Search results for: Ha Phuong Tran

Authors: Dong Tran, Thanh Dac Van, Ly Le

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Hemagglutinin (HA) and Neuraminidase (NA) play an important role in host immune evasion across influenza virus evolution process. The correlation between HA and NA evolution in respect to epitopic evolution and drug interaction has yet to be investigated. In this study, combining of sequence to structure evolution and statistical analysis on epitopic/binding site specificity, we identified potential therapeutic features of HA and NA that show specific antibody binding site of HA and specific binding distribution within NA active site of current inhibitors. Our approach introduces the use of sequence variation and molecular interaction to provide an effective strategy in establishing experimental based distributed representations of protein-protein/ligand complexes. The most important advantage of our method is that it does not require complete dataset of complexes but rather directly inferring feature interaction from sequence variation and molecular interaction. Using correlated sequence analysis, we additionally identified co-evolved mutations associated with maintaining HA/NA structural and functional variability toward immunity and therapeutic treatment. Our investigation on the HA binding specificity revealed unique conserved stalk domain interacts with unique loop domain of universal antibodies (CR9114, CT149, CR8043, CR8020, F16v3, CR6261, F10). On the other hand, NA inhibitors (Oseltamivir, Zaninamivir, Laninamivir) showed specific conserved residue contribution and similar to that of NA substrate (sialic acid) which can be exploited for drug design. Our study provides an important insight into rational design and identification of novel therapeutics targeting universally recognized feature of influenza HA/NA.

Keywords: influenza virus, hemagglutinin (HA), neuraminidase (NA), sequence evolution

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Authors: Hung Tran

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This interpretive qualitative study employed three theoretical lenses: Bronfenbrenner’s (1979) Ecological System of Human Development, Vygotsky’s (1978) Sociocultural Theory of Development, and Knowles’s (1970) Adult Learning Theory as the theoretical framework in connection with the constructivist research paradigm to investigate into positive and negative aspects of the extant English as a Foreign Language (EFL) faculty mentoring programs at four higher education institutions (HEIs) in the Mekong River Delta (MRD) of Vietnam. Four apprentice faculty members (mentees), four experienced faculty members (mentors), and two associate deans (administrators) from these HEIs participated in two tape-recorded individual interviews in the Vietnamese language. Twenty interviews were transcribed verbatim and translated into English with verification. The initial analysis of data reveals that the mentoring program, which is mandated by Vietnam’s Ministry of Education and Training, has been implemented differently at these HEIs due to a lack of officially-documented mentoring guidance. Other general themes emerging from the data include essentials of the mentoring program, approaches of the mentoring practice, the mentee – mentor relationship, and lifelong learning beyond the mentoring program. Practically, this study offers stakeholders in the mentoring cycle description of benefits and best practices of tertiary EFL mentorship and a suggested mentoring program that is metaphorically depicted as “a lifebuoy” for its current and potential administrators and mentors to help their mentees survive in the first years of teaching. Theoretically, this study contributes to the world’s growing knowledge of post-secondary mentorship by enriching the modest literature on Asian tertiary EFL mentorship.

Keywords: faculty mentorship, mentees, mentors, administrator, the MRD, Vietnam

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Authors: Thi. A. D. Tran, Matthieu Arnold, Dominique Adolphe, Laurence Schcher, Guillaume Reys

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During daily oral health cares, dental surgeons are in contact with numerous potentially infectious germs from patients' saliva and blood. In order to take into account these risks, a product development process has been unrolled to propose to the dental surgeon a personal protection equipment that is suitable with their expectations in terms of images, protection and comfort. After a consumer study, to evaluate how the users wear the garment and their expectations, specifications have been carried out and technical solutions have been developed in order to answer to the maximum of the desiderata. Thermal studies and comfort studies have been performed. The obtained results lead to define the technical solutions concerning the design of the new scrub. Three main functions have been investigated, the ergonomic aspect, the protection and the thermal comfort. In terms of ergonomic aspect, instrumented garments have been worn and pressure measurements have been done. The results highlight that a raglan shape for the sleeves has to be selected for a better dynamic comfort. Moreover, spray tests helped us to localize the potential contamination area and therefore protection devices have been placed on the garment. Concerning the thermal comfort, an I-R study was conducted in consulting room under the real working conditions; the heating zones have been detected. Based on these results, solutions have been proposed and implemented in a new gown. This new gown is currently composed of three different parts; a protective layer placed in the chest area to avoid contamination; a breathable layer placed in the back and in the armpits and a normal PET/Cotton fabric for the rest of the gown. Through the fitting tests conducted in hospital, it was obtained that the new design was highly appreciated. Some points can nevertheless be further improved. A final product will be produced based on necessary improvements.

Keywords: comfort, dentists, garment, thermal

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Authors: Pham Minh Duc, Tran Thi Thanh Hien, David A. Bengtson

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Laboratory feeding trial: the study was conducted to find out the optimal dietary vitamin C, or ascorbic acid (AA) levels in terms of the growth performance of snakehead. The growth trial included six treatments with five replications. Each treatment contained 0, 125, 250, 500, 1000 and 2000 mg AA equivalent kg⁻¹ diet which included six iso-nitrogenous (45% protein), iso-lipid (9% lipid) and isocaloric (4.2 Kcal.g¹). Eighty snakehead fingerlings (6.24 ± 0.17 g.fish¹) were assigned randomly in 0.5 m³ composite tanks. Fish were fed twice daily on demand for 8 weeks. The result showed that growth rates increased, protein efficiency ratio increased and the feed conversion ratio decreased in treatments with AA supplementation compared with control treatment. The survival rate of fish tends to increase with increase AA level. The number of RBCs, lysozyme in treatments with AA supplementation tended to rise significantly proportional to the concentration of AA. The number of WBCs of snakehead in treatments with AA supplementation was higher 2.1-3.6 times. In general, supplementation of AA in the diets for snakehead improved growth rate, feed efficiency and immune response. Hapa on-farm trial: based on the results of the laboratory feeding trial, the effects of AA on snakehead in hapas to simulate farm conditions, was tested using the following treatments: commercial feed; commercial feed plus hand mixed AA at 500; 750 and 1000 mg AA.kg⁻¹; SBM diet without AA; SBM diet plus 500; 750 and 1000 mg AA.kg⁻¹. The experiment was conducted in two experimental ponds (only SBM diet without AA placed in one pond and the rest in the other pond) with four replicate hapa each. Stocking density was 150 fish.m² and culture period was 5 months until market size was attained. The growth performance of snakehead and economic aspects were examined in this research.

