Search results for: user safety

Authors: Eunjoo Lee

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Background: As the number of surgeries increases, the incidence of adverse events is likely to become more prevalent. Patients who are somewhat knowledgeable about surgery-related adverse events are more likely to engage in safety initiatives to prevent them. Objectives: To evaluate the impact of a smartphone application developed during the study to enhance patients’ knowledge of surgery-related adverse events during hospitalization. Design: Non-randomized, one group, measured pre- and post-intervention. Participants: Thirty-six hospitalized patients admitted to the orthopedics unit of a general hospital in South Korea. Methods. First, a smartphone application to enhance patients’ knowledge of surgery-related adverse events was developed through an iterative process, which included a literature review, expert consultation, and pilot testing. The application was installed on participants’ smartphones, and research assistants taught the participants to use it. Twenty-five true/false questions were used to assess patients’ knowledge of preoperative precautions (eight items), surgical site infection (five items), Foley catheter management (four items), drainage management (four items), and anesthesia-related complications (four items). Results: Overall, the percentage of correct answers increased significantly, from 57.02% to 73.82%, although answers related to a few specific topics did not increase that much. Although the patients’ understanding of drainage management and the Foley catheter did increase substantially after they used the smartphone application, it was still relatively low. Conclusions: The smartphone application developed during this study enhanced the patients’ knowledge of surgery-related adverse events during hospitalization. However, nurses must make an additional effort to help patients to understand certain topics, including drainage and Foley catheter management. Relevance to clinical practice: Insufficient patient knowledge increases the risk of adverse events during hospitalization. Nurses should take active steps to enhance patients’ knowledge of a range of safety issues during hospitalization, in order to decrease the number of surgery-related adverse events.

Keywords: patient education, patient participation, patient safety, smartphone application, surgical errors

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Authors: Anna-Lisa Osvalder, Jonas Borell

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There are several reasons behind the use, non-use, or inadequate use of personal protective equipment (PPE) in the construction industry. Comfort and accurate size support proper use, while discomfort, misfit, and difficulties to understand how the PPEs should be handled inhibit correct usage. The need for several protective equipments simultaneously might also create problems. The purpose of this study was to analyse the correct usage, comfort, and fit of different types of PPEs used for construction work. Correct usage was analysed as guessability, i.e., human perceptions of how to don, adjust, use, and doff the equipment, and if used as intended. The PPEs tested individually or in combinations were a helmet, ear protectors, goggles, respiratory masks, gloves, protective cloths, and safety harnesses. First, an analytical evaluation was performed with ECW (enhanced cognitive walkthrough) and PUEA (predictive use error analysis) to search for usability problems and use errors during handling and use. Then usability tests were conducted to evaluate guessability, comfort, and fit with 10 test subjects of different heights and body constitutions. The tests included observations during donning, five different outdoor work tasks, and doffing. The think-aloud method, short interviews, and subjective estimations were performed. The analytical evaluation showed that some usability problems and use errors arise during donning and doffing, but with minor severity, mostly causing discomfort. A few use errors and usability problems arose for the safety harness, especially for novices, where some could lead to a high risk of severe incidents. The usability tests showed that discomfort arose for all test subjects when using a combination of PPEs, increasing over time. For instance, goggles, together with the face mask, caused pressure, chafing at the nose, and heat rash on the face. This combination also limited sight of vision. The helmet, in combination with the goggles and ear protectors, did not fit well and caused uncomfortable pressure at the temples. No major problems were found with the individual fit of the PPEs. The ear protectors, goggles, and face masks could be adjusted for different head sizes. The guessability for how to don and wear the combination of PPE was moderate, but it took some time to adjust them for a good fit. The guessability was poor for the safety harness; few clues in the design showed how it should be donned, adjusted, or worn on the skeletal bones. Discomfort occurred when the straps were tightened too much. All straps could not be adjusted for somebody's constitutions leading to non-optimal safety. To conclude, if several types of PPEs are used together, discomfort leading to pain is likely to occur over time, which can lead to misuse, non-use, or reduced performance. If people who are not regular users should wear a safety harness correctly, the design needs to be improved for easier interpretation, correct position of the straps, and increased possibilities for individual adjustments. The results from this study can be a base for re-design ideas for PPE, especially when they should be used in combinations.

Keywords: construction work, PPE, personal protective equipment, misuse, guessability, usability

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Authors: Sanjeev Sharma

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We are living in the information age. Information is not only important to an individual but also to researchers, scientists, academicians and all others who are doing work in their respective fields. The 21st century which is also known as the electronic era has brought several changes in the mechanism of the libraries in their working environment. In the present scenario, acquisition of information resources and implementation of new strategies have brought a revolution in the library’s structures and their principles. In the digital era, the role of the library has become important as new information is coming at every minute. The knowledge society wants to seek information at their desk. The libraries are managing electronic services and web-based information sources constantly in a democratic way. The basic objective of every library is to save the time of user which is based on the quality and user-orientation of services. With the advancement of information communication and technology, the libraries should pay more devotion to the development trends of the information society that would help to adjust their development strategies and information needs of the knowledge society. The knowledge-based society demands to re-define the position and objectives of all the institutions which work with information, knowledge, and culture. The situation is the era of digital India is changing at a fast speed. Everyone wants information 24x7 and libraries have been recognized as one of the key elements for open access to information, which is crucial not only to individual but also to democratic knowledge-based information society. Libraries are especially important now a day the whole concept of education is focusing more and more independent e-learning and their acting. The citizens of India must be able to find and use the relevant information. Here we can see libraries enter the stage: The essential features of libraries are to acquire, organize, store and retrieve for use and preserve publicly available material irrespective of the print as well as non-print form in which it is packaged in such a way that, when it is needed, it can be found and put to use.

