are essential in any dispute redressal process. The study also observes that the right judgment is inhibited when the record keeping is improper and due to lack of coherence between documents, the dispute resolution period is also prolonged. The finding of the research will be relevant to industry practitioners in contract drafting with a view to avoid disputes.

Keywords: construction contract, contract administration, contract management, dispute avoidance

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Ieva Bruzauskaite, Jovile Raudoniute, Karina Poliakovaite, Danguole Zabulyte, Daiva Bironaite, Ruta Aldonyte

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Introduction: Air pollution is a growing global problem which has been shown to be responsible for various adverse health outcomes. Immunotoxicity, such as dysregulated inflammation, has been proposed as one of the main mechanisms in air pollution-associated diseases. Chronic obstructive pulmonary disease (COPD) is among major morbidity and mortality causes worldwide and is characterized by persistent airflow limitation caused by the small airways disease (obstructive bronchiolitis) and irreversible parenchymal destruction (emphysema). Exact pathways explaining the air pollution induced and mediated disease states are still not clear. However, modern societies understand dangers of polluted air, seek to mitigate such effects and are in need for reliable biomarkers of air pollution. We hypothesise that post-translational modifications of structural proteins, e.g. citrullination, might be a good candidate biomarker. Thus, we have designed this study, where mice were exposed to diesel exhaust and the ongoing protein modifications and inflammation in lungs and other tissues were assessed. Materials And Methods: To assess the effects of diesel exhaust a in vivo study was designed. Mice (n=10) were subjected to everyday 2-hour exposure to diesel exhaust for 14 days. Control mice were treated the same way without diesel exhaust. The effects within lung and other tissues were assessed by immunohistochemistry of formalin-fixed and paraffin-embedded tissues. Levels of inflammation and citrullination related markers were investigated. Levels of parenchymal damage were also measured. Results: In vivo study corroborates our own data from in vitro and reveals diesel exhaust initiated inflammatory shift and modulation of lung peptidyl arginine deiminase 4 (PAD4), citrullination associated enzyme, levels. In addition, high levels of citrulline were observed in exposed lung tissue sections co-localising with increased parenchymal destruction. Conclusions: Subacute exposure to diesel exhaust renders mice lungs inflammatory and modifies certain structural proteins. Such structural changes of proteins may pave a pathways to lost/gain function of affected molecules and also propagate autoimmune processes within the lung and systemically.

Keywords: air pollution, citrullination, in vivo, lungs

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Authors: Wang Liguang, Zhang Xueqing

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The build-operate-transfer (BOT) project delivery system has provided effective routes to mobilize private sector funds, innovative technologies, management skills and operational efficiencies for public infrastructure development and have been widely used in China during the last 20 years. Many BOT projects in China will be smoothly transferred to the government soon and the transfer stage, which is considered as the last stage, must be studied carefully and handled well to achieve the overall success of BOT projects. There will be many issues faced by both the public sector and private sector in the transfer stage of BOT projects, including project post-assessment, technology and documents transfer, personal training and staff transition, etc. and sometimes additional legislation is needed for future operation and management of facilities. However, most previous studies focused on the bidding, financing, and building and operation stages instead of transfer stage. This research identifies nine key issues in the transfer stage of BOT projects through a comprehensive study on three cases in China, and the expert interview and expert discussion meetings are held to validate the key issues and give detail analysis. A proposed framework of transfer management is prepared based on the experiences derived and lessons drawn from the case studies and expert interview and discussions, which is expected to improve the transfer management of BOT projects in practice.

Keywords: BOT project, key issues, transfer management, transfer stage

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Authors: Sultan Alotaibi, Dmitri Roussinov

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Many governments recently started to change the ways of providing their services by allowing their citizens to access services from anywhere without the need of visiting the location of the service provider. Mobile government (M-government) is one of the techniques that fulfill that goal. It has been adopted by many governments. M-government can be defined as an implementation of Electronic Government (E-Government) by using mobile technology with the aim of improving service delivery to citizens, businesses and all government agencies. There have been several research projects developing models to understand the behavior of individuals towards the adoption of m-government. This paper proposes a model for adoption of m-government services in Saudi Arabia by extending Technology Acceptance Model (TAM) by introducing external factors. This paper also reports on the development of a survey instrument designed to measure user perception of mobile government acceptance. A survey instrument has been developed by using existing scales from prior instruments and a pilot study has been conducted by distributing the survey to 33 participants. As a result, a survey instrument has been refined to retain 43 items. The results also showed that the reliabilities of all the scales in the survey instrument are above the levels acceptable in current academic research, thus the instruments developed by us are capable of analyzing the factors in M-government adoption.