Keywords: fish health, growth rate, snakehead, Vitamin C

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Authors: Yongjiang Zhang, Kallol Barai, Umesh R. Hodeghatta, Trang Tran, Vikas Dhiman

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Detecting water stress on crops early and accurately is crucial to minimize its impact. This study aims to measure water stress in wild blueberry crops non-destructively by analyzing proximal hyperspectral data. The data collection took place in the summer growing season of 2022. A drought experiment was conducted on wild blueberries in the randomized block design in the greenhouse, incorporating various genotypes and irrigation treatments. Hyperspectral data ( spectral range: 400-1000 nm) using a handheld spectroradiometer and leaf water potential data using a pressure chamber were collected from wild blueberry plants. Machine learning techniques, including multiple regression analysis and random forest models, were employed to predict leaf water potential (MPa). We explored the optimal wavelength bands for simple differences (RY1-R Y2), simple ratios (RY1/RY2), and normalized differences (|RY1-R Y2|/ (RY1-R Y2)). NDWI ((R857 - R1241)/(R857 + R1241)), SD (R2188 – R2245), and SR (R1752 / R1756) emerged as top predictors for predicting leaf water potential, significantly contributing to the highest model performance. The base learner models achieved an R-squared value of approximately 0.81, indicating their capacity to explain 81% of the variance. Research is underway to develop a neural vegetation index (NVI) that automates the process of index development by searching for specific wavelengths in the space ratio of linear functions of reflectance. The NVI framework could work across species and predict different physiological parameters.

Keywords: hyperspectral reflectance, water potential, spectral indices, machine learning, wild blueberries, optimal bands

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Authors: Farzaneh Shayeganfar, Ali Ramazani

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Exciton (strong electronic interaction of electron-hole) and hot carriers created by surface plasmon polaritons has been demonstrated in nanoscale optoelectronic devices, enhancing the photoresponse of the system. Herein, we employ a quantum framework to consider coupled exciton- hot carriers effects on photovoltaiv energy distribution, scattering process, polarizability and light emission of 2D-semicnductor. We use density functional theory (DFT) to design computationally a semi-functionalized 2D honeycomb silicon boride (SiB) monolayer with H atoms, suitable for photovoltaics. The dynamical stability, electronic and optical properties of SiB and semi-hydrogenated SiB structures were investigated utilizing the Tran-Blaha modified Becke-Johnson (TB-mBJ) potential. The calculated phonon dispersion shows that while an unhydrogenated SiB monolayer is dynamically unstable, surface semi-hydrogenation improves the stability of the structure and leads to a transition from metallic to semiconducting conductivity with a direct band gap of about 1.57 eV, appropriate for photovoltaic applications. The optical conductivity of this H-SiB structure, determined using the random phase approximation (RPA), shows that light adsorption should begin at the boundary of the visible range of light. Additionally, due to hydrogenation, the reflectivity spectrum declines sharply with respect to the unhydrogenated reflectivity spectrum in the IR and visible ranges of light. The energy band gap remains direct, increasing from 0.9 to 1.8 eV, upon increasing the strain from -6% (compressive) to +6% (tensile). Additionally, compressive and tensile strains lead, respectively, to red and blue shifts of optical the conductivity threshold around the visible range of light. Overall, this study suggests that H-SiB monolayers are suitable as two-dimensional solar cell materials.

Keywords: surface plasmon, hot carrier, strain engineering, valley polariton

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Authors: Quyen Vu Dang Ha, Oanh Truong Thi, Thuoc Tran Linh, Kent Carpenter, Thinh Doan Vu, Binh Dang Thuy

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Enzyme restriction site associated DNA (EzRAD) has recently emerged as a promising genomic approach for exploring fish genetic diversity on a genome-wide scale. This is a simplified method for genomic genotyping in non-model organisms and applied for SNPs discovery in the population genetics of freshwater and marine fish in the South of Vietnam. The observations of regional-scale differentiation of commercial freshwater fish (smallscale croakers Boesemania microlepis) and marine fish (emperor Lethrinus lentjan) are clarified. Samples were collected along Hau River and coastal area in the south and center Vietnam. 52 DNA samples from Tra Vinh, An Giang Province for Boesemania microlepis and 34 DNA samples of Lethrinus lentjan from Phu Quoc, Nha Trang, Da Nang Province were used to prepare EzRAD libraries from genomic DNA digested with MboI and Sau3AI. A pooled sample of regional EzRAD libraries was sequenced using the HiSeq 2500 Illumina platform. For Boesemania microlepis, the small scale population different from upstream to downstream of Hau river were detected, An Giang population exhibited less genetic diversity (SNPs per individual from 14 to 926), in comparison to Tra Vinh population (from 11 to 2172). For Lethrinus lentjan, the result showed the minor difference between populations in the Northern and the Southern Mekong River. The numbers of contigs and SNPs vary from 1315 to 2455 and from 7122 to 8594, respectively (P ≤ 0.01). The current preliminary study reveals regional scale population disconnection probably reflecting environmental changing. Additional sampling and EzRad libraries need to be implemented for resource management in the Mekong Delta.

