Search results for: medical surveillance process

Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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Authors: D. Naresh Yadav, K. Anand Kishore, Bhaskar Bethi, Shirish H. Sonawane, D. Bhagawan

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The untreated industrial wastewater discharged into the environment causes the contamination of soil, water and air. Advanced treatment methods for enhanced wastewater treatment are attracting substantial interest among the currently employed unit processes in wastewater treatment. The textile industry is one of the predominant in wastewater production at current industrialized situation. The refused dyes at textile industry need to be treated in proper manner before its discharge into water bodies. In the present investigation, hybrid treatment process has been developed for the treatment of synthetic mixed dye wastewater. Photocatalysis and ceramic nanoporous membrane are mainly used for process integration to minimize the fouling and increase the flux. Commercial semiconducting powders (TiO2 and ZnO) has used as a nano photocatalyst for the degradation of mixed dye in the hybrid system. Commercial ceramic nanoporous tubular membranes have been used for the rejection of dye and suspended catalysts. Photocatalysis with catalyst has shown the average of 34% of decolorization (RB-32%, BG-34% and CR-36%), whereas ceramic nanofiltration has shown the 56% (RB-54%, BG-56% and CR-58%) of decolorization. Integration of photocatalysis and ceramic nanofiltration has shown 96% (RB-94%, BG-96% and CR-98%) of dye decolorization over 90 min of operation.

Keywords: photocatalysis, ceramic nanoporous membrane, wastewater treatment, advanced oxidation process, process integration

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Authors: Ebru Dalgakiran

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Border and bordering studies have come to the forefront in recent years especially with parallel to increase in international migratory movements. Although conceptualizations of the border and bordering are quite contested within academia, the general point of view is that borders are politically and socially constructed. It means that borders have always their own ‘us vs. them’, and bordering process produce separate identities as well. In that case, Turkey and Greece are notable examples since these two nation-states constructed their borders upon each other’s for years although the Turkish-Greek border was drawn with the Lausanne Treaty of 1923. Nevertheless, on the other hand, The European Union (EU) has been externalized of border management policies to build a stronger area of freedom, security, and justice within the borders. Thus, Turkish-Greek border has become one of the significant external borders of the EU. In this context, this study aims to understand whether the EU’s bordering process through externalizing border management policies can affect Turkey’s and Greece’s bordering processes. By examining official documents of the EU and conducting in-depth interviews with local actors of the border management policies of the EU in Edirne, where is the border city of Turkey with Greece, this study’s main finding is that the EU’s bordering process to control migration at the external borders affects Turkey’s and Greece’s bordering processes. It seems that Turkey and Greece construct their borders upon a common Other, ‘irregular migrants’ now.

Keywords: border, bordering, the European Union, externalization

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Authors: Peri Harish Kumar, Sai Sharan Dwarka, Tajbinder Singh Bains, Suneet John Joseph, Chaitanya Kiran, Sambhu Dutta, Sarah Makram, Mohamed Sayed Zaazouee, Alaa Ahmed Elshanbary

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Objective: To identify cancer and non-cancer causes of death in hepatocellular carcinoma (HCC) patients over different time periods after diagnosis and to compare the mortality risk of each cause in HCC patients with the general population. Methods: In this retrospective cohort study, data of 67,637 HCC patients from 1975 to 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. We investigated the association between different causes of death and the following variables: age, race, tumor stage at diagnosis, and treatment (surgery, chemotherapy, and radiotherapy); each according to the periods of <1 year, 1-5 years, 5-10 years, and >10 years following the diagnosis. Standardized mortality ratios (SMRs) and their 95% confidence intervals (CIs) were calculated for cancer and non-cancer deaths in each of the mentioned periods following diagnosis. Results: Data of 67,637 patients, of whom 50,571 patients died during the follow-up period, were analyzed. Most deaths were due to HCC itself (35,535, 70.3%), followed by other cancers (3,983, 7.9%). Common causes of non-cancer mortality included infectious and parasitic diseases including HIV (2,823 patients, SMR=105.68, 95% CI: 101.82-109.65), chronic liver disease (2,719 patients, SMR=76.56, 95% CI: 73.71,79.5), and heart diseases (1,265 patients, SMR=2.26, 95% CI: 2.14-2.39), with higher mortality risk in HCC patients than in the general population. Conclusion: Cancers stand for most deaths in patients with HCC. Besides, infectious, and parasitic diseases including HIV represent the commonest non-cancer cause of mortality.

