Search results for: internal audit

Authors: Shreya Saxena

Abstract:

Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

Procedia PDF Downloads 94

Authors: Anouschka Swart

Abstract:

In 2023, sport faces a plethora of challenges including but not limited to match-fixing, corruption and doping to its integrity that, threatens both the commercial and public appeal. The continuous changes and commercialisation that has occurred within sport have led to a variety of consequences resulting in the need for ethics to be revived, as it used to be in the past to ensure sport is not in danger. In order to understand governance better, the Institute of Directors in Southern Africa, a global network of professional firms providing Audit, Tax and Advisory services, outlined a process explaining all elements with regards to corporate governance. This process illustrates a governing body’s responsibilities as strategy, policy, oversight and accountability. These responsibilities are further elucidated to 16 governing principles which are highlighted as essential for all organisations in order to achieve and deliver on effective governance outcomes. These outcomes are good ethical culture, good performance, effective control and legitimacy therefore, the aim of the study was to investigate the general state of governance within the clubs affiliated with a rugby club in South Africa by utilizing the King IV Code as the framework. The results indicated that the King Code IV principles are implemented by these rugby clubs to ensure they demonstrate commitment to corporate governance to both internal and external stakeholders. It is however evident that a similar report focused solely on sport is a necessity in the industry as this will provide more clarity on sport specific problems.

Keywords: South Africa, sport, King IV, responsibilities

Procedia PDF Downloads 67

Authors: Ramya P, Lino Abraham Varghese, S. Bose

Abstract:

By cloud storage services, the data can be stored in the cloud, and can be shared across multiple users. Due to the unexpected hardware/software failures and human errors, which make the data stored in the cloud be lost or corrupted easily it affected the integrity of data in cloud. Some mechanisms have been designed to allow both data owners and public verifiers to efficiently audit cloud data integrity without retrieving the entire data from the cloud server. But public auditing on the integrity of shared data with the existing mechanisms will unavoidably reveal confidential information such as identity of the person, to public verifiers. Here a privacy-preserving mechanism is proposed to support public auditing on shared data stored in the cloud. It uses group signatures to compute verification metadata needed to audit the correctness of shared data. The identity of the signer on each block in shared data is kept confidential from public verifiers, who are easily verifying shared data integrity without retrieving the entire file. But on demand, the signer of the each block is reveal to the owner alone. Group private key is generated once by the owner in the static group, where as in the dynamic group, the group private key is change when the users revoke from the group. When the users leave from the group the already signed blocks are resigned by cloud service provider instead of owner is efficiently handled by efficient proxy re-signature scheme.

Keywords: data integrity, dynamic group, group signature, public auditing

Procedia PDF Downloads 387

Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

Abstract:

The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

Procedia PDF Downloads 318

Authors: Bhuvnesh Narayanan, Bernhard Weiss, Tvrtko Mandic, Adrijan Baric

Abstract:

This paper discusses a method to reconstruct internal high-frequency signals through subsampling techniques in an IC using an on-chip sensor. Though there are existing methods to internally probe and reconstruct high frequency signals through subsampling techniques; these methods have been applicable mainly for synchronized systems. This paper demonstrates a method for making such non-intrusive on-chip reconstructions possible also in non-synchronized systems. The TLP pulse is used to demonstrate the experimental validation of the concept. The on-chip sensor measures the voltage in an internal node. The jitter in the input pulse causes a varying pulse delay with respect to the on-chip sampling command. By measuring this pulse delay and by correlating it with the measured on-chip voltage, time domain waveforms can be reconstructed, and the influence of the pulse on the internal nodes can be better understood.

Keywords: on-chip sensor, jitter, transmission line pulse, subsampling

Procedia PDF Downloads 141

Authors: Beatriz Delgado

Abstract:

Although social anxiety is one of the most prevalent disorders in adolescents and causes considerable difficulties and social distress in those with the disorder, to date very few studies have explored the impact of social anxiety on academic adjustment in student populations. The aim of this study was analyze the effect of social anxiety on school functioning in Secondary Education. Specifically, we examined the relationship between social anxiety and self-concept, academic goals, causal attributions, intellectual aptitudes, and learning strategies, personality traits, and academic performance, with the purpose of creating a causal-explanatory model of academic performance. The sample consisted of 2,022 students in the seven to ten grades of Compulsory Secondary Education in Spain (M = 13.18; SD = 1.35; 51.1% boys). We found that: (a) social anxiety has a direct positive effect on internal attributional style, and a direct negative effect on self-concept. Social anxiety also has an indirect negative effect on internal causal attributions; (b) prior performance (first academic trimester) exerts a direct positive effect on intelligence, achievement goals, academic self-concept, and final academic performance (third academic trimester), and a direct negative effect on internal causal attributions. It also has an indirect positive effect on causal attributions (internal and external), learning goals, achievement goals, and study strategies; (c) intelligence has a direct positive effect on learning goals and academic performance (third academic trimester); (d) academic self-concept has a direct positive effect on internal and external attributional style. Also, has an indirect effect on learning goals, achievement goals, and learning strategies; (e) internal attributional style has a direct positive effect on learning strategies and learning goals. Has a positive but indirect effect on achievement goals and learning strategies; (f) external attributional style has a direct negative effect on learning strategies and learning goals and a direct positive effect on internal causal attributions; (g) learning goals have direct positive effect on learning strategies and achievement goals. The structural equation model fit the data well (CFI = .91; RMSEA = .04), explaining 93.8% of the variance in academic performance. Finally, we emphasize that the new causal-explanatory model proposed in the present study represents a significant contribution in that it includes social anxiety as an explanatory variable of cognitive-motivational constructs.

Keywords: academic performance, adolescence, cognitive-motivational variables, social anxiety

Procedia PDF Downloads 328

Authors: Rakesh Mishra, Mukunda Upadhyay, Rajni Singh

Abstract:

This paper attempts to link remittances sent by internal as well as international out-migrants and its domestic preferences of usage in three different dimension of Household level development in India and its states. Investment of remittances in these sectors reveals for mixed choices of preferential among the states from where people have out-migrated. The multivariate analysis implies that among all three indicators of human development, health (Investment in Food and Health) is the one that attracts the major investment followed by capital formation and least on Education. Usage of the remittances has been found to be varying across all the states in India as far as usage in health, capital formation and education are concerned. Orissa, Nagaland, Madhya Pradesh, Jharkhand, Gujarat, D & H Haweli are some of the states and union territory that contributes highest of its international remittances on health, while most of the usage of the internal remittances has second or third preferences of investment on the health except for Uttar Pradesh, D & H Haweli, Arunachal Pradesh and A & N Is. This paper tries to access usage of international remittances as well as internal remittances on the flow of remittances at the micro level and its implications across three basic determinants of Human Development that is Health, Capital formation and Education coupled with the preferences of usage in presence of Several Socio economic and Demographic variable.

Keywords: multivariate analysis, household development, remittances, internal and international migration

Procedia PDF Downloads 441

Authors: Yozna Gurung

Abstract:

This paper presents preliminary findings from an on-going study on the use of Internal State Terms (IST) in the production of narratives of Hindi-English bilinguals in an attempt to identify children at risk for Specific Language Impairment. Narratives were examined for macrostructure (story structure and story complexity) and internal state terms or mental state terms (IST/MST). 31 students generated stories based on six pictures that were matched for content and story structure in L1 (Hindi) and L2 (English) using a wordless picture narrative. From 30 sample population, 2 students are at risk of Specific Language Impairment, according to this study i.e 6.45%. They showed least development in story grammar as well as IST in both their languages.

Keywords: internal state terms, macrostructure, specific language impairment, wordless picture narrative

Procedia PDF Downloads 227

Authors: A. D. Rao, Sachiko Mohanty

Abstract:

The Internal Waves (IWs) are generated by the flow of barotropic tide over the rapidly varying and steep topographic features like continental shelf slope, subsurface ridges, and the seamounts, etc. The IWs of the tidal frequency are generally known as internal tides. These waves have a significant influence on the vertical density and hence causes mixing in the region. Such waves are also important in submarine acoustics, underwater navigation, offshore structures, ocean mixing and biogeochemical processes, etc. over the shelf-slope region. The seasonal variability of internal tides in the Bay of Bengal with special emphasis on its energetics is examined by using three-dimensional MITgcm model. The numerical simulations are performed for different periods covering August-September, 2013; November-December, 2013 and March-April, 2014 representing monsoon, post-monsoon and pre-monsoon seasons respectively during which high temporal resolution in-situ data sets are available. The model is initially validated through the spectral estimates of density and the baroclinic velocities. From the estimates, it is inferred that the internal tides associated with semi-diurnal frequency are more dominant in both observations and model simulations for November-December and March-April. However, in August, the estimate is found to be maximum near-inertial frequency at all the available depths. The observed vertical structure of the baroclinic velocities and its magnitude are found to be well captured by the model. EOF analysis is performed to decompose the zonal and meridional baroclinic tidal currents into different vertical modes. The analysis suggests that about 70-80% of the total variance comes from Mode-1 semi-diurnal internal tide in both observations as well as in the model simulations. The first three modes are sufficient to describe most of the variability for semidiurnal internal tides, as they represent 90-95% of the total variance for all the seasons. The phase speed, group speed, and wavelength are found to be maximum for post-monsoon season compared to other two seasons. The model simulation suggests that the internal tide is generated all along the shelf-slope regions and propagate away from the generation sites in all the months. The model simulated energy dissipation rate infers that its maximum occurs at the generation sites and hence the local mixing due to internal tide is maximum at these sites. The spatial distribution of available potential energy is found to be maximum in November (20kg/m²) in northern BoB and minimum in August (14kg/m²). The detailed energy budget calculation are made for all the seasons and results are analysed.

