Search results for: emergency plan

Authors: Ying-Lun Tseng Chiu-Ying Chen

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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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Authors: Chingwen Yeh, I. Chen Huang

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This paper aims to conduct a case study on kinesthetic intelligence development intervention with a child who has Asperger symptom identified by physician. First, the characteristics of Asperger were defined based on the related literature. Some Asperger's people are born with outstanding insight and are good at solving complex and difficult problems. In contrast to high-functioning autistic, Asperger children do not lose their ability to express themselves verbally. However in the cognitive function, they focus mainly on the things they are interested in instead of paying attention to the whole surrounding situation. Thus it is difficult for them not only to focus on things that they are not interesting in, but also to interact with people. Secondly, 8-weeks of kinesthetic intelligence development courses were designed within a series of physical action that including the following sections: limbs coordination, various parts of body rhythm changes, strength and space awareness and breathing practice. In classroom observations were recorded both on words and with video as the qualitative research data. Finally, in-depth interview with the case child’s teachers, parents and other in class observers were documented on a weekly base in order to examine the effectiveness of before and after the kinesthetic intelligence development course and to testify the usefulness of the lesson plan. This research found that the case child has improved significantly in terms of attention span and body movement creativity. In the beginning of intervention, the case child made less eyes contact with others. The instructor needed to face the case child to confirm the eyes contact. And the instructor also used various adjective words as guiding language for all kinds of movement sequence practice. The result can cause the case child’s attention and learning motivation. And the case child understand what to do to enhance kinesthetic intelligence. These authors hope findings of this study can contribute as reference for the further research on the related topic.

Keywords: asperger symptom, body rhythm, kinesthetic intelligence, space awareness

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Authors: Arulselvi Subramanian, Albert Venencia, Sanjeev Bhoi

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Coagulopathy of trauma is an early endogenous coagulation abnormality that occurs shortly resulting in high mortality. In emergency trauma situations, viscoelastic tests may be better in identifying the various phenotypes of coagulopathy and demonstrate the contribution of platelet function to coagulation. We aimed to determine thrombin generation and clot strength, by estimating a ratio of Maximum amplitude and R-time (MA-R ratio) for identifying trauma coagulopathy and predicting subsequent mortality. Methods: We conducted a prospective cohort analysis of acutely injured trauma patients of the adult age groups (18- 50 years), admitted within 24hrs of injury, for one year at a Level I trauma center and followed up on 3rd day and 5th day of injury. Patients with h/o coagulation abnormalities, liver disease, renal impairment, with h/o intake of drugs were excluded. Thromboelastography was done and a ratio was calculated by dividing the MA by the R-time (MA-R). Patients were further stratified into sub groups based on the calculated MA-R quartiles. First sampling was done within 24 hours of injury; follow up on 3rd and 5thday of injury. Mortality was the primary outcome. Results: 100 acutely injured patients [average, 36.6±14.3 years; 94% male; injury severity score 12.2(9-32)] were included in the study. Median (min-max) on admission MA-R ratio was 15.01(0.4-88.4) which declined 11.7(2.2-61.8) on day three and slightly rose on day 5 13.1(0.06-68). There were no significant differences between sub groups in regard to age, or gender. In the lowest MA-R ratios subgroup; MA-R1 (<8.90; n = 27), injury severity score was significantly elevated. MA-R2 (8.91-15.0; n = 23), MA-R3 (15.01-19.30; n = 24) and MA-R4 (>19.3; n = 26) had no difference between their admission laboratory investigations, however slight decline was observed in hemoglobin, red blood cell count and platelet counts compared to the other subgroups. Also significantly prolonged R time, shortened alpha angle and MA were seen in MA-R1. Elevated incidence of mortality also significantly correlated with on admission low MA-R ratios (p 0.003). Temporal changes in the MA-R ratio did not correlated with mortality. Conclusion: The MA-R ratio provides a snapshot of early clot function, focusing specifically on thrombin burst and clot strength. In our observation, patients with the lowest MA-R time ratio (MA-R1) had significantly increased mortality compared with all other groups (45.5% MA-R1 compared with <25% in MA-R2 to MA-R3, and 9.1% in MA-R4; p < 0.003). Maximum amplitude and R-time may prove highly useful to predict at-risk patients early, when other physiologic indicators are absent.

Keywords: coagulopathy, trauma, thromboelastography, mortality

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Authors: Molakala Mourya Vardhan Reddy, Kandimala Revanth, Koduru Sumanth, Beena B. M.

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Emergency response and recovery operations are severely hampered by natural catastrophes, especially floods. Understanding post-flood scenarios is essential to disaster management because it facilitates quick evaluation and decision-making. To this end, we introduce FloodNet, a brand-new high-resolution aerial picture collection created especially for comprehending post-flood scenes. A varied collection of excellent aerial photos taken during and after flood occurrences make up FloodNet, which offers comprehensive representations of flooded landscapes, damaged infrastructure, and changed topographies. The dataset provides a thorough resource for training and assessing computer vision models designed to handle the complexity of post-flood scenarios, including a variety of environmental conditions and geographic regions. Pixel-level semantic segmentation masks are used to label the pictures in FloodNet, allowing for a more detailed examination of flood-related characteristics, including debris, water bodies, and damaged structures. Furthermore, temporal and positional metadata improve the dataset's usefulness for longitudinal research and spatiotemporal analysis. For activities like flood extent mapping, damage assessment, and infrastructure recovery projection, we provide baseline standards and evaluation metrics to promote research and development in the field of post-flood scene comprehension. By integrating FloodNet into machine learning pipelines, it will be easier to create reliable algorithms that will help politicians, urban planners, and first responders make choices both before and after floods. The goal of the FloodNet dataset is to support advances in computer vision, remote sensing, and disaster response technologies by providing a useful resource for researchers. FloodNet helps to create creative solutions for boosting communities' resilience in the face of natural catastrophes by tackling the particular problems presented by post-flood situations.

Keywords: image classification, segmentation, computer vision, nature disaster, unmanned arial vehicle(UAV), machine learning.