Keywords: hepatocellular carcinoma, seer, causes of death, mortality

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Authors: Yilin Ma, Zhaomiao Liu, Xiang Wang, Yan Pang

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Microscale droplets play an increasingly important role in various applications, including medical diagnostics, material synthesis, chemical engineering, and cell research due to features of high surface-to-volume ratio and tiny scale, which can significantly improve reaction rates, enhance heat transfer efficiency, enable high-throughput parallel studies as well as reduce reagent usage. As a mature technique to manipulate small amounts of liquids, droplet microfluidics could achieve the precise control of droplet parameters such as size, uniformity, structure, and thus has been widely adopted in the engineering and scientific research of multiple fields. Necking processes of the droplet in the cross junction microchannels are experimentally and theoretically investigated and dynamic mechanisms of the neck thinning in two different regimes are revealed. According to evolutions of the minimum neck width and the thinning rate, the necking process is further divided into different stages and the main driving force during each stage is confirmed. Effects of the flow rates and the cross-sectional aspect ratio on the necking process as well as the neck profile at different stages are provided in detail. The distinct features of the two regimes in the squeezing stage are well captured by the theoretical estimations of the effective flow rate and the variations of the actual flow rates in different channels are reasonably reflected by the channel width ratio. In the collapsing stage, the quantitative relation between the minimum neck width and the remaining time is constructed to identify the physical mechanism.

Keywords: cross junction, neck thinning, force analysis, inertial mechanism

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Authors: Ananya Gangavarapu

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Convolutional Neural Networks (CNN) based models are providing diagnostic capabilities on par with the medical specialists in many specialty areas. However, collecting the medical data for training purposes is very challenging because of the increased regulations around data collections and privacy concerns around personal health data. The gathering of the data becomes even more difficult if the capture devices are edge-based mobile devices (like smartphones) with feeble wireless connectivity in rural/remote areas. In this paper, I would like to highlight Federated Learning approach to mitigate data privacy and security issues.

Keywords: deep learning in healthcare, data privacy, federated learning, training in distributed environment

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Authors: E. O. George, P. Ojeaga, D. Odejimi, O. Mattehws

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Has macroeconomic management succeeded in making privatization promote growth in Africa? What are the probable strategies that should accompany the privatization reform process to promote growth in Africa? To what extent has the privatization process succeeded in attracting foreign direct investment to Africa? The study investigates the relationship between macroeconomic management and privatization. Many African countries have embarked on one form of privatization reform or the other since 1980 as one of the stringent conditions for accessing capital from the IMF and the World Bank. Secondly globalization and the gradually integration of the African economy into the global economy also means that Africa has to strategically develop its domestic market to cushion itself from fluctuations and probable contagion associated with global economic crisis that are always inevitable Stiglitz. The methods of estimation used are the OLS, linear mixed effects (LME), 2SLS and the GMM method of estimation. It was found that macroeconomic management has the capacity to affect the success of the privatization reform process. It was also found that privatization was not promoting growth in Africa; privatization could promote growth if long run growth strategies are implemented together with the privatization reform process. Privatization was also found not to have the capacity to attract foreign investment to many African countries.

Keywords: Africa, political economy, game theory, macroeconomic management and privatization

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Authors: Jin-Uk Park

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Recently, the semiconductor industry is rapidly demanding complicated structures and mass production. From the point of view of mass production, the ETCH industry is concentrating on maintaining the ER (Etch rate) of the wafer edge constant regardless of changes over time. In this study, two major thermal factors affecting process were identified and controlled. First, the filler of the thermal pad was studied. Second, the significant difference of handling the thermal pad during PM was studied.