Keywords: available potential energy, baroclinic energy flux, internal tides, Bay of Bengal

Procedia PDF Downloads 165

Authors: Fatemeh Alsadat Borhani, Hassan Heydari, Mansour Abdi

Abstract:

The purpose of this study to determine the effectiveness of group therapy with approach reality therapy in reducing symptoms of anxiety and increased self- esteem and internal control of infertile women. The population of this study is all infertile women in Qom city in 2012 that with the use of purposeful sampling, 32 individuals were selected as sample. 16 individuals of infertile women in the control group and 16 infertile women in the experimental group is replaced. The research design was of type quasi-experimental with design pretest-posttest with control group. Thus, infertile women were randomly appointed in the experimental and control groups. Also, in this study data through normalized questionnaires, the Beck Anxiety scale, Rotter's Locus of control inventory, Cooper Smith self-esteem inventory was collected. For analysis of data, descriptive statistics, mean, standard deviation and inferential statistics, one way analysis of covariance model with SPSS version 20 software was used. The findings indicated that intervention of the group therapy with approach reality therapy in experimental group reduced symptoms of anxiety and mutually increased self-esteem and internal control in infertile women of experimental group.

Keywords: reality therapy, infertile women, anxiety, self esteem, internal control

Procedia PDF Downloads 570

Authors: Fatih Suleyman Taskincan, Ahmet Karaarslan

Abstract:

In this article, the study and analysis of Single Ended Primary Inductance Converter (SEPIC) are presented for battery charging applications that will be used in military applications. The usage of this kind of converters come from its advantage of non-reverse polarity at outputs. As capacitors charge and discharge through inductance, peak current does not occur on capacitors. Therefore, the efficiency will be high compared to buck-boost converters. In this study, the converter (SEPIC) is designed to be operated with Internal Model Controller (IMC). The traditional controllers like Proportional Integral Controller are not preferred as its linearity behavior. Hence IMC is designed for this converter. This controller is a model-based control and provides more robustness and better set point monitoring. Moreover, it can be used for an unstable process where the conventional controller cannot handle the dynamic operation. Matlab/Simulink environment is used to simulate the converter and its controller, then, the results are shown and discussed.

Keywords: DC/DC converter, single ended primary inductance converter, SEPIC, internal model controller, IMC, switched mode power supply

Procedia PDF Downloads 624

Authors: Nureni O. Adeboye, Dawud A. Agunbiade

Abstract:

This research attempts to investigate the effects of heteroscedasticity and periodicity in a Panel Data Regression Model (PDRM) by extending previous works on balanced panel data estimation within the context of fitting PDRM for Banks audit fee. The estimation of such model was achieved through the derivation of Joint Lagrange Multiplier (LM) test for homoscedasticity and zero-serial correlation, a conditional LM test for zero serial correlation given heteroscedasticity of varying degrees as well as conditional LM test for homoscedasticity given first order positive serial correlation via a two-way error component model. Monte Carlo simulations were carried out for 81 different variations, of which its design assumed a uniform distribution under a linear heteroscedasticity function. Each of the variation was iterated 1000 times and the assessment of the three estimators considered are based on Variance, Absolute bias (ABIAS), Mean square error (MSE) and the Root Mean Square (RMSE) of parameters estimates. Eighteen different models at different specified conditions were fitted, and the best-fitted model is that of within estimator when heteroscedasticity is severe at either zero or positive serial correlation value. LM test results showed that the tests have good size and power as all the three tests are significant at 5% for the specified linear form of heteroscedasticity function which established the facts that Banks operations are severely heteroscedastic in nature with little or no periodicity effects.

