Search results for: surgical innovation

Authors: George N. Zaimes, Valasia Iakovoglou, Paschalis Koutalakis, Konstantinos Ioannou, Ioannis Kosmadakis, Panagiotis Tsardaklis, Theodoros Laopoulos

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The advancements in technology allow the development of a new system that can continuously measure surface soil erosion. Continuous soil erosion measurements are required in order to comprehend the erosional processes and propose effective and efficient conservation measures to mitigate surface erosion. Mitigating soil erosion, especially in Mediterranean countries such as Greece, is essential in order to maintain environmental and agricultural sustainability. In this paper, we present the Automated Soil Erosion Monitoring System (ASEMS) that measures surface soil erosion along with other factors that impact erosional process. Specifically, this system measures ground level changes (surface soil erosion), rainfall, air temperature, soil temperature and soil moisture. Another important innovation is that the data will be collected by remote communication. In addition, stakeholder’s awareness is a key factor to help reduce any environmental problem. The different dissemination activities that were utilized are described. The overall outcomes were the development of an innovative system that can measure erosion very accurately. These data from the system help study the process of erosion and find the best possible methods to reduce erosion. The dissemination activities enhance the stakeholder's and public's awareness on surface soil erosion problems and will lead to the adoption of more effective soil erosion conservation practices in Greece.

Keywords: soil management, climate change, new technologies, conservation practices

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Authors: Jing Jiang, Yuguang Gao, Yang Yu

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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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Authors: Chien-kuo Chang, Bo-wei Wu, Yi-yun Tang, Min-chiu Wu

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This paper proposes a power equipment diagnosis system based on partial discharge (PD), which is characterized by increasing the readability of experimental data and the convenience of operation. This system integrates a variety of analysis programs of different data formats and different programming languages and then establishes a set of interfaces that can follow and expand the structure, which is also helpful for subsequent maintenance and innovation. This study shows a case of using the developed Convolutional Neural Networks (CNN) to integrate with this system, using the designed model architecture to simplify the complex training process. It is expected that the simplified training process can be used to establish an adaptive deep learning experimental structure. By selecting different test data for repeated training, the accuracy of the identification system can be enhanced. On this platform, the measurement status and partial discharge pattern of each equipment can be checked in real time, and the function of real-time identification can be set, and various training models can be used to carry out real-time partial discharge insulation defect identification and insulation state diagnosis. When the electric power equipment entering the dangerous period, replace equipment early to avoid unexpected electrical accidents.

Keywords: partial discharge, convolutional neural network, partial discharge analysis platform, adaptive deep learning

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Authors: Augustina Konadu Larbi-Ampofo, Ekemini Umoinwek

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Background: Hypercalcaemia is a common electrolyte imbalance that increases mortality if poorly controlled. Primary hyperparathyroidism often presents like this with a prevalence of 0.1-0.3%. Management due to an ectopic parathyroid adenoma in the mediastinum is challenging, especially in a patient with a pacemaker. Case Presentation: A 79-year-old woman with a history of a previous cardiac arrest, permanent pacemaker, ischaemic heart disease, bilateral renal calculi, rectal polyps, liver cirrhosis, and a family history of hyperthyroidism presented to the emergency department with acute back pain. Management and Outcome: The patient was diagnosed with primary hyperparathyroidism due to her elevated corrected calcium and parathyroid hormone levels. Parathyroid investigations consisting of an NM MIBI scan, SPECT-CT, 4D parathyroid scan, and an ultrasound scan of the neck and thorax confirmed an ectopic parathyroid adenoma in the mediastinum at the level of the aortic arch, along with benign thyroid nodules. The location of the adenoma warranted a thoracoscopic surgical approach; however, the presence of her pacemaker and other cardiovascular conditions predisposed her to a potentially poorer post-operative outcome. Discussion: Mediastinal ectopic parathyroid adenomas are rare and difficult to diagnose and treat, often needing a multimodal imaging approach for accurate localisation. Surgery is a definitive treatment; however, in this patient, long-term medical treatment with cinacalcet was the only next suitable treatment option. The difficulty with this is that cinacalcet tackles the biochemical markers of the disease entity and not the disease itself, leaving room for what happens next if there is refractory/uncontrolled hypercalcaemia in this patient with a pacemaker. Moreover, the coexistence of her multiple conditions raises the suspicion of an underlying multisystemic or multiple endocrine disorder, with multiple endocrine neoplasia coming to mind, necessitating further genetic or autoimmune investigations. Conclusion: Mediastinal ectopic parathyroid adenomas are rare, with diagnostic and management challenges.

