Search results for: medical advantage

Authors: Penina Orenstein

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In today’s world, particularly with COVID-19 a constant worldwide threat, organizations need greater visibility over their supply chains more than ever before, in order to find areas for improvement and greater efficiency, reduce the chances of disruption and stay competitive. The concept of supply chain mapping is one where every process and route is mapped in detail between each vendor and supplier. The simplest method of mapping involves sourcing publicly available data including news and financial information concerning relationships between suppliers. An additional layer of information would be disclosed by large, direct suppliers about their production and logistics sites. While this method has the advantage of not requiring any input from suppliers, it also doesn’t allow for much transparency beyond the first supplier tier and may generate irrelevant data—noise—that must be filtered out to find the actionable data. The primary goal of this research is to build data maps of supply chains by focusing on a layered approach. Using these maps, the secondary goal is to address the question as to whether the supply chain is re-engineered to make improvements, for example, to lower the carbon footprint. Using a drill-down approach, the end result is a comprehensive map detailing the linkages between tier-one, tier-two, and tier-three suppliers super-imposed on a geographical map. The driving force behind this idea is to be able to trace individual parts to the exact site where they’re manufactured. In this way, companies can ensure sustainability practices from the production of raw materials through the finished goods. The approach allows companies to identify and anticipate vulnerabilities in their supply chain. It unlocks predictive analytics capabilities and enables them to act proactively. The research is particularly compelling because it unites network science theory with empirical data and presents the results in a visual, intuitive manner.

Keywords: data mining, supply chain, empirical research, data mapping

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Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

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Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

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Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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Authors: Sepinoud Hamedi

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The ponder points to observationally look at the impact of carbon-neutrality approaches on the key assets required for Industry 4.0 driven savvy fabricating and how these assets can give a economical competitive advantage. The hypothetical system is coordinates with the regulation hypothesis and the resource-based see (RBV). The observational strategy is utilized for collecting information through studies and assist covariance-based auxiliary condition modeling is utilized to test the theories. Discoveries demonstrate that carbon–neutral-based government arrangements have a more grounded impact on unmistakable assets and human aptitudes than intangible assets related to Industry 4.0 driven shrewd fabricating. Moment, carbon–neutral arrangement arrangement with the firm’s maintainability destinations plays a directing impact on the relationship between carbon–neutral-based government arrangements and assets (substantial, intangible assets and human abilities) for Industry 4.0 driven shrewd fabricating. Finally, the three assets (substantial, intangible assets and human abilities) for Industry 4.0 driven savvy fabricating play a basic part in creating firms’ carbon–neutral capability and assist improving operational execution. Administrative suggestions incorporate venture in progressed advanced innovations, creating a solid mentality among workers and supply chain partners, and planning preparing programs for upgrading shrewd fabricating execution to create carbon-neutrality capability. This think about proposes a crossover hypothesis within the setting of carbon nonpartisanship by coordination institutional theory and RBV. Typically the primary think about that looks at the impact of carbon neutrality-based government arrangements on crucial Industry 4.0-driven savvy fabricating assets and the circuitous impact on carbon nonpartisanship capability and operational execution.

Keywords: carbon, industry 4.0, neutrality, RBV, nonpartisanship

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Authors: Eric Sitorus, Septian Prahastudhi, Turgod Nainggolan, Erwin Riyanto

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Mining by block or panel caving is a mining method that takes advantage of fractures within an ore body, coupled with gravity, to extract material from a predetermined column of ore. The caving column is weakened from beneath through the use of undercutting, after which the ore breaks up and is extracted from below in a continuous cycle. The nature of this method induces cyclical stresses on the pillars of excavations as stress is built up and released over time, which has a detrimental effect on both the installed ground support and the rock mass itself. Ground support capacity, especially on the production where excavation void ratio is highest, is subjected to heavy loading. Strain above threshold of the elongation of support capacity can yield resulting in damage to excavations. Geotechnical engineers must evaluate not only the remnant capacity of ground support systems but also investigate depth of rock mass yield within pillars, backs and floors. Ground Penetrating Radar (GPR) is a geophysical method that has the ability to evaluate rock mass damage using electromagnetic waves. This paper illustrates a case study from the Grasberg mining complex where non-invasive information on the depth of damage and condition of the remaining rock mass was required. GPR with 100 MHz antenna resolution was used to obtain images of the subsurface to determine rehabilitation requirements prior to recommencing production activities. The GPR surveys were used to calibrate the reflection coefficient response of varying rock mass conditions to known Rock Quality Designation (RQD) parameters observed at the mine. The calibrated GPR survey allowed site engineers to map subsurface conditions and plan rehabilitation accordingly.

