Search results for: call block

Authors: M. Draman, S. Z. Muhamad Yassin, M. S. Alias, Z. Lambak, M. I. Zulkifli, S. N. Padhi, K. N. Baharim, F. Maskuriy, A. I. A. Rahim

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The performance of Malay automatic speech recognition (ASR) system for the call centre environment is presented. The system utilizes Kaldi toolkit as the platform to the entire library and algorithm used in performing the ASR task. The acoustic model implemented in this system uses a deep neural network (DNN) method to model the acoustic signal and the standard (n-gram) model for language modelling. With 80 hours of training data from the call centre recordings, the ASR system can achieve 72% of accuracy that corresponds to 28% of word error rate (WER). The testing was done using 20 hours of audio data. Despite the implementation of DNN, the system shows a low accuracy owing to the varieties of noises, accent and dialect that typically occurs in Malaysian call centre environment. This significant variation of speakers is reflected by the large standard deviation of the average word error rate (WERav) (i.e., ~ 10%). It is observed that the lowest WER (13.8%) was obtained from recording sample with a standard Malay dialect (central Malaysia) of native speaker as compared to 49% of the sample with the highest WER that contains conversation of the speaker that uses non-standard Malay dialect.

Keywords: conversational speech recognition, deep neural network, Malay language, speech recognition

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Authors: E.K.K. Agyeman, P. Mousseau, A. Sarda, D. Edelin

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The uniform and controlled cooling of hot metals by the circulation of water in canals remains a challenge due to the phase change of the water and the high heat fluxes associated with the phase change. This is because, during the cooling process, the phases are not uniformly distributed along the canals with the liquid phase dominating at the entrances of the canals and the gaseous phase dominating towards the exits. The difference in thermal properties between both phases leads to a heterogeneous temperature distribution in the part being cooled. Slowing down the cooling process is also a challenge due to the high heat fluxes associated with the phase change of water. This study investigates the use of multiple water jets for the controlled and homogenous cooling of hot metal parts and the effect of gravity on the effectiveness of the cooling process with a potential application in the cooling of composite forming moulds. A hole is bored at the centre of a steel block along its length. The jets are generated from the holes of a perforated steel pipe which is placed along the centre of the hole bored in the steel block. The evolution of the temperature with respect to time on the external surface of the steel block is measured simultaneously by thermocouples and an infrared camera. Different jet positions are tested in order to identify the jet placement configuration that ensures the most homogenous cooling of the block while the cooling speed is controlled by an intermittent impingement of the jets. In order to study the effect of gravity on the cooling process, a scenario where the jets are oriented in the opposite direction to that of gravity is compared to one where the jets are aligned in the same direction as gravity. It’s observed that orienting the jets in the direction of gravity reduces the effectiveness of the cooling process on the face of the block facing the impinging jets. This is due to the formation of a deeper pool of water due to the effect gravity and of the curved surface of the canal. This deeper pool of water influences the boiling regime characterized by a slower bubble evacuation when compared to the scenario where the jets are opposed to gravity.

Keywords: cooling speed, gravity, homogenous cooling, jet impingement

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Authors: Mrudula Kudtarkar, Rajesh Mane

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Introduction: Cleft lip repair is one of the common surgeries performed in India and the usual method used for post-operative analgesia is perioperative opioids and NSAIDs. There has been an increase in use of regional techniques and Opioids are the common adjuvants but their efficacy and safety have not been studied extensively in children. Aim: A prospective, randomized, double-blind study was done to compare the efficacy, duration and safety of intraoral infraorbital nerve block on post-operative pain relief using bupivacaine alone or in combination with fentanyl or pethidine in paediatric cleft lip repair. Methodology: 45 children between the age group 5 – 60 months undergoing cleft lip surgery randomly allocated into 3 groups of 15 each received bilateral intraoral infraorbital nerve block with 0.75ml of solution. Group B received 0.25% bupivacaine; group P received 0.25% bupivacaine with 0.25mg/kg pethidine, group F received 0.25% bupivacaine with 0.25microgm/kg fentanyl. Sedation after recovery, post-operative pain intensity and duration of post-operative analgesia were assessed using Modified Hannallah Pain Score. Results: The mean duration of analgesia was 17.8 hrs in Group B, 23.53 hrs in Group F and 35.13 hrs in Group P. There was statistically significant difference between the means of the three groups- ANOVA (p < 0.05). Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

Keywords: cleft lip, infraorbital block, NSAIDS, Opiods

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Authors: Ratna Siti Khodijah, Mirzam Abdurrachman

