Search results for: surgical safety management

Authors: Chatelier Charlene, Oyegoke Adekunle, Ajayi Saheed, Jeffries Andrew

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This study seeks to understand Schedule Risk Assessments as a priori for better performance whilst exploring the strategies employed to deliver complex projects like the New Polar research ship. This high-profile vessel was offered to Natural Environment Research Council and British Antarctic Survey (BAS) by Cammell Laird Shipbuilders. The Research Ship was designed to support science in extreme environments, with the expectancy to provide a wide range of specialist scientific facilities, instruments, and laboratories to conduct research over multiple disciplines. Aim: The focus is to understand the allocation and management of schedule risk on such a Major Project. Hypothesising that "effective management of schedule risk management" could be the most critical factor in determining whether the intended benefits mentioned are delivered within time and cost constraints. Objective 1: Firstly, the study seeks to understand the allocation and management of schedule risk in Major Projects. Objective 2: Secondly, it explores "effective management of schedule risk management" as the most critical factor determining the delivery of intended benefits. Methodology: This study takes a retrospective review of schedule risk management and how it influences project performance using a case study approach for the RRS (Royal Research Ship) Sir David Attenborough. Research Contribution: The outcomes of this study will contribute to a better understanding of project performance whilst building on its under-researched relationship to schedule risk management for complex projects. The outcomes of this paper will guide further research on project performance and enable the understanding of how risk-based estimates over time impact the overall risk management of the project.

Keywords: complexity, major projects, performance management, schedule risk management, uncertainty

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Authors: Ashley Andrew

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

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

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Authors: Joana PaScoa Pinheiro, David Goncalves Ferreira, Filipe Ramos, Joaquim Soares Do Brito, Samuel Martins, Marco Sarmento

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Introduction: The SARS-CoV-2 (COVID-19) pandemic was identified in January 2020 in China, in the city of Wuhan. The increase in the number of cases over the following months was responsible for the restructuring of hospitals and departments in order to accommodate admissions related to COVID-19. Essential services, such as trauma, had to readapt to maintain their functionality and thus guarantee quick and safe access in case of an emergency. Objectives: This study describes the impact of COVID-19 on a Level III Trauma Center and particularly on the clinical management of hospitalized patients with spine injuries. Study Design & Methods: This is a retrospective cohort study whose results were obtained through the medical records of patients with spine injuries who underwent surgical intervention in the years 2019 and 2020 (period from March 1st to December 31st). A comparison between the two groups was made. In the study patients with injuries in the context of trauma were included who underwent surgery in the periods previously described. Patients hospitalized with a spine injury in a non-traumatic context and/or were not surgically treated were excluded. Results: In total, 137 patients underwent trauma spine surgery of which 71 in 2019 (51.8%) were without significant differences in intergroup comparisons. The most frequent injury mechanism in 2019 was motor vehicle crash (47.9%) compared to 2020 which was of a person falling from a height between 2-4 meters (37.9%). Cervical trauma was reported to be the most frequent spine injury in both years. There was a significant decrease in the need for intensive care in 2020, 51.4% vs 30.3%, p = .015 and the number of complications was also lower in 2020 (1.35% vs 0.98%), including the number of deaths, being the difference marginally significant. There were no significant differences regarding time for presentation to surgery or in the total days of hospitalization. Conclusions: The restructuring made in the trauma unit at a Level III Trauma Center in the context of the current COVID-19 pandemic was effective, with no significant differences between the years of 2019 vs 2020 when compared with the time for presentation to surgery or the number of days of hospitalization. It was also found that lockdown rules in 2020 were probably responsible for the decrease in the number of road traffic accidents, which justifies a significant decrease in the need for intensive care as well as in the number of complications in patients hospitalized in the context of spine trauma.

Keywords: trauma, spine, impact, covid-19

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Authors: Jonathon Bailey, Neil Bressloff, Nick Curzen

