Search results for: hospital capacity planning
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9443

Search results for: hospital capacity planning

7793 Robotic Arm-Automated Spray Painting with One-Shot Object Detection and Region-Based Path Optimization

Authors: Iqraq Kamal, Akmal Razif, Sivadas Chandra Sekaran, Ahmad Syazwan Hisaburi

Abstract:

Painting plays a crucial role in the aerospace manufacturing industry, serving both protective and cosmetic purposes for components. However, the traditional manual painting method is time-consuming and labor-intensive, posing challenges for the sector in achieving higher efficiency. Additionally, the current automated robot path planning has been a bottleneck for spray painting processes, as typical manual teaching methods are time-consuming, error-prone, and skill-dependent. Therefore, it is essential to develop automated tool path planning methods to replace manual ones, reducing costs and improving product quality. Focusing on flat panel painting in aerospace manufacturing, this study aims to address issues related to unreliable part identification techniques caused by the high-mixture, low-volume nature of the industry. The proposed solution involves using a spray gun and a UR10 robotic arm with a vision system that utilizes one-shot object detection (OS2D) to identify parts accurately. Additionally, the research optimizes path planning by concentrating on the region of interest—specifically, the identified part, rather than uniformly covering the entire painting tray.

Keywords: aerospace manufacturing, one-shot object detection, automated spray painting, vision-based path optimization, deep learning, automation, robotic arm

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7792 Prediction-Based Midterm Operation Planning for Energy Management of Exhibition Hall

Authors: Doseong Eom, Jeongmin Kim, Kwang Ryel Ryu

Abstract:

Large exhibition halls require a lot of energy to maintain comfortable atmosphere for the visitors viewing inside. One way of reducing the energy cost is to have thermal energy storage systems installed so that the thermal energy can be stored in the middle of night when the energy price is low and then used later when the price is high. To minimize the overall energy cost, however, we should be able to decide how much energy to save during which time period exactly. If we can foresee future energy load and the corresponding cost, we will be able to make such decisions reasonably. In this paper, we use machine learning technique to obtain models for predicting weather conditions and the number of visitors on hourly basis for the next day. Based on the energy load thus predicted, we build a cost-optimal daily operation plan for the thermal energy storage systems and cooling and heating facilities through simulation-based optimization.

Keywords: building energy management, machine learning, operation planning, simulation-based optimization

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7791 Preliminary Phytopharmacological Evaluation of Methanol and Petroleum Ether Extracts of Selected Vegetables of Bangladesh

Authors: A. Mohammad Abdul Motalib Momin, B. Sheikh Mohammad Adil Uddin, C. Md Mamunur Rashid, D. Sheikh Arman Mahbub, E. Mohammad Sazzad Rahman, F. Abdullah Faruque

Abstract:

The present study was designed to investigate the antioxidant and cytotoxicity potential of methanol and pet ether extracts of the Lagenaria siceraria (LM, LP), Cucumis sativus (CSM, CSP), Cucurbita maxima (CMM, CMP) plants. For the phytochemical screening, crude extract was tested for the presence of different chemical groups. In Lagenaria siceraria the following groups were identified: alkaloids, steroids, glycosides and saponins for methanol extract and alkaloids, steroids, glycosides, tannins and saponins are for pet ether extract. Glycosides, steroids, alkaloids, saponins and tannins are present in the methanol extract of Cucumis sativus; the pet ether extract has the alkaloids, steroids and saponins. Glycosides, steroids, alkaloids, saponins and tannins are present in both the methanolic and pet ether extract of Cucurbita maxima. In vitro antioxidant activity of the extracts were performed using DPPH radical scavenging, nitric oxide (NO) scavenging, total antioxidant capacity, total phenol content, total flavonoid content, and Cupric Reducing Antioxidant Capacity assays. The most prominent antioxidant activity was observed with the CSM in the DPPH free radical scavenging test with an IC50 value of 1667.23±11.00271 μg/ml as opposed to that of standard ascorbic acid (IC50 value of 15.707± 1.181 μg/ml.) In total antioxidant capacity method, CMP showed the highest activity (427.81±11.4 mg ascorbic acid/g). The total phenolic and flavonoids content were determined by Folin-Ciocalteu Reagent and aluminium chloride colorimetric method, respectively. The highest total phenols and total flavonoids content were found in CMM and LP with the value of 79.06±16.06 mg gallic acid/g & 119.0±1.41 mg quercetin/g, respectively. In nitric oxide (NO) scavenging the most prominent antioxidant activity was observed in CMM with an IC50 value of 8.119± 0.0036 μg/ml. The Cupric reducing capacity of the extracts was strong and dose dependent manner and CSM showed lowest reducing capacity. The cytotoxicity was determined by Brine shrimp lethality test and among these extracts most potent cytotoxicity was shown by CMM with LC50 value 16.98 µg/ml. The obtained results indicate that the investigated plants could be potential sources of natural antioxidants and can be used for various types of diseases.