Keywords: mediastinal ectopic parathyroid adenoma, hyperparathyroidism, SPECT/CT, nuclear medicine, multimodal imaging

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Authors: Sharadha G., Suresh Kanakkanavar

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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

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Authors: Ilias A. Makris

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In this work, we attempt to associate firm characteristics with innovative activity. We collect microdata from listed firms of selected Eurozone Country-members, after the beginning of 2007 financial crisis. The following literature, several indicators of growth and performance were selected and tested for their ability to interpret innovative activity. The main scope is to examine the possible differences in performance and growth between innovative and non-innovative firms, during a severe recession. Additionally to that, a special focus will be held on whether macroeconomic performance and national innovation system, determines the extent of innovators' performance. Preliminary findings, through correlation matrices and non-parametric tests, strongly indicate the positive relation between innovative activity and most of the measures used (profitability, size, employment), confirming that even during a recessionary period, innovative firms not only survive but also seem to succeed better economic results in almost all indexes relative to non-innovative. However, even though innovators seem to perform better in all economies examined, the extent of that performance seems to be strongly affected by the supportive mechanisms (financial and structural) that their country provides. Thus, it is clear, that the technologically intensive 'gap' between European South and North, during the economic crisis, became chaotic, due to the harsh austerity measures and reduced budgets in those countries, even in sectors with high potentials in economic activity and employment, impairing the effects of crisis and enhancing the vicious circle of recession.

Keywords: eurozone, innovative activity, development, firm performance, non-parametric tests

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Authors: Chen-Yu Chien, Shiow-Fang Shieh

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Tattoos are the most intimate form of body art. Unlike other art forms, tattoos emphasize breaking through tradition, innovation, and creativity. The designs created by tattoo artists are often regarded as true works of art. In recent years, there has been a notable increase in athletes with tattoos, thereby amplifying the beliefs and psychological expressions conveyed by tattoos on athletes compared to the past. The primary objectives of this study are 1. to explore and understand the presence and significance of tattoos for athletes and 2. to examine the impact of tattoos on athletes' performance. This study employs a semi-structured, in-depth interview method utilizing purposive sampling. The participants are athletes who have engaged in regular exercise for more than three years and have tattoos. A total of 10 athletes were interviewed, including 9 males and 1 female, aged between 24 and 43 years, each with different sports specializations. The sample was collected using snowball sampling. Results and Discussion: 1. For athletes, tattoos are not merely body decorations but serve to reinforce their inner beliefs, thereby enhancing their athletic performance. 2. Tattoos have a positive impact on the appearance of athletes. 3. The influence of tattoos on athletic performance extends beyond physical appearance, serving as a psychological motivation and support. 4. Individuals with tattoos tend to be more outgoing and extroverted, with higher impulsivity and adventurousness in their athletic endeavors. Conclusion: I. For athletes, tattoos not only have a positive impact on their appearance but also strengthen their internal beliefs. II. Athletes with tattoos exhibit not only greater extroversion and openness but also heightened impulsivity and adventurousness in their athletic performance.

Keywords: tattoo, athletes, athletic performance, psychological impact, body art

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Authors: Kruttika Bhuse

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Aim: Synergism between periodontists and orthodontists (periodontal accelerated osteogenic orthodontics- PAOO) creates crucial opportunities to enhance clinical outcomes of combined therapies regarding both disciplines and has made adult orthodontics a reality. Thus, understanding the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. Wilckodontics can be an attractive treatment option and be a “win-win” situation for both the dental surgeon and patient by reducing the orthodontic treatment time in adults. Materials and methods: In this review, data related to the clinical aspects, steps of procedure, biomechanics of bone, indications and contraindications and final outcome of wilckodontic shall be discussed. 50 supporting articles from various international journals and 70 clinical cases were reviewed to get a better understanding to design this wilckodontic - meta analysis. Various journals like the Journal Of Clinical And Diagnostic Research, Journal Of Indian Society Of Periodontology, Journal Of Periodontology, Pubmed, Boston Orthodontic University Journal, Good Practice Orthodontics Volume 2, have been referred to attain valuable information on wilckodontics which was then compiled in this single review study. Result: As a promising adjuvant technique based on the transient nature of demineralization-remineralisation process in healthy tissues, wilckodontics consists of regional acceleratory phenomenon by alveolar corticotomy and bone grafting of labial and palatal/lingual surfaces, followed by orthodontic force. The surgical wounding of alveolar bone potentiates tissue reorganization and healing by a way of transient burst of localized hard and soft tissue remodelling.This phenomenon causes bone healing to occur 10-50 times faster than normal bone turnover. Conclusion: This meta analysis helps understanding that the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. The main benefits being reduced orthodontic treatment time, increased bone volume and post-orthodontic stability.