Keywords: Boesemania microlepis, EzRAD, Lethrinus lentjan, SNPs

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Authors: Andriana E. Tran, Anna Chur-Hansen

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Sexual health is an important aspect of overall wellbeing. This study aimed to explore the sexual health experiences of men aged 50 years and over from the perspective of health care professional participants who were specializing in sexual health care and who consulted with older men. A total of ten interviews were conducted. Eleven themes were identified regarding men’s experiences with sexual health care as reported by participants. 1) Biologically focused: older male clients focus largely on the biological aspect of their sexual health without consideration of other factors which might affect their functioning. 2) Psychological concerns: there is an interaction between mental and sexual health but older male clients do not necessarily see this. 3) Medicalization of sexual functioning: advances in medicine that aid with erectile difficulties which consequently mean that older men tend to favor a medical solution to their sexual concerns. 4) Masculine identity: sexual health concerns are linked to older male clients’ sense of masculinity. 5) Penile functionality: most concerns that older male clients have center on their penile functionality. 6) Relationships: many male clients seek sexual help as they believe it improves relationships. Conversely, having supportive partners may mean older male clients focus less on the physicality of sex. 7) Grief and loss: men experience grief and loss – the loss of their sexual functioning, grief from loss of a long-term partner, and loss of intimacy and privacy when moving from independent living to residential care. 8) Social stigma: older male clients experience stigma around aging sexuality and sex in general. 9) Help-seeking behavior: older male clients will usually seek mechanistic solution for biological sexual concerns, such as medication used for penile dysfunction. 10) Dismissed by health care professionals: many older male clients seek specialist sexual health care without the knowledge of their doctors as they feel dismissed due to lack of expertise, lack of time, and the doctor’s personal attitudes and characteristics. Finally, 11) Lack of resources: there is a distinct lack of resources and training to understand sexuality for healthy older men. These findings may inform future research, professional training, public health campaigns and policies for sexual health in older men.

Keywords: ageing, biopsychosocial model, men's health, sexual health

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Authors: Thu Nhi Tran Caliste

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X-ray Bragg diffraction imaging (“topography”)entered into practical use when Lang designed an “easy” technical setup to characterise the defects / distortions in the high perfection crystals produced for the microelectronics industry. The use of this technique extended to all kind of high quality crystals, and deposited layers, and a series of publications explained, starting from the dynamical theory of diffraction, the contrast of the images of the defects. A quantitative version of “monochromatic topography” known as“Rocking Curve Imaging” (RCI) was implemented, by using synchrotron light and taking advantage of the dramatic improvement of the 2D-detectors and computerised image processing. The rough data is constituted by a number (~300) of images recorded along the diffraction (“rocking”) curve. If the quality of the crystal is such that a one-to-onerelation between a pixel of the detector and a voxel within the crystal can be established (this approximation is very well fulfilled if the local mosaic spread of the voxel is < 1 mradian), a software we developped provides, from the each rocking curve recorded on each of the pixels of the detector, not only the “voxel” integrated intensity (the only data provided by the previous techniques) but also its “mosaic spread” (FWHM) and peak position. We will show, based on many examples, that this new data, never recorded before, open the field to a highly enhanced characterization of the crystal and deposited layers. These examples include the characterization of dislocations and twins occurring during silicon growth, various growth features in Al203, GaNand CdTe (where the diffraction displays the Borrmannanomalous absorption, which leads to a new type of images), and the characterisation of the defects within deposited layers, or their effect on the substrate. We could also observe (due to the very high sensitivity of the setup installed on BM05, which allows revealing these faint effects) that, when dealing with very perfect crystals, the Kato’s interference fringes predicted by dynamical theory are also associated with very small modifications of the local FWHM and peak position (of the order of the µradian). This rather unexpected (at least for us) result appears to be in keeping with preliminary dynamical theory calculations.

Keywords: rocking curve imaging, X-ray diffraction, defect, distortion

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Authors: Thi Phuong Pham

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This paper explores the intricate relationships between Sustainable Supply Chain Management (SSCM) practices, digital transformation (DT), and enterprise performance within the context of Vietnam. Over the past two decades, there has been a paradigm shift in supply chain management, with sustainability gaining prominence due to increasing concerns about climate change, labor practices, and the environmental impact of business operations. In the ever-evolving realm of global business, sustainability and digital transformation (DT) intersecting dynamics have become pivotal catalysts for organizational success. This research investigates how integrating SSCM with DT can enhance enterprise performance, a subject of significant relevance as Vietnam undergoes rapid economic growth and digital transformation. The primary objectives of this research are twofold: (1) to examine the effects of SSCM practices on enterprise performance in three critical aspects: economic, environmental, and social performance in Vietnam and (2) to explore the mediating role of DT in this relationship. By analyzing these dynamics, the study aims to provide valuable insights for policymakers and the academic community regarding the potential benefits of aligning SSCM principles with digital technologies. To achieve these objectives, the research employs a robust mixed-method approach. The research begins with a comprehensive literature review to establish a theoretical framework that underpins the empirical analysis. Data collection was conducted through a structured survey targeting Vietnamese enterprises, with the survey instrument designed to measure SSCM practices, DT, and enterprise performance using a five-point Likert scale. The reliability and validity of the survey were ensured by pre-testing with industry practitioners and refining the questionnaire based on their feedback. For data analysis, structural equation modeling (SEM) was employed to quantify the direct effects of SSCM on enterprise performance, while mediation analysis using the PROCESS Macro 4.0 in SPSS was conducted to assess the mediating role of DT. The findings reveal that SSCM practices positively influence enterprise performance by enhancing operational efficiency, reducing costs, and improving sustainability metrics. Furthermore, DT acts as a significant mediator, amplifying the positive impacts of SSCM practices through improved data management, enhanced communication, and more agile supply chain processes. These results underscore the critical role of DT in maximizing the benefits of SSCM practices, particularly in a developing economy like Vietnam. This research contributes to the existing body of knowledge by highlighting the synergistic effects of SSCM and DT on enterprise performance. It offers practical implications for businesses that enhance their sustainability and digital capabilities, providing a roadmap for integrating these two pivotal aspects to achieve competitive advantage. The study's insights can also inform governmental policies designed to foster sustainable economic growth and digital innovation in Vietnam.