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Authors: Mohammad H. Yarmohammadian, Mehdi Nasr Isfahani, Elham Anbari

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Introduction: The awareness of using chemical, biological, and nuclear agents in everyday industrial and non-industrial incidents has increased recently; release of these materials can be accidental or intentional. Since hospitals are the forefronts of confronting Chemical, Biological, Radiological and Nuclear( CBRN) incidents, the goal of the present research was to provide a generic protocol for CBRN incidents through a comparative review of CBRN protocols and guidelines of different countries and reviewing various books, handbooks and papers. Method: The integrative approach or research synthesis was adopted in this study. First a simple narrative review of programs, books, handbooks, and papers about response to CBRN incidents in different countries was carried out. Then the most important and functional information was discussed in the form of a generic protocol in focus group sessions and subsequently confirmed. Results: Findings indicated that most of the countries had various protocols, guidelines, and handbooks for hazardous materials or CBRN incidents. The final outcome of the research synthesis was a 50 page generic protocol whose main topics included introduction, definition and classification of CBRN agents, four major phases of incident and disaster management cycle, hospital response management plan, equipment, and recommended supplies and antidotes for decontamination (radiological/nuclear, chemical, biological); each of these also had subtopics. Conclusion: In the majority of international protocols, guidelines, handbooks and also international and Iranian books and papers, there is an emphasis on the importance of incident command system, determining the safety degree of decontamination zones, maps of decontamination zones, decontamination process, triage classifications, personal protective equipment, and supplies and antidotes for decontamination; these are the least requirements for such incidents and also consistent with the provided generic protocol.

Keywords: hospital, CBRN, decontamination, generic protocol, CBRN Incidents

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Authors: Nur-E-Jannat Tinu

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Water is absolutely vital not only for the survival of human beings but also for plants, animals, and all other living organisms. Water bodies, such as lakes, rivers, ponds, and estuaries, are the source of water supply in domestic, industrial, agriculture, and aquaculture purposes. The Buriganga River flows through the south and west of Dhaka city. The water quality of this river has become a matter of concern due to anthropogenic intervention of vital pollutants such as industrial effluents, urban sewage, and solid wastes in this area. Buriganga River is at risk to contamination from untreated municipal wastes, industrial discharges, runoff from organic and inorganic fertilizers, pesticides, insecticides, and oil emission around the river. The residential and commercial establishments along the river discharge wastewater either directly into the river or through drains and canals into the river. However, several regulatory measures and policies have been enforced by the Government to protect the river Buriganga from pollution, in most cases to no affect. Water quality assessment reveals that the water is also not appropriate for irrigation purposes. The physical parameters (pH, TDS, EC, Temperature, DO, COD, BOD) indicated that the water is too poor to be useable for agricultural, drinking, or other purposes. Chemical concentrations showed significant seasonal variations with high-level concentrations during the monsoon season, presumably due to extreme seasonal surface runoff. A comparative study of Electrical Conductivity (EC) and Total Dissolved Solids (TDS) indicated a considerable increase over the last five years A change in trend was observed from 2020 June-July, probably due to monsoon and post-monsoon. EC values decreased from 775 to 665 mmho/cm during this period. DO increased significantly from the mid-post-monsoon months to the early monsoon period. The pH value of river water is strongly alkaline, ranging between 6.5 and 7.79. This indicates that ecological organic compounds cause the water to become alkaline after the monsoon and monsoon seasons. As the water pollution level is very high, an effective remediation and pollution control plan should be considered.

Keywords: precipitation, spatial distribution, effluent, remediation

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Authors: Yi-Chun Kuo, Jo-Chieh Lin

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The objective of a supply chain strategy is to reduce waste and increase efficiency to attain cost benefits, and to guarantee supply chain flexibility when facing the ever-changing market environment in order to meet customer requirements. Strategy implementation aims to fulfill common goals and attain benefits by integrating upstream and downstream enterprises, sharing information, conducting common planning, and taking part in decision making, so as to enhance the overall performance of the supply chain. With the rise of outsourcing and globalization, the increasing dependence on suppliers and customers and the rapid development of information technology, the complexity and uncertainty of the supply chain have intensified, and supply chain vulnerability has surged, resulting in adverse effects on supply chain performance. Thus, this study aims to use supply chain vulnerability as a moderating variable and apply structural equation modeling (SEM) to determine the relationships among supply chain strategy, supply chain integration, and supply chain performance, as well as the moderating effect of supply chain vulnerability on supply chain performance. The data investigation of this study was questionnaires which were collected from the management level of enterprises in Taiwan and China, 149 questionnaires were received. The result of confirmatory factor analysis shows that the path coefficients of supply chain strategy on supply chain integration and supply chain performance are positive (0.497, t= 4.914; 0.748, t= 5.919), having a significantly positive effect. Supply chain integration is also significantly positively correlated to supply chain performance (0.192, t = 2.273). The moderating effects of supply chain vulnerability on supply chain strategy and supply chain integration to supply chain performance are significant (7.407; 4.687). In Taiwan, 97.73% of enterprises are small- and medium-sized enterprises (SMEs) focusing on receiving original equipment manufacturer (OEM) and original design manufacturer (ODM) orders. In order to meet the needs of customers and to respond to market changes, these enterprises especially focus on supply chain flexibility and their integration with the upstream and downstream enterprises. According to the observation of this research, the effect of supply chain vulnerability on supply chain performance is significant, and so enterprises need to attach great importance to the management of supply chain risk and conduct risk analysis on their suppliers in order to formulate response strategies when facing emergency situations. At the same time, risk management is incorporated into the supply chain so as to reduce the effect of supply chain vulnerability on the overall supply chain performance.