Keywords: periodontal osteogenic accelerated orthodontics, alveolar corticotomy, bone augmentation, win-win situation

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Authors: Shubham Damke, Md Imtiaz, Sanchita Dei

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To stimulate the well and to enhance the production from the shaly formations, fracturing is essential. Presently the chiefly employed technology is Hydraulic Fracturing. However Hydraulic Fracturing accompanies itself with problems like disposing large volumes of fracturing wastewater, removal of water from the pores, formation damage due to injection of large amount of chemicals into underground formations and many more. Therefore embarking on the path of innovation new techniques have been developed which uses different gases such as Nitrogen, Carbon dioxide, Frac Oil, LPG, etc. are used as a base fluid for fracturing formation. However LPG proves to be the most favorable of them which eliminates the use of water and chemicals. When using it as a fracturing fluid, within the surface equipment, it is stored, gelled, and proppant blended at a constant pressure. It is then pressurized with high pressure pumps to the required surface injection pressure With lowering the total cost and increasing the productivity, LPG is also very noteworthy for fracturing shale, where if the hydraulic fracturing is done the water ‘swells’ the formation and creates surface tension, both of which inhibit the flow of oil and gas. Also fracturing with LPG increases the effective fracture length and since propane, butane and pentane is used which are already present in the natural gas therefore there is no problem of back flow because these gases get mixed with the natural gas. LPG Fracturing technology can be a promising substitute of the Hydraulic Fracturing, which could substantially reduce the capital cost of fracturing shale and will also restrict the problems with the disposal of water and on the same hand increasing the fracture length and the productivity from the shale.

Keywords: Fracking, Shale, Surface Tension, Viscosity

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Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq

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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.

Keywords: PTT, trainee, trauma, non-chest trauma patients

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Bhaskar Chakravorti, Christopher Tunnard, Ravi Shankar Chaturvedi

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This report introduces the Digital Evolution Index (DEI) as a way to gauge the transformation of economies in the advanced and developing world from traditional brick-and-mortar to digitally enabled. The DEI measures the digital trajectories of 50 countries to provide actionable, data-informed insights for businesses, investors and policymakers. Created by The Fletcher School, in collaboration with MasterCard Worldwide and DataCash, the DEI analyzes the key underlying drivers and barriers that govern a country’s evolution into a digital economy: Demand, Supply, Institutional Environment and Innovation. A longitudinal analysis of these four drivers during the years 2008 to 2013 reveals both the current state of a country’s digital economy, as well as changes over time. Combining these two measures allows us to assign each country to one of four Trajectory Zones: • Stand Out countries have shown high levels of digital development in the past and continue to remain on an upward trajectory. • Stall Out countries have achieved a high level of evolution in the past but are losing momentum and risk falling behind. • Break Out countries have the potential to develop strong digital economies. Though their overall score is still low, they are moving upward and are poised to become Stand Out countries in the future. • Watch Out countries face significant opportunities and challenges, with low scores on both current level and upward motion of their DEI. Some may be able to overcome limitations with clever innovations and stopgap measures, while others seem to be stuck.

Keywords: e-commerce, digital evolution, digital commerce ecosystems, e-consumer

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Authors: Robyn Moloney, HuiLing Xu

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Many countries wish to produce Asia-literate citizens, through language education. International contexts of Chinese language education are seeking pedagogical innovation to meet local contextual factors frequently holding back learner success. In multicultural Australia, innovative pedagogy is urgently needed to support motivation in sustained study, with greater strategic integration of technology. This research took a qualitative approach to identify need and solutions. The paper analyses strategies that three secondary school teachers are adopting to meet specific challenges in the Australian context. The data include teacher interviews, classroom observations and student interviews. We highlight the use of task-based learning and differentiated teaching for multilevel classes, and the role which digital technologies play in facilitating both areas. The strategy examples are analysed in reference both to a research-based framework for describing quality teaching, and to current understandings of motivation in language learning. The analysis of data identifies learning featuring deep knowledge, higher-order thinking, engagement, social support, utilisation of background knowledge, and connectedness, all of which work towards the learners having a sense of autonomy and an imagination of becoming an adult Chinese language user.

Keywords: Chinese pedagogy, digital technologies, motivation, secondary school

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Authors: Tibor Koltay

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Among varied new literacies, information literacy is not only the best-known one but displays numerous models and frameworks. Nonetheless, there is still a lack of its complex theoretical model that could be applied to information literacy education in public (K12) education, which often makes use of constructivist approaches. This paper aims to present the main features of such a model. To develop a complex model, the literature and practice of phenomenographic and sociocultural theories, as well as discourse analytical approaches to information literacy, have been reviewed. Besides these constructivist and expressive based educational approaches, the new model is intended to include the innovation of coupling them with a cognitive model that takes developing informational and operational knowledge into account. The convergences between different literacies (information literacy, media literacy, media and information literacy, and data literacy) were taken into account, as well. The model will also make use of a three-country survey that examined secondary school teachers’ attitudes to information literacy. The results of this survey show that only a part of the respondents feel properly prepared to teach information literacy courses, and think that they can teach information literacy skills by themselves, while they see a librarian as an expert in educating information literacy. The use of the resulting model is not restricted to enhancing theory. It is meant to raise the level of awareness about information literacy and related literacies, and the next phase of the model’s development will be a pilot study that verifies the usefulness of the methodology for practical information literacy education in selected Hungarian secondary schools.