Keywords: etcher, thermal pad, wet cleaning, thermal conductivity

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Authors: Hilary Rutto, Mbali Chiliza, Tumisang Seodigeng

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The study on reactivity of calcined calcium-based material is very important in dry flue gas desulphurisation (FGD) process, so as to produce absorbent with high sulphur dioxide capture capacity during the hydration process. The effect of calcining temperature and time on the reactivity of calcined limestone material were investigated. In this study, the reactivity was measured using a pH stat apparatus and also confirming the result by performing citric acid reactivity test. The reactivity was calculated using the shrinking core model. Based on the experiments, a mathematical model is developed to correlate the effect of time and temperature to the reactivity of absorbent. The calcination process variables were temperature (700 -1000°C) and time (1-6 hrs). It was found that reactivity increases with an increase in time and temperature.

Keywords: reactivity, citric acid, calcination, time

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Authors: Aneta Binkowska, Artur Kamecki

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The ability to provide first aid should be one of the basic skills of each of us. First aid by the Law on National Medical Emergency dated 8 September 2006 as amended, is a set of actions undertaken to save a person at the scene of an accident. In Poland, on the basis of Article 162 of the Criminal Code, we are obliged to provide first aid to the victim. In addition, according to a large part of society, unselfishness towards others in need of help is our moral obligation. The aim of the study was to learn the opinion of the members of Medical Rescue Teams (MRT) of the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service (PA and STS ‘Meditrans’) in Warsaw on how people react in real situations threatening life or health of the injured person. The study was conducted in the third quarter of 2015 on 335 members of medical rescue teams, including 77 W and 258 M, who provided medical services in the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service MRT in Warsaw. The research tool was an anonymous questionnaire survey of own design, which consisted of 12 questions: closed, half open and one open question. Respondents were divided into 3 age groups and by individual medical professions (doctor, paramedic, nurse). The straight majority of respondents encountered granting the first aid the event on the spot. However, the frequency of appearing in such proceedings isn’t too high. The first aid has most often been given in the street and in houses. The final audited fairly important element is the reason not to provide first aid by bystanders in the opinion of members of the medical teams. Respondents to this question, which was an open question were asked to name the reason for not taking any action while waiting for an ambulance. Over 50% of respondents could not answer. The most common answers were: fear, lack of knowledge and skills, reluctance, indifference, lack of training, lack of experience and fear that harm. Conclusion: The majority of respondents have encountered instances of first aid provision, but respondents assessed the frequency of such situations as low. Placing the victim in the recovery position is the simplest and most common form of first aid. Therefore, training should be introduced not only on CPR but also in the scope of helping persons in sudden health emergency, who do not have a sudden cardiac arrest. A statement can be formulated, as a main conclusion of the analysis, that only continuous education and in particular practical training will help people to overcome the barrier of their limitations in order to help others. Among the largest group of witnesses providing first aid are the elderly and youth, who are subjected to various forms of education related to first aid provision.

Keywords: BLS, first aid, medical rescue, resuscitation

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Authors: Tai-Young Park, Yangjin Park

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Introduction: This study analyzed a family therapy case involving a female client in her thirties with panic disorder (PD) in South Korea. We identified five stages of the psychological process in the development of PD and examined external situations, family dynamics, and psychological experiences at each stage. Method: The client, mother, sister, and husband participated in therapy. Researchers analyzed the transcripts, notes, and video recordings of the therapy sessions. A thematic analysis was used to examine the data and display our findings using a network. Results: The developmental process of PD was as follows: (1) formation of anxiety, (2) sheltered life, (3) crisis, (4) loss of safe haven, and (5) inner breakdown. Conclusion: The family dynamics that developed as a result of coping with external situations in each stage contributed to clients’ psychological experiences. These psychological experiences triggered anxiety, which led to the development of PD. Moreover, this study empirically suggests that family dynamics can be associated with a person’s internal experiences that could lead to PD. Our findings highlight the significance of functional family dynamics and coping patterns when facing difficult external situations or crises.