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Transcatheter Aortic Valve Implantation (TAVI) devices are stent-like frames with prosthetic leaflets on the inside, which are percutaneously implanted. The device in a crimped state is fed through the arteries to the aortic root, where the device frame is opened through either self-expansion or balloon expansion, which reveals the prosthetic valve within. The frequency at which TAVI is being used to treat aortic stenosis is rapidly increasing. In time, TAVI is likely to become the favoured treatment over Surgical Valve Replacement (SVR). Mortality after TAVI has been associated with severe Paravalvular Aortic Regurgitation (PAR). PAR occurs when the frame of the TAVI device does not make an effective seal against the internal surface of the aortic root, allowing blood to flow backwards about the valve. PAR is common in patients and has been reported to some degree in as much as 76% of cases. Severe PAR (grade 3 or 4) has been reported in approximately 17% of TAVI patients resulting in post-procedural mortality increases from 6.7% to 16.5%. TAVI devices, like SVR devices, are circular in cross-section as the aortic root is often considered to be approximately circular in shape. In reality, however, the aortic root is often non-circular. The ascending aorta, aortic sino tubular junction, aortic annulus and left ventricular outflow tract have an average ellipticity ratio of 1.07, 1.09, 1.29, and 1.49 respectively. An elliptical aortic root does not severely affect SVR, as the leaflets are completely removed during the surgical procedure. However, an elliptical aortic root can inhibit the ability of the circular Balloon-Expandable (BE) TAVI devices to conform to the interior of the aortic root wall, which increases the risk of PAR. Self-Expanding (SE) TAVI devices are considered better at conforming to elliptical aortic roots, however the valve leaflets were not designed for elliptical function, furthermore the incidence of PAR is greater in SE devices than BE devices (19.8% vs. 12.2% respectively). If a patient’s aortic root is too severely elliptical, they will not be suitable for TAVI, narrowing the treatment options to SVR. It therefore follows that in order to increase the population who can undergo TAVI, and reduce the risk associated with TAVI, non-circular devices should be developed. Computational simulations were employed to further advance our understanding of non-circular TAVI devices. Radial stiffness of the TAVI devices in multiple directions, frame bending stiffness and resistance to balloon induced expansion are all computationally simulated. Finally, a simulation has been developed that demonstrates the expansion of TAVI devices into a non-circular patient specific aortic root model in order to assess the alterations in deployment dynamics, PAR and the stresses induced in the aortic root.

Keywords: tavi, tavr, fea, par, fem

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Authors: Geremew Geidare Kailo, Igor Gáspár, András Koris, Ivana Pajčin, Flóra Vitális, Vanja Vlajkov

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Three-dimension (3D) printing, a very popular additive manufacturing technology, has recently undergone rapid growth and replaced the use of conventional technology from prototyping to producing end-user parts and products. The 3D Printing technology involves a digital manufacturing machine that produces three-dimensional objects according to designs created by the user via 3D modeling or computer-aided design/manufacturing (CAD/CAM) software. The most popular 3D printing system is Fused Deposition Modeling (FDM) or also called Fused Filament Fabrication (FFF). A 3D-printed object is considered food safe if it can have direct contact with the food without any toxic effects, even after cleaning, storing, and reusing the object. This work analyzes the processing timeline of the filament (material for 3D printing) from unboxing to the extrusion through the nozzle. It is an important task to analyze the growth of bacteria on the 3D printed surface and in gaps between the layers. By default, the 3D-printed object is not food safe after longer usage and direct contact with food (even though they use food-safe filaments), but there are solutions for this problem. The aim of this work was to evaluate the 3D-printed object from different perspectives of food safety. Firstly, testing antimicrobial 3D printing filaments from a food safety aspect since the 3D Printed object in the food industry may have direct contact with the food. Therefore, the main purpose of the work is to reduce the microbial load on the surface of a 3D-printed part. Coating with epoxy resin was investigated, too, to see its effect on mechanical strength, thermal resistance, surface smoothness and food safety (cleanability). Another aim of this study was to test new temperature-resistant filaments and the effect of high temperature on 3D printed materials to see if they can be cleaned with boiling or similar hi-temp treatment. This work proved that all three mentioned methods could improve the food safety of the 3D printed object, but the size of this effect variates. The best result we got was with coating with epoxy resin, and the object was cleanable like any other injection molded plastic object with a smooth surface. Very good results we got by boiling the objects, and it is good to see that nowadays, more and more special filaments have a food-safe certificate and can withstand boiling temperatures too. Using antibacterial filaments reduced bacterial colonies to 1/5, but the biggest advantage of this method is that it doesn’t require any post-processing. The object is ready out of the 3D printer. Acknowledgements: The research was supported by the Hungarian and Serbian bilateral scientific and technological cooperation project funded by the Hungarian National Office for Research, Development and Innovation (NKFI, 2019-2.1.11-TÉT-2020-00249) and the Ministry of Education, Science and Technological Development of the Republic of Serbia. The authors acknowledge the Hungarian University of Agriculture and Life Sciences’s Doctoral School of Food Science for the support in this study