Keywords: knowledge, society, libraries, culture

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Authors: Lorenza Sganzetta, Nunzia Borrelli

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The research intends to reflect on the current mapping of the Food Strategies, on the reasons why in the planning objectives panorama, such sustainability priorities are located in those geographic areas and on the evolutions of these priorities of the Mediterranean planning dispositions. The whirling population growth that is affecting global cities is causing an enormous challenge to conventional resource-intensive food production and supply and the urgent need to face food safety, food security and sustainability concerns. Urban or Territorial Food Strategies can provide an interesting path for the development of this new agenda within the imperative principle of sustainability. In the specific, it is relevant to explore what ‘sustainability’ means within these policies. Most of these plans include actions related to four main components and interpretations of sustainability that are food security and safety, food equity, environmental sustainability itself and cultural identity and, at the designing phase, they differ slightly from each other according to the degree of approximation to one of these dimensions. Moving from these assumptions, the article would analyze some practices and policies representatives of different Food Strategies of the world and focus on the Mediterranean ones, on the problems and negative externalities from which they start, on the first interventions that are implementing and on their main objectives. We will mainly use qualitative data from primary and secondary collections. So far, an essential observation could have been made about the relationship between these sustainability dimensions and geography. In statistical terms, the US and Canadian policies tended to devote a large research space to health issues and access to food; those northern European showed a special attention to the environmental issues and the shortening of the chain; and finally the policies that, even in limited numbers, were being developed in the Mediterranean basin, were characterized by a strong territorial and cultural imprint and their major aim was to preserve local production and the contact between the productive land and the end consumer. Recently, though, Mediterranean food planning strategies are focusing more on health related and food accessibility issues and analyzing our diets not just as a matter of culture and territorial branding but as tools for reducing public health costs and accessibility to fresh food for everyone. The article would reflect then on how Food Safety, Food Security and Health are entering the new agenda of the Mediterranean Food Strategies. The research hypothesis suggests that the economic crisis that in the last years invested both producers and consumers had a significant impact on the nutrition habits and on the redefinition of food poverty, even in the fatherland of the healthy Mediterranean diet. This trend and other variables influenced the orientation and the objectives of the food strategies.

Keywords: food security, food strategy, health, sustainability

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Authors: Fan Ye

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Adverse weather conditions, particularly those with low visibility, are critical to the driving tasks. However, the direct relationship between visibility distances and traffic flow/roadway safety is uncertain due to the limitation of visibility data availability. The recent growth of deployment of Road Weather Information Systems (RWIS) makes segment-specific visibility information available which can be integrated with other Intelligent Transportation System, such as automated warning system and variable speed limit, to improve mobility and safety. Before applying the RWIS visibility measurements in traffic study and operations, it is critical to validate the data. Therefore, an attempt was made in the paper to examine the validity and viability of RWIS visibility data by comparing visibility measurements among RWIS, airport weather stations, and weather information recorded by police in crash reports, based on Ohio data. The results indicated that RWIS visibility measurements were significantly different from airport visibility data in Ohio, but no conclusion regarding the reliability of RWIS visibility could be drawn in the consideration of no verified ground truth in the comparisons. It was suggested that more objective methods are needed to validate the RWIS visibility measurements, such as continuous in-field measurements associated with various weather events using calibrated visibility sensors.

Keywords: RWIS, visibility distance, low visibility, adverse weather

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Authors: Dalila Chaid, Yacine Houmel, Mohamed Lamine Belloulou

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Peripheral neuropathy is a rare but worrying complication of peripheral local anaesthesia. It is caused either by needle contact with the nerve root or by the direct toxicity of local anaesthetics, leading to nerve damage, injury or irritation. Although uncommon, it remains a major concern for anaesthetists. The aim of the study was to assess the prevalence of nerve block-associated neuropathy in knee surgery and to identify the contributing factors in order to minimise the occurrence of this complication. The study also assessed the severity and evolution of lesions, as well as the factors leading to neuropathic pain. Methodology: It is a retrospective observational study on cases of neuropathy related to nerve blocks of the lower limb for knee surgery over a period of seven years (2016-2022). The study included a total of 6,000 patients Analyse the anaesthetic and neuropathic pain-related parameters received from these patients to determine the prevalence and severity of neuropathy. Findings: the prevalence of nerve block-related neuropathy in our study is 5.8‰ for the sciatic nerve and 0.9‰ for the femoral nerve. This was higher compared to the reported rates in the literature, which were between 0.0 to 5‰ for the Sciatic nerve and 0.0 to 3.4‰ for the femoral nerve. These findings highlight the importance of identifying and implementing an ideal anesthesia procedure to reduce the risk of neuropathy associated with nerve blocks. Theoretical Importance: The findings of this study contribute to the existing literature on peripheral neuropathy following locoregional anesthesia. By identifying the prevalence and severity of neuropathy related to nerve blocks, as well as the underlying factors, we provide valuable insights for anesthetists to improve patient safety. This study also emphasizes the need for compliance with technical safety rules to minimize the occurrence of neuropathy. Data Collection and Analysis Procedures: For this study, 25 clinics with retrospective data were collected of neuropathy associated with nerve blocks for knee surgery over a span of seven years. Parameters related to anaesthesia and neuropathic pain were analysed to determine prevalence,severity, and progression of neuropathy. Comparison of our results with the existing literature in order to assess their significance. Questions Addressed: This study aims to define the following points: 1. The prevalence of neuropathy associated with nerve blocks for knee surgery. 2. The factors underlying the development of neuropathy after nerve blocks. 3. Reducing the risk of neuropathy by complying with technical safety rules. 4. Assessing the severity and evolution of neuropathic pain in these cases. Conclusion: this study highlights the need for careful consideration and implementation of anesthesia procedures during nerve blocks for knee surgery. The prevalence of neuropathy linked to these blocks was higher compared to the literature, emphasizing the importance of identifying and minimizing contributing factors. Compliance with technical safety rules is crucial to reduce the risk of peripheral neuropathy. This study provides valuable insights to anesthetists and contributes to improving patient safety in the field of locoregional anesthesia.