Keywords: antioxidant, cytotoxicity, methanol, petroleum ether

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7790 Application of Systems Engineering Tools and Methods to Improve Healthcare Delivery Inside the Emergency Department of a Mid-Size Hospital

Authors: Mohamed Elshal, Hazim El-Mounayri, Omar El-Mounayri

Abstract:

Emergency department (ED) is considered as a complex system of interacting entities: patients, human resources, software and hardware systems, interfaces, and other systems. This paper represents a research for implementing a detailed Systems Engineering (SE) approach in a mid-size hospital in central Indiana. This methodology will be applied by “The Initiative for Product Lifecycle Innovation (IPLI)” institution at Indiana University to study and solve the crowding problem with the aim of increasing throughput of patients and enhance their treatment experience; therefore, the nature of crowding problem needs to be investigated with all other problems that leads to it. The presented SE methods are workflow analysis and systems modeling where SE tools such as Microsoft Visio are used to construct a group of system-level diagrams that demonstrate: patient’s workflow, documentation and communication flow, data systems, human resources workflow and requirements, leadership involved, and integration between ER different systems. Finally, the ultimate goal will be managing the process through implementation of an executable model using commercialized software tools, which will identify bottlenecks, improve documentation flow, and help make the process faster.

Keywords: systems modeling, ED operation, workflow modeling, systems analysis

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7789 Open Fields' Dosimetric Verification for a Commercially-Used 3D Treatment Planning System

Authors: Nashaat A. Deiab, Aida Radwan, Mohamed Elnagdy, Mohamed S. Yahiya, Rasha Moustafa

Abstract:

This study is to evaluate and investigate the dosimetric performance of our institution's 3D treatment planning system, Elekta PrecisePLAN, for open 6MV fields including square, rectangular, variation in SSD, centrally blocked, missing tissue, square MLC and MLC shaped fields guided by the recommended QA tests prescribed in AAPM TG53, NCS report 15 test packages, IAEA TRS 430 and ESTRO booklet no.7. The study was performed for Elekta Precise linear accelerator designed for clinical range of 4, 6 and 15 MV photon beams with asymmetric jaws and fully integrated multileaf collimator that enables high conformance to target with sharp field edges. Seven different tests were done applied on solid water equivalent phantom along with 2D array dose detection system, the calculated doses using 3D treatment planning system PrecisePLAN, compared with measured doses to make sure that the dose calculations are accurate for open fields including square, rectangular, variation in SSD, centrally blocked, missing tissue, square MLC and MLC shaped fields. The QA results showed dosimetric accuracy of the TPS for open fields within the specified tolerance limits. However large square (25cm x 25cm) and rectangular fields (20cm x 5cm) some points were out of tolerance in penumbra region (11.38 % and 10.9 %, respectively). For the test of SSD variation, the large field resulted from SSD 125 cm for 10cm x 10cm filed the results recorded an error of 0.2% at the central axis and 1.01% in penumbra. The results yielded differences within the accepted tolerance level as recommended. Large fields showed variations in penumbra. These differences between dose values predicted by the TPS and the measured values at the same point may result from limitations of the dose calculation, uncertainties in the measurement procedure, or fluctuations in the output of the accelerator.

Keywords: quality assurance, dose calculation, 3D treatment planning system, photon beam

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7788 Effect of Cavities on the Behaviour of Strip Footing Subjected to Inclined Load

Authors: Ali A. Al-Jazaairry, Tahsin T. Sabbagh

Abstract:

One of the important concerns within the field of geotechnical engineering is the presence of cavities in soils. This present work is an attempt to understand the behaviour of strip footing subjected to inclined load and constructed on cavitied soil. The failure mechanism of strip footing located above such soils was studied analytically. The capability of analytical model to correctly expect the system behaviour is assessed by carrying out verification analysis on available studies. The study was prepared by finite element software (PLAXIS) in which an elastic-perfectly plastic soil model was used. It was indicated, from the results of the study, that the load carrying capacity of foundation constructed on cavity can be analysed well using such analysis. The research covered many foundation cases, and in each foundation case, there occurs a critical depth under which the presence of cavities has shown minimum impact on the foundation performance. When cavities are found above this critical depth, the load carrying capacity of the foundation differs with many influences, such as the location and size of the cavity and footing depth. Figures involving the load carrying capacity with the affecting factors studied are presented. These figures offer information beneficial for the design of strip footings rested on underground cavities. Moreover, the results might be used to design a shallow foundation constructed on cavitied soil, whereas the obtained failure mechanisms may be employed to improve numerical solutions for this kind of problems.

Keywords: axial load, cavity, inclined load, strip footing

Procedia PDF Downloads 255
7787 Husband Alcohol Drinking Behavior and Sexual Violence during Pregnancy in Nepalese Women of Kathmandu Valley, Nepal

Authors: Narayan Bhatta, Rodhana Pokhel

Abstract:

Introduction: The link between alcohol and violence is well documented, but there is a paucity of research on alcohol use by husbands and sexual violence during pregnancy in Nepal. The aim of the study is to describe the relationship between alcohol use by the husband and sexual violence during pregnancy in Nepalese women from the Kathmandu valley. Method: A cross-sectional study was conducted using a consecutive sampling design in one government hospital. Pregnant women (N = 495) attending the antenatal clinic of Paropakar Maternity and Women’s Hospital (PMWH) were recruited. Results: Approximately one-fifth (19%) of pregnant women had experienced sexual violence. Women in the first trimester of pregnancy were more likely to suffer sexual violence (35.2%) than in the second (30.7%) and third trimester of pregnancy (34%). The most common type of sexual violence against women was a physical force for sexual intercourse (91.5%), followed by sexual intercourse without the women’s consent (26.6%) and forcing them to engage in humiliating sexual activities (10.6%). Women who belong to other ethnicities like Janajatis, Dalits, and religious minorities (AOR = 0.3), women who live outside Kathmandu (AOR = 3.73), women who are illiterate (AOR = 4.67), and women whose husband has alcohol-drinking behavior (AOR = 1.68) increased the odds of experiencing sexual violence during pregnancy. Conclusion: The study concludes that a husband’s drinking behavior is an important risk factor for sexual violence against pregnant women attending the antenatal clinic. It indicates a need for routine screening during the antenatal visit to identify the violence and alcohol use of both the husband and wife.

Keywords: husband alcohol drinking behavior, Kathmandu, pregnency, sexual violence

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7786 Identifying the Phases of Indian Agriculture Towards Desertification: An Introspect of Karnataka State, India

Authors: Arun Das

Abstract:

Indian agriculture is acclaimed from the dates of Indus civilization (2500 BC). Since this time until the day, there were tremendous expansion in terms of space and technology has taken place. Abrupt growth in technology took place past one and half century. Consequent to this development, the land which was brought under agriculture in the initial stages of introducing agriculture for the first time, that land is not possessing the same physical condition. Either it has lost the productive capacity or modified into semi agriculture land. On the grounds of its capacity and interwoven characteristics seven phases of agriculture scenario has been identified. Most of the land is on the march of desertification. Identifying the stages and the phase of the agriculture scenario is most relevant from the point of view of food security at regional, national and at global level. Secondly decisive measure can put back the degenerating environmental condition into arrest. GIS and Remote sensing applications have been used to identify the phases of agriculture.

Keywords: agriculture phases, desertification, deforestation, foods security, transmigration

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7785 Hemodialysis Technique in a Diabetic Population

Authors: Daniel Thompson, Sophie Cerutti, Muhammad Peerbux, Hansraj Bookun

Abstract:

Introduction: Diabetic nephropathy is the leading cause end stage renal failure in Australia, responsible for 36% of cases. Patients who require dialysis may be suitable for haemodialysis through an arteriovenous fistula (AVF), and preoperatively careful planning is required to select suitable vessels for a long-lasting fistula that provides suitable dialysis access. Due to high levels of vascular disease in diabetic patients, we sought to investigate whether there is a difference in the types of autologous AVFs created for diabetic patients in renal failure compared to their non-diabetic counterparts. Method: Data was collected from the Australasian Vascular Audit, for all vascular surgery completed at St. Vincent’s Hospital Melbourne between 2011-2020. Patients were selected by operative type, creation of AVF, and compared in two groups, diabetic patients and patients without diabetes. Chi-squared test was utilised to determine significance. Results: Data analysis is ongoing and will be complete with updated abstract in time for the conference. Discussion: Diabetic nephropathy is the cause for roughly a third of end stage renal failure in Australia. Diabetic patients present with a unique set of challenges when it comes to dialysis access due to increased risk of peripheral vascular disease and arterial calcification. Care must be taken in the creation of fistulas to minimise complications and increase the chance of long-lasting access. Our study investigates the difference in autologous AVFs between diabetics and non-diabetics, and results may be used to influence location of fistula creation. Further research may be used to investigate patency rates of fistulas in diabetics vs non-diabetics which would further influence treatment decisions.

Keywords: dialysis, diabetes, renal access, fistula

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7784 Optimization and Operation of Charging and Discharging Stations for Hybrid Cars and their Effects on the Electricity Distribution Network

Authors: Ali Heydarimoghim

Abstract:

In this paper, the optimal placement of charging and discharging stations is done to determine the location and capacity of the stations, reducing the cost of electric vehicle owners' losses, reducing the cost of distribution system losses, and reducing the costs associated with the stations. Also, observing the permissible limits of the bus voltage and the capacity of the stations and their distance are considered as constraints of the problem. Given the traffic situation in different areas of a city, we estimate the amount of energy required to charge and the amount of energy provided to discharge electric vehicles in each area. We then introduce the electricity distribution system of the city in question. Following are the scenarios for introducing the problem and introducing the objective and constraint functions. Finally, the simulation results for different scenarios are compared.

Keywords: charging & discharging stations, hybrid vehicles, optimization, replacement

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7783 Analysis of Tools for Revitalization and Rehabilitation of Brownfields

Authors: Jiří Kugl

Abstract:

Typology and specific opportunities of brownfield revitalization are already largely described. Challenges and opportunities that brownfields represent have been adequately studied and presented, as well as specific ways in which these areas can be used or how they are used abroad. In other words, the questions why (revitalize brownfields) and what (we should do with them) are satisfactorily answered, but the question how (we can work with them) is not. This work will focus on answering this question, which will deal with tools that enable the revitalization and rehabilitation projects in the area. Tools can be divided, for example in terms of spatial planning and urban design, from an environmental perspective, from the perspective of cultural heritage protection and from the perspective of investment opportunities. The result is that the issue of brownfields is handled by numerous institutions and instruments. The aim of this paper is to identify, classify and analyze these instruments. Paper will study instruments from other countries with long-term experience with this issue (eg. France, Great Britain, USA, Germany, Denmark, Czech Republic) and analyse their contribution and the feasibility of their implementation in other countries.