Keywords: food safety, 3D printing, filaments, microbial, temperature

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Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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Authors: Minal Jain, Vinayak Malhotra

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

Keywords: combustion, propellant, regression, safety

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Authors: Virpi Oksman

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

Keywords: public acceptance, privacy, safety, survey

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Authors: Rajesh Kumar

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The largest issue in the current situation is managing solid waste since it pollutes the ecosystem. When considering how to manage waste, even the disposal of mixed waste is a challenge. The Saksham Yuva Project, which is managed by the Haryana government, highlights the consequences and drivers of managing the solid waste of urban areas in the municipal committee pundri in the present study. The overall goal of the Saksham Yuva project is to mobilise the public and educate them about the dangers associated with garbage management. There has been a 20% reduction in waste, according to the study's impacts, and the cost of waste management has also gone down. Further, the study also reported the alternative use of wastes in revenue generation by generating Khaad for agricultural purposes.

Keywords: solid waste management, people awareness, dry and wet waste disposal, material recover facility

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Authors: Gregory Michael McMahon

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Risk management for the purposes of minimizing the damages from the operations of dams has met with opposition emerging from organisations and authorities, and their practitioners. It appears that the cause may be a misunderstanding of risk management arising from exchanges that mix deterministic thinking with risk-centric thinking and that do not separate uncertainty from reliability and accuracy from probability. This paper sets out those misunderstandings that arose from dam operations at Wivenhoe in 2011, using a comparison of outcomes that have been based on the methodology and its rules and those that have been operated by applying misunderstandings of the rules. The paper addresses the performance of one risk-centric Flood Manual for Wivenhoe Dam in achieving a risk management outcome. A mixture of engineering, administrative, and legal factors appear to have combined to reduce the outcomes from the risk approach. These are described. The findings are that a risk-centric Manual may need to assist administrations in the conduct of scenario training regimes, in responding to healthy audit reporting, and in the development of decision-support systems. The principal assistance needed from the Manual, however, is to assist engineering and the law to a good understanding of how risks are managed – do not assume that risk management is understood. The wider findings are that the critical profession for decision-making downstream of the meteorologist is not dam engineering or hydrology, or hydraulics; it is risk management. Risk management will provide the minimum flood damage outcome where actual rainfalls match or exceed forecasts of rainfalls, that therefore risk management will provide the best approach for the likely history of flooding in the life of a dam, and provisions made for worst cases may be state of the art in risk management. The principal conclusion is the need for training in both risk management as a discipline and also in the application of risk management rules to particular dam operational scenarios.

Keywords: risk management, flood control, dam operations, deterministic thinking

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Authors: Z. Abdollahi Biron, P. Pisu

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Connected vehicles are one of the promising technologies for future Intelligent Transportation Systems (ITS). A connected vehicle system is essentially a set of vehicles communicating through a network to exchange their information with each other and the infrastructure. Although this interconnection of the vehicles can be potentially beneficial in creating an efficient, sustainable, and green transportation system, a set of safety and reliability challenges come out with this technology. The first challenge arises from the information loss due to unreliable communication network which affects the control/management system of the individual vehicles and the overall system. Such scenario may lead to degraded or even unsafe operation which could be potentially catastrophic. Secondly, faulty sensors and actuators can affect the individual vehicle’s safe operation and in turn will create a potentially unsafe node in the vehicular network. Further, sending that faulty sensor information to other vehicles and failure in actuators may significantly affect the safe operation of the overall vehicular network. Therefore, it is of utmost importance to take these issues into consideration while designing the control/management algorithms of the individual vehicles as a part of connected vehicle system. In this paper, we consider a connected vehicle system under Co-operative Adaptive Cruise Control (CACC) and propose a fault diagnosis scheme that deals with these aforementioned challenges. Specifically, the conventional CACC algorithm is modified by adding a Kalman filter-based estimation algorithm to suppress the effect of lost information under unreliable network. Further, a sliding mode observer-based algorithm is used to improve the sensor reliability under faults. The effectiveness of the overall diagnostic scheme is verified via simulation studies.