Keywords: audit fee lagrange multiplier test, heteroscedasticity, lagrange multiplier test, Monte-Carlo scheme, periodicity

Procedia PDF Downloads 138

Authors: Waqas Ahmad, Eisha Tahir, Shahper Aqeel, Imran Khalid Niazi, Amjad Iqbal

Abstract:

Background: Breast conservation surgery applies a number of techniques for accurate localization of lesions. Wire localization remains the method of choice in non-palpable breast cancers post-neoadjuvant chemotherapy. Objective: The aim of our study was to determine the accuracy of wire localization procedures in our department and compare it with internationally set protocols as per the Royal College of Radiologists. Post wire mammography, as well as the margin status of the postoperative specimen, assessed the accuracy of the procedure. Methods: We retrospectively reviewed the data of 225 patients who presented to our department from May 2014 to June 2015 post neoadjuvant chemotherapy with non-palpable cancers. These patients are candidates for wire localized lumpectomies either under ultrasound or stereotactic guidance. Metallic marker was placed in all the patients at the time of biopsy. Post wire mammogram was performed in all the patients and the distance of the wire tip from the marker was calculated. The presence or absence of the metallic clip in the postoperative specimen, as well as the marginal status of the postoperative specimen, was noted. Results: 157 sonographic and 68 stereotactic wire localization procedures were performed. 95% of the wire tips were within 1 cm of the metallic marker. Marginal status was negative in 94% of the patients in histopathological specimen. Conclusion: Our audit report declares more than 95% accuracy of image guided wire localization in successful excision of non-palpable breast lesions.

Keywords: breast, cancer, non-palpable, wire localization

Procedia PDF Downloads 302

Authors: Waseem Al-Talalwah

Abstract:

The superior vesical artery usually arises directly from the anterior division of the internal iliac artery. It may arise from the umbilical artery as three or four branches to supply the upper and middle parts of bladder. Current study focuses on the different origins of the superior vesical artery to provide a sufficient data for surgeons to disease iatrogenic fault. The superior vesical artery arises directly from the anterior division of the internal iliac artery in 24.5% whereas it arises indirectly as from umbilical artery in 83.7%. Further, it may arise from any branch of the anterior division as from the utrine and obturator arteries in 6.1% and in 6.3% respectively. It also shares the origin of the internal pudendal and inferior glutyeal artery as it arises from the gluteopudendal trunk in 4.1%. The superior vesical artery arises as a single, double, triple and quadruple in 69.4%, 20.4%, 8.2% and 2% respectively. In case of cystectomy for bladder cancer, surgeons have to be aware of the origin variability of superior vesical artery to prevent post-surgical complication such as intra-pelvic bleeding. Also, the as intra-pelvic bleeding has to be expected in case of hysterectomy therefore a great caution of the vesical branches arising from uterine artery has to be considered. In case of aneurysm resection of inferior gluteal artery arising from the gluteopudendal trunk, the surgeons have to be careful of the vascular supply of urinary bladder coming from above and below this common trunk as from superior and inferior vesical arteries respectively. Therefore, present study increases the awareness of clinical significance of superior vesical artery origin for surgeons to minimise the iatroginc errors.

Keywords: superior vesical artery, anterior division, internal iliac, internal pudendal, inferior glutyeal, intra-pelvic bleeding, hysterectomy, cystectomy

Procedia PDF Downloads 389

Authors: Nelson Igaba, C. Onaga, S. Hlongwane

Abstract:

Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.

Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement

Procedia PDF Downloads 173

Authors: Gourida Siham

Abstract:

Chinese society has witnessed a continuing trend of nationwide rural to urban migration since the 1970's. Before that age, under restricted hukou systems, peasants were kept still and fixed in the farm land. The year 1978 and later years saw the control of migration in China was relaxed gradually, freeing peasants to start their own businesses and reach out to work also in urban areas. Since then the “floating population” (migrants without local hukou) took great momentum and drew great attention from both the media and academia. The scale of such internal migration is enormous –the floating population has reached to a number of 79 million in 2000, and as of 2010, the number of migrant workers from rural China amounts to over 221 million and according to the annual survey results projections by National Bureau of Statistics; the total migrant workers in china in 2012 amounted to 262.61 million, which refers to an increase of 9.83 million compared with the previous year with increase percentage by 3.9%. Using China’s Jiangxi Province as a case, this paper examines patterns of internal migration as a response of emigrations in the context of high emigration communities. Our findings suggest that emigration of individuals initially deterred both inter-provincial and intra- provincial migration of other family members, and yet, overtime they had an increasing propensity to migrate internally at both scales.