Keywords: phantom limb, neuropathic pain, lower limb amputee, ultrasound-guided locoreginal anesthesia

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Authors: Rajarshi Motilal

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The birth of the Internet and the rise of social media marked an important chapter in the history of humankind. Often termed the fourth scientific revolution, the Internet has changed human lives and cognisance. The birth of Web 2.0, followed by the launch of social media and social networking sites, added another milestone to these technological advancements where connectivity and influx of information became dominant. With billions of individuals using the internet and social media sites in the 21st century, “users” became “consumers”, and orthodox marketing reshaped itself to digital marketing. Furthermore, organisations started using sophisticated algorithms to predict consumer purchase behaviour and manipulate it to sustain themselves in such a competitive environment. The rampant storage and analysis of individual data became the new normal, raising many questions about data privacy. The excessive usage of the Internet among individuals brought in other problems of them becoming addicted to it, scavenging for societal approval and instant gratification, subsequently leading to a collective dualism, isolation, and finally, depression. This study aims to determine the relationship between social media usage in the modern age and the rise of psychological and cognitive imbalances in human minds. The literature review is positioned timely as an addition to the existing work at a time when the world is constantly debating on whether social media resignation is the only way to protect user data and restore the decaying cognitive balance.

Keywords: social media, digital marketing, consumer behaviour, internet addiction, data privacy

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Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault

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Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.

Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design

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Authors: Peifang Hsieh

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New Taipei city faces increasing number of migrant families, in which the needs of children are sometimes neglected due to insufficient support from communities. Moreover, the traditional mindset of disengagement discourages citizens from preemptively identifying families in need in their communities, resulting in delay of prompt intervention from authorities concerned. To safeguard these vulnerable families, New Taipei city develops the 'Integrated Safety-Net Program for High-Risk Families' from 2011 by implementing the following measures: (A) New attitude and action: Instead of passively receiving reported case of high-risk families, the program takes proactive and preemptive approach to detect and respond at early stage, so the cases are prevented from worsening. In addition, cross-departmental integration mechanism is established to meet multiple needs of high-risk families. The children number added to the government care network is greatly increased to over 10,000, which is around 4.4 times the original number before the program. (B) New service points: 2000 city-wide convenience stores are added as service stations so that children in less privileged families can go to any of 24-hour convenience stores across the city to pick up free meals. This greatly increases the approachability to high-risk families. Moreover, the social welfare institutes will be notified with information left in convenience stores by children and follow up with further assistance, greatly enhancing chances of less privileged families being identified. (C) New Key Figures: Mobilize community officers and volunteers to detect and offer on-site assistance. Volunteer organizations within communities are connected to report and offer follow-up services in a more active manner. In total, from 2011 to 2015, 54,789 cases are identified through active care, benefiting 82,124 children. In addition, 87.49% family-cases in the program receiving comprehensive social assistance are no longer at high risk.

Keywords: cross department, high-risk families, public-private partnership, integrated safety net

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Authors: Ava Zarif Sanayei, Sedigheh Sina

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During fluoroscopically guided procedures, healthcare workers, especially radiology trainees, are at risk of exposure to elevated radiation exposure. It is vital to prioritize their safety in such settings. However, there is limited data on their monthly or annual doses. This study aimed to evaluate the equivalent dose to the eyes of the student trainee, utilizing LiF: Mg, Ti (TLD-100) chips at the radiology department of a hospital in Shiraz, Iran. Initially, the dosimeters underwent calibration procedures with the assistance of ISO-PTW calibrated phantoms. Following this, a set of dosimeters was prepared To determine HP(3) value for a trainee involved in the main operation room and controlled area utilized for two months. Three TLD chips were placed in a holder and attached to her eyeglasses. Upon completion of the duration, the TLDs were read out using a Harshaw TLD reader. Results revealed that Hp(3) value was 0.31±0.04 mSv. Based on international recommendations, students in radiology training above 18 have an annual dose limit of 0.6 rem (6 mSv). Assuming a 12-month workload, staff radiation exposure stayed below the annual limit. However, the Trainee workload may vary due to different deeds. This study's findings indicate the need for consistent, precise dose monitoring in IR facilities. Students can undertake supervised internships for up to 500 hours, depending on their institution. These internships take place in health-focused environments offering radiology services, such as clinics, diagnostic imaging centers, and hospitals. Failure to do so might result in exceeding occupational radiation dose limits. A 0.5 mm lead apron effectively absorbs 99% of radiation. To ensure safety, technologists and staff need to wear this protective gear whenever they are in the room during procedures. Furthermore, maintaining a safe distance from the primary beam is crucial. In cases where patients need assistance and must be held for imaging, additional protective equipment, including lead goggles, gloves, and thyroid shields, should be utilized for optimal safety.