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Gold is recovered from gold ores. Within the ores, there are not only gold but also several types of precious metals. Copper, silver, and platinum group elements (ruthenium, rhodium, palladium, rhenium, osmium, and iridium) are metals commonly found in the ores. These metals combine to form an ore because they have the same properties. It is due to their position in periodic-system-of-elements are near to gold. However, the presence of mercury in every gold ore has not been mentioned, even though it is located right next to gold in the periodic-system-of-elements and they are located in the same block, d-block. Thus, it is possible that mercury is contained in the ores. Moreover, the elements of the same group with mercury—zinc and cadmium—sometimes can be found in the ores. It is suspected that mercury can not be detected because the processing of gold ores usually using fire assay method. Before the ores melting, mercury would evaporate because it has the lowest boiling point of all precious metal in the ores. Therefore, it suggested doing research on the presence of mercury in gold ores by CVAAS method. The results of this study would obtain the amount of mercury in gold ores that should be purified. So it can be produced economically if possible.

Keywords: boiling point, d-block, fire assay, precious metal

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Authors: German Galvez-Garcia, Javier Albayay, Javiera Peña, Marta Lavin, George A. Michael

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The aim of this research was to investigate whether the selection of the actions needs different inhibition processes during the response selection stage. In Experiment 1, we compared the magnitude of the Spatial Stroop effect, which occurs in response selection stage, in two motor actions (lifting vs reaching) when the participants performed both actions in the same block or in different blocks (mixed block vs. pure blocks).Within pure blocks, we obtained faster latencies when lifting actions were performed, but no differences in the magnitude of the Spatial Stroop effect were observed. Within mixed block, we obtained faster latencies as well as bigger-magnitude for Spatial Stroop effect when reaching actions were performed. We concluded that when no action selection is required (the pure blocks condition), inhibition works as a unitary system, whereas in the mixed block condition, where action selection is required, different inhibitory processes take place within a common processing stage. In Experiment 2, we investigated this common processing stage in depth by limiting participants’ available resources, requiring them to engage in a concurrent auditory task within a mixed block condition. The Spatial Stroop effect interacted with Movement as it did in Experiment 1, but it did not significantly interact with available resources (Auditory task x Spatial Stroop effect x Movement interaction). Thus, we concluded that available resources are distributed equally to both inhibition processes; this reinforces the likelihood of there being a common processing stage in which the different inhibitory processes take place.

Keywords: inhibition process, motor processes, selective inhibition, dual task

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Authors: S. Summart, C. Saetiaw, T. Thosdeekoraphat, C. Thongsopa

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This article presents new current-mode oscillator circuits using CDTAs which is designed from block diagram. The proposed circuits consist of two CDTAs and two grounded capacitors. The condition of oscillation and the frequency of oscillation can be adjusted by electronic method. The circuits have high output impedance and use only grounded capacitors without any external resistor which is very appropriate to future development into an integrated circuit. The results of PSPICE simulation program are corresponding to the theoretical analysis.

Keywords: current-mode, quadrature oscillator, block diagram, CDTA

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Authors: Jonathan Ogwal, Louis H. Kamulegeya, John M. Bwanika, Davis Musinguzi

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Introduction: Community retail Pharmacy drug distribution points (CRPDDP) were implemented in the Lango sub-region as part of the Ministry of Health’s response to improving access and adherence to antiretroviral treatment (ART). Clients received their ART refills from nearby local pharmacies; as such, the need for continuous engagement through mobile phone appointment reminders and health messages. We share learnings from the implementation of mobile text reminders and voice call follow-ups among ART clients attending the CRPDDP program in northern Uganda. Methods: A retrospective data review of electronic medical records from four pharmacies allocated for CRPDDP in the Lira and Apac districts of the Lango sub-region in Northern Uganda was done from February to August 2022. The process involved collecting phone contacts of eligible clients from the health facility appointment register and uploading them onto a messaging platform customized by Rapid-pro, an open-source software. Client information, including code name, phone number, next appointment date, and the allocated pharmacy for ART refill, was collected and kept confidential. Contacts received appointment reminder messages and other messages on positive living as an ART client. Routine voice call follow-ups were done to ascertain the picking of ART from the refill pharmacy. Findings: In total, 1,354 clients were reached from the four allocated pharmacies found in urban centers. 972 clients received short message service (SMS) appointment reminders, and 382 were followed up through voice calls. The majority (75%) of the clients returned for refills on the appointed date, 20% returned within four days after the appointment date, and the remaining 5% needed follow-up where they reported that they were not in the district by the appointment date due to other engagements. Conclusion: The use of mobile text reminders and voice call follow-ups improves the attendance of community retail pharmacy refills.