Keywords: brownfields, revitalization, rehabilitation, tools, urban planning

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7782 Fuzzy Data, Random Drift, and a Theoretical Model for the Sequential Emergence of Religious Capacity in Genus Homo

Authors: Margaret Boone Rappaport, Christopher J. Corbally

Abstract:

The ancient ape ancestral population from which living great ape and human species evolved had demographic features affecting their evolution. The population was large, had great genetic variability, and natural selection was effective at honing adaptations. The emerging populations of chimpanzees and humans were affected more by founder effects and genetic drift because they were smaller. Natural selection did not disappear, but it was not as strong. Consequences of the 'population crash' and the human effective population size are introduced briefly. The history of the ancient apes is written in the genomes of living humans and great apes. The expansion of the brain began before the human line emerged. Coalescence times for some genes are very old – up to several million years, long before Homo sapiens. The mismatch between gene trees and species trees highlights the anthropoid speciation processes, and gives the human genome history a fuzzy, probabilistic quality. However, it suggests traits that might form a foundation for capacities emerging later. A theoretical model is presented in which the genomes of early ape populations provide the substructure for the emergence of religious capacity later on the human line. The model does not search for religion, but its foundations. It suggests a course by which an evolutionary line that began with prosimians eventually produced a human species with biologically based religious capacity. The model of the sequential emergence of religious capacity relies on cognitive science, neuroscience, paleoneurology, primate field studies, cognitive archaeology, genomics, and population genetics. And, it emphasizes five trait types: (1) Documented, positive selection of sensory capabilities on the human line may have favored survival, but also eventually enriched human religious experience. (2) The bonobo model suggests a possible down-regulation of aggression and increase in tolerance while feeding, as well as paedomorphism – but, in a human species that remains cognitively sharp (unlike the bonobo). The two species emerged from the same ancient ape population, so it is logical to search for shared traits. (3) An up-regulation of emotional sensitivity and compassion seems to have occurred on the human line. This finds support in modern genetic studies. (4) The authors’ published model of morality's emergence in Homo erectus encompasses a cognitively based, decision-making capacity that was hypothetically overtaken, in part, by religious capacity. Together, they produced a strong, variable, biocultural capability to support human sociability. (5) The full flowering of human religious capacity came with the parietal expansion and smaller face (klinorhynchy) found only in Homo sapiens. Details from paleoneurology suggest the stage was set for human theologies. Larger parietal lobes allowed humans to imagine inner spaces, processes, and beings, and, with the frontal lobe, led to the first theologies composed of structured and integrated theories of the relationships between humans and the supernatural. The model leads to the evolution of a small population of African hominins that was ready to emerge with religious capacity when the species Homo sapiens evolved two hundred thousand years ago. By 50-60,000 years ago, when human ancestors left Africa, they were fully enabled.

Keywords: genetic drift, genomics, parietal expansion, religious capacity

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7781 New Requirements of the Fifth Dimension of War: Planning of Cyber Operation Capabilities

Authors: Mehmet Kargaci

Abstract:

Transformation of technology and strategy has been the main factor for the evolution of war. In addition to land, maritime, air and space domains, cyberspace has become the fifth domain with emerge of internet. The current security environment has become more complex and uncertain than ever before. Moreover, warfare has evaluated from conventional to irregular, asymmetric and hybrid war. Weak actors such as terrorist organizations and non-state actors has increasingly conducted cyber-attacks against strong adversaries. Besides, states has developed cyber capabilities in order to defense critical infrastructure regarding the cyber threats. Cyber warfare will be key in future security environment. Although what to do has been placed in operational plans, how to do has lacked and ignored as to cyber defense and attack. The purpose of the article is to put forward a model for how to conduct cyber capabilities in a conventional war. First, cyber operations capabilities will be discussed. Second put forward the necessities of cyberspace environment and develop a model for how to plan an operation using cyber operation capabilities, finally the assessment of the applicability of cyber operation capabilities and offers will be presented.

Keywords: cyber war, cyber threats, cyber operation capabilities, operation planning

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7780 Noise of Aircraft Flyovers Affects Reading Saccades

Authors: Svea Missfeldt, Rainer Höger

Abstract:

A number of studies show that aircraft noise around airports negatively affects the reading comprehension of children attending schools in the neighbourhood. Yet little is known about the underlying mechanisms. Explanatory approaches discuss the attention capturing effect of noise sources which occupy mental capacity. Research suggests that attentional capacities are especially demanded when different modalities are involved at the same time. To explore whether aircraft noise affects reading processes in specific manners, students read texts in variable sound conditions while their eye movements were recorded. Besides noise caused by aircraft flyovers, which represent moving sound sources, saccades were also recorded under the condition of white noise, a natural sound setting and silence for comparison. Data showed an increase in regressive saccades when the sound of moving sources was presented. Interestingly, this effect was significantly high when the aircrafts moved in the opposite of the reading direction. Especially the latter result is not compatible with the hypothesis of a general impairment of cognitive processes by noise where the direction of movement should not have an influence. Reading is assumed to be based on two different attentional mechanisms: overt and covert attention, where the latter supports control and pre-planning of eye movements during reading. We believe that covert attention is affected by moving sound sources, resulting in an enhanced number of backwardly directed saccades.