Keywords: supply chain integration, supply chain performance, supply chain vulnerability, structural equation modeling

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Authors: Felix Olajide Ibikunle

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Introductory Statement: Sustainable participation of teenagers in sport requires deliberate and concerted plan and managerial policy rooted in the “philosophy of catch them young”. At risk, teenagers need proper integration into societal aspiration: This direction will go a long way to streamline them into the security breach and attractive nuisance free lifestyles. Basic Methodology: The population consists of children within 13-19 years old. A proportionate sampling size technique of 60% was adopted to select seven zones out of 11 geo-political zones in the Ibadan metropolis. Qualitative information and interview were used to collect needed information. Majority of the teenagers were out of school, street hawkers, motor pack, touts, and unserious vocation apprentices. These groups have the potentials of security breaches in the metropolis and beyond. Five hundred and thirty-four (534) respondents were used for the study. They were drawn from Ojoo, Akingbile, and Moniya axis = 72, Agbowo, Ajibode, and Apete axis = 74; Akobo, Basorun, and Idi-ape axis 79; Wofun, Monatan, and Iyana-Church axis = 78; Molete, Oke-ado and Oke-Bola axis = 75; Beere, Odinjo, Elekuro axis = 77; Eleyele, Ologuneru, and Alesinloye axis = 79. Major Findings: Multiple regression was used to analyze the independent variables and percentage. The respondents average age was 15.6 years old, and with 100% male. The instrument(questionnaire) used yielded; sport preference (r = 0.72); intervention (r = 0.68) and the sustainable participation (r = 0.70).The relative contributions of sport preference on participation of at risk teenagers was (F-ratio = 1.067); Intervention contribution of sport on participation of at risk teenagers = produced (F-ratio of 12.095) was significant while sustainable participation of at risk teenager produced (F-ratio = 1.062) was significant. Closing Statement: The respondents’ sport preference stimulated their participation in sport. The intervention exposed at risk-teenagers to coaching, which activated their interest and participation in sport. While sustainable participation contributed positively to evolve at risk teenagers participation in their preferred sport.

Keywords: sport, preference, intervention, teenagers, sustainable, participation and risk teenagers

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Authors: Warinthorn Kiadtikornthaweeyot Evans, Nawattakorn Kaikaew

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The communication system between the ground station and the satellite is very important to guarantee contact between both sides. Thailand, led by Geo-Informatics and Space Technology Development Agency (GISTDA), has received satellite images from other nation's satellites for a number of years. In 2008, Thailand Earth Observation Satellite (THEOS) was the first Earth observation satellite owned by Thailand. The mission was monitoring our country with affordable access to space-based Earth imagery. At this time, the control ground station was initially used to control the THEOS satellite by our Thai engineers. The Tele-commands were sent to the satellite according to requests from government and private sectors. Since then, GISTDA's engineers have gained their skill and experience to operate the satellite. Recently the desire to use satellite data is increasing rapidly due to space technology moving fast and giving us more benefits. It is essential to ensure that Thailand remains competitive in space technology. Thai Engineers have started to improve the performance of the control ground station in many different sections, also developing skills and knowledge in areas of satellite communication. Human resource skills are being enforced with development projects through capacity building. This paper focuses on the hands-on capacity building of GISTDA's engineers to develop a small automatic tracking antenna. The final achievement of the project is the first phase prototype of a small automatic tracking antenna to support the new technology of the satellites. There are two main subsystems that have been developed and tested; the tracking system and the monitoring and control software. The prototype first phase functions testing has been performed with Two Line Element (TLE) and the mission planning plan (MPP) file calculated from THEOS satellite by GISTDA.

Keywords: capacity building, small tracking antenna, automatic tracking system, project development procedure

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Authors: Poonsook Thatchaopas, Nik Kamariah Nikmat, Nattakarn Eakuru

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Since 2003, the Thai Government has implemented several initiatives to encourage and incubate entrepreneurial skills and motivation among her citizens. One of the initiatives is the “One College One Product” business model or well known as ‘OCOP’, launched by the Vocational Education Commission to encourage partnership between college students to choose at least one product for business venture. In line with this mission, several business enterprises were established such as food products, restaurants, spa, Thai massage, minimart, computer maintenance, karaoke centre, internet café, mini theater etc. Currently, these business incubator projects can be observed at 404 vocational colleges and 21 incubation centres to encourage entrepreneurial small and medium enterprise (SME) development. However, the number of successful OCOP projects is still minimal. Out of the 404 individual OCOP projects at Vocational Colleges around Thailand, very few became successful. The objective of this paper is to identify the critical success factors needed to be a successful OCOP business entrepreneur. This study uses qualitative method by interviewing business partners of an OCOP business called Crispy Roti Krua Acheeva Brand (CRKAB). It is a snack food company that is developed at Pattani Vocational College in South Thailand. This project was initiated by three female entrepreneurs who were alumni student cum owners of the CRKAB. The finding shows that the main critical success factors are self-confidence, creativity or innovativeness, knowledge, skills and perseverance. Additionally, they reiterated that the keys to business success are product quality, perceived price, promotion, branding, new packaging to increase sales and continuous developments. The results implies for a student business SME to be successful, the company should have credible partners and effective marketing plan.

Keywords: student entrepreneurship, business incubator, food industry, qualitative, Thailand

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Authors: Linyao Qiu, Zhiqiang Du

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As the rapid development of urbanization, economic developments, and steady population growth in China, the widespread devastation, economic damages, and loss of human lives caused by numerous forms of natural disasters are becoming increasingly serious every year. Disaster management requires available and effective cooperation of different roles and organizations in whole process including mitigation, preparedness, response and recovery. Due to the imbalance of regional development in China, the disaster management capabilities of national and provincial disaster reduction centers are uneven. When an undeveloped area suffers from disaster, neither local reduction department could get first-hand information like high-resolution remote sensing images from satellites and aircrafts independently, nor sharing mechanism is provided for the department to access to data resources deployed in other place directly. Most existing disaster management systems operate in a typical passive data-centric mode and work for single department, where resources cannot be fully shared. The impediment blocks local department and group from quick emergency response and decision-making. In this paper, we introduce a collaborative platform for distributed disaster reduction. To address the issues of imbalance of sharing data sources and technology in the process of disaster reduction, we propose a multi-role oriented collaboration business mechanism, which is capable of scheduling and allocating for optimum utilization of multiple resources, to link various roles for collaborative reduction business in different place. The platform fully considers the difference of equipment conditions in different provinces and provide several service modes to satisfy technology need in disaster reduction. An integrated collaboration system based on focusing services mechanism is designed and implemented for resource scheduling, functional integration, data processing, task management, collaborative mapping, and visualization. Actual applications illustrate that the platform can well support data sharing and business collaboration between national and provincial department. It could significantly improve the capability of disaster reduction in China.