Keywords: antiretroviral treatment, community retail drug distribution points, mobile text reminders, voice call follow-up

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Authors: Gaurav Bansod, Swapnil Sutar, Abhijit Patil, Jagdish Patil

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This paper proposes an ultra-lightweight cipher NUX. NUX is a generalized Feistel network. It supports 128/80 bit key length and block length of 64 bit. For 128 bit key length, NUX needs only 1022 GEs which is less as compared to all existing cipher design. NUX design results into less footprint area and minimal memory size. This paper presents security analysis of NUX cipher design which shows cipher’s resistance against basic attacks like Linear and Differential Cryptanalysis. Advanced attacks like Biclique attack is also mounted on NUX cipher design. Two different F function in NUX cipher design results in high diffusion mechanism which generates large number of active S-boxes in minimum number of rounds. NUX cipher has total 31 rounds. NUX design will be best-suited design for critical application like smart grid, IoT, wireless sensor network, where memory size, footprint area and the power dissipation are the major constraints.

Keywords: lightweight cryptography, Feistel cipher, block cipher, IoT, encryption, embedded security, ubiquitous computing

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Authors: Abbas Raza Ali

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Big Data technology is gradually becoming a dire need of large enterprises. These enterprises are generating massively large amount of off-line and streaming data in both structured and unstructured formats on daily basis. It is a challenging task to effectively extract useful insights from the large scale datasets, even though sometimes it becomes a technology constraint to manage transactional data history of more than a few months. This paper presents a framework to efficiently manage massively large and complex datasets. The framework has been tested on a communication service provider producing massively large complex streaming data in binary format. The communication industry is bound by the regulators to manage history of their subscribers’ call records where every action of a subscriber generates a record. Also, managing and analyzing transactional data allows service providers to better understand their customers’ behavior, for example, deep packet inspection requires transactional internet usage data to explain internet usage behaviour of the subscribers. However, current relational database systems limit service providers to only maintain history at semantic level which is aggregated at subscriber level. The framework addresses these challenges by leveraging Big Data technology which optimally manages and allows deep analysis of complex datasets. The framework has been applied to offload existing Intelligent Network Mediation and relational Data Warehouse of the service provider on Big Data. The service provider has 50+ million subscriber-base with yearly growth of 7-10%. The end-to-end process takes not more than 10 minutes which involves binary to ASCII decoding of call detail records, stitching of all the interrogations against a call (transformations) and aggregations of all the call records of a subscriber.

Keywords: big data, communication service providers, enterprise data warehouse, stream computing, Telco IN Mediation

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Authors: Tingting Lin, Manfred von Willich, Dafu Lou, Phil Eisen

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A white-box implementation of a cryptographic algorithm is a software implementation intended to resist extraction of the secret key by an adversary. To date, most of the white-box techniques are used to protect block cipher implementations. However, a large proportion of the white-box implementations are proven to be vulnerable to affine equivalence attacks and other algebraic attacks, as well as differential computation analysis (DCA). In this paper, we identify a class of block ciphers for which we propose a method of constructing white-box implementations. Our method is based on threshold implementations and operations in composite fields. The resulting implementations consist of lookup tables and few exclusive OR operations. All intermediate values (inputs and outputs of the lookup tables) are masked. The threshold implementation makes the distribution of the masked values uniform and independent of the original inputs, and the operations in composite fields reduce the size of the lookup tables. The white-box implementations can provide resistance against algebraic attacks and DCA-like attacks.

Keywords: white-box, block cipher, composite field, threshold implementation

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Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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Authors: G. S. Thyagaraju, U. P. Kulkarni

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Context-aware computing refers to a general class of computing systems that can sense their physical environment, and adapt their behaviour accordingly. Context aware computing makes systems aware of situations of interest, enhances services to users, automates systems and personalizes applications. Context-aware services have been introduced into mobile devices, such as PDA and mobile phones. In this paper we are presenting a novel approaches used to realize the context aware mobile. The context aware mobile phone (CAMP) proposed in this paper senses the users situation automatically and provides user context required services. The proposed system is developed by using artificial intelligence techniques like Bayesian Network, fuzzy logic and rough sets theory based decision table. Bayesian Network to classify the incoming call (high priority call, low priority call and unknown calls), fuzzy linguistic variables and membership degrees to define the context situations, the decision table based rules for service recommendation. To exemplify and demonstrate the effectiveness of the proposed methods, the context aware mobile phone is tested for college campus scenario including different locations like library, class room, meeting room, administrative building and college canteen.