Keywords: aircraft noise, attentional processes, cognition, eye movements, reading saccades

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7779 Dialysis Access Surgery for Patients in Renal Failure: A 10-Year Institutional Experience

Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

Abstract:

Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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7778 Transit Facility Planning in Fringe Areas of Kolkata Metropolitan Region

Authors: Soumen Mitra, Aparna Saha

Abstract:

The perceived link between the city and the countryside is evolving rapidly and is getting shifted away from the assumptions of mainstream paradigms to new conceptual networks where rural-urban links are being redefined. In this conceptual field, the fringe interface is still considered as a transitional zone between city and countryside, and is defined as a diffused area rather than a discrete territory. In developing countries fringe areas are said to have both rural and urban characteristics but are devoid of basic municipal facilities. Again, when the urban core areas envelopes the fringe areas along with it the character of fringe changes but services are not well facilitated which in turn results to uneven growth, rapid and haphazard development. One of the major services present in fringe areas is inter-linkages in terms of transit corridors. Planning for the appropriate and sustainable future of fringe areas requires a sheer focus on these corridors pertaining to transit facility, for better accessibility and mobility. Inducing a transit facility plan enhances the various facilities and also increases their proximity for user groups. The study focuses on the western fringe region of Kolkata metropolis which is a major source of industrial hub and housing sector, thus converting the agricultural lands into non-agricultural use. The study emphasizes on providing transit facilities both physical (stops, sheds, terminals, etc.) and operational (ticketing system, route prioritization, integration of transit modes, etc.), to facilitate the region as well as accelerate the growth pattern systematically. Hence, the scope of this work is on the basis of prevailing conditions in fringe areas and attempts for an effective transit facility plan. The strategies and recommendations are in terms of road widening, service coverage, feeder route prioritization, bus stops facilitation, pedestrian facilities, etc, which in turn enhances the region’s growth pattern. Thus, this context of transit facility planning acts as a catalytic agent to avoid the future unplanned growth and accelerates it towards an integrated development.

Keywords: feeder route, fringe, municipal planning, transit facility

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7777 Effective Slab Width for Beam-End Flexural Strength of Composite Frames with Circular-Section Columns

Authors: Jizhi Zhao, Qiliang Zhou, Muxuan Tao

Abstract:

The calculation of the ultimate loading capacity of composite frame beams is an important step in the design of composite frame structural systems. Currently, the plastic limit theory is mainly used for this calculation in the codes adopted by many countries; however, the effective slab width recommended in most codes is based on the elastic theory, which does not accurately reflect the complex stress mechanism at the beam-column joints in the ultimate loading state. Therefore, the authors’ research group put forward the Compression-on-Column-Face mechanism and Tension-on-Transverse-Beam mechanism to explain the mechanism in the ultimate loading state. Formulae are derived for calculating the effective slab width in composite frames with rectangular/square-section columns under ultimate lateral loading. Moreover, this paper discusses the calculation method of the effective slab width for the beam-end flexural strength of composite frames with circular-section columns. The proposed design formula is suitable for exterior and interior joints. Finally, this paper compares the proposed formulae with available formulae in other literature, current design codes, and experimental results, providing the most accurate results to predict the effective slab width and ultimate loading capacity.

Keywords: composite frame structure, effective slab width, circular-section column, design formulae, ultimate loading capacity

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7776 Behavior of Square Reinforced-Concrete Columns Strenghtened with Carbon Fiber Reinforced Polymers (CFRP) under Concentric Loading

Authors: Dana Abed, Mu`Tasim Abdel-Jaber, Nasim Shatarat

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This study aims at investigating the influence of cross-sectional size on axial compressive capacity of carbon fiber reinforced polymer (CFRP) wrapped square reinforced concrete short columns. Three sets of columns were built for this purpose: 200x200x1200 mm; 250x250x1500 mm and 300x300x1800 mm. Each set includes a control column and a strengthened column with one layer of CFRP sheets. All columns were tested under the effect of pure axial compression load. The results of the study show that using CFRP sheets resulted in capacity enhancement of 37%, 32% and 27% for the 200×200, 250×250, and 300×300 mm, respectively. The results of the experimental program demonstrated that the percentage of improvement in strength decreased by increasing the cross-sectional size of the column.

Keywords: CFRP, columns, concentric loading, cross-sectional

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7775 A Review on Robot Trajectory Optimization and Process Validation through off-Line Programming in Virtual Environment Using Robcad

Authors: Ashwini Umale

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Trajectory planning and optimization is a fundamental problem in articulated robotics. It is often viewed as a two phase problem of initial feasible path planning around obstacles and subsequent optimization of a trajectory satisfying dynamical constraints. An optimized trajectory of multi-axis robot is important and directly influences the Performance of the executing task. Optimal is defined to be the minimum time to transition from the current speed to the set speed. In optimization of trajectory through virtual environment explores the most suitable way to represent robot motion from virtual environment to real environment. This paper aims to review the research of trajectory optimization in virtual environment using simulation software Robcad. Improvements are to be expected in trajectory optimization to generate smooth and collision free trajectories with minimization of overall robot cycle time.