Keywords: annual dose limits, Hp(3), individual monitoring, radiation protection, TLD-100

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Authors: Jin-Qu Chen, Jie Liu, Yong Yin, Zi-Qi Ju, Yu-Yao Wu

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Increase in travel fare and station’s failure will have huge impact on passengers’ travel. The Urban Rail Transit (URT) station’s accessibility reliability under increasing travel fare and station failure are analyzed in this paper. Firstly, the passenger’s travel path is resumed based on stochastic user equilibrium and Automatic Fare Collection (AFC) data. Secondly, calculating station’s importance by combining LeaderRank algorithm and Ratio of Station Affected Passenger Volume (RSAPV), and then the station’s accessibility evaluation indicators are proposed based on the analysis of passenger’s travel characteristic. Thirdly, station’s accessibility under different scenarios are measured and rate of accessibility change is proposed as station’s accessibility reliability indicator. Finally, the accessibility of Hangzhou metro stations is analyzed by the formulated models. The result shows that Jinjiang station and Liangzhu station are the most important and convenient station in the Hangzhou metro, respectively. Station failure and increase in travel fare and station failure have huge impact on station’s accessibility, except for increase in travel fare. Stations in Hangzhou metro Line 1 have relatively worse accessibility reliability and Fengqi Road station’s accessibility reliability is weakest. For Hangzhou metro operational department, constructing new metro line around Line 1 and protecting Line 1’s station preferentially can effective improve the accessibility reliability of Hangzhou metro.

Keywords: automatic fare collection data, AFC, station’s accessibility reliability, stochastic user equilibrium, urban rail transit, URT

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Authors: Ashley Andrew

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Over the years, there have been drastic developments in technology that have altered the ways we interact with and utilize technology. Social media platforms have expanded, access to information is easily accessible on cellular devices, ways of banking have changed, and virtual meetings/work have become the norm. The COVID-19 pandemic also highlighted the importance of pivoting and adapting to the benefits that technology provides, including Accessibility (services are more available to people living in remote areas and/or with mobility concerns), Convenience (technology has allowed easier options for booking appointments and connecting with loved ones), Availability (People can attend services that best meet their availability/schedule). Although there have been large improvements in accessibility to services and resources with the evolution of technology, there are also some major concerns that are not being addressed when it comes to technology and intimate partner violence. This study explores how the growth in technology has changed the way people are being abused and harmed and the sad reality that regulations and laws have not caught up with the advances in technology. The study will also explore cyberstalking, social media triggers, and location-tracking devices and applications. By exploring how technology impacts intimate partner violence, clinicians will learn how to better assess and safety plan for these risk factors.

Keywords: abuse, intimate partner violence, safety planning, technology

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Authors: Minal Jain, Vinayak Malhotra

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Solid Propellant ignition consists of rapid and complex events comprising of heat generation and transfer of heat with spreading of flames over the entire burning surface area. Proper combustion and thus propulsion depends heavily on the modes of heat transfer characteristics and cavity volume. Fire safety is an integral component of a successful rocket flight failing to which may lead to overall failure of the rocket. This leads to enormous forfeiture in resources viz., money, time, and labor involved. When the propellant is ignited, thrust is generated and the casing gets heated up. This heat adds on to the propellant heat and the casing, if not at proper orientation starts burning as well, leading to the whole rocket being completely destroyed. This has necessitated active research efforts emphasizing a comprehensive study on the inter-energy relations involved for effective utilization of the solid rocket motors for better space missions. Present work is focused on one of the major influential aspects of this detrimental burning which is the presence of an external heat source, in addition to a potential heat source which is already ignited. The study is motivated by the need to ensure better combustion and fire safety presented experimentally as a simplified small-scale mode of a rocket carrying a solid propellant inside a cavity. The experimental setup comprises of a paraffin wax candle as the pilot fuel and incense stick as the external heat source. The candle is fixed and the incense stick position and location is varied to investigate the find the influence of the pilot heat source. Different configurations of the external heat source presence with separation distance are tested upon. Regression rates of the pilot thin solid fuel are noted to fundamentally understand the non-linear heat and mass transfer which is the governing phenomenon. An attempt is made to understand the phenomenon fundamentally and the mechanism governing it. Results till now indicate non-linear heat transfer assisted with the occurrence of flaming transition at selected critical distances. With an increase in separation distance, the effect is noted to drop in a non-monotonic trend. The parametric study results are likely to provide useful physical insight about the governing physics and utilization in proper testing, validation, material selection, and designing of solid rocket motors with enhanced safety.

Keywords: combustion, propellant, regression, safety

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Authors: Virpi Oksman

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Drones are new phenomenon in public spaces. Adoption of this kind of new technologies requires public acceptance. Drones and other unmanned aerial systems may have various impacts on people’s living environments, and the public is exposed to possible disadvantages of drones. Public acceptance may be expressed as positive or negative attitude by majority of the citizens towards the new technology or service or as rapid adoption of it in everyday life. In various parts of the globe, in cities and in rural areas, drones as emerging technologies are perceived quite differently. Public acceptance studies of drones have been conducted mostly in highly urbanized environments like in Singapore and in European cities. This paper presents results of a Nordic survey study (N=1000) conducted in Sweden and in Finland. The survey aims at understanding the level of acceptance of different uses of drones in public spaces and the main concerns and benefits related to emerging UAM technologies. The study shows that even though the general attitude towards drones is quite positive, privacy and safety, and noise levels are the main concerns by Nordic citizens. Also, for what purpose and by whom the drones are operated affects the acceptability significantly. The study concludes, that there is need for regulations that safeguard public interests. In addition, considering privacy in design, and quiet environmentally friendly drones support public acceptance of drones.