Keywords: context aware mobile, fuzzy logic, decision table, Bayesian probability

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Authors: T. C. Ng, R. Radzi, T. K. Ng, H. C. Chen

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The analgesic effects of lidocaine-bupivacaine block in cats undergoing routine orchiectomy were determined in this controlled, randomized, and blinded study. Twelve cats were randomly assigned to two groups. Cats in local block group received subcutaneous infiltration of 1 mg/kg of 2% lidocaine and 1 mg/kg of 0.5% bupivacaine into the scrotal sac. Cats in control group received equivolume of saline. Both groups were induced with mixture of ketamine (15 mg/kg) and acepromazine (0.1 mg/kg) intramuscularly and maintained on sevoflurane via facemask. Non-invasive blood pressures (BP), heart (HR), and respiratory rate (RR) were measured intra-operatively at specific events. Post-operatively, all cats received meloxicam, 0.2 mg/kg subcutaneously. Pain scores were determined at 4, 8, and 24 hours postoperatively. Mechanical pressure thresholds (MPT) at the perineum and metatarsus were determined at 2, 4, 8, and 24 hours postoperatively. Intra-operatively, the BP and HR tended to be higher in the control group. The increment in HR peaked during traction and autoligation of the spermatic cord in the control group. There was no treatment difference in RR. Post-operatively, pain scores in the group given local blocks were lower than the control group at 4 hour post-operation. There was no treatment difference in the post-operative HR, RR, BP and MPT values. In conclusion, subcutaneous infiltration of lidocaine-bupivacaine into the scrotal sac before orchiectomy improved intra-operative hemodynamic stability and provided better analgesia up to 4 hours post-surgery.

Keywords: analgesia, bupivacaine, cat, lidocaine, local block, orchiectomy

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Authors: Ifeyinwa Ijeoma Obianyo, Luqman Adedeji Taiwo, Olugbenga O. Amu, Azikiwe Peter Onwualu

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Improving the durability of building materials saves maintenance costs, construction time, and energy. In this study, titanium dioxide coated conventional and non-conventional composites were produced, and the effects of titanium dioxide coatings were investigated. Conventional composites were produced using river sand and Portland cement, whereas non-conventional composites were produced by partially replacing river sand and Portland cement with quarry dust and rice husk ash. Water absorption and thickness swelling tests were conducted on the produced coated and non-coated block samples. A reduction in water absorption was observed in the coated composite samples when compared to the non-coated composite samples, and this is an indication of the improved durability of the samples coated with titanium dioxide. However, there was an increase in the thickness swelling of coatings on the coated block samples, but this increase has a slight influence on the compressive strength of the coated samples. The outcome of this study indicates that coating composite building blocks with titanium dioxide will improve theirdurability. Also, the site exposure experiments revealed the self-cleansing properties of TiO2-coated composite block samples, while the Rhodamine B discolouration test confirmed the photocatalytic features of TiO2-coated composite block samples.

Keywords: titanium dioxide, water absorption, durability, mechanical properties, building composite

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Authors: Jangje Park, So Young Kim

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The market demand for audio quality in mobile devices continues to increase, and audible buzz noise generated in time division communication is a chronic problem that goes against the market demand. In the case of time division type communication, the RF Power Amplifier (RF PA) is driven at the audio frequency cycle, and it makes various influences on the audio signal. In this paper, we measured the ground bounce noise generated by the peak current flowing through the ground network in the RF PA with the audio frequency; it was confirmed that the noise is the cause of the audible buzz noise during a call. In addition, a grounding method of the microphone device that can improve the buzzing noise was proposed. Considering that the level of the audio signal generated by the microphone device is -38dBV based on 94dB Sound Pressure Level (SPL), even ground bounce noise of several hundred uV will fall within the range of audible noise if it is induced by the audio amplifier. Through the grounding method of the microphone device proposed in this paper, it was confirmed that the audible buzz noise power density at the RF PA driving frequency was improved by more than 5dB under the conditions of the Printed Circuit Board (PCB) used in the experiment. A fundamental improvement method was presented regarding the buzzing noise during a mobile phone call.