Keywords: business collaboration, data sharing, distributed disaster reduction, focusing service

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Authors: Amizawati Mohd Amir, Ruhanita Maelah, Zaidi Mohd Noor

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As part of the Malaysia Higher Institutions' Strategic Plan in promoting high-quality research and education, the Ministry of Higher Education has introduced various instrument to assess the universities performance. The aims are that university will produce more commercially-oriented research and continue to contribute in producing professional workforce for domestic and foreign needs. Yet the spirit of the success lies in the commitment of university particularly the academic staff to translate the vision into reality. For that reason, the element of fairness and justice in assessing individual academic staff performance is crucial to promote directly linked between university and individual work goals. Focusing on public research universities (RUs) in Malaysia, this study observes at the issue through the practice of university contemporary performance measurement system. Accordingly management control theory has conceptualized that contemporary performance measurement consisting of three dimension namely strategic, comprehensive and dynamic building upon equity theory, the relationships between contemporary performance measurement system and organizational justice and in turn the effect on academic staff work performance are tested based on online survey data administered on 365 academic staff from public RUs, which were analyzed using statistics analysis SPSS and Equation Structure Modeling. The findings validated the presence of strategic, comprehensive and dynamic in the contemporary performance measurement system. The empirical evidence also indicated that contemporary performance measure and procedural justice are significantly associated with work performance but not for distributive justice. Furthermore, procedural justice does mediate the relationship between contemporary performance measurement and academic staff work performance. Evidently, this study provides evidence on the importance of perceptions of justice towards influencing academic staff work performance. This finding may be a fruitful input in the setting up academic staff performance assessment policy.

Keywords: comprehensive, dynamic, distributive justice, contemporary performance measurement system, strategic, procedure justice, work performance

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Authors: Kevin R. Wilson, Roger Mantie

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Community arts-based learning and participatory education are pedagogical techniques that serve to be advantageous for students, curriculum development, and local communities. Using an interpretive approach to examine the significance of this arts-informed research in relation to the eight ‘design imperatives’ proposed as the new model for measuring quality in scholarship for Arizona State University as ‘A New American University’, the purpose of this study was to investigate personal, social, and cultural benefits resulting from student engagement in interdisciplinary community-based projects. Students from a graduate level music education class at the ASU Tempe campus (n=7) teamed with students from an undergraduate level community development class at the ASU Downtown Phoenix campus (n=14) to plan, facilitate, and evaluate seven community-based projects in several locations around the Phoenix-metro area. Data was collected using photo evidence, student reports, and evaluative measures designed by the students. The effectiveness of each project was measured in terms of their ability to meet the eight design imperatives to: 1) leverage place; 2) transform society; 3) value entrepreneurship; 4) conduct use-inspired research; 5) enable student success; 6) fuse intellectual disciplines; 7) be socially embedded; and 8) engage globally. Results indicated that this community arts-based project sufficiently captured the essence of each of these eight imperatives. Implications for how the nature of this interdisciplinary initiative allowed for the eight imperatives to manifest are provided, and project success is expounded upon in relation to utility of each imperative. Discussion is also given for how this type of service learning project formatted within the ‘New American University’ model for measuring quality in academia can be a beneficial pedagogical tool in higher education.

Keywords: community arts-based learning, participatory education, pedagogy, service learning

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Authors: Konstantinos G. Kostinakis, Asimina M. Athanatopoulou

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A key issue in seismic risk analysis within the context of Performance-Based Earthquake Engineering is the evaluation of the expected seismic damage of structures under a specific earthquake ground motion. The assessment of the seismic performance strongly depends on the choice of the seismic Intensity Measure (IM), which quantifies the characteristics of a ground motion that are important to the nonlinear structural response. Several conventional IMs of ground motion have been used to estimate their damage potential to structures. Yet, none of them has been proved to be able to predict adequately the seismic damage. Therefore, alternative, scalar intensity measures, which take into account not only ground motion characteristics but also structural information have been proposed. Some of these IMs are based on integration of spectral values over a range of periods, in an attempt to account for the information that the shape of the acceleration, velocity or displacement spectrum provides. The adequacy of a number of these IMs in predicting the structural damage of 3D R/C buildings is investigated in the present paper. The investigated IMs, some of which are structure specific and some are nonstructure-specific, are defined via integration of spectral values. To achieve this purpose three symmetric in plan R/C buildings are studied. The buildings are subjected to 59 bidirectional earthquake ground motions. The two horizontal accelerograms of each ground motion are applied along the structural axes. The response is determined by nonlinear time history analysis. The structural damage is expressed in terms of the maximum interstory drift as well as the overall structural damage index. The values of the aforementioned seismic damage measures are correlated with seven scalar ground motion IMs. The comparative assessment of the results revealed that the structure-specific IMs present higher correlation with the seismic damage of the three buildings. However, the adequacy of the IMs for estimation of the structural damage depends on the response parameter adopted. Furthermore, it was confirmed that the widely used spectral acceleration at the fundamental period of the structure is a good indicator of the expected earthquake damage level.