Keywords: TAM, m-government, e-government, model, acceptance, mobile government

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Authors: Habsah Mohamad Sabli, Mohammad Fardillah Wahi

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The main aim of this research study is to better understand and measure students' perceptions towards the effectiveness of mobile learning. This paper reports on the results of a survey of three hundred nineteen students at Polytechnic Mukah Sarawak (PMU) about their perception to the use of mobile technology in education. An analysis of the quantitative survey findings is presented focusing on the ramification for mobile-learning (m-learning) practices in higher learning and teaching environments. In this paper we present our research findings about the level of perception and gender correlations with perceived ease of use and perceived usefulness using M-Learning in learning activities among students in Polytechnic Mukah (PMU). Based on gender respondent, were 150 female (47.0%) and 169 male (53.0%). The survey findings further revealed that perception of students are in moderately high and agree for using m-learning. The perceived ease of use and perceived usefulness is significant with weak correlations between students to adapt m-learning for active learning activities. The outcome of this research can benefit the decision makers of higher institution in Mukah Sarawak regard to way to enhance m-learning and promote effective teaching and learning activities as well as strengthening the quality of learning delivery.

Keywords: M-learning, student attitudes, student perception, mobile technology

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Authors: Loredana Elena Nita, Maria Bercea, Aurica P. Chiriac, Iordana Neamtu

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The paper is devoted to the behavior of gels based on poly(itaconic anhydride-co-3, 9-divinyl-2, 4, 8, 10-tetraoxaspiro (5.5) undecane) copolymers, with different ratio between the comonomers, and hyaluronic acid (HA). The gel formation was investigated by small-amplitude oscillatory shear measurements following the viscoelastic behavior as a function of gel composition, temperature and shear conditions. Hyaluronic acid was investigated in the same conditions and its rheological behavior is typical to viscous fluids. In the case of the copolymers, the ratio between the two comonomers influences the viscoelastic behavior, a higher content of itaconic anhydride favoring the gel formation. Also, the sol-gel transition was evaluated according to Winter-Chambon criterion that identifies the gelation point when the viscoelastic moduli (G’ and G”) behave similarly as a function of oscillation frequency. From rheological measurements, an optimum composition was evidenced for which the system presents a typical gel-like behavior at 37 °C: the elastic modulus is higher than the viscous modulus and they are not dependent on the oscillation frequency. The formation of the 3D macroporous network was also evidenced by FTIR spectra, SEM microscopy and chemical imaging. These hydrogels present a high potential as drug delivery systems.

Keywords: copolymer, viscoelasticity, gelation, 3D network

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Authors: Katarzyna Niewiadomska

Abstract:

Many technology startups fail to achieve a worthwhile return on investment for their funders, founders, and employees. Failures in product development, to-market strategy, sales, and delivery are commonly recognized. Founder failures are not as obvious and harder to identify. This paper explores six critical failure points that entrepreneurs and innovators are susceptible to and aims to link their emotional intelligence and behavioral profile to the points at which they experienced self-perceived failure. A model of six failure points from the perspective of the technology entrepreneur ranging from pre-startup to maturity is provided. By analyzing emotional and behavioral profile data from entrepreneurs and recording in-person accounts, certain key emotional and behavioral clusters contributing to each failure point are determined, and several underlying factors are defined and discussed. Recommendations that support entrepreneurs and innovators stalling at each failure point are given. This work can enable stakeholders to evaluate founder emotional and behavioral profiles and to take risk-mitigating action, either through coaching or through more robust team creation, to avoid founder-related company failure. The paper will be of interest to investors funding startups, executives leading them and mentors supporting them.

Keywords: behavior, emotional intelligence, entrepreneur, failure

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Authors: Ramin Vafadary, Maryam Khanbaghi

Abstract:

Forecasting electricity load is important for various purposes like planning, operation, and control. Forecasts can save operating and maintenance costs, increase the reliability of power supply and delivery systems, and correct decisions for future development. This paper compares various time series methods to forecast 24 hours ahead of electricity load. The methods considered are the Holt-Winters smoothing, SARIMA Modeling, LSTM Network, Fbprophet, and Tensorflow probability. The performance of each method is evaluated by using the forecasting accuracy criteria, namely, the mean absolute error and root mean square error. The National Renewable Energy Laboratory (NREL) residential energy consumption data is used to train the models. The results of this study show that the SARIMA model is superior to the others for 24 hours ahead forecasts. Furthermore, a Bagging technique is used to make the predictions more robust. The obtained results show that by Bagging multiple time-series forecasts, we can improve the robustness of the models for 24 hours ahead of electricity load forecasting.

