Search results for: operating room nursing

Authors: Philippe Dillien, Patrice Forget, Harald Engel, Olivier Cornu, Marc De Kock, Jean Cyr Yombi

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Introduction: Hip fracture precedes commonly death in elderly people. Identification of high-risk patients may contribute to target patients in whom optimal management, resource allocation and trials efficiency is needed. The aim of this study is to construct a predictive score of mortality after hip fracture on the basis of the objective prognostic factors available: Neutrophil-to-lymphocyte ratio (NLR), age, and sex. C-Reactive Protein (CRP), is also considered as an alternative to the NLR. Patients and methods: After the IRB approval, we analyzed our prospective database including 286 consecutive patients with hip fracture. A score was constructed combining age (1 point per decade above 74 years), sex (1 point for males), and NLR at postoperative day+5 (1 point if >5). A receiver-operating curve (ROC) curve analysis was performed. Results: From the 286 patients included, 235 were analyzed (72 males and 163 females, 30.6%/69.4%), with a median age of 84 (range: 65 to 102) years, mean NLR values of 6.47+/-6.07. At one year, 82/280 patients died (29.3%). Graphical analysis and log-rank test confirm a highly statistically significant difference (P<0.001). Performance analysis shows an AUC of 0.72 [95%CI 0.65-0.79]. CRP shows no advantage on NLR. Conclusion: We have developed a score based on age, sex and the NLR to predict the risk of mortality at one year in elderly patients after surgery for a hip fracture. After external validation, it may be included in clinical practice as in clinical research to stratify the risk of postoperative mortality.

Keywords: neutrophil-to-lymphocyte ratio, hip fracture, postoperative mortality, medical and health sciences

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Authors: Yung-Hui Tang, Yan-Chiou Ku, Li-Chi Huang

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Aim: The aim of this study is to explore the effect of the Humanoid Diagram Teaching (HDT) strategy on novice nurses’ care ability and retention rate. Methods: This study was a quasi-experimental study using two groups concurrently with repeat measurements sample consisted of 24 novice nurses (12 in each experimental and control group) in a medical center in southern Taiwan. Both groups all received regular training program (nursing standard techniques and practices, concept map, mini-CEX, CbD, and clinical education and training), and experimental group added the HDT program. The HDT strategy includes the contents of patients’ body humanoid drawing and discussion for 30 minutes each time, three times a week, and continually for four weeks. The effectiveness of ＨDT was evaluated by mini-CEX, CbD and clinical assessment and retention rate at the 3rd month and 6th month. Results: The novice nurses' care ability were examined, only CbD score in the control group was improved in the 3rd month and with statistical difference, p = .003. The mini-CEX and CbD in the experimental group were significantly improved in both the first and third month with statistical differences p = .00. Although mini-CEX and CbD in the experimental group were higher than the control group, but there was no significant difference p > .05. Retention rate of the experimental group in the third month and sixth month was significantly higher than the control group, and there was a statistically significant difference p < .05. Conclusions: The study reveals that HDT strategy can help novice nurses learning, enhancing their knowledge and technical capability, analytical skills in case-based caring, and retention. The HDT strategy can be served as an effective strategy for novice training for better nurse retention rate.

Keywords: humanoid diagram teaching strategy, novice nurses retention, teaching strategy of nurse retention, visual learning mode

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Authors: Muhammad Wasif, Asif Ahmed Shaikh, Sarosh Hashmat Lodi, Muhammad Aslam Bhutto, Riazuddin

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Risk Management System is quite popular in profit- based organizations, health and safety and project management fields since the last few decades. But due to rapidly changing environment and requirement of ISO 9001:2015 standards, public-sector institution, especially higher education institutes are also performing risk assessment to monitor the performance of the institution and aligning it with the latest benchmark. In this context, NED University of Engineering and Technology performed research and developed a Standard Operating Procedure (SOP) for the risk assessment, its monitoring and control. In this research, risks are broken into the four sources, namely; Internal Academics Risks, External Academics Risks, Internal Non-academic Risks, External Non-academic Risks. Risks are identified by the management at all levels. Severity and likelihood of the risks are assigned based on the previous audit results and the customer complains. Risk Ratings are calculated to orderly arrange the risk according to the Risk Rating, and controls for the risks are designed, which are assigned to the responsible person. At the end of the article, result and analysis on the different sources of risk are discussed in details and the conclusion is drawn. Discussion on few sample risks are presented in this article. Hence it is presented in the research that the Risk Management System can be applied in a Higher Education Institute to effectively control the risks which might affect the scope and Quality Management System of an organization.