Keywords: fault diagnostics, communication network, connected vehicles, packet drop out, platoon

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Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

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Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

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Authors: Wanchalerm Patanacharoenwong, Panaya Sudta, Prachya Bumrungkun

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The paper focuses on the development of a system that combines Internet of Things (IoT) technologies and deep learning algorithms for anomaly detection in residential Electric Vehicle (EV) charging in smart cities. With the increasing number of EVs, ensuring efficient and reliable charging systems has become crucial. The aim of this research is to develop an integrated IoT and deep learning system for detecting anomalies in residential EV charging and enhancing EV load profiling and event detection in smart cities. This approach utilizes IoT devices equipped with infrared cameras to collect thermal images and household EV charging profiles from the database of Thailand utility, subsequently transmitting this data to a cloud database for comprehensive analysis. The methodology includes the use of advanced deep learning techniques such as Recurrent Neural Networks (RNN) and Long Short-Term Memory (LSTM) algorithms. IoT devices equipped with infrared cameras are used to collect thermal images and EV charging profiles. The data is transmitted to a cloud database for comprehensive analysis. The researchers also utilize feature-based Gaussian mixture models for EV load profiling and event detection. Moreover, the research findings demonstrate the effectiveness of the developed system in detecting anomalies and critical profiles in EV charging behavior. The system provides timely alarms to users regarding potential issues and categorizes the severity of detected problems based on a health index for each charging device. The system also outperforms existing models in event detection accuracy. This research contributes to the field by showcasing the potential of integrating IoT and deep learning techniques in managing residential EV charging in smart cities. The system ensures operational safety and efficiency while also promoting sustainable energy management. The data is collected using IoT devices equipped with infrared cameras and is stored in a cloud database for analysis. The collected data is then analyzed using RNN, LSTM, and feature-based Gaussian mixture models. The approach includes both EV load profiling and event detection, utilizing a feature-based Gaussian mixture model. This comprehensive method aids in identifying unique power consumption patterns among EV owners and outperforms existing models in event detection accuracy. In summary, the research concludes that integrating IoT and deep learning techniques can effectively detect anomalies in residential EV charging and enhance EV load profiling and event detection accuracy. The developed system ensures operational safety and efficiency, contributing to sustainable energy management in smart cities.

Keywords: cloud computing framework, recurrent neural networks, long short-term memory, Iot, EV charging, smart grids

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Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

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An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

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Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

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Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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Authors: Frederick Johnson

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Product management has a long and well-established history within the consumer goods industry, despite being one of the most obscure aspects of brand management. Many global manufacturing organizations are now opting for external cloud-based Manufacturing Execution Systems (MES) to replace costly and outdated monolithic MES solutions. Other global manufacturing leaders are restructuring their organizations to support human-centered values, agile methodologies, and fluid operating principles. Still, industry-leading organizations struggle to apply the appropriate framework for managing evolving external MES solutions as internal "digital products." Product management complements these current trends in technology and philosophical thinking in the market. This paper discusses the central problems associated with adopting product management processes by analyzing its traditional theories and characteristics. Considering these ideas, the article then constructs a translated internal digital product management framework by combining new and existing approaches and principles. The report concludes by demonstrating the framework's capabilities and potential effectiveness in achieving digital maturity and business agility within a manufacturing environment.

Keywords: internal product management, digital transformation, manufacturing information technology, manufacturing execution systems

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

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

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

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Authors: Joseph Uche Azubike, Evelyn Ngozi Agbasi, M. I. Ogbonna

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The audit committee of the board of directors could no longer handle the enterprise's risks. Therefore, a risk management committee was created to control them. Thus, this study examined how enterprise risk management committee characteristics affected Nigerian exchange-listed banks' financial performance from 2013 to 2022. The study's hypotheses and three objectives were to determine how enterprise risk management committee size, composition, and gender diversity affect Nigerian banks' performance. An ex-post facto study design collected secondary data from bank annual reports. We used descriptive statistics, correlation analysis, and Ordinary least square regression to analyze panel data. Enterprise risk management committee size and composition had both negative and no significant effect on bank financial performance in Nigeria, whereas enterprise risk committee gender diversity has a 10% favorable effect. The report advises that adding more women with relevant knowledge to the risk committee to boost performance and allowing women to be at the lead of such risk management could improve bank performance in Nigeria since they are noted to be thorough in their tasks.

Keywords: bank, committee, enterprise, management, performance, risk

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Authors: Lisandro Blas, Héctor Tamanini

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From earliest 90 to now, no many companies or organization can “really” implement a knowledge management (KM) system that works (no only viewed from a measurement model, but in this continuity). Which are the reasons of that? Some of the reason maybe could be embedded in how KM is demanded (usefulness, priority, experts, a definition of KM) vs the importance and resources that the organizations afford (budget, responsible of a specific area of KM, intangibility). Many organizations “claim” the importance of Knowledge Management but thhese demands are not reflecting these claims in their future actions. With another’s tools or managements ideas the organizations put the economics and human resources to work. Why it´s not occur in KM? This paper tray to explain some of this reasons and tray to deal with this situations through a survey done in 2011 for a IAPG (Argentinean Institute from Oil & Gas) Congress.