Keywords: audio frequency, buzz noise, ground bounce, microphone grounding

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Authors: Santosh Sharma Parajuli, Diwas Manandhar

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Background: Perioperative pain management plays an integral part in patients undergoing cardiac surgery. We studied the effect of Erector Spinae Plane block on acute postoperative pain reduction and 24 hours opioid consumption in adult cardiac surgical patients. Methods: Twenty-five adult cardiac surgical patients who underwent cardiac surgery with sternotomy in whom ESP catheters were placed preoperatively were kept in group E, and the other 25 patients who had undergone cardiac surgery without ESP catheter and pain management done with conventional opioid injection were placed in group C. Fentanyl was used for pain management. The primary study endpoint was to compare the consumption of fentanyl and to assess the numeric rating scale in the postoperative period in the first 24 hours in both groups. Results: The 24 hours fentanyl consumption was 43.00±51.29 micrograms in the Erector Spinae Plane catheter group and 147.00±60.94 micrograms in the control group postoperatively which was statistically significant (p <0.001). The numeric rating scale was also significantly reduced in the Erector Spinae Plane group compared to the control group in the first 24 hours postoperatively. Conclusion: Erector Spinae Plane block is superior to the conventional opioid injection method for postoperative pain management in CABG patients. Erector Spinae Plane block not only decreases the overall opioid consumption but also the NRS score in these patients.

Keywords: erector, spinae, plane, numerical rating scale

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Authors: Minakshi Jain, Sachin Yadav

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Gram Panchayat is the smallest unit of Democracy in India. Grassroots Democracy has been further strengthened by implementation of the 73rd Constitutional Amendment act (CAA) in 1992. To analyse the impact of grassroots democracy the three villages are selected, which have the representation of each section of the society. The selected villages belongs to the same block and district of Haryana state. Villages are selected to access the marginalized group such as women and other backward class. These groups are isolated and do not participate in the grassroots level development process. The caste continue to be a relevant factor in determining the rural leadership. The earlier models of Panchayati Raj failed to benefit the marginalized groups of the society. The 73rd CAA, advocates a uniform three tier system of Panchayat at District level (Zilla Panchayat), Taluka/Block level (Block Panchayat), and village level (Gram Panchayat). The socio-economic profile of representatives in each village is important factor in rural development. The study will highlight the socio-economic profile of elected members at gram Panchayat level, Block Level and District level. The analysis reveals that there is a need to educate and develop the capacity and capability of the elected representative. Training must be imparted to all of them to enable them to function as per provision in the act. The paper will analyse the impact of act on rural development than propose some measures to further strengthen the Panchayati Raj Institution (PRI’s) at grassroots level.

Keywords: democracy, rural development, marginalized people, function

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Authors: Irati Barandiaran, Xabier Velasco-Iza, Galder Kortaberria

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Hybrid inorganic/organic nanostructured materials based on block copolymers are of considerable interest in the field of Nanotechnology, taking into account that these nanocomposites combine the properties of polymer matrix and the unique properties of the added nanoparticles. The use of block copolymers as templates offers the opportunity to control the size and the distribution of inorganic nanoparticles. This research is focused on the surface modification of inorganic nanoparticles to reach a good interface between nanoparticles and polymer matrices which hinders the nanoparticle aggregation. The aim of this work is to obtain a good and selective dispersion of Fe3O4 magnetic nanoparticles into different types of block copolymers such us, poly(styrene-b-methyl methacrylate) (PS-b-PMMA), poly(styrene-b-ε-caprolactone) (PS-b-PCL) poly(isoprene-b-methyl methacrylate) (PI-b-PMMA) or poly(styrene-b-butadiene-b-methyl methacrylate) (SBM) by using different grafting strategies. Fe3O4 magnetic nanoparticles have been surface-modified with polymer or block copolymer brushes following different grafting methods (grafting to, grafting from and grafting through) to achieve a selective location of nanoparticles into desired domains of the block copolymers. Morphology of fabricated hybrid nanocomposites was studied by means of atomic force microscopy (AFM) and with the aim to reach well-ordered nanostructured composites different annealing methods were used. Additionally, nanoparticle amount has been also varied in order to investigate the effect of the nanoparticle content in the morphology of the block copolymer. Nowadays different characterization methods were using in order to investigate magnetic properties of nanometer-scale electronic devices. Particularly, two different techniques have been used with the aim of characterizing synthesized nanocomposites. First, magnetic force microscopy (MFM) was used to investigate qualitatively the magnetic properties taking into account that this technique allows distinguishing magnetic domains on the sample surface. On the other hand, magnetic characterization by vibrating sample magnetometer and superconducting quantum interference device. This technique demonstrated that magnetic properties of nanoparticles have been transferred to the nanocomposites, exhibiting superparamagnetic behavior similar to that of the maghemite nanoparticles at room temperature. Obtained advanced nanostructured materials could found possible applications in the field of dye-sensitized solar cells and electronic nanodevices.