Keywords: block caving, ground penetrating radar, reflectivity, RQD

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Authors: M. Insiat Islam Rabby, M. Mahbubur Rahman, Eshanul Islam, A. K. M. Sadrul Islam

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The numerical and simulative analysis of laminar heat exchange convection of aluminum oxide (Al₂O₃) - water nanofluid for the developed region through two parallel plates is presented in this present work. The second order single phase energy equation, mass and momentum equation are solved by using finite volume method with the ANSYS FLUENT 16 software. The distance between two parallel plates is 4 mm and length is 600 mm. Aluminum oxide (Al₂O₃) is used as nanoparticle and water is used as the base/working fluid for the investigation. At the time of simulation 1% to 5% volume concentrations of the Al₂O₃ nanoparticles are used for mixing with water to produce nanofluid and a wide range of interval of Reynolds number from 500 to 1100 at constant heat flux 500 W/m² at the channel wall has also been introduced. The result reveals that for increasing the Reynolds number the Nusselt number and heat transfer coefficient are increased linearly and friction factor decreased linearly in the developed region for both water and Al₂O₃-H₂O nanofluid. By increasing the volume fraction of Al₂O₃-H₂O nanofluid from 1% to 5% the value of Nusselt number increased rapidly from 0.7 to 7.32%, heat transfer coefficient increased 7.14% to 31.5% and friction factor increased very little from 0.1% to 4% for constant Reynolds number compared to pure water. At constant heat transfer coefficient 700 W/m2-K the pumping power advantages have been achieved 20% for 1% volume concentration and 62% for 3% volume concentration of nanofluid compared to pure water.

Keywords: convective heat transfer, pumping power, constant heat flux, nanofluid, nanoparticles, volume concentration, thermal conductivity

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Authors: K. Sathishkumar, V. Thiagarasu

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Due to recent advances in DNA microarray technology, it is now feasible to obtain gene expression profiles of tissue samples at relatively low costs. Many scientists around the world use the advantage of this gene profiling to characterize complex biological circumstances and diseases. Microarray techniques that are used in genome-wide gene expression and genome mutation analysis help scientists and physicians in understanding of the pathophysiological mechanisms, in diagnoses and prognoses, and choosing treatment plans. DNA microarray technology has now made it possible to simultaneously monitor the expression levels of thousands of genes during important biological processes and across collections of related samples. Elucidating the patterns hidden in gene expression data offers a tremendous opportunity for an enhanced understanding of functional genomics. However, the large number of genes and the complexity of biological networks greatly increase the challenges of comprehending and interpreting the resulting mass of data, which often consists of millions of measurements. A first step toward addressing this challenge is the use of clustering techniques, which is essential in the data mining process to reveal natural structures and identify interesting patterns in the underlying data. This work presents an analysis of several clustering algorithms proposed to deals with the gene expression data effectively. The existing clustering algorithms like Support Vector Machine (SVM), K-means algorithm and evolutionary algorithm etc. are analyzed thoroughly to identify the advantages and limitations. The performance evaluation of the existing algorithms is carried out to determine the best approach. In order to improve the classification performance of the best approach in terms of Accuracy, Convergence Behavior and processing time, a hybrid clustering based optimization approach has been proposed.

Keywords: microarray technology, gene expression data, clustering, gene Selection

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Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

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Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Main text: Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. Conclusions: The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments

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Authors: Karthik K. R, Viswanath V, Asraff A. K

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The first stage of a new-generation launch vehicle of ISRO makes use of large pressure vessels made of Aluminium alloy AA2219 to store fuel and oxidizer. These vessels have many weld joints that may contain cracks or crack-like defects during their fabrication. These defects may propagate across the vessel during pressure testing or while in service under the influence of tensile stresses leading to catastrophe. Though ductile materials exhibit significant stable crack growth prior to failure, it is not generally acceptable for an aerospace component. There is a need to predict the initiation of stable crack growth. The structural integrity of the vessel from fracture considerations can be studied by constructing the Failure Assessment Diagram (FAD) that accounts for both brittle fracture and plastic collapse. Critical crack sizes of the pressure vessel may be highly conservative if it is predicted from FAD alone. If the J-R curve for material under consideration is available apriori, the critical crack sizes can be predicted to a certain degree of accuracy. In this paper, a novel approach is proposed to predict the integrity of a weld in a pressure vessel made of AA2219 material. Fracture parameter ‘J-integral’ at the crack front, evaluated through finite element analyses, is used in the new procedure. Based on the simulation of tension tests carried out on SCT specimens by NASA, a cut-off value of J-integral value (J?ᵤₜ_ₒ??) is finalised. For the pressure vessel, J-integral at the crack front is evaluated through FE simulations incorporating different surface cracks at long seam weld in a cylinder and in dome petal welds. The obtained J-integral, at vessel level, is compared with a value of J?ᵤₜ_ₒ??, and the integrity of vessel weld in the presence of the surface crack is firmed up. The advantage of this methodology is that if SCT test data of any metal is available, the critical crack size in hardware fabricated using that material can be predicted to a better level of accuracy.