Keywords: sustainable supply chain management, digital transformation, enterprise performance, Vietnam

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Authors: Volker Landersheim, Daria Manushyna, Thinh Pham, Dai-Duong Tran, Thomas Geury, Omar Hegazy, Steven Wilkins

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Air pollution is one of the emerging problems in our society. Targets of reduction of CO₂ emissions address low-carbon and resource-efficient transport. (Plug-in) hybrid electric propulsion concepts offer the possibility to reduce total cost of ownership (TCO) and emissions for public transport vehicles (e.g., bus application). In this context, typically, diesel engines are used to form the hybrid propulsion system of the vehicle. Though the technological development of diesel engines experience major advantages, some challenges such as the high amount of particle emissions remain relevant. Gaseous fuels (i.e., compressed natural gases (CNGs) or liquefied petroleum gases (LPGs) represent an attractive alternative to diesel because of their composition. In the framework of the research project 'Optimised Real-world Cost-Competitive Modular Hybrid Architecture' (ORCA), which was funded by the EU, two different hybrid-electric propulsion concepts have been investigated: one using a diesel engine as internal combustion engine and one using CNG as fuel. The aim of the current study is to analyze specific benefits for the aforementioned hybrid propulsion systems for predefined driving scenarios with regard to emissions and total cost of ownership in bus application. Engine models based on experimental data for diesel and CNG were developed. For the purpose of designing optimal energy management strategies for each propulsion system, maps-driven or quasi-static models for specific engine types are used in the simulation framework. An analogous modelling approach has been chosen to represent emissions. This paper compares the two concepts regarding their CO₂ and NOx emissions. This comparison is performed for relevant bus missions (urban, suburban, with and without zero-emission zone) and with different energy management strategies. In addition to the emissions, also the downsizing potential of the combustion engine has been analysed to minimize the powertrain TCO (pTCO) for plug-in hybrid electric buses. The results of the performed analyses show that the hybrid vehicle concept using the CNG engine shows advantages both with respect to emissions as well as to pTCO. The pTCO is 10% lower, CO₂ emissions are 13% lower, and the NOx emissions are more than 50% lower than with the diesel combustion engine. These results are consistent across all usage profiles under investigation.

Keywords: bus transport, emissions, hybrid propulsion, pTCO, CNG

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Authors: Safa Ladhari, Alireza Saidi, Phuong Nguyen-Tri

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During health crises, such as COVID-19, using disposable protective equipment (PEs) (masks, gowns, etc.) causes long-term problems, increasing the volume of hazardous waste that must be handled safely and expensively. Therefore, producing textiles for antimicrobial and reusable materials is highly desirable to decrease the use of disposable PEs that should be treated as hazardous waste. In addition, if these items are used regularly in the workplace or for daily activities by the public, they will most likely end up in household waste. Furthermore, they may pose a high risk of contagion to waste collection workers if contaminated. Therefore, to protect the whole population in times of sanitary crisis, it is necessary to equip these materials with tools that make them resilient to the challenges of carrying out daily activities without compromising public health and the environment and without depending on them external technologies and producers. In addition, the materials frequently used for EPs are plastics of petrochemical origin. The subject of the present work is replacing petroplastics with bioplastic since it offers better biodegradability. The chosen polymer is polyhydroxybutyrate (PHB), a family of polyhydroxyalkanoates synthesized by different bacteria. It has similar properties to conventional plastics. However, it is renewable, biocompatible, and has attractive barrier properties compared to other polyesters. These characteristics make it ideal for EP protection applications. The current research topic focuses on the preparation and rapid evaluation of the biological activity of nanotechnology-based antimicrobial agents to treat textile surfaces used for PE. This work will be carried out to provide antibacterial solutions that can be transferred to a workplace application in the fight against short-term biological risks. Three main objectives are proposed during this research topic: 1) the development of suitable methods for the deposition of antibacterial agents on the surface of textiles; 2) the development of a method for measuring the antibacterial activity of the prepared textiles and 3) the study of the biodegradability of the prepared textiles. The studied textile is a non-woven fabric based on a biodegradable polymer manufactured by the electrospinning method. Indeed, nanofibers are increasingly studied due to their unique characteristics, such as high surface-to-volume ratio, improved thermal, mechanical, and electrical properties, and confinement effects. The electrospun film will be surface modified by plasma treatment and then loaded with hybrid antibacterial silver and titanium dioxide nanoparticles by the dip-coating method. This work uses simple methods with emerging technologies to fabricate nanofibers with suitable size and morphology to be used as components for protective equipment. The antibacterial agents generally used are based on silver, zinc, copper, etc. However, to our knowledge, few researchers have used hybrid nanoparticles to ensure antibacterial activity with biodegradable polymers. Also, we will exploit visible light to improve the antibacterial effectiveness of the fabric, which differs from the traditional contact mode of killing bacteria and presents an innovation of active protective equipment. Finally, this work will allow for the innovation of new antibacterial textile materials through a simple and ecological method.

Keywords: protective equipment, antibacterial textile materials, biodegradable polymer, electrospinning, hybrid antibacterial nanoparticles

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Maria F. Seran

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In second language interaction, an EFL student always carries his knowledge of targeted language and sometimes gets influenced by his first language cultures which makes him transfer his utterances from the first language to the second language. The influence of L1 cultures somehow can lead to face-threatening act when it comes to responding on speech act, for instance, compliment. A speaker praises a compliment to show gratitude, and in return, he expects for compliment respond uttered by the hearer. While Western people use more acceptance continuum on compliment response, Indonesians utter more denial continuum which can somehow put the speakers into a face-threating situation and offense. This study investigated compliment response employed by EFL students and English native speakers. The study was distinct as none compliment response studies had been conducted to compare the compliment response between English native speakers and two different Indonesian EFL proficiency groups in which this research sought to meet this need. This study was significant for EFL teachers because it gave insight on cross-cultural understanding and brought pedagogical implication on explicit pragmatic instruction. Two research questions were set, 1. How do Indonesian EFL students and English native speakers respond compliments? 2. Is there any correlation between Indonesia EFL students’ proficiency and their compliment response use in English? The study involved three groups of participants; 5 English native speakers, 10 high-proficiency and 10 low-proficiency Indonesian EFL university students. The research instruments used in this study were as follows, an online TOEFL prediction test, focusing on grammar skill which was modified from Barron TOEFL exercise test, and a discourse completion task (DCT), consisting of 10 compliment respond items. Based on the research invitation, 20 second-year university students majoring in English education at Widya Mandira Catholic University, Kupang, East Nusa Tenggara, Indonesia who willingly participated in the research took the TOEFL prediction test online from the link provided. Students who achieved score 75-100 in test were categorized as high-proficiency students, while, students who attained score below 74 were considered as low-proficiency students. Then, the DCT survey was administered to these EFL groups and the native speaker group. Participants’ responses were coded and analyzed using categories of compliment response framework proposed by Tran. The study found out that 5 native speakers applied more compliment upgrades and appreciation token in compliment response, whereas, Indonesian EFL students combined some compliment response strategies in their utterance, such as, appreciation token, return and compliment downgrade. There is no correlation between students’ proficiency level and their CR responds as most EFL students in both groups produced less varied compliment responses and only 4 Indonesian high-proficiency students uttered more varied and were similar to the native speakers. The combination strategies used by EFL students can be explained as the influence of pragmatic transfer from L1 to L2; therefore, EFL teachers should explicitly teach more compliment response strategies to raise students’ awareness on English culture and elaborate their speaking to be more competence as close to native speakers as possible.