Keywords: atomic force microscopy, block copolymers, grafting techniques, iron oxide nanoparticles

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Seyedomid Fatemi

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The walls of the building, as the main intermediary between the outside and the inside of the building, play an important role in controlling the environmental conditions and ensuring the comfort of the residents, thus reducing the heating and cooling loads. Therefore, the use of suitable materials is considered one of the simplest and most effective ways to reduce the heating and cooling loads of the building, which will also save energy. Therefore, in order to achieve the goal of the research "Ranking of optimal materials for building walls," optimal materials for building walls in a temperate and humid climate (case example: Sari city) from the perspective of embodied energy, waste of electricity and gas energy, cost and reuse been investigated to achieve sustainable architecture. In this regard, using information obtained from Sari Municipality, design components have been presented by experts using the Delphi method. Considering the criteria of experts' opinions (cost and reuse), the amount of embodied energy of the materials, as well as the amount of waste of electricity and gas of different materials of the walls, with the help of the AHP weighting technique and finally with the TOPSIS technique, the best type of materials in the order of 1- 3-D Panel 2-ICF-, 3-Cement block with pumice, 4-Wallcrete block, 5-Clay block, 6-Autoclaved Aerated Concrete (AAC), 7-Foam cement block, 8-Aquapanel and 9-Reinforced concrete wall for use in The walls of the buildings were proposed in Sari city.

Keywords: optimum materials, building walls, moderate and humid climate, sustainable architecture, AHP-TOPSIS technique

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Authors: Antwi Kwaku Dei, Lyford Conrad Power

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This paper investigates the outcome of participating in the government of Ghana block farm program on rural households’ farm productivity, income, food security and nutritional status in Northern Ghana using cross-sectional data. Data analysis was done using the Instrumental Variable and the Heckman Selection Bias procedures. Our analysis indicates that participation in the block farm program significantly increased directly the productivity of maize, rice, and soybean by 21.3 percent, 15.8 percent, and 12.3 percent respectively. Also, the program participation was found to increase households’ farm income by 20 percent in northern Ghana. Furthermore, program participation was found to improve household food security and nutrition by 19 percent and 14 percent respectively through income effect. Based on the benefit-cost ratio of 1.59 the results from the study recommends that the program is expanded to other communities in the northern region. Further analysis indicates that rural households’ decision to participate in food security intervention programs is significantly influenced by factors including the gender of the household head, the age of the household head, and household size. Results of the study further show that gender of household head, household size, household monthly income, household assets, women educational status, the age of women, marital status of women, are significant determinants of food security and nutrition status in Northern Ghana.

Keywords: block farm program, farm productivity, , household food security, Northern Ghana

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Authors: Kawar Salih

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It has been proven that designing sustainable buildings starts from early stages of urban design. The design of urban blocks specifically, is considered as one of the pragmatic strategies of sustainable urbanism. There have been previous studies that focused on the impact of urban block design and regulation on the outdoor thermal comfort in the semi-arid regions. However, no studies have been found that concentrated on that impact on the internal behavior of buildings of those regions specifically the daylight quality and energy performance. Further, most studies on semi-arid regions are focusing only on the cooling load reduction, neglecting the heating load. The study has focused on two parameters of urban block distribution which are the block orientation and the surface-to-volume ratio with the consideration of both heating and cooling loads of buildings. In Duhok (a semi-arid city in Kurdistan region of Iraq), energy consumption and daylight quality of different types of residential blocks have been examined using dynamic simulation. The findings suggest that there is a considerable higher energy load for heating than cooling, contradicting many previous studies about these regions. The results also highlight that the orientation of urban blocks can vary the energy consumption to 8%. Regarding the surface-to-volume ratio (S/V), it was observed that after the twice enlargement of the S/V, the energy consumption increased 15%. Though, the study demonstrates as well that there are opportunities for reducing energy consumption with the increase of the S/V which contradicts many previous research on S/V impacts on energy consumption. These results can help to design urban blocks with the bigger S/V than existing blocks in the city which it can provide better indoor daylight and relatively similar energy consumption.