Keywords: communication, data literacy, discourse analysis, information literacy education, media and information literacy media literacy, phenomenography, public education, sociocultural theory

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Authors: Carmela Mariano

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The literature, the scientific and disciplinary debate related to the impacts of climate change on the territory has highlighted, in recent years, the need for climate-proof and resilient tools of urban planning that adopt an integrated and inter-scalar approach for the construction of urban regeneration strategies by the objectives of the European Strategy on adaptation to climate change, the 2030 Agenda for Sustainable Development and the Climate Conference. This article addresses the operational implications of urban climate resilience in urban planning tools as a priority objective of policymakers (government bodies, institutions, etc.) to respond to the risks of climate change-related impacts on the environment. Within the general framework of the research activities carried out by the author, this article provides a critical synthesis of the analysis and evaluation of some case studies from the Italian national context, which enabled, through an inductive method, the assessment of the process of implementing the adaptation to climate change within the regional urban planning frameworks (regional urban laws), specific regional adaptation strategies or local adaptation plans and within the territorial and urban planning tools of a metropolitan or local scale. This study aims to identify theoretical–methodological, and operational references for the innovation and integration of planning tools concerning climate change that allow local planners to test these references in specific territorial contexts to practical adaptation strategies for local action.

Keywords: urban resilience, urban regeneration, climate-proof-planning, urban planning

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Authors: Selin Öztürk Demirkiran

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Approaches towards sustainability and energy efficiency are significant topics of our era. These approaches need to be addressed across various fields and are relevant to multiple disciplines. Building facades, as the first surface encountering external weather conditions, should be considered and analyzed within this context. Current seasonal changes due to global warming and the influence on climates have highlighted the necessity for building systems to adapt to these changes, emphasizing the need for long-lasting solutions. Therefore, this study aims to examine adaptive system applications using examples from similar climatic regions and buildings of different functions, classifying them according to adaptive system criteria. It also aims to explore and evaluate the current stage of such systems in Turkey and the potential for their implementation. In this study, six building examples with different functions, including two examples for each adaptive type, were analyzed from regions with climates similar to those in Turkey, with detailed examination sheets prepared. The purpose of this study is to contribute to ongoing developments by presenting findings on current concepts and analyses and proposing a distinct approach for the characterization of these elements at the scale of Turkey. From this perspective, there is a considerable amount of literature on adaptive facade designs, and while application examples exist, adaptive approaches have been developed and partially implemented. It is expected that innovative solutions in this field will find a place in Turkey in the near future, following the increasing number of examples globally.

Keywords: adaptive facade, smart building facades, facade innovation, sustainability.

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Authors: Naeem Hassan

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The study intended to investigate the impact of the e banking system on the performance efficiency of the commercial banks in KP, Pakistan. In addition to this main purpose, the study also aimed at analyzing the impact of e banking on the service quality as well as satisfaction of the customers using e banking system. More over, the focus was also given to highlight the risks involved in the e banking system. The researcher has adopted the quantitative methodology in the study. in order to reach concrete finding, the researcher has analyzed the secondary data taken from the annual reports of selected banks and State bank of Pakistan as well as the primary data collected through the self-administrated questionnaire from the participants selected for the current study. The study highlighted that there is a significant impact of e banking on the financial efficiency on the commercial banks in KP, Pakistan. Additionally, the results of the study also show that the online banking is having significant effects on the customer satisfaction. The researcher recommends on the bases of findings that commercial banks should continue to adopt new technologies which will improve their margins and hence their net profit after tax in order to attract more investors. Additionally, commercial bank needs to minimize the time and risk in e-banking to attract more customers which will improve their net profit. Furthermore, the study findings also recommend the banking policy makers should also review policies related to promotion of innovation adoption and transfer of technology. Commercial banking system should encourage adoption of innovations that will improve profit of the banking industry.

Keywords: E-banking, performance efficiency, commercial banks, effect

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Authors: Achim Kampker, Kai Kreiskoether, Johannes Wagner, Sarah Fluchs

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The growing speed of innovation in related industries requires the automotive industry to adapt and increase release frequencies of new vehicle derivatives which implies a significant reduction of investments per vehicle and ramp-up times. Emerging markets in various parts of the world augment the currently dominating established main automotive markets. Local content requirements such as import tariffs on final products impede the accessibility of these micro markets, which is why in the future market exploitation will not be driven by pure sales activities anymore but rather by setting up local assembly units. The aim of this paper is to provide an overview of the concept of decentralized assembly and to discuss and critically assess some currently researched and crucial approaches in production technology. In order to determine the scope in which complementary mobile assembly can be profitable for manufacturers, a general cost model is set up and each cost driver is assessed with respect to varying levels of decentralization. One main result of the paper is that the presented approaches offer huge cost-saving potentials and are thus critical for future production strategies. Nevertheless, they still need to be further exploited in order for decentralized assembly to be profitable for companies. The optimal level of decentralization must, however, be specifically determined in each case and cannot be defined in general.