Keywords: higher education, quality management system, risk assessment, risk management

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Authors: Siva Teja Golla, B. Venkatesham

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The recent technologies in hybrid and high-end cars have subsided the noise from major sources like engines and transmission systems. This resulted in the unmasking of the previously subdued noises. These noises are becoming noticeable to the passengers, causing annoyance to them and affecting the perceived quality of the vehicle. Sloshing in the fuel tank is one such source of noise. Sloshing occurs due to the excitations undergone by the fuel tank due to the vehicle's movement. Sloshing noise occurs due to the interaction of the fluid with the surrounding tank walls or with the fluid itself. The noise resulting from the interaction of the fluid with the structure is ‘Hit noise’, and the noise due to fluid-fluid interaction is ‘Splash noise’. The type of interactions the fluid undergoes inside the tank, and the type of noise generated depends on a variety of factors like the fill level of the tank, type of fluid, presence of objects like baffles inside the tank, type and strength of the excitation, etc. There have been studies done to understand the effect of each of these parameters on the generation of different types of sloshing noises. But little work is done in the psychoacoustic aspect of these sounds. The psychoacoustic study of the sloshing noises gives an understanding of the level of annoyance it can cause to the passengers and helps in taking necessary measures to address it. In view of this, the current paper focuses on the calculation of the psychoacoustic parameters like loudness, sharpness, roughness and fluctuation strength for the sloshing noise. As the noise generation mechanisms for the hit and splash noises are different, these parameters are calculated separately for them. For this, the fluid flow regimes that predominantly cause the hit-and-splash noises are to be separately emulated inside the tank. This is done through a reciprocating test rig, which imposes reciprocating excitation to a rectangular tank filled with the fluid. By varying the frequency of excitation, the fluid flow regimes with the predominant generation of hit-and-splash noises can be separately created inside the tank. These tests are done in a quiet room and the noise generated is captured using microphones and is used for the calculation of psychoacoustic parameters of the sloshing noise. This study also includes the effect of fill level and the presence of baffles inside the tank on these parameters.

Keywords: sloshing, hit noise, splash noise, sound quality

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Authors: Marin Mandić, Elis Sutlović, Tonći Modrić, Luka Stanić

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With the restructuring and deregulation of the power system, storage owners, generation companies or private producers can offer their multiple services on various power markets and earn income in different types of markets, such as the day-ahead, real-time, ancillary services market, etc. During the COVID-19 pandemic, electricity prices, as well as ancillary services prices, increased significantly. The optimization of the energy storage operation was performed using a suitable model for simulating the operation of a pumped storage hydropower plant under market conditions. The objective function maximizes the income earned through energy arbitration, regulation-up, regulation-down and spinning reserve services. The optimization technique used for solving the objective function is mixed integer linear programming (MILP). In numerical examples, the pumped storage hydropower plant operation has been optimized considering the already achieved hourly electricity market prices from Nord Pool for the pre-pandemic (2019) and the pandemic (2020 and 2021) years. The impact of the electricity market prices during the COVID-19 pandemic on energy storage operation is shown through the analysis of income, operating hours, reserved capacity and consumed energy for each service. The results indicate the role of energy storage during a significant fluctuation in electricity and services prices.