Keywords: FAD, j-integral, fracture, surface crack

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Authors: Rafi Ullah, Shah Muhammad Emaduddin, Taha Jilani

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Vehicle Adhoc Networks (VANET) belongs to a special class of Mobile Adhoc Network (MANET) with high mobility. Network is created by road side vehicles equipped with communication devices like GPS and Wifi etc. Since the environment is highly dynamic due to difference in speed and high mobility of vehicles and weak stability of the network connection, it is a challenging task to design an efficient routing protocol for such an unstable environment. Our proposed algorithm uses heuristic for the calculation of optimal path for routing the packet efficiently in collaboration with several other parameters like geographical location, speed, priority, the distance among the vehicles, communication range, and networks congestion. We have incorporated probabilistic, heuristic and machine learning based approach inconsistency with the relay function of the memory buffer to keep the packet moving towards the destination. These parameters when used in collaboration provide us a very strong and admissible heuristics. We have mathematically proved that the proposed technique is efficient for the routing of packets, especially in a medical emergency situation. These networks can be used for medical emergency, security, entertainment and routing purposes.

Keywords: heuristics routing, intelligent routing, VANET, route optimization

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Authors: Vishnu Nagendra, Marten Van Der Veen, Stefania Giodini

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Effective humanitarian logistics operations are a cornerstone in the success of disaster relief operations. However, for effectiveness, they need to be demand driven and supported by adequate data for prioritization. Without this data operations are carried out in an ad hoc manner and eventually become chaotic. The current availability of geospatial data helps in creating models for predictive damage and vulnerability assessment, which can be of great advantage to logisticians to gain an understanding on the nature and extent of the disaster damage. This translates into actionable information on the demand for relief goods, the state of the transport infrastructure and subsequently the priority areas for relief delivery. However, due to the unpredictable nature of disasters, the accuracy in the models need improvement which can be done using remote sensing data from UAVs (Unmanned Aerial Vehicles) or satellite imagery, which again come with certain limitations. This research addresses the need for a framework to combine data from different sources to support humanitarian logistic operations and prediction models. The focus is on developing a workflow to combine data from satellites and UAVs post a disaster strike. A three-step approach is followed: first, the data requirements for logistics activities are made explicit, which is done by carrying out semi-structured interviews with on field logistics workers. Second, the limitations in current data collection tools are analyzed to develop workaround solutions by following a systems design approach. Third, the data requirements and the developed workaround solutions are fit together towards a coherent workflow. The outcome of this research will provide a new method for logisticians to have immediately accurate and reliable data to support data-driven decision making.

Keywords: unmanned aerial vehicles, damage prediction models, remote sensing, data driven decision making

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Authors: Daniel J. Glauber

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Knowledge transfer between personnel could benefit an organization’s improved competitive advantage in the marketplace from a strategic approach to knowledge management. The lack of information sharing between personnel could create knowledge transfer gaps while restricting the decision-making processes. Knowledge transfer between personnel can potentially improve information sharing based on an implemented knowledge management strategy. An organization’s capacity to gain more knowledge is aligned with the organization’s prior or existing captured knowledge. This case study attempted to understand the overall influence of a KMS within the corporate environment and knowledge exchange between personnel. The significance of this study was to help understand how organizations can improve the Return on Investment (ROI) of a knowledge management strategy within a knowledge-centric organization. A qualitative descriptive case study was the research design selected for this study. The lack of information sharing between personnel may create knowledge transfer gaps while restricting the decision-making processes. Developing a knowledge management strategy acceptable at all levels of the organization requires cooperation in support of a common organizational goal. Working with management and executive members to develop a protocol where knowledge transfer becomes a standard practice in multiple tiers of the organization. The knowledge transfer process could be measurable when focusing on specific elements of the organizational process, including personnel transition to help reduce time required understanding the job. The organization studied in this research acknowledged the need for improved knowledge management activities within the organization to help organize, retain, and distribute information throughout the workforce. Data produced from the study indicate three main themes including information management, organizational culture, and knowledge sharing within the workforce by the participants. These themes indicate a possible connection between an organizations KMS, the organizations culture, knowledge sharing, and knowledge transfer.