Keywords: compliment response, English native speakers, Indonesian EFL students, speech acts

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Authors: Hai L. Tran

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Previous research on agenda setting effects has often focused on the top-down influence of the media at the aggregate level, while overlooking the capacity of audience members to select media and content to fit their individual dispositions. The decentralized characteristics of online communication and digital news create more choices and greater user control, thereby enabling each audience member to seek out a unique blend of media sources, issues, and elements of messages and to mix them into a coherent individual picture of the world. This study examines how audiences use media differently depending on their prior dispositions, thereby making sense of the world in ways that are congruent with their preferences and cognitions. The current undertaking is informed by theoretical frameworks from two distinct lines of scholarship. According to the ideological migration hypothesis, individuals choose to live in communities with ideologies like their own to satisfy their need to belong. One tends to move away from Zip codes that are incongruent and toward those that are more aligned with one’s ideological orientation. This geographical division along ideological lines has been documented in social psychology research. As an extension of agenda setting, the agendamelding hypothesis argues that audiences seek out information in attractive media and blend them into a coherent narrative that fits with a common agenda shared by others, who think as they do and communicate with them about issues of public. In other words, individuals, through their media use, identify themselves with a group/community that they want to join. Accordingly, the present study hypothesizes that because ideology plays a role in pushing people toward a physical community that fits their need to belong, it also leads individuals to receive an idiosyncratic blend of media and be influenced by such selective exposure in deciding what issues are more relevant. Consequently, the individualized focus of media choices impacts how audiences perceive political news coverage and what they know about political issues. The research project utilizes recent data from The American Trends Panel survey conducted by Pew Research Center to explore the nuanced nature of agenda setting at the individual level and amid heightened polarization. Hypothesis testing is performed with both nonparametric and parametric procedures, including regression and path analysis. This research attempts to explore the media-public relationship from a bottom-up approach, considering the ability of active audience members to select among media in a larger process that entails agenda setting. It helps encourage agenda-setting scholars to further examine effects at the individual, rather than aggregate, level. In addition to theoretical contributions, the study’s findings are useful for media professionals in building and maintaining relationships with the audience considering changes in market share due to the spread of digital and social media.

Keywords: agenda setting, agendamelding, audience fragmentation, ideological migration, partisanship, polarization

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Authors: Hai L. Tran

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When covering events and issues, the news media often employ both personal accounts as well as facts and figures. However, the process of using numbers and narratives in the newsroom is mostly operated through trial and error. There is a demonstrated need for the news industry to better understand the specific effects of storytelling and data-driven reporting on the audience as well as explanatory factors driving such effects. In the academic world, anecdotal evidence and statistical evidence have been studied in a mutually exclusive manner. Existing research tends to treat pertinent effects as though the use of one form precludes the other and as if a tradeoff is required. Meanwhile, narratives and statistical facts are often combined in various communication contexts, especially in news presentations. There is value in reconceptualizing and theorizing about both relative and collective impacts of numbers and narratives as well as the mechanism underlying such effects. The current undertaking seeks to link theory to practice by providing a complete picture of how and why people are influenced by information conveyed through quantitative and qualitative accounts. Specifically, the cognitive-experiential theory is invoked to argue that humans employ two distinct systems to process information. The rational system requires the processing of logical evidence effortful analytical cognitions, which are affect-free. Meanwhile, the experiential system is intuitive, rapid, automatic, and holistic, thereby demanding minimum cognitive resources and relating to the experience of affect. In certain situations, one system might dominate the other, but rational and experiential modes of processing operations in parallel and at the same time. As such, anecdotes and quantified facts impact audience response differently and a combination of data and narratives is more effective than either form of evidence. In addition, the present study identifies several media variables and human factors driving the effects of statistics and anecdotes. An integrative model is proposed to explain how message characteristics (modality, vividness, salience, congruency, position) and individual differences (involvement, numeracy skills, cognitive resources, cultural orientation) impact selective exposure, which in turn activates pertinent modes of processing, and thereby induces corresponding responses. The present study represents a step toward bridging theoretical frameworks from various disciplines to better understand the specific effects and the conditions under which the use of anecdotal evidence and/or statistical evidence enhances or undermines information processing. In addition to theoretical contributions, this research helps inform news professionals about the benefits and pitfalls of incorporating quantitative and qualitative accounts in reporting. It proposes a typology of possible scenarios and appropriate strategies for journalists to use when presenting news with anecdotes and numbers.