Keywords: developmental process, family therapy, panic disorder, psychological dynamics

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Authors: Mehdi Salari

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This work introduces a new experimental method of martensite treatment contains accumulative roll-bonding used for producing the nano/ultrafine grained structure in low carbon steel. The ARB process up to 4 cycles was performed under unlubricated conditions, while the annealing process was carried out in the temperature range of 450–550°C for 30–100 min. The microstructures of the deformed and annealed specimens were investigated. The results showed that in the annealed specimen at 450°C for 30 or 60 min, recrystallization couldn’t be completed. Decrease in time and temperature intensified the volume fraction of the martensite cell blocks. Fully equiaxed nano/ultrafine grained ferrite was developed from the martensite cell blocks during the annealing at temperature around 500°C for 100 min.

Keywords: martensite process, accumulative roll bonding, recrystallization, nanostructure, plain carbon steel

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Authors: Seyed Ata Khalkhkali Sharifi, Gholamhossein Majzoubi, Farhad Abroush

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Developing mechanical properties of pure titanium has been reviewed in this paper by using ECAP process. At the first step of this article, the experimental samples were prepared as mentioned in the standards. Then pure grade 2 Ti was processed via equal-channel angular pressing (ECAp) for 2 passes following route-A at 400°C. After processing, the microstructural evolution, tensile, fatigue, hardness properties and wear behavior were investigated. Finally, the effect of ECAP process on these samples was analyzed. The results showed improvement in strength values with a slight decrease in ductility. The analysis on 30 points within the sample showed hardness increase in each pass. Also, it was concluded that fatigue properties were increased too.

Keywords: equal-channel angular pressing, titanium, mechanical behavior, engineering materials and applications

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Authors: J. V. Thanikal, M. Torrijos, Philipe Sousbie, S. M. Rizwan, R. Senthil Kumar, Hatem Yezdi

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Co-digestion is one of the advantages of anaerobic digestion process because; several wastes having complimentary characteristics can be treated in a single process. The anaerobic co-digestion process, which can be defined as the simultaneous treatment of two –or more – organic biodegradable waste streams by anaerobic digestion offers great potential for the proper disposal of the organic fraction of solid waste coming from source or separate collection systems. The results of biogas production for sewage sludge, when used as a single substrate, were low (350ml/d), and also the biodegradation rate was slow. Sewage sludge as a co-substrate did not show much effect on biogas yield. The vegetable substrates (Potato, Carrot, Spinach) with a total charge of 27–36 g VS, with a HRT starting from 3 days and ending with 1 day, shown a considerable increase in biogas yield 3.5-5 l/d.

Keywords: anaerobic digestion, co-digestion, vegetable substrate, sewage sludge

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Authors: Eugenia Jilinguirian

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In the healthcare industry, data mining is essential since it transforms the field by collecting useful data from large datasets. Data mining is the process of applying advanced analytical methods to large patient records and medical histories in order to identify patterns, correlations, and trends. Healthcare professionals can improve diagnosis accuracy, uncover hidden linkages, and predict disease outcomes by carefully examining these statistics. Additionally, data mining supports personalized medicine by personalizing treatment according to the unique attributes of each patient. This proactive strategy helps allocate resources more efficiently, enhances patient care, and streamlines operations. However, to effectively apply data mining, however, and ensure the use of private healthcare information, issues like data privacy and security must be carefully considered. Data mining continues to be vital for searching for more effective, efficient, and individualized healthcare solutions as technology evolves.

Keywords: data mining, healthcare, big data, individualised healthcare, healthcare solutions, database

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Authors: Ilsun Pang, Kwanghun Kim, Sungsun Baik

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Large diameter Si wafer is used as semiconductor substrate. Large diameter Si crystal ingot should be needed in order to increase wafer size. To make convection of large silicon melt stable, magnetic field is normally applied, but magnetic field is expensive and it is not proper to stabilize the large Si melt. To solve the problem, we propose a continuous Czochralski process which can be applied to small melt without magnetic field. We used granule poly, which has size distribution of 1~3 mm and is easily supplied in double crucible during silicon ingot growth. As the result, we produced 420 mm diameter ingot. In this paper, we describe an experimental study on crystal growth of large diameter silicon by Continuous Czochralski process.