Keywords: knowledge management into organizations, new perspectives, failure in implementation, claim

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Authors: Naznin Sultana Daisy, Mohammad Hesam Hafezi, Lei Liu

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Nowadays, oily solid waste management has become an important issue for many countries due to frequent oil spill accidents and the increase of industrial oily wastewater. The historical oil spill data show that marine oil spills that affect the shoreline can, in extreme cases, produce up to 30 or 40 times more waste than the volume of oil initially released. Hence, responsive authorities aim to develop the most effective oily waste management solution in a timely manner to manage and minimize the waste generated. In this study initially, we tried to develop the roadmap of oily waste management for three-tiered spill scenarios for Atlantic Canada. For that purpose, three oily waste disposal scenarios are evaluated via six criteria which are determined according to the opinions of the experts from the field. Consequently, through sustainable response strategies, the most appropriate and feasible scenario is determined. The results of this study will assist to develop an integrated oily waste management system for identifying the optimal waste-generation-allocation-disposal schemes and generating the optimal management alternatives based on the holistic consideration of environmental, technological, economic, social, and regulatory factors.

Keywords: oily waste management, marine oil spill, multi-criteria decision making, oil spill response

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Authors: Bahman Ghaderi, Hedayat Hosseini, Parviz Kafche

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The role of knowledge management processes in achieving the strategic goals of organizations is crucial. To this end, understanding the relationship between knowledge management processes and different aspects of strategic thinking (followed by long-term organizational planning) should be considered. This research examines the relationship between each of the five knowledge management processes (creation, storage, transfer, audit, and deployment) with each dimension of strategic thinking (vision, creativity, thinking, communication and analysis) in one of the major sectors of the food industry in Iran. In this research, knowledge management and its dimensions (knowledge acquisition, knowledge storage, knowledge transfer, knowledge auditing, and finally knowledge utilization) as independent variables and strategic thinking and its dimensions (creativity, systematic thinking, vision, strategic analysis, and strategic communication) are considered as the dependent variable. The statistical population of this study consisted of 245 managers and employees of Minoo Food Industrial Group in Tehran. In this study, a simple random sampling method was used, and data were collected by a questionnaire designed by the research team. Data were analyzed using SPSS 21 software. LISERL software is also used for calculating and drawing models and graphs. Among the factors investigated in the present study, knowledge storage with 0.78 had the most effect, and knowledge transfer with 0.62 had the least effect on knowledge management and thus on strategic thinking.

Keywords: knowledge management, strategic thinking, knowledge management processes, food industry

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Authors: Samuel Quashie

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The importance of theory for PhD construction management research cannot be underestimated, as it requires a sound theoretical basis. Theory efficiency reduces errors in the research problem, solving it by building upon current theory. Provides a structure for examination, enables the efficient development of the construction management field and to it practical real world problems. The aim is to develop the theoretical framework for the application of descriptive theory within the PhD research design To apply the proposed theoretical framework using the case of the topic of ‘integrated management system,’ classifying the phenomena into categories, explore the association between the category–defining attributes and the outcome observed. Forming categorization based upon attributes of phenomena (framework and typologies), and statement of association (models). Predicting (deductive process) and confirming (inductive process). The descriptive theory is important and provides a structure for examination, enables the efficient development of construction management field and to it practical real world problems. In conclusion, the work done in management presents fertile ground for research and theory development.

Keywords: descriptive theory, PhD research design, theoretical framework, construction management

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Authors: Siham G. Farag

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

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

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Authors: M. Kishore Kumar

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The ancient Vedas and Upanishads are a treasure of knowledge gifted to the world by India. The four Vedas, a conglomerate of Hindu scriptures, contain many principles of modern management at organisation as well as at individual levels. It lays down the duties of a King and ministers as well as its citizens and cites values for leadership. Bhagawadgita (or ‘Gita’ in short), popularly cited as Pancham (Fifth) Veda, is stated to be sermoned about 5000 years ago by Lord Krishna. In the midst of the Kurukshetra battle, Gitopadesh was given various aspects such as dharma (duties), karma (action), stithaprajna (stable mind), nishkama (detachment from results) and ethics. Arjun was steered to victory by Lord Krishna as his charioteer, and the 700-odd-verse holy text Bhagawadgita can become a valuable guide for all of us to achieve success in business management. Many parallels exist between modern-day management theories and principles enshrined in Vedic texts.