Keywords: electrical market prices, electricity market, energy storage optimization, mixed integer linear programming (MILP) optimization

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Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

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The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

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Authors: Maxime Moreau, Silvère Baron, Jean-Marc Lobaccaro, Karine Charlet, Sébastien Menecier, Frédéric Perisse

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Cold Atmospheric Plasma (CAP) is an ionized gas generated at atmospheric pressure with the temperature of heavy particles (molecules, ions, atoms) close to the room temperature. Recent studies have shown that both in-vitro and in-vivo plasma exposition to many cancer cell lines are efficient to induce the apoptotic way of cell death. In some other works, normal cell lines seem to be less impacted by plasma than cancer cell lines. This is called selectivity of plasma. It is highly likely that the generated RNOS (Reactive Nitrogen Oxygen Species) in the plasma jet, but also in the medium, play a key-role in this selectivity. In this study, two CAP devices will be compared to electrical power, chemical species composition and their efficiency to kill cancer cells. A particular focus on the action of hydrogen peroxide will be made. The experiments will take place as described next for both devices: electrical and spectroscopic characterization for different voltages, plasma treatment of normal and cancer cells to compare the CAP efficiency between cell lines and to show that death is induced by an oxidative stress. To enlighten the importance of hydrogen peroxide, an inhibitor of H2O2 will be added in cell culture medium before treatment and a comparison will be made between the results of cell viability in this case and those from a simple plasma exposition. Besides, H2O2 production will be measured by only treating medium with plasma. Cell lines will also be exposed to different concentrations of hydrogen peroxide in order to characterize the cytotoxic threshold for cells and to make a comparison with the quantity of H2O2 produced by CAP devices. Finally, the activity of catalase for different cell lines will be quantified. This enzyme is an important antioxidant agent against hydrogen peroxide. A correlation between cells response to plasma exposition and this activity could be a strong argument in favor of the predominant role of H2O2 to explain the selectivity of plasma cancer treatment by cold atmospheric plasma.

Keywords: cold atmospheric plasma, hydrogen peroxide, prostate cancer, selectivity

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Authors: Marisa Galiza Filipe

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In 1942, at the height of the Second World War, Roosevelt and Churchill planned to occupy the Azores to establish air and naval bases. The islands' privileged position in the middle of the Atlantic made them a strategic location for both the Axis and the Allies. For the Germans, the occupation of the island was also a strategic place to launch an attack on the United States of America, and for the British and Americans, the islands were the perfect spot to counterattack the German sinking of British boats and submarines. Salazar avoided the concession of the islands until 1943, claiming, on the one hand, the policy of neutrality, a decision made in agreement with England, and on the other hand, the reaffirmation of Portuguese sovereignty over the territory. Aware of the constant changes and supported by a network of informers on the islands, the German and British spies played a crucial role in the negotiations between Portugal and the Allies and the ceding of the bases by Salazar, which prevented their forced occupation. The espionage caused several diplomatic tensions, and the large number of German spies denounced by the British, operating on the islands under the watchful eye of the PVDE and Salazar, weakened the Portuguese-British alliance. Using primary source documents in the Ministério dos Negócios Estrangeiros (MNE) archives, this paper introduces the spies that operated on the islands, their missions and motives, organizations, and modus operandi. As a chess game, any move was careful thinking and the spies were valuable assets to control and use information that could lead to the occupation of the islands and, ultimately, change the tide of the war.

Keywords: espionage, Azores, WWI, neutrality

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Authors: Reiner-Ace P. Mateo, Vince Paolo F. Obille

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The traditional method of classifying the potential mineral resources requires a significant amount of time and money. In this paper, an alternative way to classify potential mineral resources with GIS application in Surigao del Sur. The three (3) analog map data inputs integrated to GIS are geologic map, topographic map, and land cover/vegetation map. The indicators used in the classification of potential nickel laterite integrated from the analog map data inputs are a geologic indicator, which is the presence of ultramafic rock from the geologic map; slope indicator and the presence of plateau edges from the topographic map; areas of forest land, grassland, and shrublands from the land cover/vegetation map. The potential mineral of the area was classified from low up to very high potential. The produced mineral potential classification map of Surigao del Sur has an estimated 4.63% low nickel laterite potential, 42.15% medium nickel laterite potential, 43.34% high nickel laterite potential, and 9.88% very high nickel laterite from its ultramafic terrains. For the validation of the produced map, it was compared with known occurrences of nickel laterite in the area using a nickel mining tenement map from the area with the application of remote sensing. Three (3) prominent nickel mining companies were delineated in the study area. The generated potential classification map of nickel-laterite in Surigao Del Sur may be of aid to the mining companies which are currently in the exploration phase in the study area. Also, the currently operating nickel mines in the study area can help to validate the reliability of the mineral classification map produced.