Keywords: Czochralski, ingot, silicon crystal, wafer

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Authors: Lior B. Navon

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The objective of this study is to investigate how technology, such as social media, can influence the biopower hierarchy between the medical knowledge about the body and women’s bodily knowledge through the case study of the hashtag 'notpee'. In January 2015, the hashtag #notpee, relating to a feminine physiological phenomenon called female ejaculation (FE) or squirting (SQ) started circulating on twitter. This hashtag, born as a reaction to a medical study claiming that SQ is essentially involuntary emission of urine during sexual activity, sparked an unusual public discourse about FE, a phenomenon that is usually not discussed or referred to in socio-legitimate public spheres. This unusual backlash got the attention of women’s magazines and blogs, as well as more mainstream large and respected outlets such as The Guardian and CNN. Both the tweets on twitter, as well as the media coverage of them, were mainly aimed at rejecting the research’s findings. While not offering an alternative and choosing to define the phenomenon by negation, women argued that the fluid extracted was not pee based on their personal experiences. Based on a critical discourse analysis of 742 tweets with the hashtag 'notpee' between January 2015 and January 2016, and of 15 articles covering the backlash, this study suggests that the #notpee backlash challenged the power balance between the medical knowledge about the feminine body and the feminine bodily knowledge through two different, yet related, forms of resistance to biopower. The first resistance is to the authority over knowledge production — who has the power to produce 'true' statements when it comes to the body? Is it the women who experience the phenomenon, or is it the medical institution? The second resistance to biopower has to do with what we regard as facts or veracity. A critical discourse analysis reveals that while both the scientific field, as well as the women arguing against its findings, use empirical information, they, nevertheless, rely on two dichotomic databases- while the scientific research relies on samples from the 'dead like body', these woman are relying on their lived subjective senses as a source for fact making. Nevertheless, while #notpee is asking to change the power relations between the feminine subjective bodily knowledge and the seemingly objective masculine medical knowledge about the body, it by no means dismisses it. These women are essentially asking the medical institution to take into consideration the subjective body as well as the objective one while acknowledging and accepting the power of the latter over knowledge production.

Keywords: biopower, female ejaculation, new media, bodily knowledge

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Authors: Fernanda Rodriguez

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Breast cancer is pervasive among women, and an increasing number of women are opting for a mastectomy: a medical operation in which one or both breasts are removed with the intention of treating or averting breast cancer. However, there is an emerging population of cancer survivors in European nations that, rather than attempting to reconstruct their breasts to resemble as much as possible ‘normal’ breasts, have turned to dress their scars with decorative tattoos. At a practical level, this study hopes to improve the support systems of these women by possibly providing professionals in the medical field, tattoo artists, and family members of cancer survivors with a deeper understanding of their motivations and decision-making processes for choosing an alternative restorative route - such as decorative tattoos - after their mastectomy. At an intellectual level, however, this study aims to narrow a gap in the academic field concerning the relationship between mastectomies and alternative methods of healing, such as decorative tattoos, as well as to broaden the understanding regarding meaning-making and the ‘normal’ feminine body. Thus, by means of semi-structured interviews and a phenomenological standpoint, this research set itself the goal to understand why do women who have undergone a mastectomy choose to dress their scars with decorative tattoos instead of attempting to regain ‘normalcy’ through breast reconstruction or 3D areola tattoos? The results obtained from the interviews with fifteen women showed that the disillusionment with one part of the other of breast restoration techniques had led these women to find an alternative form of healing that allows them not only to close a painful chapter of their life but also to regain control over their bodies after a period of time in which agency was taking away from them. Decorative post-mastectomy tattoos allow these women to grant their bodies with new meanings and produce their own interpretation of their feminine body and identity.