Keywords: blocke orienation, building energy consumption, urban block design, semi-arid regions, surfacet-to-volume ratio

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Authors: Amit Bhattacharyya

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The economic scenario of any region does not show the real picture for the measurement of overall development. Therefore, economic development must be accompanied by social development to be able to make an assessment to measure the level of development. The spatial variation with respect to social development has been discussed taking into account the quality of functioning of a social system in a specific area. In this paper, an attempt has been made to study the spatial distribution of social infrastructural facilities and analyze the magnitude of regional disparities at inter- block level in Barddhman district. It starts with the detailed account of the selection process of social infrastructure indicators and describes the methodology employed in the empirical analysis. Analyzing the block level data, this paper tries to identify the disparity among the blocks in the levels of social development. The results have been subsequently explained using both statistical analysis and geo spatial technique. The paper reveals that the social development is not going on at the same rate in every part of the district. Health facilities and educational facilities are concentrated at some selected point. So overall development activities come to be concentrated in a few centres and the disparity is seen over the blocks.

Keywords: disparity, inter-block, social development, spatial variation

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Authors: Deepika Sudevan, Patrick Rozycki, Laurent Gornet

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This paper presents the experimental identification of the fatigue limit for pristine and impacted Carbon Fiber Reinforced Epoxy polymer (CFRP) woven composites based on the relatively new self-heating methodology for composites. CFRP composites of [0/90]8 and quasi isotropic configurations prepared using hand-layup technique are subjected to low energy impacts (20 J energy) simulating a barely visible impact damage (BVID). Runway debris strike, tool drop or hailstone impact can cause a BVID on an aircraft fuselage made of carbon composites and hence understanding the post-impact fatigue response of CFRP laminates is of immense importance to the aerospace community. The BVID zone on the specimens is characterized using X-ray Tomography technique. Both pristine and impacted specimens are subjected to several blocks of constant amplitude (CA) fatigue loading keeping R-ratio a constant but with increments in the mean loading stress after each block. The number of loading cycles in each block is a subjective parameter and it varies for pristine and impacted CFRP specimens. To monitor the temperature evolution during fatigue loading, thermocouples are pasted on the CFRP specimens at specific locations. The fatigue limit is determined by two strategies, first is by considering the stabilized temperature in every block and second is by considering the change in the temperature slope per block. The results show that both strategies can be adopted to determine the fatigue limit in both pristine and impacted CFRP composites.

Keywords: CFRP, fatigue limit, low energy impact, self-heating, WRM

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Authors: Krystian Wójcik, Sara Wróblewska, Marcin Łojek, Katarzyna Sobień

Abstract:

Polish Geological Survey selected five of the most prospective areas for oil and gas exploration in Poland. They are dedicated to the 6th international tender round for hydrocarbon concessions, planned in 2022. The main exploration target of these areas is related to conventional and unconventional accumulations of gas and oil in the Carpathian basement, Carpathian Foredeep and Outer Carpathians (Block 413 – 414), as well as in the Carboniferous, Rotliegend, Main Dolomite (Block 208, Cybinka – Torzym, Zielona Góra West), and in the Mesozoic of the Polish Lowlands (Koło).

Keywords: concession policy, international tender, oil and gas exploration horizons, prospective areas

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

Abstract:

Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

Procedia PDF Downloads 54

Authors: Antonello Troncone, Luigi Pugliese, Andrea Parise, Enrico Conte

Abstract:

The present study deals with the landslides periodically reactivated by groundwater level fluctuations owing to rainfall. The main type of movement which generally characterizes these landslides consists in sliding with quite small-displacement rates. Another peculiar characteristic of these landslides is that soil deformations are essentially concentrated within a thin shear band located below the body of the landslide, which, consequently, undergoes an approximately rigid sliding. In this context, a simple method is proposed in the present study to forecast the movements of this type of landslides owing to rainfall. To this purpose, the landslide body is schematized by means of a two-block model. Some analytical solutions are derived to relate rainfall measurements with groundwater level oscillations and these latter, in turn, to landslide mobility. The proposed method is attractive for engineering applications since it requires few parameters as input data, many of which can be obtained from conventional geotechnical tests. To demonstrate the predictive capability of the proposed method, the application to a well-documented landslide periodically reactivated by rainfall is shown.