Keywords: data, narrative, number, anecdote, storytelling, news

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Authors: Fayez Hanna, Viet Tran

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A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

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Authors: Hai L. Tran

Abstract:

In the digital age, evidence-based reporting is touted as a best practice for seeking the truth and keeping the public well-informed. Journalists are expected to rely on evidence to demonstrate the validity of a factual statement and lend credence to an individual account. Evidence can be obtained from various sources, and due to a rich supply of evidence types available, the definition of this important concept varies semantically. To promote clarity and understanding, it is necessary to break down the various types of evidence and categorize them in a more coherent, systematic way. There is a wide array of devices that digital journalists deploy as proof to back up or refute a truth claim. Evidence can take various formats, including verbal and visual materials. Verbal evidence encompasses quotes, soundbites, talking heads, testimonies, voice recordings, anecdotes, and statistics communicated through written or spoken language. There are instances where evidence is simply non-verbal, such as when natural sounds are provided without any verbalized words. On the other hand, other language-free items exhibited in photos, video footage, data visualizations, infographics, and illustrations can serve as visual evidence. Moreover, there are different sources from which evidence can be cited. Supporting materials, such as public or leaked records and documents, data, research studies, surveys, polls, or reports compiled by governments, organizations, and other entities, are frequently included as informational evidence. Proof can also come from human sources via interviews, recorded conversations, public and private gatherings, or press conferences. Expert opinions, eye-witness insights, insider observations, and official statements are some of the common examples of testimonial evidence. Digital journalism studies tend to make broad references when comparing qualitative versus quantitative forms of evidence. Meanwhile, limited efforts are being undertaken to distinguish between sister terms, such as “data,” “statistical,” and “base-rate” on one side of the spectrum and “narrative,” “anecdotal,” and “exemplar” on the other. The present study seeks to develop the evidence taxonomy, which classifies evidence through the quantitative-qualitative juxtaposition and in a hierarchical order from broad to specific. According to this scheme, data, statistics, and base rate belong to the quantitative evidence group, whereas narrative, anecdote, and exemplar fall into the qualitative evidence group. Subsequently, the taxonomical classification arranges data versus narrative at the top of the hierarchy of types of evidence, followed by statistics versus anecdote and base rate versus exemplar. This research reiterates the central role of evidence in how journalists describe and explain social phenomena and issues. By defining the various types of evidence and delineating their logical connections it helps remove a significant degree of conceptual inconsistency, ambiguity, and confusion in digital journalism studies.

Keywords: evidence, evidence forms, evidence types, taxonomy

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Authors: Chang Liu, Hanwen Zhang, Vikash Sharma, Don Eliseo Lucerno-Prisno III, Emmanuel Yujuico, Maulik Chokshi, Prashanthi Krishnakumar, Bach Xuan Tran, Giang Thu Vu, Kamilla Anna Pinter, Shenglan Tang

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Background and Aims: Globally, many health systems focus on hospital-based healthcare models targeting acute care and disease treatment, which are not effective in addressing the challenges of ageing populations, chronic conditions, multi-morbidities, and increasingly unhealthy lifestyles. Recently, integrated care programs on chronic diseases have been developed, piloted, and implemented to meet such challenges. However, integrated care programs in the Asia-Pacific region vary in the levels of integration from linkage to coordination to full integration. This study aims to identify and analyze existing cases of integrated care in the Asia-Pacific region and identify the facilitators and barriers in order to improve existing cases and inform future cases. Methods: The study is a comparative study, with a combination approach of desk-based research and key informant interviews. The selected countries included in this study represent a good mix of lower-middle income countries (the Philippines, India, Vietnam, and Fiji), upper-middle income country (China), and high-income country (Singapore) in the Asia-Pacific region. Existing integrated care programs were identified through the scoping review approach. Trigger, history, general design, beneficiaries, and objectors were summarized with barriers and facilitators of integrated care based on key informant interviews. Representative case(s) in each country were selected and comprehensively analyzed through deep-dive case studies. Results: A total of 87 existing integrated care programs on chronic diseases were found in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines, and 1 in Fiji. 9 representative cases of integrated care were selected for in-depth description and analysis, with 2 in China, the Philippines, and Vietnam, and 1 in Singapore, India, and Fiji. Population aging and the rising chronic disease burden have been identified as key drivers for almost all the six countries. Among the six countries, Singapore has the longest history of integrated care, followed by Fiji, the Philippines, and China, while India and Vietnam have a shorter history of integrated care. Incentives, technologies, education, and performance evaluation would be crucial for developing strategies for implementing future programs and improve already existing programs. Conclusion: Integrated care is important for addressing challenges surrounding the delivery of long-term care. To date, there is an increasing trend of integrated care programs on chronic diseases in the Asia-Pacific region, and all six countries in our study set integrated care as a direction for their health systems transformation.

Keywords: integrated healthcare, integrated care delivery, chronic diseases, Asia-Pacific region

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Authors: S. B. Q. Tran

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Drop condensation is the phenomenon that the tiny drops form when the oversaturated vapour present in the environment condenses on a substrate and makes the droplet growth. Recently, this subject has received much attention due to its applications in many fields such as thin film growth, heat transfer, recovery of atmospheric water and polymer templating. In literature, many papers investigated theoretically and experimentally in macro droplet growth with the size of millimeter scale of radius. However few papers about nanodroplet condensation are found in the literature especially theoretical work. In order to understand the droplet growth in nanoscale, we perform the numerical simulation work to study nanodroplet growth. We investigate and discuss the role of the droplet shape and monomer diffusion on drop growth and their effect on growth law. The effect of droplet shape is studied by doing parametric studies of contact angle and disjoining pressure magnitude. Besides, the effect of pinning and de-pinning behaviours is also studied. We investigate the axisymmetric homogeneous growth of 10–100 nm single water nanodroplet on a substrate surface. The main mechanism of droplet growth is attributed to the accumulation of laterally diffusing water monomers, formed by the absorption of water vapour in the environment onto the substrate. Under assumptions of quasi-steady thermodynamic equilibrium, the nanodroplet evolves according to the augmented Young–Laplace equation. Using continuum theory, we model the dynamics of nanodroplet growth including the coupled effects of disjoining pressure, contact angle and monomer diffusion with the assumption of constant flux of water monomers at the far field. The simulation result is validated by comparing with the published experimental result. For the case of nanodroplet growth with constant contact angle, our numerical results show that the initial droplet growth is transient by monomer diffusion. When the flux at the far field is small, at the beginning, the droplet grows by the diffusion of initially available water monomers on the substrate and after that by the flux at the far field. In the steady late growth rate of droplet radius and droplet height follow a power law of 1/3, which is unaffected by the substrate disjoining pressure and contact angle. However, it is found that the droplet grows faster in radial direction than high direction when disjoining pressure and contact angle increase. The simulation also shows the information of computational domain effect in the transient growth period. When the computational domain size is larger, the mass coming in the free substrate domain is higher. So the mass coming in the droplet is also higher. The droplet grows and reaches the steady state faster. For the case of pinning and de-pinning droplet growth, the simulation shows that the disjoining pressure does not affect the droplet radius growth law 1/3 in steady state. However the disjoining pressure modifies the growth rate of the droplet height, which then follows a power law of 1/4. We demonstrate how spatial depletion of monomers could lead to a growth arrest of the nanodroplet, as observed experimentally.