Keywords: alternative femininity, decorative mastectomy tattoos, gender embodiment, social stigmatization

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Authors: Ramdani Nadia, Kheddaoui Abdelkrim, Nemmich Said, Tilmatine Amar

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The waste production nationwide is increasing every year, on account of therapid urbanization and growing populations, also consumption modes. Algerian political authorities have chosen Technical Landfill Centres (TLC) as a competitive and safe technique of waste management. However, storing these wastes in a bad way poses several environmental challenges, especially in the Department of Saïda, the latter have significant groundwaters. The major problem registered on this Landfill is the leachate resulting from the degradation of buried wastes which were disposed off the outside of the leachate basin and present a source of pollution for the local groundwaters by heavy metals and pathogenic germs. The present paper investigates the leachate treatment ozone process produced by Dielectric Barrier Discharge (DBD) under high potential. The experimental results obtained allowed us to show the efficiency of the treatment process by ozone based on the micro pollutant analysis (DCO, DBO5 , COT, heavy metals) and microbial analysis, after ozonation treatment. The results show that 80% of micro pollutants are eliminated and 100% destruction of all bacteria which reveals the high efficiency of the process.

Keywords: landfill, leachate, treatment, ozone, polluants, bacteria, micropolluant

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Authors: Michael A. Sprayberry, Vincent C. Paquit

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Process parameter optimization in metal powder bed electron beam melting (MPBEBM) is crucial to ensure the technology's repeatability, control, and industry-continued adoption. Despite continued efforts to address the challenges via the traditional design of experiments and process mapping techniques, there needs to be more successful in an on-the-fly optimization framework that can be adapted to MPBEBM systems. Additionally, data-intensive physics-based modeling and simulation methods are difficult to support by a metal AM alloy or system due to cost restrictions. To mitigate the challenge of resource-intensive experiments and models, this paper introduces a Multi-Objective Reinforcement Learning (MORL) methodology defined as an optimization problem for MPBEBM. An off-policy MORL framework based on policy gradient is proposed to discover optimal sets of beam power (P) – beam velocity (v) combinations to maintain a steady-state melt pool depth and phase transformation. For this, an experimentally validated Eagar-Tsai melt pool model is used to simulate the MPBEBM environment, where the beam acts as the agent across the P – v space to maximize returns for the uncertain powder bed environment producing a melt pool and phase transformation closer to the optimum. The culmination of the training process yields a set of process parameters {power, speed, hatch spacing, layer depth, and preheat} where the state (P,v) with the highest returns corresponds to a refined process parameter mapping. The resultant objects and mapping of returns to the P-v space show convergence with experimental observations. The framework, therefore, provides a model-free multi-objective approach to discovery without the need for trial-and-error experiments.

Keywords: additive manufacturing, metal powder bed fusion, reinforcement learning, process parameter optimization

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Authors: Timo Miebach, Kirsten Hoeper, Carolin Felix

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In times of competitive pressures and demographic change, hospitals have to reconsider their strategies as a company. Due to the fact, that operations are one of the main income and one of the primary cost drivers otherwise, a process-oriented approach and an efficient use of resources seems to be the right way for getting a consistent market position. Thus, the efficient operation room occupancy planning is an important cause variable for the success and continued the existence of these institutions. A high utilization of resources is essential. This means a very high, but nevertheless sensible capacity-oriented utilization of working systems that can be realized by avoiding downtimes and a thoughtful occupancy planning. This engineering approach should help hospitals to reach her break-even point. Firstly, the aim is to establish a strategy point, which can be used for the generation of a planned throughput time. Secondly, the operation planning and control should be facilitated and implemented accurately by the generation of time modules. More than 100,000 data records of the Hannover Medical School were analyzed. The data records contain information about the type of conducted operation, the duration of the individual process steps, and all other organizational-specific data such as an operating room. Based on the aforementioned data base, a generally valid model was developed by an analysis to define a strategy point which takes the conflict of capacity utilization and low overtime into account. Furthermore, time modules were generated in this work, which allows a simplified and flexible operation planning and control for the operation manager. By the time modules, it is possible to reduce a high average value of the idle times of the operation rooms. Furthermore, the potential is used to minimize the idle time spread.