Keywords: damage measures, bidirectional excitation, spectral based IMs, R/C buildings

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Authors: Lawong Damian Bernsah

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Neglected Tropical Diseases (NTDs) are most predominant among the poor and rural populations and are endemic in 149 countries. These diseases are the most prevalent and responsible for infecting 1.4 billion people worldwide. There are 17 neglected tropical diseases recognized by WHO that constitute the fourth largest disease health and economic burden of all communicable diseases. Five of these 17 diseases are considered for the cost analysis of this paper: lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, and soil transmitted helminth infections. WHO has proposed a roadmap for eradication and elimination by 2020 and treatments have been donated through the London Declaration by pharmaceutical manufacturers. The paper estimates the cost of NTD control programme and elimination for each NTD disease and total in Nigeria. This is necessary as it forms the bases upon which programme budget and expenditure could be based. Again, given the opportunity cost the resources for NTD face it is necessary to estimate the cost so as to provide bases for comparison. Cost of NTDs control and elimination programme is estimated using the population at risk for each NTD diseases and for the total. The population at risk is gotten from the national master plan for the 2015 - 2020, while the cost per person was gotten for similar studies conducted in similar settings and ranges from US$0.1 to US$0.5 for Mass Administration of Medicine (MAM) and between US$1 to US$1.5 for each NTD disease. The combined cost for all the NTDs was estimated to be US$634.88 million for the period 2015-2020 and US$1.9 billion for each NTD disease for the same period. For the purpose of sensitivity analysis and for robustness of the analysis the cost per person was varied and all were still high. Given that health expenditure for Nigeria (% of GDP) averages 3.5% for the period 1995-2014, it is very clear that efforts have to be made to improve allocation to the health sector in general which is hoped could trickle to NTDs control and elimination. Thus, the government and the donor partners would need to step-up budgetary allocation and also to be aware of the costs of NTD control and elimination programme since they have alternative uses. Key Words: Neglected Tropical Disease, Cost Analysis, NTD Programme Control and Elimination, Cost per Person

Keywords: Neglected Tropical Disease, Cost Analysis, Neglected Tropical Disease Programme Control and Elimination, Cost per Person

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Authors: Lito M. Amit, Venecio U. Ultra, Young-Woong Song

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The business process outsourcing (BPO) in the Philippines is expanding rapidly attracting more than 2% of total employment. Currently, the BPO industry is confronted with several issues pertaining to sustainable productivity such as meeting the staffing gap, high rate of employees’ turnover and workforce retention, and the occupational health and safety (OHS) of call center agents. We conducted a survey of OHS programs and health concerns among call center agents in the Philippines and determined the sociocultural factors that affect the vulnerability of call center agents to occupational health risks and hazards. The majority of the agents affirmed that OHS are implemented and OHS orientation and emergency procedures were conducted at employment initiations, perceived favorable and convenient working environment except for occasional noise disturbances and acoustic shock, visual, and voice fatigues. Male agents can easily adjust to the demands and changes in their work environment and flexible work schedules than female agents. Female agents have a higher tendency to be pressured and humiliated by low work performance, experience a higher incidence of emotional abuse, psychological abuse, and experience more physical stress than male agents. The majority of the call center agents had a night-shift schedule and regardless of other factors, night shift work brings higher stress to agents. While working in a call center, higher incidence of headaches and insomnia, burnout, suppressed anger, anxiety, and depressions were experienced by female, younger (21-25 years old) and those at night shift than their counterpart. Most common musculoskeletal disorders include body pain in the neck, shoulders and back; and hand and wrist disorders and these are commonly experienced by female and younger workers. About 30% experienced symptoms of cardiovascular and gastrointestinal disorders and weakened immune systems. Overall, these findings have shown the variable vulnerability by a different subpopulation of call center agents and are important in the occupational health risk prevention and management towards a sustainable human resource for BPO industry in the Philippines.

Keywords: business process outsourcing industry, health risk of call center agents, socio-cultural determinants, Philippines

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Authors: Janmejoy Gupta, Arnab Paul, Manjari Chakraborty

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Jharkhand is a state located in the eastern part of India. The Tropic of Cancer (23.5 degree North latitude line) passes through Ranchi district in Jharkhand. Mud huts with burnt clay tiled roofs in Jharkhand are an integral component of the state’s vernacular architecture. They come in various shapes, with a number of them having a courtyard type of plan. In general, it has been stated that designing dwellings with courtyards in them is a climate-responsive strategy in composite climate. The truth behind this hypothesis is investigated in this paper. In this paper, three types of mud huts with courtyards situated in Ranchi district in Jharkhand are taken as a study and through temperature measurements in the south-side rooms and courtyards, in addition to Autodesk Ecotect (Version 2011) software simulations, their thermal performance throughout the year are observed. Temperature measurements are specifically taken during the peak of summer and winter and the average temperatures in the rooms and courtyards during seven day-periods in peak of summer and peak of winter are plotted graphically. Thereafter, on the basis of the study and software simulations, the hypothesis is verified and the thermally better performing dwelling types in summer and winter identified among the three sub-types studied. Certain recommendations with respect to increasing thermal comfort in courtyard type mud huts in general are also made. It is found that all courtyard type dwellings do not necessarily show better thermal performance in summer and winter in composite climate. The U shaped dwelling with open courtyard on southern side offers maximum amount of thermal-comfort inside the rooms in the hotter part of the year and the square hut with a central courtyard, with the courtyard being closed from all sides, shows superior thermal performance in winter. The courtyards in all the three case-studies are found to get excessively heated up during summer.

Keywords: courtyard, mud huts, simulations, temperature measurements, thermal performance

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Authors: Elsa Marta Soares, Ana Rita Valente, Cristiana Rodrigues, Filipa Gonçalves

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Background: The assessment of feelings and attitudes of preschool children in relation to stuttering is crucial. Negative experiences can lead to anxiety, worry or frustration. To avoid the worsening of attitudes and feelings related to stuttering, it is important the early detection in order to intervene as soon as possible through an individualized intervention plan. Then it is important to have Portuguese instruments that allow this assessment. Aims: The aim of the present study is to realize the translation and adaptation of the Communication Attitude Test for Children in Preschool Age and Kindergarten (KiddyCat) for EP. Methodology: For the translation and adaptation process, a methodological study was carried out with the following steps: translation, back translation, assessment by a committee of experts and pre-test. This abstract describes the results of the first two phases of this process. The translation was accomplished by two bilingual individuals without experience in health and any knowledge about the instrument. One of them was an English teacher and the other one a Translator. The back-translation was conducted by two Senior Class Teachers that live in United Kingdom without any knowledge in health and about the instrument. Results and Discussion: In translation there were differences in semantic equivalences of various expressions and concepts. A discussion between the two translators, mediated by the researchers, allowed to achieve the consensus version of the translated instrument. Taking into account the original version of KiddyCAT the results demonstrated that back-translation versions were similar to the original version of this assessment instrument. Although the back-translators used different words, they were synonymous, maintaining semantic and idiomatic equivalences of the instrument’s items. Conclusion: This project contributes with an important resource that can be used in the assessment of feelings and attitudes of preschool children who stutter. This was the first phase of the research; expert panel and pretest are being developed. Therefore, it is expected that this instrument contributes to an holistic therapeutic intervention, taking into account the individual characteristics of each child.