Keywords: mineral potential classification, nickel laterites, GIS, remote sensing, Surigao del Sur

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Authors: Pierre van Tonder, Dinesh Muthoo, Kim twiname

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Many existing and newly built structures are constructed on the design basis of the engineer and the workmanship of the construction company. However, when considering larger structures where more people are exposed to the building, its structural integrity is of great importance considering the safety of its occupants (Raghu, 2013). But how can the structural integrity of a building be monitored efficiently and effectively. This is where the fourth industrial revolution step in, and with minimal human interaction, data can be collected, analysed, and stored, which could also give an indication of any inconsistencies found in the data collected, this is where the Fibre Bragg Grating (FBG) monitoring system is introduced. This paper illustrates how data can be collected and converted to develop stress – strain behaviour and to produce bending moment diagrams for the utilisation and prediction of the structure’s integrity. Embedded fibre optic sensors were used in this study– fibre Bragg grating sensors in particular. The procedure entailed making use of the shift in wavelength demodulation technique and an inscription process of the phase mask technique. The fibre optic sensors considered in this report were photosensitive and embedded in the slab and beams for data collection and analysis. Two sets of fibre cables have been inserted, one purposely to collect temperature recordings and the other to collect strain and temperature. The data was collected over a time period and analysed used to produce bending moment diagrams to make predictions of the structure’s integrity. The data indicated the fibre Bragg grating sensing system proved to be useful and can be used for structural health monitoring in any environment. From the experimental data for the slab and beams, the moments were found to be64.33 kN.m, 64.35 kN.m and 45.20 kN.m (from the experimental bending moment diagram), and as per the idealistic (Ultimate Limit State), the data of 133 kN.m and 226.2 kN.m were obtained. The difference in values gave room for an early warning system, in other words, a reserve capacity of approximately 50% to failure.

Keywords: fibre bragg grating, structural health monitoring, fibre optic sensors, beams

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Authors: Kamran Siddique, Hiroyuki Asada, Yoshifumi Ogami

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The use of Micro Gas Turbine (MGT) as the engine in Unmanned Aerobic Vehicles (UAVs) and power source in Robotics is widespread these days. Research has been conducted in the past decade or so to improve the performance of different components of MGT. This type of engine has interrelated components which have non-linear characteristics. Therefore, the overall engine performance depends on the individual engine element’s performance. Computational Fluid Dynamics (CFD) is one of the simulation method tools used to analyze or even optimize MGT system performance. In this study, the compressor of the MGT is designed, and performance optimization is being done using CFD. Performance of the micro compressor is improved in order to increase the overall performance of MGT. A high value of pressure ratio is to be achieved by studying the effect of change of different operating parameters like mass flow rate and revolutions per minute (RPM) and aerodynamical and geometrical parameters on the pressure ratio of the compressor. Two types of compressor designs are considered in this study; 3D centrifugal and ‘planar’ designs. For a 10 mm impeller, the planar model is the simplest compressor model with the ease in manufacturability. On the other hand, 3D centrifugal model, although more efficient, is very difficult to manufacture using current microfabrication resources. Therefore, the planar model is the best-suited model for a micro compressor. So. a planar micro compressor has been designed that has a good pressure ratio, and it is easy to manufacture using current microfabrication technologies. Future work is to fabricate the compressor to get experimental results and validate the theoretical model.

Keywords: computational fluid dynamics, microfabrication, MEMS, unmanned aerobic vehicles

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Authors: Dharshini M., Hema N. S.