Keywords: automotive assembly, e-mobility, production technology, release capability, small series assembly

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Authors: Wilhelmus Hary Susilo

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The marketplace would have at least some resources that are unique (e.g., well communication, knowledgeable employees, consumer value, effective transaction, efficient production processes and institutional branding). The institutions should have an advantage in resources and then could lead to positions of competitive advantage. These major challenges focus on increasing unique consumer value on reliable purchases that influence of loyalty and pursuit of a sustainable competitive advantage from the Institutions in Jakarta. Furthermore, a research was conducted with a quantitative method and a confirmatory strategic research design. The research resulted in entire confirmatory factors analysis (1st CFA and 2nd CFA) among variables pertains to; χ2//Df (9.30, 4.38, 6.95, 2.76, 2.97, 2.91, 2.32 and 6.90), GFI (0.72, 0.82, 0.82, 0.81, 0.78, 0.84, 0.89 and 0.70) and CFI (0.90, 0.95, 0.93, 0.92, 0.95, 0.91, 0.96 and 0.89), which indicates a good model. Furthermore, the hybrid model is well fit with, χ2//Df=1.84, P value = 0.00, RMSEA = 0.076, GFI = 0.76, NNFI= 0.95, PNFI= 0.82, IFI= 0.96, RFI= 0.91, AGFI= 0.71 and CFI= 0.96. The result was significant hypothesis, i.e. variables of communitization marketing 3.0 and price perception influenced to unique value of consumer with tvalue =4.46 and 5.89. Furthermore, the consumers value influenced the purchasing with t value = 5.94. Additionally, the loyalty, the ‘communitization’, and the character building marketing 3.0 are affecting the pursuit of a sustainable competitive advantage from institutions with t value = 7.57, -2.12, and 2.04. Finally, the test between the most superior variable dimensions is significantly correlated between INOV and WDES, RESPON and ATT covariance matrix value= 0.72 and 0.71. Thus, ‘communitization’ and character building marketing 3.0 with dimensions of responsibility and technologies would increase a competitive advantage with the dimensions of the innovation and the job design from the institutions.

Keywords: consumer loyalty, marketing 3.0, unique consumer value, purchase, sustainable competitive advantage

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Authors: Rosalie Menon, Angela Reid

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Building integrated photovoltaic systems with air collectors (hybrid PV-T) have proved successful however there are few examples of their application in the UK. The opportunity to pull heat from behind the PV system to contribute to a building’s heating system is an efficient use of waste energy and its potential to improve the performance of the PV array is well documented. As part of Glasgow School of Art’s estate expansion, the purchase and redevelopment of an existing 1950’s college building was used as a testing vehicle for the hybrid PV-T system as an integrated element of the upper floor and roof. The primary objective of the feasibility study was to determine if hybrid PV-T was technically and financially suitable for the refurbished building. The key consideration was whether the heat recovered from the PV panels (to increase the electrical efficiency) can be usefully deployed as a heat source within the building. Dynamic thermal modelling (IES) and RetScreen Software were used to carry out the feasibility study not only to simulate overshadowing and optimise the PV-T locations but also to predict the atrium temperature profile; predict the air load for the proposed new 4 No. roof mounted air handling units and to predict the dynamic electrical efficiency of the PV element. The feasibility study demonstrates that there is an energy reduction and carbon saving to be achieved with each hybrid PV-T option however the systems are subject to lengthy payback periods and highlights the need for enhanced government subsidy schemes to reward innovation with this technology in the UK.

Keywords: building integrated, photovoltatic thermal, pre-heat air, ventilation

Procedia PDF Downloads 171

Authors: Keping Zuo, Foad Kabinejadian, Gideon Praveen Kumar Vijayakumar, Fangsen Cui, Pei Ho, Hwa Liang Leo