Keywords: augmented young-laplace equation, contact angle, disjoining pressure, nanodroplet growth

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Authors: Christina Tran, Lu Khoo, Andrea Waylen

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Introduction: The evolution of the dental consultation from paternalism to partnership has been well documented in developed Western countries. Great emphasis is now placed on the importance of empowering patients to make decisions regarding their care, obtaining informed consent, and maintaining patient privacy and confidentiality. With the majority of communication occurring non-verbally, clinicians often adopt behaviours which suggest an approachable and positive attitude. However, evidence indicates that in Asia, a paternalistic model may be favored in medicine. The power imbalance occurring in doctor-patient relationships worldwide may be exacerbated by various factors in Southeast Asia: the strong hierarchical culture, and the large education gap between doctor and patient. Further insight into this matter can be gained by observing patient-dentist communication in Cambodia. The dentist:population ratio in Cambodia is approximately 1:33,000, with rural areas remaining extremely underserviced. We have carried out an observational study of communication in a voluntary dental clinic in Cambodia with the aim of describing whether the patient-dentist relationship follows a paternalistic or patient-centred model. Method: Over a period of two weeks, two clinicians provided dental care as part of a voluntary program in two Cambodian settings: a temporary, rural clinic and a permanent clinic in Phnom Penh. The clinicians independently recorded their experiences in diaries, making observations on the verbal and non-verbal communication between patients and staff. General observations such as the clinic environment were also made. The diaries were then compared and analyzed using a thematic approach. Results: The overall themes that emerged were regarding the clinic environment, verbal communication, and non-verbal communication. Regarding the clinic environment, the rural clinic was arranged in order to easily direct patients from one dentist to another, with little emphasis on continuous patient care. There was also little consideration for patient privacy: patients were often treated in the presence of many observers, including other waiting patients. However, the permanent clinic was structured to allow greater patient privacy, with continuous patient care occurring throughout the appointment. Regarding verbal communication, there was a strongly paternalistic approach to gaining consent and giving instruction. Patients rarely asked questions regarding their treatment, with dentists doing little to encourage patient involvement. Non-verbal communication between patients and dentists was generally paternalistic, with the dentist often addressing the supine patient from above. Patients often avoided making eye-contact, which may have indicated discomfort or lack of engagement. Both adult and paediatric patients rarely raised verbal concerns regarding pain during treatment, despite displaying non-verbal signs of experiencing pain. Anxious paediatric patients were sometimes managed with physical restraint by their mothers to facilitate treatment. Conclusion: Patient-professional communication in the Cambodian dental setting was observed to be generally paternalistic in nature, although more patient-centred aspects were observed in the established, urban setting. However, it should be noted that these observations are subjective in nature, and that the patients’ actual perceptions of their communication experience were unexplored. Further observations in variety of dental settings in Cambodia are needed before any definitive conclusions can be made.

Keywords: patient-dentist communication, paternalism, patient-centered, non-verbal communication

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Authors: Truong H. Le, Ngoc M. To, Quang N. Tran, Luu T. Cao, Chi V. Le

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Introduction: In Vietnam, the current monitoring and treatment for ordinary diabetic patient mostly based on glucose monitoring with HbA1c test for every three months (recommended goal is HbA1c < 6.5%~7%). For diabetes in pregnant women or Gestational diabetes mellitus (GDM), glycemic control until the time of delivery is extremly important because it could reduce significantly medical implications for both the mother and the child. Besides, GDM requires continuos glucose monitoring at least every two weeks and therefore an alternative marker of glycemia for short-term control is considering a potential tool for the healthcare providers. There are published studies have indicated that the glycosylated serum protein is a better indicator than glycosylated hemoglobin in GDM monitoring. Based on the actual practice in Vietnam, this study was designed to evaluate the role of serum fructosamine as a monitoring tool in GDM treament and its correlations with fasting blood glucose (G0), 2-hour postprandial glucose (G2) and glycosylated hemoglobin (HbA1c). Methods: A cohort study on pregnant women diagnosed with GDM by the 75-gram oralglucose tolerance test was conducted at Endocrinology Department, Cho Ray hospital, Vietnam from June 2014 to March 2015. Cho Ray hospital is the final destination for GDM patient in the southern of Vietnam, the study population has many sources from other pronvinces and therefore researchers belive that this demographic characteristic can help to provide the study result as a reflection for the whole area. In this study, diabetic patients received a continuos glucose monitoring method which consists of bi-weekly on-site visit every 2 weeks with glycosylated serum protein test, fasting blood glucose test and 2-hour postprandial glucose test; HbA1c test for every 3 months; and nutritious consultance for daily diet program. The subjects still received routine treatment at the hospital, with tight follow-up from their healthcare providers. Researchers recorded bi-weekly health conditions, serum fructosamine level and delivery outcome from the pregnant women, using Stata 13 programme for the analysis. Results: A total of 500 pregnant women was enrolled and follow-up in this study. Serum fructosamine level was found to have a light correlation with G0 ( r=0.3458, p < 0.001) and HbA1c ( r=0.3544, p < 0.001), and moderately correlated with G2 ( r=0.4379, p < 0.001). During study timeline, the delivery outcome of 287 women were recorded with the average age of 38.5 ± 1.5 weeks, 9% of them have macrosomia, 2.8% have premature birth before week 35th and 9.8% have premature birth before week 37th; 64.8% of cesarean section and none of them have perinatal or neonatal mortality. The study provides a reference interval of serum fructosamine for GDM patient was 112.9 ± 20.7 μmol/dL. Conclusion: The present results suggests that serum fructosamine is as effective as HbA1c as a reflection of blood glucose control in GDM patient, with a positive result in delivery outcome (0% perinatal or neonatal mortality). The reference value of serum fructosamine measurement provided a potential monitoring utility in GDM treatment for hospitals in Vietnam. Healthcare providers in Cho Ray hospital is considering to conduct more studies to test this reference as a target value in their GDM treatment and monitoring.