Keywords: trajectory optimization, forward kinematics and reverse kinematics, dynamic constraints, robcad simulation software

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7774 Supercomputer Simulation of Magnetic Multilayers Films

Authors: Vitalii Yu. Kapitan, Aleksandr V. Perzhu, Konstantin V. Nefedev

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The necessity of studying magnetic multilayer structures is explained by the prospects of their practical application as a technological base for creating new storages medium. Magnetic multilayer films have many unique features that contribute to increasing the density of information recording and the speed of storage devices. Multilayer structures are structures of alternating magnetic and nonmagnetic layers. In frame of the classical Heisenberg model, lattice spin systems with direct short- and long-range exchange interactions were investigated by Monte Carlo methods. The thermodynamic characteristics of multilayer structures, such as the temperature behavior of magnetization, energy, and heat capacity, were investigated. The processes of magnetization reversal of multilayer structures in external magnetic fields were investigated. The developed software is based on the new, promising programming language Rust. Rust is a new experimental programming language developed by Mozilla. The language is positioned as an alternative to C and C++. For the Monte Carlo simulation, the Metropolis algorithm and its parallel implementation using MPI and the Wang-Landau algorithm were used. We are planning to study of magnetic multilayer films with asymmetric Dzyaloshinskii–Moriya (DM) interaction, interfacing effects and skyrmions textures. This work was supported by the state task of the Ministry of Education and Science of the Russia # 3.7383.2017/8.9

Keywords: The Monte Carlo methods, Heisenberg model, multilayer structures, magnetic skyrmion

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7773 Thermal Properties and Water Vapor Permeability for Cellulose-Based Materials

Authors: Stanislavs Gendelis, Maris Sinka, Andris Jakovics

Abstract:

Insulation materials made from natural sources have become more popular for the ecologisation of buildings, meaning wide use of such renewable materials. Such natural materials replace synthetic products which consume a large quantity of energy. The most common and the cheapest natural materials in Latvia are cellulose-based (wood and agricultural plants). The ecological aspects of such materials are well known, but experimental data about physical properties remains lacking. In this study, six different samples of wood wool panels and a mixture of hemp shives and lime (hempcrete) are analysed. Thermal conductivity and heat capacity measurements were carried out for wood wool and cement panels using the calibrated hot plate device. Water vapor permeability was tested for hempcrete material by using the gravimetric dry cup method. Studied wood wool panels are eco-friendly and harmless material, which is widely used in the interior design of public and residential buildings, where noise absorption and sound insulation is of importance. They are also suitable for high humidity facilities (e.g., swimming pools). The difference in panels was the width of used wood wool, which is linked to their density. The results of measured thermal conductivity are in a wide range, showing the worsening of properties with the increasing of the wool width (for the least dense 0.066, for the densest 0.091 W/(m·K)). Comparison with mineral insulation materials shows that thermal conductivity for such materials are 2-3 times higher and are comparable to plywood and fibreboard. Measured heat capacity was in a narrower range; here, the dependence on the wool width was not so strong due to the fact that heat capacity value is related to mass, not volume. The resulting heat capacity is a combination of two main components. A comparison of results for different panels allows to select the most suitable sample for a specific application because the dependencies of the thermal insulation and heat capacity properties on the wool width are not the same. Hempcrete is a much denser material compared to conventional thermal insulating materials. Therefore, its use helps to reinforce the structural capacity of the constructional framework, at the same time, it is lightweight. By altering the proportions of the ingredients, hempcrete can be produced as a structural, thermal, or moisture absorbent component. The water absorption and water vapor permeability are the most important properties of these materials. Information about absorption can be found in the literature, but there are no data about water vapor transmission properties. Water vapor permeability was tested for a sample of locally made hempcrete using different air humidity values to evaluate the possible difference. The results show only the slight influence of the air humidity on the water vapor permeability value. The absolute ‘sd value’ measured is similar to mineral wool and wood fiberboard, meaning that due to very low resistance, water vapor passes easily through the material. At the same time, other properties – structural and thermal of the hempcrete is totally different. As a result, an experimentally-based knowledge of thermal and water vapor transmission properties for cellulose-based materials was significantly improved.

Keywords: heat capacity, hemp concrete, thermal conductivity, water vapor transmission, wood wool

Procedia PDF Downloads 221
7772 Optimizing Human Diet Problem Using Linear Programming Approach: A Case Study

Authors: P. Priyanka, S. Shruthi, N. Guruprasad

Abstract:

Health is a common theme in most cultures. In fact all communities have their concepts of health, as part of their culture. Health continues to be a neglected entity. Planning of Human diet should be done very careful by selecting the food items or groups of food items also the composition involved. Low price and good taste of foods are regarded as two major factors for optimal human nutrition. Linear programming techniques have been extensively used for human diet formulation for quiet good number of years. Through the process, we mainly apply “The Simplex Method” which is a very useful statistical tool based on the theorem of Elementary Row Operation from Linear Algebra and also incorporate some other necessary rules set by the Simplex Method to help solve the problem. The study done by us is an attempt to develop a programming model for optimal planning and best use of nutrient ingredients.