Keywords: internal migration, jiangxi, nanchang, remittances

Procedia PDF Downloads 400

Authors: Hakim S. Sultan Aljibori

Abstract:

An experimental procedure is developed to study the performance of composite thin wall cylinders subjected to internal pressure loading for investigations of stress distribution through the composite cylinders wall. Three types of fibers were used in this study are; woven roving glass fiber/epoxy, hybrid fiber/epoxy, and Kevlar fiber/epoxy composite specimens were fabricated and tested. All of these specimens subjected to uniformed pressure load using the hydraulic pump. Axial stress is identified, and values were found after collecting all the results. Comparison between the deferent types of specimens was done. Thus, the present investigation concludes the efficient and effective composite cylinder experimentally and provides a considerable advantage for using woven roving fibers in pressure vessels applications.

Keywords: stress distribution, composite material, internal pressure, glass fiber, hybrid fiber

Procedia PDF Downloads 156

Authors: Protik Basu, Indranil Ghosh, Pranab K. Dan

Abstract:

Lean management is an integrated socio-technical system to bring about a competitive state in an organization. The purpose of this paper is to explore and integrate the role of customers and suppliers with the internal practices of the Indian manufacturing industries towards successful implementation of lean manufacturing (LM). An extensive literature survey is carried out. An attempt is made to build an exhaustive list of all the input manifests related to customers, suppliers and internal practices necessary for LM implementation, coupled with a similar exhaustive list of the benefits accrued from its successful implementation. A structural model is thus conceptualized, which is empirically validated based on the data from the Indian manufacturing sector. With the current impetus on developing the industrial sector, the Government of India recently introduced the Lean Manufacturing Competitiveness Scheme that aims to increase competitiveness with the help of lean concepts. There is a huge scope to enrich the Indian industries with the lean benefits, the implementation status being quite low. Hardly any survey-based empirical study in India has been found to integrate customers and suppliers with the internal processes towards successful LM implementation. This empirical research is thus carried out in the Indian manufacturing industries. The basic steps of the research methodology followed in this research are the identification of input and output manifest variables and latent constructs, model proposition and hypotheses development, development of survey instrument, sampling and data collection and model validation (exploratory factor analysis, confirmatory factor analysis, and structural equation modeling). The analysis reveals six key input constructs and three output constructs, indicating that these constructs should act in unison to maximize the benefits of implementing lean. The structural model presented in this paper may be treated as a guide to integrating customers and suppliers with internal practices to successfully implement lean. Integrating customers and suppliers with internal practices into a unified, coherent manufacturing system will lead to an optimum utilization of resources. This work is one of the very first researches to have a survey-based empirical analysis of the role of customers, suppliers and internal practices of the Indian manufacturing sector towards an effective lean implementation.

Keywords: customer management, internal manufacturing practices, lean benefits, lean implementation, lean manufacturing, structural model, supplier management

Procedia PDF Downloads 175

Authors: M. Moharami Gargari, S. Javdani Zamani, A. Mohammadnejad, S. Abuali

Abstract:

As maritime container transport is developing fast, the need arises for efficient operations at container terminals. One of the most important determinants of container handling efficiency is the productivity of quay cranes and internal transportation vehicles, which are responsible transporting of containers for unloading and loading operations for container vessels. For this reason, this paper presents an integrated mathematical model formulation for discrete berths with quay cranes and internal transportations vehicles. The problems have received increasing attention in the literature and the present paper deals with the integration of these interrelated problems. A new mixed integer linear formulation is developed for the Berth Allocation Problem (BAP), Quay Crane Assignment and Scheduling Problem (QCASP) and Internal Transportation Scheduling (ITS), which accounts for cranes and trucks positioning conditions.

Keywords: discrete berths, container terminal, truck scheduling, dynamic vessel arrival

Procedia PDF Downloads 394

Authors: C. Malça, P. Gonçalves, N. Alves, A. Mateus

Abstract:

Regardless of the manufacturing process used, subtractive or additive, material, purpose and application, produced components are conventionally solid mass with more or less complex shape depending on the production technology selected. Aspects such as reducing the weight of components, associated with the low volume of material required and the almost non-existent material waste, speed and flexibility of production and, primarily, a high mechanical strength combined with high structural performance, are competitive advantages in any industrial sector, from automotive, molds, aviation, aerospace, construction, pharmaceuticals, medicine and more recently in human tissue engineering. Such features, properties and functionalities are attained in metal components produced using the additive technique of Rapid Prototyping from metal powders commonly known as Selective Laser Melting (SLM), with optimized internal topologies and varying densities. In order to produce components with high strength and high structural and functional performance, regardless of the type of application, three different internal topologies were developed and analyzed using numerical computational tools. The developed topologies were numerically submitted to mechanical compression and four point bending testing. Finite Element Analysis results demonstrate how different internal topologies can contribute to improve mechanical properties, even with a high degree of porosity relatively to fully dense components. Results are very promising not only from the point of view of mechanical resistance, but especially through the achievement of considerable variation in density without loss of structural and functional high performance.