Keywords: rainfall, water level fluctuations, landslide mobility, two-block model

Procedia PDF Downloads 106

Authors: Sophio Kobauri, David Tugushi, Vladimir P. Torchilin, Ramaz Katsarava

Abstract:

Hydrophobic / hydrophilically modified functional polymers are of high interest in modern biomedicine due to their ability to solubilize water-insoluble / poorly soluble (hydrophobic) drugs. Among the many approaches that are being developed in this direction, one of the most effective methods is the use of polymeric micelles (PMs) (micelles formed by amphiphilic block-copolymers) for solubilization of hydrophobic biologicals. For therapeutic purposes, PMs are required to be stable and biodegradable, although quite a few amphiphilic block-copolymers are described capable of forming stable micelles with good solubilization properties. For obtaining micelle-forming block-copolymers, polyethylene glycol (PEG) derivatives are desirable to use as hydrophilic shell because it represents the most popular biocompatible hydrophilic block and various hydrophobic blocks (polymers) can be attached to it. Although the construction of the hydrophobic core, due to the complex requirements and micelles structure development, is the very actual and the main problem for nanobioengineers. Considering the above, our research goal was obtaining biodegradable micelles for the solubilization of hydrophobic drugs and biologicals. For this purpose, we used biodegradable polymers– pseudo-proteins (PPs)(synthesized with naturally occurring amino acids and other non-toxic building blocks, such as fatty diols and dicarboxylic acids) as hydrophobic core since these polymers showed reasonable biodegradation rates and excellent biocompatibility. In the present study, we used the hydrophobic amino acid – L-phenylalanine (MW 4000-8000Da) instead of L-leucine. Amino-PEG (MW 2000Da) was used as hydrophilic fragments for constructing the suitable micelles. The molecular weight of PP (the hydrophobic core of micelle) was regulated by variation of used monomers ratios. Micelles were obtained by dissolving of synthesized amphiphilic polymer in water. The micelle-forming property was tested using dynamic light scattering (Malvern zetasizer NanoZSZEN3600). The study showed that obtaining amphiphilic block-copolymer form stable neutral micelles 100 ± 7 nm in size at 10mg/mL concentration, which is considered as an optimal range for pharmaceutical micelles. The obtained preliminary data allow us to conclude that the obtained micelles are suitable for the delivery of poorly water-soluble drugs and biologicals.

Keywords: amino acid – L-phenylalanine, pseudo-proteins, amphiphilic block-copolymers, biodegradable micelles

Procedia PDF Downloads 122

Authors: Sanchita B. Sarma, M. P. Nath

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Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of magnesium or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine in patients with mild preeclampsia undergoing caesarean section. Sixty women with mild preeclampsia undergoing elective caesarean section were included in a prospective, double blind, controlled trial. Patients were randomly assigned to receive spinal anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 µg fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg) (group M) with 0.15ml preservative free distilled water. Onset, duration and recovery of sensory and motor block, time to maximum sensory block, duration of spinal anaesthesia and postoperative analgesic requirements were studied. Statistical comparison was carried out using the Chi-square or Fisher’s exact tests and Independent Student’s t-test where appropriate. The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anaesthesia (246 vs. 284) and motor block (186.3 vs. 210) were significantly longer in the magnesium group. Total analgesic top up requirement was less in group M. Hemodynamic parameters were similar in both the groups. Intrathecal magnesium caused minimal side effects. Since Fentanyl and other opioid congeners are not available throughout the country easily, magnesium with its easy availability and less side effect profile can be a cost effective alternative to fentanyl in managing pregnancy induced hypertension (PIH) patients given along with Bupivacaine intrathecally in caesarean section.

Keywords: analgesia, magnesium, pre eclampsia, spinal anaesthesia

Procedia PDF Downloads 302

Authors: Sung Ham, Chanho Song, Jiabin Wu

Abstract:

Employees are commonly incentivized on both quantity and quality performance and much of the extant literature focuses on demonstrating that multitasking incentives lead to tradeoffs. Alternatively, we consider potential solutions to the tradeoff problem from both a theoretical and an experimental perspective. Across two field experiments from a call center, we find that tradeoffs can be mitigated when incentives are jointly enhanced across tasks, where previous research has suggested that incentives be reduced instead of enhanced. In addition, we also propose and test, in a laboratory setting, the implications of revising the metric used to assess quality. Our results indicate that metrics can be adjusted to align quality and quantity more efficiently. Thus, this alignment has the potential to thwart the classic tradeoff problem. Finally, we validate our findings with an economic experiment that verifies that effort is largely consistent with our theoretical predictions.

Keywords: incentives, multitasking, field experiment, experimental economics

Procedia PDF Downloads 147