Keywords: assessment, feelings and attitudes, preschool children, stuttering

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Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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Authors: Dylan Elliott, Katya Pertsova

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Preposition errors are some of the most common errors created by L2 speakers. In addition, improving error correction and detection methods remains an open issue in the realm of Natural Language Processing (NLP). This research investigates whether the bidirectional encoder representations from the transformers model (BERT) have the potential to correct preposition errors accurately enough to be useful in error correction software. This research finds that BERT performs strongly when the scope of its error correction is limited to preposition choice. The researchers used an open-source BERT model and over three hundred thousand edited sentences from Wikipedia, tagged for part of speech, where only a preposition edit had occurred. To test BERT’s ability to detect errors, a technique known as multi-level masking was used to generate suggestions based on sentence context for every prepositional environment in the test data. These suggestions were compared with the original errors in the data and their known corrections to evaluate BERT’s performance. The suggestions were further analyzed to determine if BERT more often agreed with the judgements of the Wikipedia editors. Both the untrained and fined-tuned models were compared. Finetuning led to a greater rate of error-detection which significantly improved recall, but lowered precision due to an increase in false positives or falsely flagged errors. However, in most cases, these false positives were not errors in preposition usage but merely cases where more than one preposition was possible. Furthermore, when BERT correctly identified an error, the model largely agreed with the Wikipedia editors, suggesting that BERT’s ability to detect misused prepositions is better than previously believed. To evaluate to what extent BERT’s false positives were grammatical suggestions, we plan to do a further crowd-sourcing study to test the grammaticality of BERT’s suggested sentence corrections against native speakers’ judgments.

Keywords: BERT, grammatical error correction, preposition error detection, prepositions

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Authors: Firoozeh Ghazanfari, Kourosh Amraei, Parisa Poorabadi

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Mild cognitive impairment is one of the neurocognitive disorders that go beyond age-related decline in cognitive functions, but in fact, it is not so severe which affects daily activities. This study aimed to investigate and compare the effectiveness of treatment with cranial electrical stimulation, brain training and their double combination on the language and verbal fluency of the elderly with mild cognitive impairment. This is a single-subject method with comparative intervention designs. Four patients with a definitive diagnosis of mild cognitive impairment by a psychiatrist were selected via purposive and convenience sampling method. Addenbrooke's Cognitive Examination Scale (2017) was used to assess language and verbal fluency. Two groups were formed with different order of cranial electrical stimulation treatment, brain training by pencil and paper method and their double combination, and two patients were randomly replaced in each group. The arrangement of the first group included cranial electrical stimulation, brain training, double combination and the second group included double combination, cranial electrical stimulation and brain training, respectively. Treatment plan included: A1, B, A2, C, A3, D, A4, where electrical stimulation treatment was given in ten 30-minutes sessions (5 mA and frequency of 0.5-500 Hz) and brain training in ten 30-minutes sessions. Each baseline lasted four weeks. Patients in first group who first received cranial electrical stimulation treatment showed a higher percentage of improvement in the language and verbal fluency subscale of Addenbrooke's Cognitive Examination in comparison to patients of the second group. Based on the results, it seems that cranial electrical stimulation with its effect on neurotransmitters and brain blood flow, especially in the brain stem, may prepare the brain at the neurochemical and molecular level for a better effectiveness of brain training at the behavioral level, and the selective treatment of electrical stimulation solitude in the first place may be more effective than combining it with paper-pencil brain training.

Keywords: cranial electrical stimulation, treatment, brain training, verbal fluency, cognitive impairment

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Authors: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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Authors: Bharat Rawat, Shekhar Rajbhandari, Yadav Bhatta, Jay Prakash Jaiswal, Shivaji Bikram Silwal, Rajiv Shrestha, Shova Sunuwar

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Introduction: The honey produced by the bees fed on Rhobdodendron species containing grayanotoxin is known as mad honey. Grayanotoxin is found in honey obtained from the nectar of Rhododendron species growing on the mountains of the Black Sea region of Turkey and also in Japan, Nepal, Brazil, parts of North America, and Europe. Although the incidence of grayanotoxin poisoning is rare, there is concern that the number of cases per year will rise with the increasing demand for organic products. Mad honey intoxication might present with mild symptoms of cardiovascular, gastrointestinal and neurological systems or might also present with a life-threatening form with AV block and cardiovascular collapse. In this article, we describe the summary of five cases, which came to our hospital with mad honey related cardiac complications. Findings: In last one year, five cases presented in the emergency department with sudden onset of Loss of consciousness, dizziness, shortness of breath. They felt difficulty after the consumption of 1-3 teaspoonful of wild honey. The honey was brought from most of the rural parts of Nepal like khotang. Some of them also came with vomiting, dizziness, and loose stool. On examination, most of them had severe bradycardia and low blood pressure. No abnormalities were detected on systemic examinations. In one patient, ECG and cardiac enzymes showed features of the acute coronary syndrome, but his treadmill test done few days later was normal. All patients were managed with inj. Atropine, I/V normal saline, and other supportive measures and discharged in a stable condition within one or two days. Conclusions: Rhododendrons is the national flower of Nepal. The specific species of rhododendron found in Nepal which contains the toxin is not known. Bees feeding on these rhododendrons are known to transfer the grayanotoxin to the honey they produce. Most symptoms are mild and resolve themselves without medical intervention. Signs and symptoms of grayanotoxin poisoning rarely last more than 24 hours and are usually not fatal. Some signs of mad honey poisoning include Bradycardia, Cardiac arrhythmia, Hypotension, Nausea and Vomiting. They respond to close monitoring and appropriate supportive treatment. Normally, patients recover completely with no residual damage to the heart or its conduction system.