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Carotid artery stenting (CAS) is the standard procedure for patients with severe carotid stenosis at high risk for carotid endarterectomy (CAE). A major drawback of CAS is the higher incidence of procedure-related stroke compared with traditional open surgical treatment for carotid stenosis - CEA, even with the use of the embolic protection devices (EPD). As the currently available bare metal stents cannot address this problem, our research group developed a novel preferential covered-stent for carotid artery aims to prevent friable fragments of atherosclerotic plaques from flowing into the cerebral circulation, and yet maintaining the flow of the external carotid artery. The preliminary animal studies have demonstrated the potential of this novel covered-stent design for the treatment of carotid atherosclerotic stenosis. The purpose of this study is to evaluate the effect of membrane coating on the stent flexibility in order to improve the clinical performance of our novel covered stents. A total of 21 stents were evaluated in this study: 15 self expanding bare nitinol stents and 6 PTFE-covered stents. 10 of the bare stents were coated with 11%, 16% and 22% Polyurethane(PU), 4%, 6.25% and 11% EE, as well as 22% PU plus 5 μm Parylene. Different laser cutting designs were performed on 4 of the PTFE covert stents. All the stents, with or without the covered membrane, were subjected to a three-point flexural test. The stents were placed on two supports that are 30 mm apart, and the actuator is applying a force in the exact middle of the two supports with a loading pin with radius 2.5 mm. The loading pin displacement change, the force and the variation in stent shape were recorded for analysis. The flexibility of the stents was evaluated by the lumen area preservation at three displacement bending levels: 5mm, 7mm, and 10mm. All the lumen areas in all stents decreased with the increase of the displacement from 0 to 10 mm. The bare stents were able to maintain 0.864 ± 0.015, 0.740 ± 0.025 and 0.597 ± 0.031of original lumen area at 5 mm, 7 mm and 10mm displacement respectively. For covered stents, the stents with EE coating membrane showed the best lumen area preservation (0.839 ± 0.005, 0.7334 ± 0.043 and 0.559 ± 0.014), whereas, the stents with PU and Parylene coating were only 0.662, 0.439 and 0.305. Bending stiffness was also calculated and compared. These results provided optimal material information and it was crucial for enhancing clinical performance of our novel covered stents.

Keywords: carotid artery, covered stent, nonlinear, hyperelastic, stress, strain

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Authors: Babatunde Osabiya

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Cybersecurity has emerged as a pressing policy problem in recent years, affecting individuals, businesses, and governments worldwide. This research paper aims to critically review the literature on cybersecurity policy and apply policy theory to propose a policy approach that balances the freedom to access and use technology with the human rights risks and threats posed by cyber. Drawing on various credible sources, the paper examines the scale and seriousness of cyber threats, highlighting the growing threat posed by cybercriminals, hackers, and nation-states. The paper also identifies the key challenges facing policymakers, including the need for more significant investment in cybersecurity research and development and the importance of balancing the benefits of technological innovation with the risks to privacy, security, and human rights. To address these challenges, the paper proposes a policy approach emphasizing investing in cybersecurity research and development to maintain a technological edge over potential adversaries. This approach also highlights the need for greater collaboration between government, industry, and civil society to develop effective cybersecurity policies and practices that protect the rights and freedoms of people while mitigating the risks posed by cyber threats. This paper will contribute to the growing body of literature on cybersecurity policy and offers a policy framework for addressing this critical policy challenge.

Keywords: security risk, legal framework, cyber security and policy, national security

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Authors: Cam-Duc Au, Philippe Krahnhof, Lars Klingenberger

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German banks are experiencing harsh times due to rising costs and declining profits. On the one hand, acquisition costs for new customers are increasing because of the rise of innovative FinTechs, which entered the market with one specific goal: disrupting the whole financial services industry by occupying parts of the value chain. On the other hand, the COVID-19 pandemic, as well as an overall low level of interest rates, cause the traditional source of bank income to still drain. Consequently, traditional banks must rethink their strategies or their identity, so to speak, because they go beyond their traditional offering of products and services. Having said that, banks may create new sources of income to stabilize their economic situation and replenish profits. The given paper aims to research the opportunities of establishing an ecosystem model. In doing so, the paper contributes to the current literature debate and provide reference points for traditional banks to start. Firstly, a systematic literature review introduces a selection of research works the author regards as significant. In the following step, quantitative data from an online survey with bank clients are analysed by means of descriptive statistics to show the perspective of Germans with regards to an ecosystem offering. The final research findings indicate that the surveyed retail banking clients express interest in the new offer, whereas non-financial products and services are of lower interest than their financial pendants.

Keywords: banking, ecosystem, disruptive innovation, digital offering, open-banking-strategy, financial services industry

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Authors: Nazanin Pilevari, Kamyar Mahmoodi

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The purpose of this research is to provide a model based on fuzzy inference system for evaluating empowerment of Knowledge management. The first prototype of the research was developed based on the study of literature. In the next step, experts were provided with these models and after implementing consensus-based reform, the views of Fuzzy Delphi experts and techniques, components and Index research model were finalized. Culture, structure, IT and leadership were considered as dimensions of empowerment. Then, In order to collect and extract data for fuzzy inference system based on knowledge and Experience, the experts were interviewed. The values obtained from designed fuzzy inference system, made review and assessment of the organization's empowerment of Knowledge management possible. After the design and validation of systems to measure indexes ,empowerment of Knowledge management and inputs into fuzzy inference) in the AYANDEH Bank, a questionnaire was used. In the case of this bank, the system output indicates that the status of empowerment of Knowledge management, culture, organizational structure and leadership are at the moderate level and information technology empowerment are relatively high. Based on these results, the status of knowledge management empowerment in AYANDE Bank, was moderate. Eventually, some suggestions for improving the current situation of banks were provided. According to studies of research history, the use of powerful tools in Fuzzy Inference System for assessment of Knowledge management and knowledge management empowerment such an assessment in the field of banking, are the innovation of this Research.