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The project for the production of aniline is done by providing 295.46 tons per day of nitrobenzene as feed. The material and energy balance calculations for the different equipment like distillation column, heat exchangers, reactor and mixer are carried out with simulation via DWSIM. The conversion of nitrobenzene to aniline by hydrogenation process is considered to be 96% and the total production of the plant was found to be 215 TPD. The cost estimation of the process is carried out to estimate the feasibility of the plant. The net profit and percentage return of investment is estimated to be ₹27 crores and 24.6%. The payback period was estimated to be 4.05 years and the unit production cost is ₹113/kg. A techno-economic analysis was performed for the production of aniline; the result includes economic analysis and sensitivity analysis of critical factors. From economic analysis, larger the plant scale increases the total capital investment and annual operating cost, even though the unit production cost decreases. Uncertainty analysis was performed to predict the influence of economic factors on profitability and the scenario analysis is one way to quantify uncertainty. In scenario analysis the best-case scenario and the worst-case scenario are compared with the base case scenario. The best-case scenario was found at a feed rate of 120 kmol/hr with a unit production cost of ₹112.05/kg and the worst-case scenario was found at a feed rate of 60 kmol/hr with a unit production cost of ₹115.9/kg. The base case is closely related to the best case by 99.2% in terms of unit production cost. since the unit production cost is less and the profitability is more with less payback time, it is feasible to construct a plant at this capacity.

Keywords: aniline, nitrobenzene, economic analysis, unit production cost

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Authors: Lotha Valan, Åsa Hörnsten, Ulf Isaksson

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Introduction: Sweden has a national child health care program (CHCP) where all parents are offered support to raise their children and support them for lifelong health. A systematic review concludes that there is a request for guidance in using the internet effectively for the health purposes of their children. However, a study about internet use among young mothers means that the internet is not always easy to navigate for parents, and they may need support. To fill this gap and develop a digital channel to complement the child health care (CHC) for the support of parents of children within CHC, there is a demand to investigate parents' needs in relation to this purpose. Methods: The study had a qualitative approach using focus group interviews with parents. The interview data were analyzed using qualitative content analysis. Results: The main theme highlights that parents expected that a digital support channel would be something that might strengthen them toward independence concerning the care of their children in a positive way. However, they also felt that they needed personal support and that relationships with other parents and the child health care nurse were significant and meaningful. Another parental desire that emerged was that a future digital channel would facilitate and simplify access to care, and they suggested having both planned and urgent times available for parents to book. The digital channel was expected to make this possible and be a good complement to the physical contacts the traditional child healthcare currently offers. Discussion/conclusions: The parents in this study believed that digital solutions could increase their parental power in relation to the care of their children. Examples were given as nurse-led parent groups where parents with similar problems and experiences around their children could support each other and were expected to strengthen them over time. The parents stressed that a planned digital support channel also needs satisfactory solutions for both contact and response. It was suggested that there should be bookable times for both planned and urgent needs and also the possibility of rescheduling visits.

Keywords: child healthcare, parents, digital support, nursing

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Authors: Kalsoom Sumra

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The increasing concern of public sector reforms brings new challenges to public service ethics in developing countries not only at central level but also at local level. This paper aims to identify perceptions on public service ethics of public officials and examines more generally the understanding of public servants in Pakistan towards public service ethics in local public organizations. The study uses an independently administered structured questionnaire to collect data to know the extent of the recognition of public service ethics in local organizations. A total of 150 completed questionnaires are analyzed received from public servants working at the local level in Pakistan. The analysis explores how traditional, social patterns and cultural ethics can provide us with a rounded picture of the main antecedents, moderators of public service ethics in Pakistan. Moreover, the findings of this study contribute in association of public service ethics which are crucial in ongoing political and administrative culture of Pakistan, the most crucial core for public organizational ethical climate. This study also has numerous implications for local public administration and it highlights the importance of expanding research agenda on public service ethics in developing settings with challenging institutional contexts with imperfect training and operating environments. This study may well be particularly important for practice of public service ethics in developing countries in public administration. To the best of author’s knowledge, this study is the first of its kind to provide an initial step in practical implications to emphasize relevant public service ethics in public administration in developing transparent and accountable organization.