Keywords: gestational diabetes mellitus, monitoring tool, serum fructosamine, Vietnam

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Authors: T. N. Tran Thi, J. Morse, C. Detlefs, P. K. Cook, C. Yıldırım, A. C. Jakobsen, T. Zhou, J. Hartwig, V. Zurbig, D. Caliste, B. Fernandez, D. Eon, O. Loto, M. L. Hicks, A. Pakpour-Tabrizi, J. Baruchel

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The ability to grow boron-doped diamond epilayers of high crystalline quality is a prerequisite for the fabrication of diamond power electronic devices, in particular high voltage diodes and metal-oxide-semiconductor (MOS) transistors. Boron and intrinsic diamond layers are homoepitaxially overgrown by microwave assisted chemical vapour deposition (MWCVD) on single crystal high pressure, high temperature (HPHT) grown bulk diamond substrates. Various epilayer thicknesses were grown, with dopant concentrations ranging from 1021 atom/cm³ at nanometer thickness in the case of 'delta doping', up 1016 atom/cm³ and 50µm thickness or high electric field drift regions. The crystalline quality of these overgrown layers as regards defects, strain, distortion… is critical for the device performance through its relation to the final electrical properties (Hall mobility, breakdown voltage...). In addition to the optimization of the epilayer growth conditions in the MWCVD reactor, other important questions related to the crystalline quality of the overgrown layer(s) are: 1) what is the dependence on the bulk quality and surface preparation methods of the HPHT diamond substrate? 2) how do defects already present in the substrate crystal propagate into the overgrown layer; 3) what types of new defects are created during overgrowth, what are their growth mechanisms, and how can these defects be avoided? 4) how can we relate in a quantitative manner parameters related to the measured crystalline quality of the boron doped layer to the electronic properties of final processed devices? We describe synchrotron-based techniques developed to address these questions. These techniques allow the visualization of local defects and crystal distortion which complements the data obtained by other well-established analysis methods such as AFM, SIMS, Hall conductivity…. We have used Grazing Incidence X-ray Diffraction (GIXRD) at the ID01 beamline of the ESRF to study lattice parameters and damage (strain, tilt and mosaic spread) both in diamond substrate near surface layers and in thick (10–50 µm) overgrown boron doped diamond epi-layers. Micro- and nano-section topography have been carried out at both the BM05 and ID06-ESRF) beamlines using rocking curve imaging techniques to study defects which have propagated from the substrate into the overgrown layer(s) and their influence on final electronic device performance. These studies were performed using various commercially sourced HPHT grown diamond substrates, with the MWCVD overgrowth carried out at the Fraunhofer IAF-Germany. The synchrotron results are in good agreement with low-temperature (5°K) cathodoluminescence spectroscopy carried out on the grown samples using an Inspect F5O FESEM fitted with an IHR spectrometer.

Keywords: synchrotron X-ray diffaction, crystalline quality, defects, diamond overgrowth, rocking curve imaging

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Authors: Peregrine James Dalziel, Philip Vu Tran

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Objective / Introduction: Demand for radiology services from Emergency Departments (ED) continues to increase with greater demands placed on radiology staff providing reports for the management of complex cases. Queuing theory indicates that wide variability of process time with the random nature of request arrival increases the probability of significant queues. This can lead to delays in the time-to-availability of radiology reports (TTA-RR) and potentially impaired ED patient flow. In addition, greater “cognitive workload” of greater volume may lead to reduced productivity and increased errors. We sought to quantify the potential ED flow improvements obtainable from increased radiology providers serving 3 public hospitals in Melbourne Australia. We sought to assess the potential productivity gains, quality improvement and the cost-effectiveness of increased labor inputs. Methods & Materials: The Western Health Medical Imaging Department moved from single resident coverage on weekend days 8:30 am-10:30 pm to a limited period of 2 resident coverage 1 pm-6 pm on both weekend days. The TTA-RR for weekend CT scans was calculated from the PACs database for the 8 month period symmetrically around the date of staffing change. A multivariate linear regression model was developed to isolate the improvement in TTA-RR, between the two 4-months periods. Daily and hourly scan volume at the time of each CT scan was calculated to assess the impact of varying department workload. To assess any improvement in report quality/errors a random sample of 200 studies was assessed to compare the average number of clinically significant over-read addendums to reports between the 2 periods. Cost-effectiveness was assessed by comparing the marginal cost of additional staffing against a conservative estimate of the economic benefit of improved ED patient throughput using the Australian national insurance rebate for private ED attendance as a revenue proxy. Results: The primary resident on call and the type of scan accounted for most of the explained variability in time to report availability (R2=0.29). Increasing daily volume and hourly volume was associated with increased TTA-RR (1.5m (p<0.01) and 4.8m (p<0.01) respectively per additional scan ordered within each time frame. Reports were available 25.9 minutes sooner on average in the 4 months post-implementation of double coverage (p<0.01) with additional 23.6 minutes improvement when 2 residents were on-site concomitantly (p<0.01). The aggregate average improvement in TTA-RR was 24.8 hours per weekend day This represents the increased decision-making time available to ED physicians and potential improvement in ED bed utilisation. 5% of reports from the intervention period contained clinically significant addendums vs 7% in the single resident period but this was not statistically significant (p=0.7). The marginal cost was less than the anticipated economic benefit based assuming a 50% capture of improved TTA-RR inpatient disposition and using the lowest available national insurance rebate as a proxy for economic benefit. Conclusion: TTA-RR improved significantly during the period of increased staff availability, both during the specific period of increased staffing and throughout the day. Increased labor utilisation is cost-effective compared with the potential improved productivity for ED cases requiring CT imaging.

Keywords: workflow, quality, administration, CT, staffing

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