Keywords: rhobdodendron, honey, grayanotoxin, bradycardia

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Authors: Bikram Jung Kunwar

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Forests have central roles in climate change. The conservation of forests sequestrates the carbon from the atmosphere and also regulates the carbon cycle. However, knowingly and unknowingly the world’s forests were deforested and degraded annually at the rate of 0.18% and emitted the carbon to the atmosphere. The IPCC reports claimed that the deforestation and forest degradation accounts 1/5th of total carbon emission, which is second position after fossil fuels. Since 1.6 billion people depend on varying degree on forests for their daily livelihood, not all deforestation are undesirable. Therefore, to conserve the forests and find the livelihood opportunities for forest surrounding people is prerequisites to address the climate change problems especially in developing countries, and also a growing concern to the forestry sector researchers, planners and policy makers. The study examines the role of community based forest management in carbon mitigation and adaptation taking the examples of Nepal’s community forestry program. In the program, the government hands over a part of national forests to the local communities with sole forest management authorities. However, the government itself retained the ownership rights of forestland. Local communities organized through a local institution called Community Forest User Group (CFUG) managed the forests. They also formed an operational plan with technical prescriptions and a constitution with forest management rules and regulations. The implementation results showed that the CFUGs are not only found effective to organize the local people and construct a local institution to forest conservation and management activities, but also they are able to collect a community fund from the sale of forest products and carried out various community development activities. These development activities have decisive roles to improve the livelihood of forest surrounding people and eventually to address the climate change problems.

Keywords: climate change, community forestry, local institution, Nepal

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Authors: Romel Cordova Shedan

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The traditional seismic design is the methodology of Forced Based Design (FBD). The Displacement Based Design (DBD) is a seismic design that considers structural damage to achieve a failure mechanism of the structure before the collapse. It is easier to quantify damage of a structure with displacements rather than forces. Therefore, a structure to achieve an inelastic displacement design with good ductility, it is necessary to be damaged. The first part of this investigation is about differences between the methodologies of DBD and FBD with some DBD advantages. In the second part, there is a study case about a dual building 5-story, which is regular in plan and elevation. The building is located in a seismic zone, which acceleration in firm soil is 45% of the acceleration of gravity. Then it is applied both methodologies into the study case to compare its displacements, shear forces and overturning moments. In the third part, the Dynamic Time History Analysis (DTHA) is done, to compare displacements with DBD and FBD methodologies. Three accelerograms were used and the magnitude of the acceleration scaled to be spectrum compatible with design spectrum. Then, using ASCE 41-13 guidelines, the hinge plastics were assigned to structure. Finally, both methodologies results about study case are compared. It is important to take into account that the seismic performance level of the building for DBD is greater than FBD method. This is due to drifts of DBD are in the order of 2.0% and 2.5% comparing with FBD drifts of 0.7%. Therefore, displacements of DBD is greater than the FBD method. Shear forces of DBD result greater than FBD methodology. These strengths of DBD method ensures that structure achieves design inelastic displacements, because those strengths were obtained due to a displacement spectrum reduction factor which depends on damping and ductility of the dual system. Also, the displacements for the study case for DBD results to be greater than FBD and DTHA. In that way, it proves that the seismic performance level of the building for DBD is greater than FBD method. Due to drifts of DBD which are in the order of 2.0% and 2.5% compared with little FBD drifts of 0.7%.

Keywords: displacement-based design, displacement spectrum reduction factor, dynamic time history analysis, forced based design

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Authors: Bhavishya Ramchandani

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A little electronic device that is worn on the finger is called a smart ring. It incorporates mobile technology and has features that make it simple to use the device. These gadgets, which resemble conventional rings and are usually made to fit on the finger, are outfitted with features including access management, gesture control, mobile payment processing, and activity tracking. A poor sleep pattern, an irregular schedule, and bad eating habits are all part of the problems with health that a lot of people today are facing. Diets lacking fruits, vegetables, legumes, nuts, and whole grains are common. Individuals in India also experience metabolic issues. In the medical field, smart rings will help patients with problems relating to stomach illnesses and the incapacity to consume meals that are tailored to their bodies' needs. The smart ring tracks all bodily functions, including blood sugar and glucose levels, and presents the information instantly. Based on this data, the ring generates what the body will find to be perfect insights and a workable site layout. In addition, we conducted focus groups and individual interviews as part of our core approach and discussed the difficulties they're having maintaining the right diet, as well as whether or not the smart ring will be beneficial to them. However, everyone was very enthusiastic about and supportive of the concept of using smart rings in healthcare, and they believed that these rings may assist them in maintaining their health and having a well-balanced diet plan. This response came from the primary data, and also working on the Emerging Technology Canvas Analysis of smart rings in healthcare has led to a significant improvement in our understanding of the technology's application in the medical field. It is believed that there will be a growing demand for smart health care as people become more conscious of their health. The majority of individuals will finally utilize this ring after three to four years when demand for it will have increased. Their daily lives will be significantly impacted by it.

Keywords: smart ring, healthcare, electronic wearable, emerging technology

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Authors: Snezana Rajkovic, Miroslava Markovic, Ljubinko Rakonjac, Aleksandar Lucic, Radoslav Rajkovic

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Woolly apple aphid, Eriosoma lanigerum (Hausmann) is a widely distributed pest of apple trees, especially where its parasites have been killed by insecticides. It can also be found on pear, hawthorn, mountain ash, and elm trees. Relatively small to medium-sized aphids, characterized by a reddish-brown body, a blood-red stain when crushed and a fluffy, flocculent wax covering. Specialized dermal glands produce the characteristic fluffy or powdery wax, which gives E. lanigerum its characteristic 'woolly' appearance. Also, woolly apple aphid is a problemm in nursery production of spure.The experiments were carried out in the nursery “Nevade” in Gornji Milanovac, "Srbijasume" on the spruce seedlings, aged 2 years. In this study, organic insecticide King Bo, aqueous solution (a. i. oxymatrine 0.2% + psoralen 0.4%), manufacturer Beijing Kingbo Biotech Co. Ltd., Beijing, China. extracted from plants and used as pesticides in nursery production were investigated. King Bo, bioinsecticide is manufactured from refined natural herbal extract several wild medicinal plants, such as Sophora flavescens Ait, Veratrum nigrum L, A. Carmichael, etc. Oxymatrine 2.4 SL is a stomach poison that has antifeeding and repellent action. This substance stimulates development and growth in a host plant and also controls the appearance of downy mildew.The trials were set according to instructions of methods-monitoring of changes in the number of larvae and adults compared to before treatment. The treatment plan was made according to fully randomized block design. The experiment was conducted in four repetitions. The basic plot had the area of 25 m2. Phytotoxicity was estimated by PP methods 1/135 (2), the intensity of infection according to Towsend-Heuberger, the efficiency by Abbott, the analysis of variance with Ducan test and PP/181 (2).