Keywords: public service ethics, accountability and transparency, public service reforms, public administration, organizational ethical climate

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Authors: Noof Eid Al Shammari

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Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

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Authors: Rohollah Ghasemi, Arvin Ghorbani

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This study investigates the effect of austempering temperature on microstructure and scratch behavior of the austempered heat-treated compacted graphite irons. The as-cast was used as base material for heat treatment practices. The samples were extracted from as-cast ferritic CGI pieces and were heat treated under austenitising temperature of 900°C for 60 minutes which followed by quenching in salt-bath at different austempering temperatures of 275°C, 325°C and 375°C. For all heat treatments, an austempering holding time of 30 minutes was selected for this study. Light optical microscope (LOM) and scanning electron microscope (SEM) and electron back scattered diffraction (EBSD) analysis confirmed the ausferritic matrix formed in all heat-treated samples. Microscratches were performed under the load of 200, 600 and 1000 mN using a sphero-conical diamond indenter with a tip radius of 50 μm and induced cone angle 90° at a speed of 10 μm/s at room temperature ~25°C. An instrumented nanoindentation machine was used for performing nanoindentation hardness measurement and microscratch testing. Hardness measurements and scratch resistance showed a significant increase in Brinell, Vickers, and nanoindentation hardness values as well as microscratch resistance of the heat-treated samples compared to the as-cast ferritic sample. The increase in hardness and improvement in microscratch resistance are associated with the formation of the ausferrite matrix consisted of carbon-saturated retained austenite and acicular ferrite in austempered matrix. The maximum hardness was observed for samples austempered at 275°C which resulted in the formation of very fine acicular ferrite. In addition, nanohardness values showed a quite significant variation in the matrix due to the presence of acicular ferrite and carbon-saturated retained austenite. It was also observed that the increase of austempering temperature resulted in increase of volume of the carbon-saturated retained austenite and decrease of hardness values.

Keywords: austempered CGI, austempering, scratch testing, scratch plastic deformation, scratch hardness

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Authors: Tolga Hayit, Ucman Ergun, Ugur Fidan

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Being healthy is undoubtedly an indispensable necessity for human life. With technological improvements, in the literature, various health monitoring and imaging systems have been developed to satisfy your health needs. In this context, the work of monitoring and recording the data of individual health monitoring data via wireless technology is also being part of these studies. Nowadays, mobile devices which are located in almost every house and which become indispensable of our life and have wireless technology infrastructure have an important place of making follow-up health everywhere and every time because these devices were using in the health monitoring systems. In this study, Arduino an open-source microcontroller card was used in which a sample sugar measuring device was connected in series. In this way, the glucose data (glucose ratio, time) obtained with the glucometer is transferred to the mobile device based on the Android operating system with the Bluetooth technology channel. A mobile application was developed using the Apache Cordova framework for listing data, presenting graphically and reading data over Arduino. Apache Cordova, HTML, Javascript and CSS are used in coding section. The data received from the glucometer is stored in the local database of the mobile device. It is intended that people can transfer their measurements to their mobile device by using wireless technology and access the graphical representations of their data. In this context, the aim of the study is to be able to perform health monitoring by using different wireless technologies in mobile devices that can respond to different wireless technologies at present. Thus, that will contribute the other works done in this area.

Keywords: Arduino, Bluetooth, glucose measurement, mobile health monitoring

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Authors: Osama Elgadi, Martin Birkett, Wai Ming Cheung

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This paper investigates the barriers behind the underutilisation of six sigma in Libyan manufacturing companies (LMCs). A mixed-method methodology is proposed, starting by conducting interviews to collect qualitative data followed by the development of a questionnaire to obtain quantitative data. The focus of this paper is on discussing the findings of the interview stage and how these can be used to further develop the questionnaire stage. The interview results showed that only four key barriers were highlighted as being encountered by LMCs. With a difference in terms of their significance, these factors were identified, and placed in descending order according to their importance, namely: “Lack of top management commitment”, “Lack of training”, “Lack of knowledge about six sigma”, and “Culture effect”. The findings also showed that some barriers which, were found in previous studies of six sigma implementation were not considered as barriers to LMCs but can, in fact, be considered as success factors or enablers for six sigma adoption. These factors were identified as: “sufficiency of time and financial resources”; “customers unsatisfied”; “good communication between all departments in the company”; “we are certain about its results and benefits to our company and unhappy with the current quality system”. These results suggest that LMCs face fewer barriers to adopting six sigma than many well-established global companies operating in other countries and could take advantage of these successful factors by developing and implementing a six sigma framework to improve their product quality and competitiveness.