Keywords: goal, motivation, leadership, mind, management

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Authors: Idris Haruna Muhammad, Okorie Austine Uche

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

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

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Authors: Simangele Dlamini

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Smart city development is seen as a way of facing the challenges brought about by the growing urban population the world over. Research indicates that cities have a role to play in combating urban challenges like crime, waste disposal, greenhouse gas emissions, and resource efficiency. These solutions should be such that they do not make city management less sustainable but should be solutions-driven, cost and resource-efficient, and smart. This study explores opportunities on how the City of Johannesburg, South Africa, can use Geographic Information Systems, Big Data and the Internet of Things (IoT) in identifying opportune areas to initiate smart city initiatives such as smart safety, smart utilities, smart mobility, and smart infrastructure in an integrated manner. The study will combine Big Data, using real-time data sources to identify hotspot areas that will benefit from ICT interventions. The GIS intervention will assist the city in avoiding a silo approach in its smart city development initiatives, an approach that has led to the failure of smart city development in other countries.

Keywords: smart cities, internet of things, geographic information systems, johannesburg

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Authors: Pitchayanin Sukholthaman

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Gradually accumulated, the enormous amount of waste has caused tremendous adverse impacts to the world. Bangkok, Thailand, is chosen as an urban city of a developing country having coped with serious MSW problems due to the vast amount of waste generated, ineffective and improper waste management problems. Waste generation is the most important factor for successful planning of MSW management system. Thus, the prediction of MSW is a very important role to understand MSW distribution and characteristic; to be used for strategic planning issues. This study aims to find influencing variables that affect the amount of Bangkok MSW generation quantity.

Keywords: MSW generation, MSW quantity prediction, MSW management, multiple regression, Bangkok

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Authors: Wan Norhayate Wan Daud, Fakhrul Anwar Zainol, Maslina Mansor

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The study was conducted to produce case studies from the Malaysian public universities stands point East Coast of Malaysia. The aim of this study is to analyze the effects of knowledge management on human capital toward organizational innovation. The focus point of this study is on the management member in the faculties of these three Malaysian Public Universities in the East Coast state of Peninsular Malaysia. In this case, respondents who agreed to further participate in the research will be invited to a one-hour face-to-face semi-structured, in-depth interview. As a result, the sample size for this study was 3 deans of Faculty of Management. Lastly, this study tries to recommend the framework of organizational innovation in Malaysian Public Universities.

Keywords: human capital, knowledge management, organizational innovation, public university

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Authors: Saba Latif

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The study is about exploring the Impact of Classroom Management Techniques on students’ Well-being at the secondary level. The objectives of the study are to identify the classroom management practices of teachers and their impact on students’ achievement. All secondary schools of Lahore city are the population of study. The researcher randomly selected ten schools, and from these schools, two hundred students participated in this study. Data has been collected by using Classroom Management and Students’ Wellbeing questionnaire. Frequency analysis has been applied. The major findings of the study are calculated as follows: The teacher’s instructional activities affect classroom management. The secondary school students' seating arrangement can influence the learning-teaching process. Secondary school students strongly disagree with the statement that the large size of the class affects the teacher’s classroom management. The learning environment of the class helps students participate in question-and-answer sessions. All the activities of the teachers are in accordance with practices in the class. The discipline of the classroom helps the students to learn more. The role of the teacher is to guide, and it enhances the performance of the teacher. The teacher takes time on disciplinary rules and regulations of the classroom. The teacher appreciates them when they complete the given task. The teacher appreciates teamwork in the class.

Keywords: classroom management, strategies, wellbeing, practices

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Authors: Roscoe McLean, Jared Padayachee, Glen Bright

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There is currently a gap in the technology covering the rapid establishment of control after a reconfiguration in a Reconfigurable Manufacturing System. This gap involves the detection of the factory floor state and the communication link between the factory floor and the high-level software. In this paper, a thin, hardware-supported Middleware Management System (MMS) is proposed and its design and implementation are discussed. The research found that a cost-effective localization technique can be combined with intelligent software to speed up the ramp-up of a reconfigured system. The MMS makes the process more intelligent, more efficient and less time-consuming, thus supporting the industrial implementation of the RMS paradigm.

Keywords: intelligent systems, middleware, reconfigurable manufacturing, management system

Procedia PDF Downloads 669