Keywords: knowledge management, knowledge management empowerment, fuzzy inference system, fuzzy Delphi

Procedia PDF Downloads 359

Authors: Elmahdi Khalil, Saad Enniari, Mostapha Zbakh

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Cloud computing promises to increase innovation and the velocity with witch applications are deployed, all while helping any enterprise meet most IT service needs at a lower total cost of ownership and higher return investment. As the march of cloud continues, it brings both new opportunities and new security challenges. To take advantages of those opportunities while minimizing risks, we think that Intrusion Detection Systems (IDS) integrated in the cloud is one of the best existing solutions nowadays in the field. The concept of intrusion detection was known since past and was first proposed by a well-known researcher named Anderson in 1980's. Since that time IDS's are evolving. Although, several efforts has been made in the area of Intrusion Detection systems for cloud computing environment, many attacks still prevail. Therefore, the work presented in this paper proposes a multi criteria analysis and a comparative study between several IDS architectures designated to work in a cloud computing environments. To achieve this objective, in the first place we will search in the state of the art of several consistent IDS architectures designed to work in a cloud environment. Whereas, in a second step we will establish the criteria that will be useful for the evaluation of architectures. Later, using the approach of multi criteria decision analysis Mac Beth (Measuring Attractiveness by a Categorical Based Evaluation Technique we will evaluate the criteria and assign to each one the appropriate weight according to their importance in the field of IDS architectures in cloud computing. The last step is to evaluate architectures against the criteria and collecting results of the model constructed in the previous steps.

Keywords: cloud computing, cloud security, intrusion detection/prevention system, multi-criteria decision analysis

Procedia PDF Downloads 472

Authors: Jyh-Ping Chen, Chia-Lin Sheu

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In this study, we propose to use electrospinning to fabricate porous nanofibrous membranes as postsurgical anti-adhesion barriers and to improve the properties of current post-surgical anti-adhesion products. We propose to combine FDA-approved biomaterials with anti-adhesion properties, polycaprolactone (PCL), polyethylene glycol (PEG), hyaluronic acid (HA) with silver nanoparticles (Ag) and ibuprofen (IBU), to produce anti-adhesion barrier nanofibrous membranes. For this purpose, PEG/PCL/Ag/HA/IBU core-shell nanofibers were prepared. The shell layer contains PEG + PCL to provide mechanical supports and Ag was added to the outer PEG-PCL shell layer during electrospinning to endow the nanofibrous membrane with anti-bacterial properties. The core contains HA to exert anti-adhesion and IBU to exert anti-inflammation effects, respectively. The nanofibrous structure of the membranes can reduce cell penetration while allowing nutrient and waste transports to prevent postsurgical adhesion. Nanofibers with different core/shell thickness ratio were prepared. The nanofibrous membranes were first characterized for their physico-chemical properties in detail, followed by in vitro cell culture studies for cell attachment and proliferation. The HA released from the core region showed extended release up to 21 days for prolonged anti-adhesion effects. The attachment of adhesion-forming fibroblasts is reduced using the nanofibrous membrane from DNA assays and confocal microscopic observation of adhesion protein vinculin expression. The Ag released from the shell showed burst release to prevent E Coli and S. aureus infection immediately and prevent bacterial resistance to Ag. Minimum cytotoxicity was observed from Ag and IBU when fibroblasts were culture with the extraction medium of the nanofibrous membranes. The peritendinous anti-adhesion model in rabbits and the peritoneal anti-adhesion model in rats were used to test the efficacy of the anti-adhesion barriers as determined by gross observation, histology, and biomechanical tests. Within all membranes, the PEG/PCL/Ag/HA/IBU core-shell nanofibers showed the best reduction in cell attachment and proliferation when tested with fibroblasts in vitro. The PEG/PCL/Ag/HA/IBU nanofibrous membranes also showed significant improvement in preventing both peritendinous and peritoneal adhesions when compared with other groups and a commercial adhesion barrier film.