Keywords: bioinsecticide, efficacy, nurssery production, woolly apple aphid

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Authors: Anita Lazurko, Laszlo Pinter, Jeremy Richardson

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Uncertain climate projections, multiple possible development futures, and a financing gap create challenges for water infrastructure decision making. In contrast to conventional predict-plan-act methods, an emerging decision paradigm that enables social-ecological resilience supports decisions that are appropriate for uncertainty and leverage social, ecological, and economic multifunctionality. Concurrently, water infrastructure project finance plays a powerful role in sustainable infrastructure development but remains disconnected from discourse in socio-ecological resilience. At the time of research, a project to transfer water from Lesotho to Botswana through South Africa in the Orange-Senqu River Basin was at the pre-feasibility stage. This case was analysed through documents and interviews to investigate how uncertainty and multifunctionality are conceptualised and considered in decisions for the resilience of water infrastructure and to explore bridging concepts that might allow project finance to better enable socio-ecological resilience. Interviewees conceptualised uncertainty as risk, ambiguity and ignorance, and multifunctionality as politically-motivated shared benefits. Numerous efforts to adopt emerging decision methods that consider these terms were in use but required compromises to accommodate the persistent, conventional decision paradigm, though a range of future opportunities was identified. Bridging these findings to finance revealed opportunities to consider a more comprehensive scope of risk, to leverage risk mitigation measures, to diffuse risks and benefits over space, time and to diverse actor groups, and to clarify roles to achieve multiple objectives for resilience. In addition to insights into how multiple decision paradigms interact in real-world decision contexts, the research highlights untapped potential at the juncture between socio-ecological resilience and project finance.

Keywords: socio-ecological resilience, finance, multifunctionality, uncertainty

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Authors: Wei Yao

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A steerable and flexible drill is needed in orthopaedic surgery. For example, osteoarthritis is a common condition affecting millions of people for which joint replacement is an effective treatment which improves the quality and duration of life in elderly sufferers. Conventional surgery is not very accurate. Computer navigation and robotics can help increase the accuracy. For example, In Total Hip Arthroplasty (THA), robotic surgery is currently practiced mainly on acetabular side helping cup positioning and orientation. However, femoral stem positioning mostly uses hand-rasping method rather than robots for accurate positioning. The other case for using a flexible drill in surgery is Anterior Cruciate Ligament (ACL) Reconstruction. The majority of ACL Reconstruction failures are primarily caused by technical mistakes and surgical errors resulting from drilling the anatomical bone tunnels required to accommodate the ligament graft. The proposed new steerable drill system will perform orthopedic surgery through curved tunneling leading to better accuracy and patient outcomes. It may reduce intra-operative fractures, dislocations, early failure and leg length discrepancy by making possible a new level of precision. This technology is based on a robotically assisted, steerable, hand-held flexible drill, with a drill-tip tracking device and a multi-modality navigation system. The critical differentiator is that this robotically assisted surgical technology now allows the surgeon to prepare 'patient specific' and more anatomically correct 'curved' bone tunnels during orthopedic surgery rather than drilling straight holes as occurs currently with existing surgical tools. The flexible and steerable drill and its navigation system for femoral milling in total hip arthroplasty had been tested on sawbones to evaluate the accuracy of the positioning and orientation of femoral stem relative to the pre-operative plan. The data show the accuracy of the navigation system is better than traditional hand-rasping method.

Keywords: navigation, robotic orthopedic surgery, steerable drill, tracking

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Authors: Henry Pariaman, Iwa Garniwa, Isti Surjandari, Bambang Sugiarto

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Availability of a complex system of thermal power plant is strongly influenced by the reliability of spare parts and maintenance management policies. A reliability-centered maintenance (RCM) technique is an established method of analysis and is the main reference for maintenance planning. This method considers the consequences of failure in its implementation, but does not deal with further risk of down time that associated with failures, loss of production or high maintenance costs. Risk-based maintenance (RBM) technique provides support strategies to minimize the risks posed by the failure to obtain maintenance task considering cost effectiveness. Meanwhile, condition-based maintenance (CBM) focuses on monitoring the application of the conditions that allow the planning and scheduling of maintenance or other action should be taken to avoid the risk of failure prior to the time-based maintenance. Implementation of RCM, RBM, CBM alone or combined RCM and RBM or RCM and CBM is a maintenance technique used in thermal power plants. Implementation of these three techniques in an integrated maintenance will increase the availability of thermal power plants compared to the use of maintenance techniques individually or in combination of two techniques. This study uses the reliability, risks and conditions-based maintenance in an integrated manner to increase the availability of thermal power plants. The method generates MPI (Priority Maintenance Index) is RPN (Risk Priority Number) are multiplied by RI (Risk Index) and FDT (Failure Defense Task) which can generate the task of monitoring and assessment of conditions other than maintenance tasks. Both MPI and FDT obtained from development of functional tree, failure mode effects analysis, fault-tree analysis, and risk analysis (risk assessment and risk evaluation) were then used to develop and implement a plan and schedule maintenance, monitoring and assessment of the condition and ultimately perform availability analysis. The results of this study indicate that the reliability, risks and conditions-based maintenance methods, in an integrated manner can increase the availability of thermal power plants.

Keywords: integrated maintenance techniques, availability, thermal power plant, MPI, FDT

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