Keywords: public acceptance, privacy, safety, survey

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Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

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Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

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Authors: Syeda Sahra, Abdullah Jahangir, Rachelle Hamadi, Ahmad Jahangir, Allison Glaser

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Background: Antimicrobial resistance is on the rise. The use of redundant and inappropriate antibiotics is contributing to recurrent infections and resistance. Newer antibiotics with more robust coverage for gram-negative bacteria are in great demand for complicated urinary tract infections (cUTIs), complicated intra-abdominal infections (cIAIs), hospital-acquired bacterial pneumonia (H.A.B.P.), and ventilator-associated bacterial pneumonia (V.A.B.P.). Objective: We performed this meta-analysis to evaluate the efficacy and safety profile of a new antibiotic, Imipenem/cilastatin/relebactam, compared to other broad-spectrum antibiotics for complicated infections. Search Strategy: We conducted a systemic review search on PubMed, Embase, and Central Cochrane Registry. Selection Criteria: We included randomized clinical trials (R.C.T.s) with the standard of care as comparator arm with Imipenem/cilastatin/relebactam as intervention arm. Analysis: For continuous variables, the mean difference was used. For discrete variables, we used the odds ratio. For effect sizes, we used a confidence interval of 95%. A p-value of less than 0.05 was used for statistical significance. Analysis was done using a random-effects model irrespective of heterogeneity. Heterogeneity was evaluated using the I2 statistic. Results: The authors observed similar efficacy at clinical and microbiologic response levels on early follow-up and late follow-up compared to the established standard of care. The incidence of drug-related adverse events, serious adverse events, and drug discontinuation due to adverse events were comparable across both groups. Conclusion: Imipenem/cilastatin/relebactam has a non-inferior safety and efficacy profile compared to peer antibiotics to treat severe bacterial infections (cUTIs, cIAIs, H.A.B.P., V.A.B.P.).

Keywords: bacterial pneumonia, complicated intra-abdominal infections, complicated urinary tract infection, Imipenem, cilastatin, relebactam

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Authors: Siham G. Farag

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The main objective of this paper is to provide a new methodology for road safety assessment in Oman through the development of suitable accident prediction models. GLM technique with Poisson or NBR using SAS package was carried out to develop these models. The paper utilized the accidents data of 31 un-signalized T-intersections during three years. Five goodness-of-fit measures were used to assess the overall quality of the developed models. Two types of models were developed separately; the flow-based models including only traffic exposure functions, and the full models containing both exposure functions and other significant geometry and traffic variables. The results show that, traffic exposure functions produced much better fit to the accident data. The most effective geometric variables were major-road mean speed, minor-road 85th percentile speed, major-road lane width, distance to the nearest junction, and right-turn curb radius. The developed models can be used for intersection treatment or upgrading and specify the appropriate design parameters of T- intersections. Finally, the models presented in this thesis reflect the intersection conditions in Oman and could represent the typical conditions in several countries in the middle east area, especially gulf countries.

Keywords: accidents prediction models (APMs), generalized linear model (GLM), T-intersections, Oman

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Authors: M. B. Ricardo De Oliveira, A. Borghi-Silva, E. Paravizo, F. Lizarelli, L. Di Thomazzo, D. Braatz

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Prototypes are a critical feature in the product development process, as they help the project team visualize early concept flaws, communicate ideas and introduce an initial product testing. Involving stakeholders, such as consumers and users, in prototype tests allows the gathering of valuable feedback, contributing for a better product and making the design process more participatory. Even though recent studies have shown that user evaluation of prototypes is valuable, few articles provide a method or protocol on how designers should conduct it. This multidisciplinary study (involving the areas of physiotherapy, engineering and computer science) aims to develop an evaluation protocol, using an ergometric step prototype as the product prototype to be assessed. The protocol consisted of performing two tests (the 2 Minute Step Test and the Portability Test) to allow users (patients) and consumers (physiotherapists) to have an experience with the prototype. Furthermore, the protocol contained four Likert-Scale questionnaires (one for users and three for consumers), that inquired participants about how they perceived the design characteristics of the product (performance, safety, materials, maintenance, portability, usability and ergonomics), in their use of the prototype. Additionally, the protocol indicated the need to conduct interviews with the product designers, in order to link their feedback to the ones from the consumers and users. Both tests and interviews were recorded for further analysis. The participation criteria for the study was gender and age for patients, gender and experience with 2 Minute Step Test for physiotherapists and involvement level in the product development project for designers. The questionnaire's reliability was validated using Cronbach's Alpha and the quantitative data of the questionnaires were analyzed using non-parametric hypothesis tests with a significance level of 0.05 (p <0.05) and descriptive statistics. As a result, this study provides a concise evaluation protocol which can assist designers in their development process, collecting quantitative feedback from consumer and users, and qualitative feedback from designers.

Keywords: Product Design, Product Evaluation, Prototypes, Step

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Authors: Idris Haruna Muhammad, Okorie Austine Uche

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This paper presents a study on reliability of shear connector exposed to fire situation in accordance with Eurocode 4. The reliability analysis i reliability analysis is based on First Order Second Moment Integration Technique (FOSMIT) using FORM 5. Performance functions for shear connector are derived for normal and under fire condition and their implied safety levels are evaluated. Four (4) design variables which include ultimate tensile strength, diameter of the stud, temperature and span of the steel beam are treated as random variables with their statistical characteristic adopted from literature. Results show that for normal condition the β – value decrease from 7.95 to 5.43 which show it is conservative in safety level for normal condition. Under fire condition, β – value decrease from 2.88 to – 0.32 with corresponding load ratio of 0.2 to 1.2. It was also shown from sensitivity assessment, that the temperature and span of the beam decrease with increase in their β – values while ultimate tensile strength and diameter of the stud increase with increase in their β – values for a given load ratio of 0.2 to 1.2.