Keywords: knowledge transfer, management, knowledge management strategies, organizational learning, codification

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Authors: Jung Ae Park, Jooyong Park

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Writing is an important learning activity that cultivates higher level thinking. Effective and immediate feedback is necessary to help improve students' writing skills. Peer assessment can be an effective method in writing tasks because it makes it possible for students not only to receive quick feedback on their writing but also to get a chance to examine different perspectives on the same topic. Peer assessment can be practiced frequently and has the advantage of immediate feedback. However, there is controversy about the accuracy of peer assessment. In this study, we tried to demonstrate experimentally how the accuracy of peer assessment could be improved. Participants (n=76) were randomly assigned to groups of 4 members. All the participant graded two sets of 4 essays on the same topic. They graded the first set twice, and the second set or the posttest once. After the first grading of the first set, each group in the experimental condition 1 (discussion group), were asked to discuss the results of the peer assessment and then to grade the essays again. Each group in the experimental condition 2 (reading group), were asked to read the assessment on each essay by an expert and then to grade the essays again. In the control group, the participants were asked to grade the 4 essays twice in different orders. Afterwards, all the participants graded the second set of 4 essays. The mean score from 4 participants was calculated for each essay. The accuracy of the peer assessment was measured by Pearson correlation with the scores of the expert. The results were analyzed by two-way repeated measure ANOVA. The main effect of grading was observed: Grading accuracy got better as the number of grading experience increased. Analysis of posttest accuracy revealed that the score variations within a group of 4 participants decreased in both discussion and reading conditions but not in the control condition. These results suggest that having students discuss their grading together can be an efficient means to improve peer assessment accuracy. By discussing, students can learn from others about what to consider in grading and whether their grading is too strict or lenient. Further research is needed to examine the exact cause of the grading accuracy.

Keywords: peer assessment, evaluation accuracy, discussion, score variations

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Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

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Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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Authors: Tri Murti Tugiman, Awalyya Fasha

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This research aims to analyze the magnitude of the economic losses incurred as a result of a person suffering from a particular disease of the ten highest in the productive age diseases in Hospitals Inche Abdul Moeis Samarinda. This research was a descriptive survey research and a secondary data analysis. For the analysis of economic losses populations used are all in patients who suffer from the 10 highest diseases in the productive age in hospitals IA Moeis Samarinda in 2011. Sampling was performed by using a stratified random sampling with samples of 77 people. Research results indicate that the direct cost community incurred to obtain medical services in hospitals IA Moeis is IDR 74437520. The amount of indirect costs incurred during service in a community hospital is IDR 10562000. The amount lost due to sickness fee is IDR 5377800. The amount of economic lost people to obtain medical services in hospitals IA Moeis is IDR 90377320. The number of days of hospitalization was as much as 171 respondents throughout the day. This study suggests the economic loss could be prevented by changes in the lifestyle of the people who clean and healthy along with the following insurance.

Keywords: hospitalized, economic lost, productive age diseases, secondary data analysis

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Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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Authors: Ebru Dural, M. Zulfu Asık

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Laminated glass is a kind of safety glass, which is made by 'sandwiching' two glass sheets and a polyvinyl butyral (PVB) interlayer in between them. When the glass is broken, the interlayer in between the glass sheets can stick them together. Because of this property, the hazards of sharp projectiles during natural and man-made disasters reduces. They can be widely applied in building, architecture, automotive, transport industries. Laminated glass can easily undergo large displacements even under their own weight. In order to explain their true behavior, they should be analyzed by using large deflection theory to represent nonlinear behavior. In this study, a nonlinear mathematical model is developed for the analysis of laminated glass cylindrical shell which is free in radial directions and restrained in axial directions. The results will be verified by using the results of the experiment, carried out on laminated glass cylindrical shells. The behavior of laminated composite cylindrical shell can be represented by five partial differential equations. Four of the five equations are used to represent axial displacements and radial displacements and the fifth one for the transverse deflection of the unit. Governing partial differential equations are derived by employing variational principles and minimum potential energy concept. Finite difference method is employed to solve the coupled differential equations. First, they are converted into a system of matrix equations and then iterative procedure is employed. Iterative procedure is necessary since equations are coupled. Problems occurred in getting convergent sequence generated by the employed procedure are overcome by employing variable underrelaxation factor. The procedure developed to solve the differential equations provides not only less storage but also less calculation time, which is a substantial advantage in computational mechanics problems.

Keywords: laminated glass, mathematical model, nonlinear behavior, PVB

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Authors: Mostafa Mjahed

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This paper concerns the control of a nonlinear system using two different methods, reference model and genetic algorithm. The quadcopter is a nonlinear unstable system, which is a part of aerial robots. It is constituted by four rotors placed at the end of a cross. The center of this cross is occupied by the control circuit. Its motions are governed by six degrees of freedom: three rotations around 3 axes (roll, pitch and yaw) and the three spatial translations. The control of such system is complex, because of nonlinearity of its dynamic representation and the number of parameters, which it involves. Numerous studies have been developed to model and stabilize such systems. The classical PID and LQ correction methods are widely used. If the latter represent the advantage to be simple because they are linear, they reveal the drawback to require the presence of a linear model to synthesize. It also implies the complexity of the established laws of command because the latter must be widened on all the domain of flight of these quadcopter. Note that, if the classical design methods are widely used to control aeronautical systems, the Artificial Intelligence methods as genetic algorithms technique receives little attention. In this paper, we suggest comparing two PID design methods. Firstly, the parameters of the PID are calculated according to the reference model. In a second phase, these parameters are established using genetic algorithms. By reference model, we mean that the corrected system behaves according to a reference system, imposed by some specifications: settling time, zero overshoot etc. Inspired from the natural evolution of Darwin's theory advocating the survival of the best, John Holland developed this evolutionary algorithm. Genetic algorithm (GA) possesses three basic operators: selection, crossover and mutation. We start iterations with an initial population. Each member of this population is evaluated through a fitness function. Our purpose is to correct the behavior of the quadcopter around three axes (roll, pitch and yaw) with 3 PD controllers. For the altitude, we adopt a PID controller.