Keywords: capacity, operating room, surgery planning and control, utilization

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Authors: Samy Madbouly

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The relaxation behavior of biorenewable castor oil-based polyurethane-lignin thin films synthesized in homogenous waterborne dispersions was investigated as a function of concentration at different temperatures and frequencies using broadband dielectric relaxation spectroscopy (BDRS). The molecular dynamics of the glass relaxation process and the local relaxation process of the PU-LS thin films were studied over a wide range of temperatures (-70 to 30 ℃) and frequencies (5 × 10−2 to 0.5 × 107 Hz) for different lignin concentration. Four relaxation processes have been observed namely; ?-, β-, γ-relaxations and ionic conductivity for pure castor oil-based PU and castor oil-lignin-based PU thin films at different temperatures and frequencies ranges. The Vogel-Fulcher-Tammann equation was found to be well described the temperature dependence of the characteristic relaxation times of the ?-relaxation process. However, on the other hand, the molecular dynamics of both β- and γ-relaxation processes were given by the Arrhenius equation. The incorporation of lignin into the castor oil-based PU significantly increased the glass transition temperature and primitivity of the thin films. In addition, the broadness, intensity, and molecular dynamics of the only observed ?-relaxation process were found to be strongly dependent on lignin concentration.

Keywords: castor oil, lignin, polyurethane, dielectric, dispersions

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Authors: Heba Ahmed Nawafleh

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In this study, two commercial resins were evaluated to concentrate uranium from real solutions that were produced from analkaline leaching process of carbonate deposits. The adsorption was examined using a batch process. Different parameters were evaluated, including initial pH, contact time, temperature, adsorbent dose, and finally, uranium initial concentration. Both resins were effective and selective for uranium ions from the tested leaching solution. The adsorption isotherms data were well fitted for both resins using the Langmuir model. Thermodynamic functions (Gibbs free energy change ΔG, enthalpy change ΔH, and entropy change ΔS) were calculated for the adsorption of uranium. The result shows that the adsorption process is endothermic, spontaneous, and chemisorption processes took place for both resins. The kinetic studies showed that the equilibrium time for uranium ions is about two hours, where the maximum uptake levels were achieved. The kinetics studies were carried out for the adsorption of U ions, and the data was found to follow pseudo-second-order kinetics, which indicates that the adsorption of U ions was chemically controlled. In addition, the reusability (adsorption/ desorption) process was tested for both resins for five cycles, these adsorbents maintained removal efficiency close to first cycle efficiency of about 91% and 80%.

Keywords: uranium, adsorption, ion exchange, thermodynamic and kinetic studies

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Authors: Mohammed Sharaf, Alireza Shokri, Adrian Small, Toby Bridges

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This paper investigates digital transformation challenges in SMEs within the automotive supply chain. A case study approach and participant observation revealed significant data management and process optimization barriers, corroborated by a conceptual model. Stakeholder feedback, visualized through a pie chart, emphasized data management and process efficiency as primary concerns. Recommended strategies include implementing advanced data systems, process simplification, and enhancing digital skills. Despite the single-case study limitation, the findings offer actionable insights for SMEs to leverage Industry 4.0 technologies effectively. This research contributes to the strategic roadmap necessary for SMEs to achieve competitive digital transformation.

Keywords: automotive supply chain, digital transformation, industry 4.0

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Authors: Delband Yekta Moazami

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Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.

Keywords: hiv, addiction, attitudes, healthcare workers

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Authors: Heba M. Gobara, Ahmed A. M. El-Naggar, Rasha S. El-Sayed, Amal A. AlKahlawy

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In this study, metal organic framework (Cr-MIL-101) and TiO₂ nanoparticles were utilized as two semiconductors for water splitting process. The coupling of both semiconductors in order to improve the photocatalytic reactivity for the hydrogen production in presence of methanol as a hole scavenger under visible light (sunlight) has been performed. The forementioned semiconductors and the collected samples after water splitting application are characterized by several techniques viz., XRD, N₂ adsorption-desorption, TEM, ED, EDX, Raman spectroscopy and the total content of carbon. The results revealed an efficient yield of H₂ production with maximum purity 99.3% with the in-situ formation of graphene oxide nanosheets and multiwalled carbon nanotubes coated over the surface of the physically mixed Cr-MIL-101–TiO₂ system. The amount of H₂ gas produced was stored when using Cr-MIL-101 catalyst individually. The obtained data in this work provides promising candidate materials for pure hydrogen production as a clean fuel acquired from the water splitting process. In addition, the in-situ production of graphene nanosheets and carbon nanotubes is counted as promising advances for the presented process.