Keywords: Composite steel beam, Fire condition, Shear stud, Sensitivity study

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Authors: Elysa V. Largo, Lormaine Anne A. Branzuela, Julie Marisol D. Pagalilauan, Neil C. Concibido, Monet Concepcion M. Detras

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The energy demand in the country is increasing; thus, nuclear energy is recently mandated to add to the energy mix. The Philippines has the Bataan Nuclear Power Plant (BNPP), which can be a source of nuclear energy; however, it has not been operated since the completion of its construction. Thus, evaluating the safety of BNPP is vital. This study explored the possible deviations that may occur in the operation of a nuclear power plant with a pressurized water reactor, which is similar to BNPP, through a virtual process hazard analysis (PHA) using the hazard and operability (HAZOP) technique. Temperature, pressure, and flow were used as parameters. A total of 86 causes of various deviations were identified, wherein the primary system and line from reactor coolant pump to reactor vessel are the most critical system and node, respectively. A total of 348 scenarios were determined. The critical events are radioactive leaks due to nuclear meltdown and sump overflow that could lead to multiple worker fatalities, one or more public fatalities, and environmental remediation. There were existing safeguards identified; however, further recommendations were provided to have additional and supplemental barriers to reduce the risk.

Keywords: PSM, PHA, HAZOP, nuclear power plant

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Authors: Issam Jebreen, Eman Al-Qbelat

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Outsourcing software development projects can be challenging, and there are several common challenges that organizations face. A study was conducted with a sample of 46 papers on outsourcing challenges, and the results show that there are several common challenges faced by organizations when outsourcing software development projects. Poor outsourcing relationship was identified as the most significant challenge, with 35% of the papers referencing it. Lack of quality was the second most significant challenge, with 33% of the papers referencing it. Language and cultural differences were the third most significant challenge, with 24% of the papers referencing it. Non-competitive price was another challenge faced by organizations, with 21% of the papers referencing it. Poor coordination and communication were also identified as a challenge, with 21% of the papers referencing it. Opportunistic behavior, lack of contract negotiation, inadequate user involvement, and constraints due to time zone were also challenges faced by organizations. Other challenges faced by organizations included poor project management, lack of technical capabilities, vendor employee high turnover, poor requirement specification, IPR issues, poor management of budget, schedule, and delay, geopolitical and country instability, the difference in development methodologies, failure to manage end-user expectations, and poor monitoring and control. In conclusion, outsourcing software development projects can be challenging, but organizations can mitigate these challenges by selecting the right outsourcing partner, having a well-defined contract and clear communication, having a clear understanding of the requirements, and implementing effective project management practices.

Keywords: software outsourcing, vendor, outsourcing challenges, quality model, continent, country, global outsourcing, IT workforce outsourcing.

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Authors: Djalal Hamed

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The aim of this paper is to perform, by mean of the finite volume method, a numerical solution of the transient natural convection in a narrow rectangular channel between two vertical parallel Material Testing Reactor (MTR)-type fuel plates, imposed under a heat flux with a cosine shape to determine the margin of the nuclear core power at which the natural convection cooling mode can ensure a safe core cooling, where the cladding temperature should not reach a specific safety limits (90 °C). For this purpose, a computer program is developed to determine the principal parameters related to the nuclear core safety, such as the temperature distribution in the fuel plate and in the coolant (light water) as a function of the reactor core power. Throughout the obtained results, we noticed that the core power should not reach 400 kW, to ensure a safe passive residual heat removing from the nuclear core by the upward natural convection cooling mode.

Keywords: buoyancy force, friction force, finite volume method, transient natural convection

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Authors: Biao Ma, Jikai Liu, Man Chen, Jianpeng Wu, Liyong Wang, Changsong Zheng

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Proposing an appropriate control strategy is an effective and practical way to address the overheat problems of the wet multi-plate clutch in Direct Shift Gearbox under the long-time creeping condition. To do so, the temperature variation of the wet multi-plate clutch is investigated firstly by establishing a thermal resistance model for the gearbox cooling system. To calculate the generated heat flux and predict the clutch temperature precisely, the friction torque model is optimized by introducing an improved friction coefficient, which is related to the pressure, the relative speed and the temperature. After that, the heat transfer model and the reasonable friction torque model are employed by the vehicle powertrain model to construct a comprehensive co-simulation model for the Direct Shift Gearbox (DSG) vehicle. A creeping control strategy is then proposed and, to evaluate the vehicle performance, the safety temperature (250 ℃) is particularly adopted as an important metric. During the creeping process, the temperature of two clutches is always under the safety value (250 ℃), which demonstrates the effectiveness of the proposed control strategy in avoiding the thermal failures of clutches.