Keywords: quadcopter, genetic algorithm, PID, fitness, model, control, nonlinear system

Procedia PDF Downloads 417

Authors: Engy S. El-Kayal, Mohamed M. S. Arafa

Abstract:

There are various causes of ankle pain including traumatic and non-traumatic causes. Various imaging techniques are available for assessment of AP. MRI is considered to be the imaging modality of choice for ankle joint evaluation with an advantage of its high spatial resolution, multiplanar capability, hence its ability to visualize small complex anatomical structures around the ankle. However, the high costs and the relatively limited availability of MRI systems, as well as the relatively long duration of the examination all are considered disadvantages of MRI examination. Therefore there is a need for a more rapid and less expensive examination modality with good diagnostic accuracy to fulfill this gap. HRU has become increasingly important in the assessment of ankle disorders, with advantages of being fast, reliable, of low cost and readily available. US can visualize detailed anatomical structures and assess tendinous and ligamentous integrity. The aim of this study was to compare the diagnostic accuracy of HRU with MRI in the assessment of patients with AP. We included forty patients complaining of AP. All patients were subjected to real-time HRU and MRI of the affected ankle. Results of both techniques were compared to surgical and arthroscopic findings. All patients were examined according to a defined protocol that includes imaging the tendon tears or tendinitis, muscle tears, masses, or fluid collection, ligament sprain or tears, inflammation or fluid effusion within the joint or bursa, bone and cartilage lesions, erosions and osteophytes. Analysis of the results showed that the mean age of patients was 38 years. The study comprised of 24 women (60%) and 16 men (40%). The accuracy of HRU in detecting causes of AP was 85%, while the accuracy of MRI in the detection of causes of AP was 87.5%. In conclusions: HRU and MRI are two complementary tools of investigation with the former will be used as a primary tool of investigation and the latter will be used to confirm the diagnosis and the extent of the lesion especially when surgical interference is planned.

Keywords: ankle pain (AP), high-resolution ultrasound (HRU), magnetic resonance imaging (MRI) ultrasonography (US)

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Authors: Magdi Elmessiry, Adel Elmessiry

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The fashion industry represents a significant portion of the global gross domestic product, however, it is plagued by cheap imitators that infringe on the trademarks which destroys the fashion industry's hard work and investment. While eventually the copycats would be found and stopped, the damage has already been done, sales are missed and direct and indirect jobs are lost. The infringer thrives on two main facts: the time it takes to discover them and the lack of tracking technologies that can help the consumer distinguish them. Blockchain technology is a new emerging technology that provides a distributed encrypted immutable and fault resistant ledger. Blockchain presents a ripe technology to resolve the infringement epidemic facing the fashion industry. The significance of the study is that a new approach leveraging the state of the art blockchain technology coupled with artificial intelligence is used to create a framework addressing the fashion infringement problem. It transforms the current focus on legal enforcement, which is difficult at best, to consumer awareness that is far more effective. The framework, Crypto CopyCat, creates an immutable digital asset representing the actual product to empower the customer with a near real time query system. This combination emphasizes the consumer's awareness and appreciation of the product's authenticity, while provides real time feedback to the producer regarding the fake replicas. The main findings of this study are that implementing this approach can delay the fake product penetration of the original product market, thus allowing the original product the time to take advantage of the market. The shift in the fake adoption results in reduced returns, which impedes the copycat market and moves the emphasis to the original product innovation.

Keywords: fashion, infringement, blockchain, artificial intelligence, textiles supply chain

Procedia PDF Downloads 249

Authors: P. Cinthuja, J. A. O. A Jayakody, M. P. M. Perera, W. V. D. N. Weerarathna, S.E. Nirosha, D. K. D. C. Indeewari, T. Kaethieswaran, S. B. Adikari