Keywords: six sigma, barriers, Libyan manufacturing companies, interview

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Authors: Karissa Graham, Andrew Campbell-Lloyd

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The deep inferior epigastric artery perforator flap (DIEP) is used to reconstruct large volumes of tissue. The DIEP flap is based on the deep inferior epigastric artery (DIEA) and vein. Accurate knowledge of the anatomy of these vessels allows for efficient dissection of the flap, minimal damage to surrounding tissue, and a well vascularized flap. A 54 year old lady was assessed for bilateral delayed autologous reconstruction with DIEP free flaps. The right DIEA was consistent with the described anatomy. The left DIEA had a vessel branching shortly after leaving the external iliac artery and before entering the muscle. This independent branch entered the muscle and had a long intramuscular course to the largest perforator. The main DIEA vessel demonstrated a type II branching pattern but had perforators that were too small to have a viable DIEP flap. There were no communicating arterial branches between the independent vessel and DIEA, however, there was one venous communication between them. A muscle sparing transverse rectus abdominis muscle flap was raised using the main periumbilical perforator from the independent vessel. Our case report demonstrated an unreported anatomical variant of the DIEA. A few anatomical variants have been described in the literature, including a unilateral absent DIEA and peritoneal-cutaneous perforators that had no connection to the DIEA. Doing a pre-operative CTA helps to identify these rare anatomical variations, which leads to safer, more efficient, and effective operating.

Keywords: aberrant anatomy, CT angiography, DIEP anatomy, free flap

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Authors: R. Vetrimurugan, Terry Lim, M. J. Goodson, R. Nagarajan

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This study investigates the cleaning performance of high intensity 360 kHz frequency on the removal of nano-dimensional and sub-micron particles from various surfaces, uniformity of the cleaning tank and run to run variation of cleaning process. The uniformity of the cleaning tank was measured by two different methods i.e 1. ppbTM meter and 2. Liquid Particle Counting (LPC) technique. In the second method, aluminium metal spacer components was placed at various locations of the cleaning tank (such as centre, top left corner, bottom left corner, top right corner, bottom right corner) and the resultant particles removed by 360 kHz frequency was measured. The result indicates that the energy was distributed more uniformly throughout the entire cleaning vessel even at the corners and edges of the tank when megasonic sweeping technology is applied. The result also shows that rinsing the parts with 360 kHz frequency at final rinse gives lower particle counts, hence higher cleaning efficiency as compared to other frequencies. When megasonic sweeping technology is applied each piezoelectric transducers will operate at their optimum resonant frequency and generates stronger acoustic cavitational force and higher acoustic streaming velocity. These combined forces are helping to enhance the particle removal and at the same time improve the overall cleaning performance. The multiple extractions study was also carried out for various frequencies to measure the cleaning potential and asymptote value.

Keywords: power distribution, megasonic sweeping, cavitation intensity, particle removal, laser particle counting, nano, submicron

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Authors: Monika Šípová, Daniela Marušáková, Claudia Aparicio

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New sources and ways of producing energy are still seeking, and one of the sustainable ways is Generation IV nuclear reactors. The supercritical water-cooled reactor is one of the six nuclear reactors of Generation IV, and as a consequence of the development of light water, reactors seem to be the most perspective. Thus, materials usually used in light water reactors are also tested under the expected operating conditions of the supercritical water-cooled reactor. Austenitic stainless steel 08Cr18Ni10Ti is widely used in the eastern types of light water nuclear power plants. Therefore, specimens of 08Cr18Ni10Ti were exposed to conditions close to the pseudo-critical point of water and high-temperature supercritical water. The description and evaluation of the corrosion behaviour of austenitic stainless steel have been done based on the results of X-ray diffraction in combination with energy dispersive spectroscopy and electron backscatter diffraction. Thus, significant differences have been found in the structure and composition of oxides formed depending on the temperature of exposure. The high temperature of supercritical water resulted in localised form of corrosion in contrast to the thin oxide layer of 1 µm present on the surface of specimens exposed close to the pseudo-critical point of water. The obtained results are important for further research as the supercritical water can be successfully used as a coolant for small modular reactors, which are currently of interest.