Keywords: creeping control strategy, direct shift gearbox, temperature variation, wet clutch

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Authors: K. S. Vedasingha, K. K. M. T. Perera, K. I. Hathurusinghe, H. W. I. Akalanka, Nelum Chathuranga Amarasena, Nalaka R. Dissanayake

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Railways provide the most convenient and economically beneficial mode of transportation, and it has been the most popular transportation method among all. According to the past analyzed data, it reveals a considerable number of accidents which occurred at railways and caused damages to not only precious lives but also to the economy of the countries. There are some major issues which need to be addressed in railways of South Asian countries since they fall under the developing category. The goal of this research is to minimize the influencing aspect of railway level crossing accidents by developing the “railway process automation system”, as there are high-risk areas that are prone to accidents, and safety at these places is of utmost significance. This paper describes the implementation methodology and the success of the study. The main purpose of the system is to ensure human safety by using the Internet of Things (IoT) and image processing techniques. The system can detect the current location of the train and close the railway gate automatically. And it is possible to do the above-mentioned process through a decision-making system by using past data. The specialty is both processes working parallel. As usual, if the system fails to close the railway gate due to technical or a network failure, the proposed system can identify the current location and close the railway gate through a decision-making system, which is a revolutionary feature. The proposed system introduces further two features to reduce the causes of railway accidents. Railway track crack detection and motion detection are those features which play a significant role in reducing the risk of railway accidents. Moreover, the system is capable of detecting rule violations at a level crossing by using sensors. The proposed system is implemented through a prototype, and it is tested with real-world scenarios to gain the above 90% of accuracy.

Keywords: crack detection, decision-making, image processing, Internet of Things, motion detection, prototype, sensors

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Authors: Tuula Heinonen, Wilhelm Gaus

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At present safety, assessment starts with animal tests although their predictivity is often poor. Even after extended human use experimental data are often judged as the core information for risk assessment. However, the best opportunity to generate true evidence is to match all available information. Cross matching methodology combines the different fields of knowledge and types of data (e.g. in-vitro and in-vivo experiments, clinical observations, clinical and epidemiological studies, and daily life observations) and gives adequate weight to individual findings. To achieve a consolidated outcome, the information from all available sources is analysed and compared with each other. If single pieces of information fit together a clear picture becomes visible. If pieces of information are inconsistent or contradictory careful consideration is necessary. 'Cross' can be understood as 'orthographic' in geometry or as 'independent' in mathematics. Results coming from different sources bring independent and; therefore, they result in new information. Independent information gives a larger contribution to evidence than results coming repeatedly from the same source. A successful example of cross matching is the assessment of Ginkgo biloba where we were able to come to the conclusive result: Ginkgo biloba leave extract is well tolerated and safe for humans.

Keywords: cross-matching, human use, safety assessment, Ginkgo biloba leave extract

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Authors: Ratri A. Benedictus, Felicia M. Yolanda

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Public transport is a crucial issue for capital city in developing country, such as Jakarta. Inadequate number and low quality of public transport services resulting personal vehicles as the main option. As a result, traffic jams are getting worse in Jakarta. The low quality of public transport, particularly buses, compounded by the risk behavior of the driver. Traffic accidents involving public bus in Jakarta were often the case, even result in fatality. The purpose of this study is to get a description of risk behavior among the public bus drivers in Jakarta. 132 bus drivers become respondent of this study. Risky Driving Behavior scale of Dorn were used. Data were analyzed using descriptive statistics. 51.5% of respondents felt often showing risky behavior while on driving. The highest type of risky driving behavior is still using the unsafe bus (62%). Followed by trespass the bus line (30%), over speed (21%), violate the road signs (15%) and driving with unhealthy physical condition (4%). Results of this study suggested that high understanding of the bus drivers on their risk behaviors have not lead to the emergence of safe driving behavior. Therefore, together with technical engineering and instrumentation work intervention over this issue, psychological aspects also need to be considered, such as: risk perception, safety attitude,safety culture, locus of control and Fatalism.

Keywords: bus driver, psychological factors, public transportation, risky driving behavior

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Authors: Debalina Ghoshal

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Nuclear security is the ‘prevention and detection of, and response to unauthorised removal, sabotage, unauthorised access, illegal transfer or other malicious acts involving nuclear or radiological material or their associated facilities.’ Ever since the end of Cold War, nuclear materials security has remained a concern for global security. However, with the increase in terrorist attacks not just in India especially, security of nuclear materials remains a priority. Therefore, India has made continued efforts to tighten its security on nuclear materials to prevent nuclear theft and radiological terrorism. Nuclear security is different from nuclear safety. Physical security is also a serious concern and India had been careful of the physical security of its nuclear materials. This is more so important since India is expanding its nuclear power capability to generate electricity for economic development. As India targets 60,000 MW of electricity production by 2030, it has a range of reactors to help it achieve its goal. These include indigenous Pressurised Heavy Water Reactors, now standardized at 700 MW per reactor Light Water Reactors, and the indigenous Fast Breeder Reactors that can generate more fuel for the future and enable the country to utilise its abundant thorium resource. Nuclear materials security can be enhanced through two important ways. One is through proliferation resistant technologies and diplomatic efforts to take non proliferation initiatives. The other is by developing technical means to prevent any leakage in nuclear materials in the hands of asymmetric organisations. New Delhi has already implemented IAEA Safeguards on their civilian nuclear installations. Moreover, the IAEA Additional Protocol has also been ratified by India in order to enhance its transparency of nuclear material and strengthen nuclear security. India is a party to the IAEA Conventions on Nuclear Safety and Security, and in particular the 1980 Convention on the Physical Protection of Nuclear Material and its amendment in 2005, Code of Conduct in Safety and Security of Radioactive Sources, 2006 which enables the country to provide for the highest international standards on nuclear and radiological safety and security. India's nuclear security approach is driven by five key components: Governance, Nuclear Security Practice and Culture, Institutions, Technology and International Cooperation. However, there is still scope for further improvements to strengthen nuclear materials and nuclear security. The NTI Report, ‘India’s improvement reflects its first contribution to the IAEA Nuclear Security Fund etc. in the future, India’s nuclear materials security conditions could be further improved by strengthening its laws and regulations for security and control of materials, particularly for control and accounting of materials, mitigating the insider threat, and for the physical security of materials during transport. India’s nuclear materials security conditions also remain adversely affected due to its continued increase in its quantities of nuclear material, and high levels of corruption among public officials.’ This paper would study briefly the progress made by India in nuclear and nuclear material security and the step ahead for India to further strengthen this.