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The aims of the study was to measure physical fitness parameters of school badminton players in the Kandy district and determine the factors contributing to improve the physical fitness. Height, weight, handgrip was measured and sit and reach test, shoulder flexibility test, standing long jump test, 20m sprint speed test, agility T-test and 20 m multistage shuttle run test were performed on 183 school badminton players. Linear regression and correlation tests were performed using body mass index, practiced duration, age category, level of performance, additional sports involvement as independent variables and physical fitness parameter as dependent variables. Results: The present study showed that the upper body power, upper body strength and endurance and speed depended on body mass index both in male and female school badminton players. Speed, agility, flexibility of shoulders, explosive power of shoulder and aerobic endurance depended on the duration of practiced. Furthermore, involvement in additional sports other than badminton did not enhance the performance of badminton players. But it decreased player’s performance by decreasing agility and speed. Age had an effect on the upper body power, explosive power of lower limb, agility and speed both in both males and females. Conclusions: The performance of badminton players could be enhanced by maintaining a proper body mass index. Badminton specific parameter could be improved by increasing the duration of practiced. Involvement in other sports does not give an added advantage to badminton players to improve their performance.

Keywords: agility, Body Mass Index, endurance, badminton

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Authors: Bereket Amare Mulu

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Ethiopia is one of the countries that consists of a huge variety of botanical resources as compared to the world. The agroclimatic is suitable for a variety of plants to grow effectively throughout the year. Sources of food plants are basic items for people in the world. Production of food items is a prior activity and needs more resources and attention to produce a huge amount of production. The local food is rich in nutrition and healthful foods. The local food is fresh and not exposed to infections easily. The community can easily get the food items in their surroundings. The local food sources are not expensive when it is compared to the other proceed food items, and it is affordable to the community purchasing power. The food is very tasty and palatable capacity by the whole community categories. The basic problems in Ethiopia are the community experiences some of the common food source items. On the contrary, inefficient food production, low economic growth, and climate variability affected food production. This leads to serious food shortages and acute health problems. The objective of the study is to identify local food sources and analyze the advantage and benefits of local food sources. Casava is one of the root crop plants in Ethiopia and easily adapts to any type of agroecology in every place in the country. 50 community members have been identified to prepare casava in different forms of food items. They have prepared in the forms of Bread, Injera, Porridge, Boiled casava, fried chips Casava, and Cocktails. The prepared food items have been exposed to the community as a food festival to eat and taste how much interesting Even though there is a cultural barrier to eating the food items, the community had the food and tasted it the food. The result showed that community awareness is still not addressed the benefits of local food sources yet. The local food has high nutritional value and healthful foods. The local food sources are fresh and easily produced in every place of the country.

Keywords: bread, cassava, injera, nutrition

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Authors: Lakhminandan Kakati, Merenjungla Jamir

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Rearing of six strains of Samia ricini (eri silk worm) i.e. Yellow plain (YP), Yellow spotted (YS), Yellow Zebra (YZ), Greenish blue plain (GBP), Greenish blue spotted (GBS) and Greenish blue zebra (GBZ) was conducted on Ricinus communis (Castor), Heteropanax fragrans (Kesseru), Evodia fraxinifolia (Payam) and Manihot utilissima (Tapioca) to evaluate the effect of seasonal pattern on larval duration and cocoon parameters in Nagaland, India. Larval duration during spring season was maximum in all strains in all food plants; however minimum for all strains was recorded during summer season on Castor, Kesseru and Tapioca. Cocoon weight was recorded to be minimum (2.8 ± 2 0.55 gm) in YP on Kesseru and maximum (4.06 ± 0.68 gm) in GBZ on Castor during spring season; shell weight fluctuated between 0.34 ± 0.08 gm during spring in GBS on Kesseru and 0.58 ± 0.09 gm during summer in YZ on Castor and percentage of silk ratio was found to be minimum and maximum in YP on Payam during spring (11.37 ± 1.29) and in GBS on Castor during summer (16.05 ± 1.59) respectively. The variation in larval duration and cocoon parameters reflected variation in nutrient composition of food plants and dynamic environment conditions prevailing in different seasons of the year. Payam and Tapioca plants could be fed either singly or alternately with Castor or Kesseru to attain the commercial advantage to ensure more value added production. While there were differences in the productivity parameters with respect to strains and seasons, the present study shows that all the strains on four host plants expressed adaptability and suitability for commercial rearing under Nagaland climatic condition.

Keywords: alternative food plants, Larval and cocoon parameters, Nagaland Inia, six strains of Samia ricini

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Authors: Jasna Prester, Ivana Rašić Bakarić, Božidar Matijević