Keywords: additive manufacturing, internal topologies, porosity, rapid prototyping, selective laser melting

Procedia PDF Downloads 328

Authors: Nititorn Ounpipat

Abstract:

The objective of this study was to find the relationship between internal communication and job satisfaction, and to find out the best communication channel to contact employees for a quality working within the operation or organizational rules. The sample size of 100% who were working as a shop floor level employee in the company. The study used the quantitative research method by distributing a structured questionnaire to collect data from 150 employees as the sample size. Inferential statistics and forward multiple regression analysis were used to analyze the results of this research. The result shows that communication channel correlated with job satisfaction. Each channel has a correlation with the satisfaction of working with the Department Board Information and All Employee / Weekly Meeting Relevance high. Since there is a correlation coefficient equal. 851 and. 840, respectively. Company Board Information, Memo, Letter, Leader, Supervisor, Friends and Email Relevance moderate as well.

Keywords: internal communication channels, job satisfaction, personal feedback, Rayong province

Procedia PDF Downloads 221

Authors: G. K. Guseynova, V. V. Krylov, L. T. Khamidova, N. A. Polunina, V. A. Lukyanchikov

Abstract:

The report presents complex ultrasound diagnostics in patients with symptomatic steno-occlusive lesions of extra- and intracranial branches of brachiocephalic arteries (BCA). The tasks and possibilities of ultrasound diagnostics at different stages of treatment of patients with symptomatic occlusion of internal carotid artery (ICA) are covered in detail; qualitative and quantitative characteristics of blood flow; parameters of the wall and lumen of the main arteries of the head; methods of ultrasound examination of indirect assessment of the functional status are presented. Special attention is paid to the description of indicators that are predictors of the consistency of formed extra-intracranial low-flow shunts, examples of functioning and failed anastomoses are analyzed.

Keywords: CBF, cerebral blood flow; CTA, external carotid artery; ICA, internal carotid artery; MCA, middle cerebral artery; MRA, magnetic resonance angiography; OEF, oxygen extraction fraction; TIA, transient ischaemic attack, ultrasound, low-flow bypass, anastomoses

Procedia PDF Downloads 38

Authors: B. Kenny, M. Dixon, A. Boshell

Abstract:

The use of alcoholic surgical prep was recently introduced into the Royal Newcastle Center for elective procedures. In the past 3 months there have been a significant number of burns believed to be related to ‘pooling’ of this surgical prep in patients undergoing procedures where they are placed in the lateral position with hip bolsters. The aim of the audit was to determine the reason for the burns, analyze what pre-existing factors may contribute to the development of the burns and what can be changed to prevent further burns occurring. All patients undergoing a procedure performed on the hip who were placed in the lateral position with sacral and anterior, superior iliac spine (ASIS) support with ‘bolsters’ were included in the audit. Patients who developed a ‘burn’ were recorded, details of the surgery, demographics, surgical prep used and length of surgery were obtained as well as photographs taken to document the burn. Measures were then taken to prevent further burns and the efficacy was documented. Overall 14 patients developed burns over the ipsilateral ASIS. Of these, 13 were Total Hip Arthroplasty (THA) and 1 was a removal of femoral nail. All patients had Chlorhexidine 0.5% in Alcohol 70% Tinted Red surgical preparation or Betadine Alcoholic Skin Prep (70% etoh). Patients were set up in the standard lateral decubitus position with sacral and bilateral ASIS bolsters with a valband covering. 86% of patients were found to have pre-existing hypersensitivities to various substances. There is very little literature besides a few case reports on surgical prep-related burns. The case reports that do exist are related to the use of tourniquet-related burns and there is no mention in the literature examining ‘bolster’ related burns. The burns are hypothesized to be caused by pooling of the alcoholic solution which is amplified by the use of Valband.