Keywords: bagging, Fbprophet, Holt-Winters, LSTM, load forecast, SARIMA, TensorFlow probability, time series

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Authors: Huayang Yu, Nicola Ingram, David C. Green, Paul D. Thornton

Abstract:

The dual stimuli-controlled release of doxorubicin from gel-embedded nanoparticles is reported. Non-cytotoxic polymer nanoparticles are formed from poly(ethylene glycol)-b-poly(benzyl glutamate) that, uniquely, contain a central ester link. This connection renders the nanoparticles pH-responsive, enabling extensive doxorubicin release in acidic solutions (pH 6.5), but not in solutions of physiological pH (pH 7.4). Doxorubicin loaded nanoparticles were found to be stable for at least 31 days and lethal against the three breast cancer cell lines tested. Furthermore, doxorubicin-loaded nanoparticles could be incorporated within a thermoresponsive poly(2-hydroxypropyl methacrylate) gel depot, which forms immediately upon injection of poly(2-hydroxypropyl methacrylate) into aqueous solution. The combination of the poly(2-hydroxypropyl methacrylate) gel and poly(ethylene glycol)-b-poly(benzyl glutamate) nanoparticles yields an injectable doxorubicin delivery system that facilities near-complete drug release when maintained at elevated temperatures (37 °C) in acidic solution (pH 6.5). In contrast, negligible payload release occurs when the material is stored at room temperature in a non-acidic solution (pH 7.4). The system has great potential as a vehicle for the prolonged, site-specific release of chemotherapeutics.

Keywords: biodegradable, nanoparticle, polymer, thermoresponsive

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Authors: Amit Kumar Jain, Surbhi Jain

Abstract:

The urban freight in a city constitutes 10 to 18 per cent of all city road traffic, and 40 per cent of air pollution and noise emissions, are directly related to commercial transport. The policy measures implemented by urban planners have sought to restrict rather than assist goods-vehicle operations. This approach has temporarily controlled the urban transport demand during peak hours of traffic but has not effectively solved transport congestion. The solution discussed in the paper envisages the development of a comprehensive network of Urban Freight Stations (UFS) connected through underground conveyor belts in the city in line with baggage segregation and distribution in any of the major airports. The transportation of freight shall be done in standard size containers/cars through rail borne carts. The freight can be despatched or received from any of the UFS. Once freight is booked for a destination from any of the UFS, it would be stuffed in the container and digitally tagged for the destination. The container would reach the destination UFS through a network of rail borne carts. The container would be de-stuffed at the destination UFS and sent for further delivery, or the consignee may be asked to collect the consignment from urban freight station. The obvious benefits would be decongestion of roads, reduction in air and noise pollution, saving in manpower used for freight transportation.

Keywords: congestion, urban freight, intelligent transport system, pollution

Procedia PDF Downloads 303

Authors: Abdelkadir Muzey Mohammed, Habtu Alemayehu Atsbaha, Yohannes Yirga Kefela, Woldegebriel Assefa Woldegerima, Kiros Tedla Gebrehiwot

Abstract:

The circumstances of war and conflict have long been associated with concerns about heightening HIV infection due to the use of sexual violence and rape as a weapon of war and lack of health services access to the patients with HIV as well as sexual violence and rape victims. This paper examines the impact of war related mass rape on HIV incidence and prevalence in the war ravaged Tigray, Ethiopia. Risk equation model and uncertainty analyses with sampled ranges of parameters were employed using data from WHO, Ethiopian Public Health Institute and Ethiopian Central Statistical Agency was used. Our analysis indicated that the mass rape committed in Tigray could cause an increase of incidence and prevalence by a median of 63.01% and 1.14% respectively. The significant increase in HIV incidence and prevalence due to mass rape demands a special attention including region wide improved surveillance and tracing of rape survivors. Furthermore, HIV prevention and treatment strategies such as delivery of emergency health service, providing pre and post exposure treatments on the basis of human rights should priority of governmental and nongovernmental organizations in a conflict situation.

Keywords: conflict situation, mass rape, HIV, mathematical model, uncertainty analysis

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