Keywords: hydrogen production, water splitting, photocatalysts, Graphene

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Authors: Shri Krishna Mishra, Badri Yadav

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Effect of collaborative learning on development of process skills and attitude towards science is It rightly said that the destiny of the nation is shaped inside its classroom. Classroom is a place where the pupil and teacher interact purposefully to gain knowledge. Teaching is the principal mode of education. It can be called a transaction between teacher and pupil, in which one transmits knowledge to other. The teaching learning process consists of three important components, the pupils, the teacher and the curriculum; the classroom is the collection of students of their own individual abilities and needs. In the present classroom teaching learners are either persuasive recipient or passive observant. The school environment leading to low-achievement we have to try better to develop in the young mind. Children are the sticks of dynamite, bundles of energy and potential power waiting to be ignited. Guide them carefully to a place where their potentialities and strength will be used to build a better world. Man’s future depends to large extent on scientific advances and development of productive activity. Science is considered as an important subject in school curricular. The education commission (1964-66) has suggested that science education is necessary for all children at school stage. It is essential to develop children’s logical and critical thinking. But these days thinking process and academic achievement of students have been suppressed by competitive environment of our schools. How the students perceive each other and interact with one another is a neglected aspect of instruction. In the constructivist perspective learning in a process of construction of knowledge. Learners actively construct their own knowledge by connecting new ideas to existing ideas on the basis of materials/ activities presented to them (experience).

Keywords: effect of collaborative learning, development of process skills, science education, attitude towards science

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Authors: Pei-Jun Xue, Ming-Yu Hsiao

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Language is the emblem of a culture, representing the extension of cultural life. In addition, it is also an important tool for communication and message transmission. It carries not only information but also covers the self-conscious of the information constructor as well as the situational experiences of users from different backgrounds. Moreover, design can be regarded as a language, a dynamic process of coding and decoding. With the designers’ experiences in everyday life, they bring them into the products’ experiences. Considered from the aspects of atmosphere and the five senses, a designer should consider and reconsider how to communicate the messages effectively to suit the users’ needs. In the process of language learning, we should understand the construction behind it and the rules of the compositions of language codes. Regarding the understanding of the design of works or the form of product construction, it is necessary for us to understand the coding system during the process of product construction. The form (signifiers) and meanings (signified) of Chinese characters are closely related. At the same time, it is also a process of simplifying the complicated to the simple. This study discusses the chinese characters that used in the cultural symbols construction, and analysis of existing products by Peirce's semiotic triangles. Through people's cognition of Chinese characters and constitute method, help to understand the way of construction product symbol.

Keywords: cultural-creative product design, cultural product, cultural symbols, linguistic symbols

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Authors: R. S. Mehta, G. N. Mandal

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Hepatitis-B is the major infectious disease of mankind. In Nepal it is reported that more than 4.3% of Nepalese population at any time in their life has been infected with Hepatitis-B virus (HBV). The objective of this study was to evaluate the effectiveness of planned educational programme regarding knowledge and practice of hepatitis-B among the nurses working at medical units of BPKIHS. Pre-experimental research design was used to conduct the study among the nurses working in medical units of BPKIHS. Total 40 nurses were included in the pre-test and 34 in the post-test. The education intervention was arranged on 24th May 2012 from 2:15 pm to 4:45 pm i.e. two and half hours. After two weeks of education intervention post-test was conducted. Most of the participants (60%) were of the age group of 18-22 years, Hindu (82.5%), and unmarried (65%). After education intervention there is significant differences in knowledge on the components of Hepatitis-B at 0.05 level of significance. There is no difference in the attitude components after post-test except the component patient contaminated with Hepatitis-B must be called as the last patient (p=0.035). It can conclude that hepatitis-B educational program improved knowledge and practice among the nurses.

Keywords: educational program, Hepatitis-B, pre-experimental design, medical units

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Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

Procedia PDF Downloads 194