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Various prominent scholars and substantial practitioner-oriented literature on innovation orientation have shown positive effects on firm performance. There is a myriad of factors that influence and enhance innovation but it has been found in the literature that new product innovations accounted for an average of 14 percent of sales revenues for all firms. If there is one thing that has changed in innovation management during the last decade, it is the growing reliance on external partners. As a consequence, a new task for purchasing arises, as firms need to understand which suppliers actually do have high potential contributing to the innovativeness of the firm and which do not. Purchasing function in an organization is extremely important as it deals on an average of 50% or more of a firm's expenditures. In the nineties the purchasing department was largely seen as a transaction-oriented, clerical function but today purchasing integration provides a formal interface mechanism between purchasing and other firm functions that services other functions within the company. Purchasing function has to be organized differently to enable firm innovation potential. However, innovations are inherently risky. There are behavioral risk (that some partner will take advantage of the other party), technological risk in terms of complexity of products and processes of manufacturing and incoming materials and finally market risks, which in fact judge the value of the innovation. These risks are investigated in this work since it has been found in the literature that the higher the technological risk, higher will be the centralization of the purchasing function as an interface with other supply chain members. Most researches on organization of purchasing function were done by case study analysis of innovative firms. This work actually tends to prove or discard results found in the literature based on case study method. A large data set of 1493 companies, from 25 countries collected in the GMRG 4 survey served as a basis for analysis.

Keywords: purchasing function organization, innovation, technological risk, GMRG 4 survey

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Authors: Najla Alhkalaf

Abstract:

The focus of this study is answering the following question: How do e-government services in Bahrain support the productivity of SMEs? This study examines the current E-government function in enhancing SME productivity in Bahrain through analysing the efficiency of e- government by viewing its facilitators and barriers from the perspective of different stakeholders. The study aims to identify and develop best practice guidelines with the end-goal of creating a standardised channel of communication between e-government and SMEs that fulfil the requirement of SME owners, and thus achieve the prime objective of e-government. E-government services for SMEs have been offered in Bahrain since 2005. However, the current services lack the required mechanism for SMEs to fully take advantage of these services because of lagging communication between service provider and end-user. E-government employees believe that a lack of awareness and trust are the main stumbling block, whereas the SME owners believe that there is a lack of sufficiency in the content and efficiency provided through e- services. A questionnaire has been created based on a pilot study that highlighted the main indicators of e-government efficiency and SMEs productivity as well as previous studies conducted on this subject. This allowed for quantitative data to be extracted. Also interviews were conducted with SME owners and government employees from both case studies, which formed the qualitative data for this study. The findings portray that both the service provider and service receiver largely agree on the existence of most of the technical and administrative barriers. However, the data reflects a level of dissatisfaction from the SME side, which contradicts with the perceived level of satisfaction from the government employees. Therefore, the data supports the argument that assures the existence of a communication gap between stakeholders. To this effect, this research would help build channels of communication between stakeholders, and then induces a plan unlocking the potential of e-government application. The conclusions of this study will help devise an optimised E-government strategy for Bahrain.

Keywords: e-government, SME, e-services, G2B, government employees' perspective, entrepreneurs' perspective, enterprise

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Authors: Marc Polo, Núria Arbonés Arán

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Amsterdam is considered one of the great European capitals, which concentrates the headquarters of various multinational companies and which, in addition, enjoys a huge tourist attraction. Its typical residential buildings next to the canals, the museums, or its striking "Red Light District" are a great focus of attraction. In 2019 almost 9 million tourists visited it, but few of them traveled to the farthest neighborhood in the city: Amsterdam-Zuidoost (Amsterdam-Southeast). This neighborhood is geographically separated from the urban core, which makes it an exclave of Amsterdam as it does not border any of the other boroughs. Bijlmermeer neighborhood is the largest of the Amsterdam-Zuidoost, and it was born in the 1960s with the expectations of becoming the city of the future. Its main architect, Siegfried Nassuth, was inspired by the Swiss Le Corbusier to design nearly 18,000 homes, most of which were in high-rise tower blocks and built together, forming a recognizable "honeycombed" pattern. For more than 40 years, a series of infrastructure and social vicissitudes have made the neighborhood outline quite different as it was expected to be. It helped also varied elements such as ethnicity, demolitions, or unoccupied apartments. The called “city of the future” became home to immigrants, drug addicts, and vandals, and the conflicts denigrated the Amsterdam-Zuidoost. This work analyzes the evolution of the Bijlmermeer from its origins and illustrates relevant international referents able to help the area. The purpose of the work is to show how different variations along the recent history didn't help enough, but how there are positive perspectives for the future taking advantage of the food as a creative issue. The research, based on academic literature, existing material in different stadiums, plus the analysis of the city imaginaries, will help to concrete relevant elements in terms of innovation, creativity, and disruption. Despite of radical renewal that is taking place, the research will demonstrate that there are still new opportunities for the old Bijlmermeer.