Keywords: arthroplasty, chemical burns, wounds, rehabilitation

Procedia PDF Downloads 296

Authors: Adeyinka Adesanya, Isaac Bamgboye

Abstract:

There is a growing need to develop the processes to produce renewable fuels and chemicals due to the economic, political, and environmental concerns associated with fossil fuels. Lignocellulosic biomass is an excellent renewable feedstock because it is both abundant and inexpensive. This project aims at producing bioethanol from lignocellulosic plants (Sorghum Arundinacieum and Heteropogon Contortus) by biochemical means, computing the energy audit of the process and determining the fuel properties of the produced ethanol. Acid pretreatment (0.5% H2SO4 solution) and enzymatic hydrolysis (using malted barley as enzyme source) were employed. The ethanol yield of wild sorghum was found to be 20% while that of spear grass was 15%. The fuel properties of the bioethanol from wild sorghum are 1.227 centipoise for viscosity, 1.10 g/cm3 for density, 0.90 for specific gravity, 78 °C for boiling point and the cloud point was found to be below -30 °C. That of spear grass was 1.206 centipoise for viscosity, 0.93 g/cm3 for density 1.08 specific gravity, 78 °C for boiling point and the cloud point was also found to be below -30 °C. The energy audit shows that about 64 % of the total energy was used up during pretreatment, while product recovery which was done manually demanded about 31 % of the total energy. Enzymatic hydrolysis, fermentation, and distillation total energy input were 1.95 %, 1.49 % and 1.04 % respectively, the alcoholometric strength of bioethanol from wild sorghum was found to be 47 % and the alcoholometric strength of bioethanol from spear grass was 72 %. Also, the energy efficiency of the bioethanol production for both grasses was 3.85 %.

Keywords: lignocellulosic biomass, wild sorghum, spear grass, biochemical conversion

Procedia PDF Downloads 231

Authors: Raja Ezman Raja Shariff

Abstract:

Acute kidney injury (AKI) is commonly seen in inpatients, and places a great cost on the NHS and patients. Timely and appropriate management is both nephron sparing and potentially life-saving. Ultrasound scanning (USS) is a well-recognised method for stratifying patients. Subsequently, the NICE AKI guidance has defined groups in whom scanning is recommended within 6 hours of request (pyonephrosis), within 24 hours (obstruction/cause unknown), and in whom routine scanning isn't recommended (cause for AKI identified). The audit looks into whether Stockport NHS Trust USS practice was in line with such recommendations. The audit evaluated 92 patients with AKI who had USS, between 01/01/14 to 30/04/14. Data collection was divided into 2 parts. Firstly, radiology request cards and the online imaging software (PACS) were evaluated. Then, the electronic case notes (ADVANTIS) was evaluated further. Based on request cards, 10% of requests were for pyonephrosis. Only 33% were scanned within 6hours and a further 33% within 24hours. 75% were requested for possible obstructions and unknown cause collectively. Of those due to possible obstruction, 71% of patients were scanned within 24 hours. Of those with unknown cause, 50% were scanned within 24 hours. 15% of requests had a cause declared and so potentially did not require scanning. Evaluation of the patients’ notes suggested further interesting findings. Firstly, potentially 39% of patients had a known cause for AKI, therefore, did not need USS. Subsequently, the cohort of unknown cause and possible obstruction was collectively reduced to 45%. Alarmingly the patient cohort with possible pyonephrosis went up to 16%, suggesting an under-recognition of this life-threatening condition. We plan to highlight these findings within our institution and make changes to encourage more appropriate requesting and timely scanning. Time will tell if we manage to save or increase our costs in this cost-conscious NHS. Patient benefits, though, seem to be guaranteed.

Keywords: AKI, ARF, kidney, renal

Procedia PDF Downloads 397

Authors: Helena Macedo, Larissa Tomaz, Levi Guimarães, Luís Cerqueira-Pinto, José Dinis-Carvalho

Abstract:

In the context of retail logistics, the pursuit of operational efficiency and cost optimization involves a rigorous distinction between value-added and non-value-added activities. In today's competitive market, optimizing efficiency and reducing operational costs are paramount for retail businesses. This research paper focuses on the development of a classification model adapted to the retail sector, specifically examining internal logistics processes. Based on a comprehensive analysis conducted in a retail supermarket located in the north of Portugal, which covered various aspects of internal retail logistics, this study questions the concept of value and the definition of wastes traditionally applied in a manufacturing context and proposes a new way to assess activities in the context of internal logistics. This study combines quantitative data analysis with qualitative evaluations. The proposed classification model offers a systematic approach to categorize operations within the retail logistics chain, providing actionable insights for decision-makers to streamline processes, enhance productivity, and allocate resources more effectively. This model contributes not only to academic discourse but also serves as a practical tool for retail businesses, aiding in the enhancement of their internal logistics dynamics.