Keywords: anti-adhesion, electrospinning, hyaluronic acid, ibuprofen, nanofibers

Procedia PDF Downloads 181

Authors: Mohammed Al-Zubaidi, Katherine Ong, Pravin Viswambaram, Steve McCombie, Oliver Oey, Jeremy Ong, Richard Gauci, Ronny Low, Dickon Hayne

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Objective: Lymph node involvement along with distant metastasis in a patient with invasive bladder cancer determines the disease survival, therefeor, it is an essential determinant of the therapeutic management and outcome. This retrospective study aims to determine the accuracy of FDG PET scan in detecting lymphatic involvement and distant metastatic urothelial cancer compared to conventional CT staging. Method: A retrospective review of 76 patients with UC or BC who underwent surgery or confirmatory biopsy that was staged with both CT and 18F-FDG-PET (up to 8 weeks apart) between 2015 and 2020. Fifty-sevenpatients (75%) had formal pelvic LN dissection or biopsy of suspicious metastasis. 18F-FDG-PET reports for positive sites were qualitative depending on SUV Max. On the other hand, enlarged LN by RECIST criteria 1.1 (>10 mm) and other qualitative findings suggesting metastasis were considered positive in CT scan. Histopathological findings from surgical specimens or image-guided biopsies were considered the gold standard in comparison to imaging reports. 18F-FDG-avid or enlarged pelvic LNs with surgically proven nodal metastasis were considered true positives. Performance characteristics of 18F-FDG-PET and CT, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (PPV), were calculated. Results: Pelvic LN involvement was confirmed histologically in 10/57 (17.5%) patients. Sensitivity, specificity, PPV and NPV of CT for detecting pelvic LN metastases were 41.17% (95% CI:18-67%), 100% (95% CI:90-100%) 100% (95% CI:59-100%) and 78.26% (95% CI:64-89%) respectively. Sensitivity, specificity, PPV and NPV of 18F-FDG-PET for detecting pelvic LN metastases were 62.5% (95% CI:35-85%), 83.78% (95% CI:68-94%), 62.5% (95% CI:35-85%), and 83.78% (95% CI:68-94%) respectively. Pre-operative staging with 18F-FDG-PET identified the distant metastatic disease in 9/76 (11.8%) patients who were occult on CT. This retrospective study suggested that 18F-FDG-PET may be more sensitive than CT for detecting pelvic LN metastases. 7/76 (9.2%) patients avoided cystectomy due to 18F-FDG-PET diagnosed metastases that were not reported on CT. Conclusion: 18F-FDG-PET is more sensitive than CT for pelvic LN metastases, which can be used as the standard modality of bladder cancer staging, as it may change the treatment by detecting lymph node metastasis that was occult in CT. Further research involving randomised controlled trials comparing the diagnostic yield of 18F-FDG-PET and CT in detecting nodal and distant metastasis in UC or BC is warranted to confirm our findings.

Keywords: FDG PET, CT scan, urothelial cancer, bladder cancer

Procedia PDF Downloads 121

Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

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Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

Procedia PDF Downloads 149

Authors: Ann-May Marais

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South African higher education institutions are following the global adoption of a blended approach to teaching and learning. Blended learning is viewed as a transformative teaching-learning approach, as it provides students with the optimum experience by mixing the best of face-to-face and online learning. Although academics realise the benefits of blended learning, they find it challenging and time-consuming to implement blended strategies. Professional development is a critical component of the adoption of higher education teaching-learning approaches. The Institutional course for higher education academics offered at a South African University was designed in a blended model, implemented and evaluated. This paper reports on a study that investigated the experiences of academics on the blended approach used during the induction course. A qualitative design-based research methodology was employed, and data was collected using participant feedback and document analysis. The data gathered from each of the four ICNL offerings were used to inform the design of the next course. Findings indicated that lecturers realised that blended learning could cater to student diversity, different learning styles, engagement, and innovation. Furthermore, it emerged that the course has to cater for diversity in technology proficiency and readiness of participants. Participants also require ongoing support in technology usage and discipline-specific blended learning workshops. This paper contends that the modelling of a blended approach to professional development can be an effective way to motivate academics to apply blended learning in their teaching-learning experiences.

Keywords: blended learning, professional development, induction course, integration of technology

Procedia PDF Downloads 162

Authors: M. F. Amado, A. Amado, F. Poggi, J. Correia de Freitas

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Today it is widely understood that global energy consumption patterns are directly related to the ongoing urban expansion and development process. This expansion is based on the natural growth of human activities and has left most urban areas totally dependent on fossil fuel derived external energy inputs. This status-quo of production, transportation, storage and consumption of energy has become inefficient and is set to become even more so when the continuous increases in energy demand are factored in. The territorial management of land use and related activities is a central component in the search for more efficient models of energy use, models that can meet current and future regional, national and European goals. In this paper, a methodology is developed and discussed with the aim of improving energy efficiency at the municipal level. The development of this methodology is based on the monitoring of energy consumption and its use patterns resulting from the natural dynamism of human activities in the territory and can be utilized to assess sustainability at the local scale. A set of parameters and indicators are defined with the objective of constructing a systemic model based on the optimization, adaptation and innovation of the current energy framework and the associated energy consumption patterns. The use of the model will enable local governments to strike the necessary balance between human activities, economic development, and the local and global environment while safeguarding fairness in the energy sector.

Keywords: solar urban planning, solar smart city, urban development, energy efficiency

Procedia PDF Downloads 328