Keywords: India, nuclear security, nuclear materials, non proliferation

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Authors: Peniah Mabaso-Shamano

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The paper evaluates Shona terms that were created to teach Phonetics and Phonology courses at Great Zimbabwe University (GZU). The phonetics and phonology terms to be discussed in this paper were created using different processes and strategies such as translation, borrowing, neologising, compounding, transliteration, circumlocution among many others. Most phonetics and phonology terms are alien to Shona and as a result, there are no suitable Shona equivalents. The lecturers and students for these courses have a mammoth task of creating terminology for the different modules offered in Shona and other Zimbabwean indigenous languages. Most linguistic reference books are written in English. As such, lecturers and students translate information from English to Shona, a measure which is proving to be too difficult for them. A term creation workshop was held at GZU to try to address the problem of lack of terminology in indigenous languages. Different indigenous language practitioners from different tertiary institutions convened for a two-day workshop at GZU. Due to the 'specialized' nature of phonetics and phonology, it was too difficult to come up with 'proper' indigenous terms. The researcher will consult tertiary institutions lecturers who teach linguistics courses and linguistics students to get their views on the created terms. The people consulted will not be the ones who took part in the term creation workshop held at GZU. The selected participants will be asked to evaluate and back-translate some of the terms. In instances where they feel the terms created are not suitable or user-friendly, they will be asked to suggest other terms. Since the researcher is also a linguistics lecturer, her observation and views will be important. From her experience in using some of the terms in teaching phonetics and phonology courses to undergraduate students, the researcher noted that most of the terms created have shortcomings since they are not user-friendly. These shortcomings include terms longer than the English terms as some terms are translated to Shona through a whole statement. Most of these terms are neologisms, compound neologisms, transliterations, circumlocutions, and blends. The paper will show that there is overuse of transliterated terms due to the lack of Shona equivalents for English terms. Most single English words were translated into compound neologisms or phrases after attempts to reduce them to one word terms failed. In other instances, circumlocution led to the problem of creating longer terms than the original and as a result, the terms are not user-friendly. The paper will discuss and evaluate the different phonetics and phonology terms created and the different strategies and processes used in creating them.

Keywords: blending, circumlocution, term creation, translation

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Authors: Praveen Vayalamkuzhi, Veeraragavan Amirthalingam

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Studies on safety on highways are becoming the need of the hour as over 400 lives are lost every day in India due to road crashes. In order to evaluate the factors that lead to different levels of crash severity, it is necessary to investigate the level of safety of highways and their relation to crashes. In the present study, an attempt is made to identify the factors that contribute to road crashes and to quantify their effect on the severity of road crashes. The study was carried out on a four-lane divided rural highway in India. The variables considered in the analysis includes components of horizontal alignment of highway, viz., straight or curve section; time of day, driveway density, presence of median; median opening; gradient; operating speed; and annual average daily traffic. These variables were considered after a preliminary analysis. The major complexities in the study are the heterogeneous traffic and the speed variation between different classes of vehicles along the highway. To quantify the impact of each of these factors, statistical analyses were carried out using Logit model and also negative binomial regression. The output from the statistical models proved that the variables viz., horizontal components of the highway alignment; driveway density; time of day; operating speed as well as annual average daily traffic show significant relation with the severity of crashes viz., fatal as well as injury crashes. Further, the annual average daily traffic has significant effect on the severity compared to other variables. The contribution of highway horizontal components on crash severity is also significant. Logit models can predict crashes better than the negative binomial regression models. The results of the study will help the transport planners to look into these aspects at the planning stage itself in the case of highways operated under heterogeneous traffic flow condition.

Keywords: geometric design, heterogeneous traffic, road crash, statistical analysis, level of safety

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Authors: Selamawit Mulubrhan Gidey

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Adama city, having an area of 29.86 km2, is one of the main cities in Ethiopia experiencing rapid growth in business and construction activities which in turn with an increasing number of vehicles at an alarming rate. For this reason, currently, there is an attempt to develop public transport assignment modeling in the city. Still, there is a huge gap in developing public transport assignments along the road segments of the city with operational and safety performance due to high traffic volume. Thus, the introduction of public transport assignment modeling in Adama City can have a massive impact on the road safety and capacity problem in the city. City transport modeling is important in city transportation planning, particularly in overcoming existing transportation problems such as traffic congestion. In this study, the Adama City transportation model was developed using the PTV VISUM software, whose transportation modeling is based on the four-step model of transportation. Based on the traffic volume data fed and simulated, the result of the study shows that the developed model has better reliability in representing the traffic congestion conditions in Adama city, and the simulation clearly indicates the level of congestion of each route selected and thus, the city road administrative office can take managerial decisions on public transport assignment so as to overcome traffic congestion executed along the selected routes.

Keywords: trip modelling, PTV VISUM, public transport assignment, congestion

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