Keywords: diet formulation, linear programming, nutrient ingredients, optimization, simplex method

Procedia PDF Downloads 558
7771 Impact of Clinical Pharmacist Intervention in Improving Drug Related Problems in Patients with Chronic Kidney Disease

Authors: Aneena Suresh, C. S. Sidharth

Abstract:

Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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7770 Assessment and Evaluation of Traffic Noise in Selected Government Healthcare Facilities at Birnin Kebbi, Kebbi State-Nigeria

Authors: Muhammad Naziru Yahaya, Buhari Samaila, Nasiru Abubakar

Abstract:

Noise pollution caused by vehicular movement in urban cities has reached alarming proportions due to continuous increases in vehicles and industrialization. Traffic noise causes deafness, annoyance, and other health challenges. According to World Health Organization recommends 60Db daytime sound levels and 40db night time sound levels in hospitals, schools, and other residential areas. Measurements of traffic noise were taken at six different locations of selected healthcare facilities at Birnin Kebbi (Sir Yahaya Memorial Hospital and Federal Medical Centre Birnin Kebbi). The data was collected in the vicinity of hospitals using the slow setting of the device and pointed at noise sources. An integrated multifunctional sound level GM1352, KK2821163 model, was used for measuring the emitted noise and temperatures. The data was measured and recorded at three different periods of the day 8 am – 12 pm, 3 pm – 6 pm, and 6 pm – 8:30 pm, respectively. The results show that a fair traffic flow producing an average sound level in the order of 38db – 64db was recorded at GOPDF, amenityF, and ante-natalF. Similarly, high traffic noise was observed at GOPDS, amenityS, and Fati-LamiS in the order of 52db – 78db unsatisfactory threshold for human hearing.

Keywords: amenities, healthcare, noise, hospital, traffic

Procedia PDF Downloads 116
7769 Evidence-Based Practice Attributes across Nursing Roles at a Children’s Hospital

Authors: Rose Chapman Rodriguez

Abstract:

Problem: Evidence-based practice (EBP) attributes are significantly associated with EBP implementation science, which improves patient care outcomes. Nurses influence EBP, yet little is known of the specific EBP attributes of pediatric nurses in their clinical sub-specialties. Aim: This study aims to investigate the relationship between nursing academic degree, years of experience, and clinical specialty, with mean survey scores on EBP belief, organizational culture, and implementation scales across all levels of nursing in a Children’s Hospital. Methods: A convenience sample of nurses (n=185) participated in a descriptive, cross-sectional, correlational study in May 2023. The electronic surveys comprised 11 demographic questions and nine survey items from the short-version EBP Beliefs Scale (Cronbach α = 0.81), Organizational Culture and Readiness Scale for System-wide Integration Scale (Cronbach α = 0.87), and EBP Implementation Scale (Cronbach α = 0.89). Findings: EBP belief scores were notably higher in nurses working in neonatology (m=4.33), critical care (m=4.47), and among nurse leaders (m=4.50). There was a statistically significant difference in EBP organizational culture among nurse leaders (m = 3.95, p=0.039) compared to clinical nurses (m = 3.34) and advanced practice nurses (m = 3.34). EBP implementation was favorable in neonatology (m=4.20), acute care (m=4.05), and nurse leaders (m=4.33). No significant difference or correlation was found in EBP belief, organizational culture, or implementation mean scores related to nurses' age, academic nursing degree, or years of experience in our cohort (EBP beliefs (r = -.06, p = .400), organizational readiness (r = .02, p = .770), and implementation scales (r = .01, p = .867). Conclusions: This study identified nurse’s EBP attributes in a Children’s Hospital using key variables studied in EBP social cognitive theory and learning theory. Magnet status, shared governance structure, specialty certification, and nurse leaders play a significant role in favorable EBP culture and implementation. Nurses’ unit level ‘group culture’ may vary depending on the EBP attributes and collaborative efforts of local teams. Opportunities for mentoring were identified, which may continue to enhance EBP implementation science across all nursing roles in our pediatric organization.

Keywords: evidence-based practice, peditrics, nursing roles, implementation

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7768 Influence of the Substitution of C for Mg and Ni on the Microstructure and Hydrogen Storage Characteristics of Mg2Ni Alloys

Authors: Sajad Haghanifar, Seyed-Farshid Kashani Bozorg

Abstract:

Nano-crystalline Mg2Ni-based powder was produced by mechanical alloying technique using binary and ternary powder mixtures with stoichiometric compositions of Mg2Ni, Mg1.9C0.1Ni and Mg2C0.1Ni0.9. The structures and morphologies of the milled products were studied by XRD, SEM and HRTEM. Their electrochemical hydrogen storage characteristics were investigated in 6 M KOH solution. X-Ray diffraction, scanning and transmission electron microscopy of the milled products showed the formation of Mg2Ni-based nano-crystallites after 5, 15 and 30 h of milling using the initial powder mixtures of Mg1.9C0.1Ni, Mg2Ni and Mg2C0.1Ni0.9, respectively. It was found that partial substitution of C for Mg has beneficial effect on the formation kinetic of nano-crystalline Mg2Ni. Contrary to this, partial substitution of C for Ni was resulted in retardation of formation kinetic of nano-crystalline Mg2Ni. In addition, the negative electrode made from Mg1.9C0.1Ni ternary milled product after 30 hour of milling exhibited the highest initial discharge capacity and longest discharge life. Thus, partial substitution of C for Mg is beneficial to electrode properties of the Mg2Ni-based crystallites. The relation between the discharge capacity and cycling number of mechanically alloyed products was proposed on the basis of the fact that the degradation of discharge capacity was mainly caused by the oxidation of magnesium and nickel. The experimental data fitted the deduced equation well.

Keywords: Mg2Ni, hydrogen absorbing materials, electrochemical properties, nano-crystalline, amorphous, mechanical alloying, carbon

Procedia PDF Downloads 434
7767 A Prospective Neurosurgical Registry Evaluating the Clinical Care of Traumatic Brain Injury Patients Presenting to Mulago National Referral Hospital in Uganda

Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

Procedia PDF Downloads 235
7766 High Capacity SnO₂/Graphene Composite Anode Materials for Li-Ion Batteries

Authors: Hilal Köse, Şeyma Dombaycıoğlu, Ali Osman Aydın, Hatem Akbulut

Abstract:

Rechargeable lithium-ion batteries (LIBs) have become promising power sources for a wide range of applications, such as mobile communication devices, portable electronic devices and electrical/hybrid vehicles due to their long cycle life, high voltage and high energy density. Graphite, as anode material, has been widely used owing to its extraordinary electronic transport properties, large surface area, and high electrocatalytic activities although its limited specific capacity (372 mAh g-1) cannot fulfil the increasing demand for lithium-ion batteries with higher energy density. To settle this problem, many studies have been taken into consideration to investigate new electrode materials and metal oxide/graphene composites are selected as a kind of promising material for lithium ion batteries as their specific capacities are much higher than graphene. Among them, SnO₂, an n-type and wide band gap semiconductor, has attracted much attention as an anode material for the new-generation lithium-ion batteries with its high theoretical capacity (790 mAh g-1). However, it suffers from large volume changes and agglomeration associated with the Li-ion insertion and extraction processes, which brings about failure and loss of electrical contact of the anode. In addition, there is also a huge irreversible capacity during the first cycle due to the formation of amorphous Li₂O matrix. To obtain high capacity anode materials, we studied on the synthesis and characterization of SnO₂-Graphene nanocomposites and investigated the capacity of this free-standing anode material in this work. For this aim, firstly, graphite oxide was obtained from graphite powder using the method described by Hummers method. To prepare the nanocomposites as free-standing anode, graphite oxide particles were ultrasonicated in distilled water with SnO2 nanoparticles (1:1, w/w). After vacuum filtration, the GO-SnO₂ paper was peeled off from the PVDF membrane to obtain a flexible, free-standing GO paper. Then, GO structure was reduced in hydrazine solution. Produced SnO2- graphene nanocomposites were characterized by scanning electron microscopy (SEM), energy dispersive X-ray spectrometer (EDS), and X-ray diffraction (XRD) analyses. CR2016 cells were assembled in a glove box (MBraun-Labstar). The cells were charged and discharged at 25°C between fixed voltage limits (2.5 V to 0.2 V) at a constant current density on a BST8-MA MTI model battery tester with 0.2C charge-discharge rate. Cyclic voltammetry (CV) was performed at the scan rate of 0.1 mVs-1 and electrochemical impedance spectroscopy (EIS) measurements were carried out using Gamry Instrument applying a sine wave of 10 mV amplitude over a frequency range of 1000 kHz-0.01 Hz.

Keywords: SnO₂-graphene, nanocomposite, anode, Li-ion battery

Procedia PDF Downloads 227
7765 A Review on Modeling and Optimization of Integration of Renewable Energy Resources (RER) for Minimum Energy Cost, Minimum CO₂ Emissions and Sustainable Development, in Recent Years

Authors: M. M. Wagh, V. V. Kulkarni

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The rising economic activities, growing population and improving living standards of world have led to a steady growth in its appetite for quality and quantity of energy services. As the economy expands the electricity demand is going to grow further, increasing the challenges of the more generation and stresses on the utility grids. Appropriate energy model will help in proper utilization of the locally available renewable energy sources such as solar, wind, biomass, small hydro etc. to integrate in the available grid, reducing the investments in energy infrastructure. Further to these new technologies like smart grids, decentralized energy planning, energy management practices, energy efficiency are emerging. In this paper, the attempt has been made to study and review the recent energy planning models, energy forecasting models, and renewable energy integration models. In addition, various modeling techniques and tools are reviewed and discussed.

Keywords: energy modeling, integration of renewable energy, energy modeling tools, energy modeling techniques

Procedia PDF Downloads 345
7764 Introduction of a Standardised Proforma to Optimise Post-Operative Analgesia after Caesarean Section

Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

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Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

Procedia PDF Downloads 106