Keywords: lean retail, lean logisitcs, retail logistics, value-added and non-value-added

Procedia PDF Downloads 57

Authors: S. Sadallah

Abstract:

In this paper, dynamic programming is used to determine the optimal management of financial resources in company. Solution of the problem by consider into simpler substructures is constructed. The optimal management of internal capital of company are simulated. The tools applied in this development are based on graph theory. The software of given problems is built by using greedy algorithm. The obtained model and program maintenance enable us to define the optimal version of management of proper financial flows by using visual diagram on each level of investment.

Keywords: management, software, optimal, greedy algorithm, graph-diagram

Procedia PDF Downloads 279

Authors: Emma Carr, Bilal Aslam-Pervez, David Laraway

Abstract:

Litigation against surgeons and hospitals continues to increase in Western countries. While verbal consent is all that is required legally, it has for a long time been considered that written consent offers proof of discussion and interaction between the surgeon and the patient. Inadequate consenting of patients continues in the United Kingdom leaving surgeons and Health Trusts open to litigation. We present a standardised consent form which improves patient autonomy and engagement. The General Medical Council recommends that all material risks relevant to the patient are discussed and recorded prior to undergoing surgery, regardless of how likely they are to occur. Current literature was reviewed to evaluate complications associated with surgical management of mandible fractures. Analysis of risks on 52 consent forms were analysed within the Glasgow OMFS department, leading to a procedure-specific form being designed and implemented. This audit showed that the documentation of risks on consent forms was extremely variable- with uncommon risks not being recorded. Interestingly, not a single consent form was found which highlighted all the risks associated with mandible fractures. Our re-audit data confirms 100% of risks being discussed when a procedure specific form is utilised. Our hope, is to introduce further forms for inclusion on the BAOMS website and peripheral distribution. The forms are quick and easy to print and leave more time for consultation with the patient. Whilst we are under no illusion that the forms may not decrease the incidence of intended litigation, we feel confident that they will decrease the chances of it being successful.

Keywords: consent, litigation, mandible fracture, surgery

Procedia PDF Downloads 185

Authors: Kent Salomonsson, Xuefang Zhao, Sara Kallin

Abstract:

Human soft tissue is loaded and deformed by any activity, an effect known as a stress-strain relationship, and is often described by a load and tissue elongation curve. Several advances have been made in the fields of biology and mechanics of soft human tissue. However, there is limited information available on in vivo tissue mechanical characteristics and behavior. Confident mechanical properties of human soft tissue cannot be extrapolated from e.g. animal testing. Thus, there is need for non invasive methods to analyze mechanical characteristics of soft human tissue. In the present study, the internal mechanical conditions of the lower limb, which is subject to an external load, is studied by use of the finite element method. A detailed finite element model of the lower limb is made possible by use of MRI scans. Skin, fat, bones, fascia and muscles are represented separately and the material properties for them are obtained from literature. Previous studies have been shown to address macroscopic deformation features, e.g. indentation depth, to a large extent. However, the detail in which the internal anatomical features have been modeled does not reveal the critical internal strains that may induce hypoxia and/or eventual tissue damage. The results of the present study reveals that lumped material models, i.e. averaging of the material properties for the different constituents, does not capture regions of critical strains in contrast to more detailed models.

Keywords: FEM, tissue, indentation, properties

Procedia PDF Downloads 356

Authors: David Gamboa, Bernardo Herrera, Karen Cacua

Abstract:

Nanomaterials have been explored as alternatives to reduce particulate matter from diesel engines, which is one of the most common pollutants of the air in urban centers. However, the use of nanomaterials as additives for diesel has to overcome the instability of the dispersions to be considered viable for commercial use. In this work, functionalization of carbon nanotubes with amide groups was performed to improve the stability of these nanomaterials in a mix of 90% petroleum diesel and 10% palm oil biodiesel (B10) in concentrations of 50 and 100 ppm. The resulting nano fuel was used as the fuel for a stationary internal combustion engine, where the particulate matter, NOx, and CO were measured. The results showed that the use of amide groups significantly enhances the time for the carbon nanotubes to remain suspended in the fuel, and at the same time, these nanomaterials helped to reduce the particulate matter and NOx emissions. However, the CO emissions with nano fuel were higher than those ones with the combustion of B10. These results suggest that carbon nanotubes have thermal and catalytic effects on the combustion of B10.

Keywords: carbon nanotubes, diesel, internal combustion engine, particulate matter

Procedia PDF Downloads 122