Keywords: amsterdam, bijlmermeer, creativity, food

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Authors: Nirali Shukla, Neel Shah

Abstract:

The World Bank Institute (WBI) is undertaking a review of government interventions aimed at facilitating sustainable investment in public private partnerships (PPPs) in various under developed countries. The study presents best practice for applying financial model to make PPPs financially viable. The lessons presented here, if properly implemented, can help countries use limited funds to attract more private investment, get more infrastructure built and, as a result, achieve greater economic growth. The four countries Brazil, Colombia, Mexico, and India in total develop an average of nearly US$50 billion in PPPs per year. There are a range of policies and institutional arrangements governments use to provide subsidies to PPPs. For example, some countries have created dedicated agencies, or ‘funds’, capitalized with money from the national budget to manage and allocate subsidies. Other countries have established well-defined policies for appropriating subsidies on an ad hoc basis through an annual budget process. In this context, subsidies are direct fiscal contributions or grants paid by the government to a project when revenues from user fees are insufficient to cover all capital and operating costs while still providing private investors with a reasonable rate of return. Without subsidies, some infrastructure projects that would provide economic or social gains, but are not financially viable, would go undeveloped. But the Financial model of BOLT (PPP) model described in this study suggests that it is most feasible option rather than going for subsidy schemes for making infrastructure projects financially viable. The major advantage for implementing this model is the government money is saved and can be used for other projects as well as the private investors are getting better rate of return than subsidized schemes.

Keywords: PPP, BOLT, subsidy schemes, financial model

Procedia PDF Downloads 743

Authors: Angelis P. Barlampas, Ghita Bianca-Andreea

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A case of a prostatic midline cyst is presented, which was found during a routine general ultrasound examination in an otherwise healthy young man. The incidence of prostatic cysts discovered in suprapubic ultrasound examination has constantly been rising over the previous decades. Despite the fact that the majority of them are benign, a significant amount is related to symptoms, such as pain, dysuria, infertility, and even cancer. The wide use of ultrasound examination and the increasing availability of high-resolution ultrasound systems have rendered new diagnostic challenges. Once upon a time a suprapubic ultrasound was only useful for measuring only the size and the dimensions of the prostatic gland. It did not have the ability to analyze and resolve structures such as cystic or solid nodules. The current machine equipment has managed to depict the imaging characteristics of lesions with high acuity that compares of an intrarectal ultrasound. But the last one is a specialized examination, which demands expertise and good knowledge. Maybe the time has come for the general radiologist and, especially the one who uses suprapubic ultrasound, to pay more attention to the examination of the prostate gland and to take advantage of the superb abilities and the high resolution of the new ultrasound systems. That is exactly, what this case is emphasizing. The incidental discovery of prostatic cysts, and the relatively little available literature about managing them turns them into an interesting theme for exploring and studying. The prostatic cysts are further divided into midline and paramidline cysts, with the first being usually utricle cysts. A more precise categorization is as follows: A midline cystic lesion usually regards a Mullerian duct cyst, a prostatic utricle cyst, an ejaculatory duct cyst, a prostatic cystadenoma, a ductus deferens cyst, and a TURP. On the other hand, a lateral cystic lesion usually refers to a cystic degeneration of benign prostatic hyperplasia, a prostatic retention cyst, a seminal vesicle cyst, diverticular prostatitis, a prostatic abscess, cavitatory prostatitis from chronic prostatitis, a parasitic prostatic cyst, a cystic prostatic carcinoma, e.t.c.

Keywords: prostatic cyst, radiology, benign prostatic lesions, prostatic cancer, suprapubic prostatic ultrasound

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Authors: Emily Jin, Harry Sharples, Anne Weist

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Introduction: NICE Evidence Search Student Champion Scheme is a peer-assisted learning scheme that aims to improve the routine use of evidence-based information by future health and social care staff. The focus is on the NICE evidence search portal that provides selected information from more than 800 reliable health, social care, and medicines sources, including up-to-date guidelines and information for the public. This paper aims to evaluate the effectiveness of the scheme when implemented in Liverpool School of Medicine and to understand the experiences of those attending. Methods: Twelve student champions were recruited and trained in February 2020 as peer tutors during a workshop facilitated by NICE. Cascade sessions were then organised and delivered on an optional basis for students, in small groups of < 10 to approximately 70 attendees. Surveys were acquired immediately before and 8-12 weeks after cascade sessions (n=47 and 45 respectively). Data from these surveys facilitated the analysis of the scheme. Results: Surveys demonstrated 74% of all attendees frequently searched for health and social care information online as a part of their studies. However, only 15% of attendees reported having prior formal training on searching for health information, despite receiving such training earlier on in the curriculum. After attending cascade sessions, students reported a 58% increase in confidence when searching for information using evidence search, from a pre-session a baseline of 36%. Conclusion: NICE Evidence Search Student Champion Scheme provided clear benefits for attending students, increasing confidence in searching for peer-reviewed, mainly secondary sources of health information. The lack of reported training represents the unmet need that the champion scheme satisfies, and this likely benefits student champions as well as attendees. Increasing confidence in searching for healthcare information online may support future evidence-based decision-making.

Keywords: evidence-based medicine, NICE, medical education, medical school, peer-assisted learning

Procedia PDF Downloads 120