Keywords: localised corrosion, supercritical water, stainless steel, electron backscatter diffraction

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Authors: Pablo Cid Galache, Laura Zamorano Bonilla

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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

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Authors: KuiDong Kang, Hye Bin Yim, Su Ah Kim

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Purpose: Tectorigenin is an isoflavone derived from the rhizome of Belamacanda chinensis. In this study, oxygen-induced retinopathy was used to characterize the anti-angiogenic properties of tectorigenin in mice. Methods: ICR neonatal mice were exposed to 75% oxygen from postnatal day P7 until P12 and returned to room air (21% oxygen) for five days (P12 to P17). Mice were subjected to daily intraperitoneal injection of tectorigenin (1 mg/kg, 10 mg/kg) and vehicle from P12 to P17. Retro-orbital injection of FITC-dextran was performed and retinal flat mounts were viewed by fluorescence microscopy. The Central avascular area was quantified from the digital images in a masked fashion using image analysis software (NIH ImageJ). Neovascular tufts were quantified by using SWIFT_NV and neovascular lumens were quantified from a histologic section in a masked fashion. Immunohistochemistry and Western blot analysis were also performed to demonstrate the anti-angiogenic activity of this compound in vivo. Results: In the retina of tectorigenin injected mouse (10mg/kg), the central non-perfusion area was significantly decreased compared to the vehicle injected group (1.76±0.5 mm2 vs 2.85±0.6 mm2, P<0.05). In vehicle-injected group, 33.45 ± 5.51% of the total retinal area was avascular, whereas the retinas of pups treated with high-dose (10 mg/kg) tectorigenin showed avascular retinal areas of 21.25 ±4.34% (P<0.05). High dose of tectorigenin also significantly reduced the number of vascular lumens in the histologic section. Tectorigenin (10 mg/kg) significantly reduced the expression of vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2), MMP-9, and angiotensin II compared to the vehicle injected group. Tectorigenin did not affect CD31 abundance at any tested dose. Conclusions: Our results show that tectorigenin possesses powerful anti-angiogenic properties and can attenuate new vessel formation in the retina after systemic administration. These results imply that this compound can be considered as a candidate substance for therapeutic inhibition of retinal angiogenesis.

Keywords: tectorigenin, anti-angiogenic, retinopathy, Belamacanda chinensis

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Authors: Anthony Townsend, Robyn Fasser

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While complete objectivity is a desirable scientific position from which to conduct a care and contact evaluation (CCE), it is precisely the recognition that we are inherently incapable of operating objectively that is the foundation of ethical practice and skilled assessment. Drawing upon recent research from Daniel Kahneman (2021) on the differences between noise and bias, as well as different inherent biases collectively termed “The Elephant in the Brain” by Kevin Simler and Robin Hanson (2019) from Oxford University, this presentation addresses both the various ways in which our judgments, perceptions and even procedures can be distorted and contaminated while conducting a CCE, but also considers the value of second order cybernetics and the psychodynamic concept of ‘ambivalence’ as a conceptual basis to inform our assessment methodologies to limit such errors or at least better identify them. Both a conceptual framework for ambivalence, our higher-order capacity to allow for the convergence and consideration of multiple emotional experiences and cognitive perceptions to inform our reasoning, and a practical methodology for assessment relying on data triangulation, Bayesian inference and hypothesis testing is presented as a means of promoting ethical practice for health care professionals conducting CCEs. An emphasis on widening awareness and perspective, limiting ‘splitting’, is demonstrated both in how this form of emotional processing plays out in alienating dynamics in families as well as the assessment thereof. In addressing this concept, this presentation aims to illuminate the value of ambivalence as foundational to ethical practice for assessors.

Keywords: ambivalence, forensic, psychology, noise, bias, ethics

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Authors: Cheng-Chi Yu, Chi-Shiun Chiou

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This study developed a plug-in hybrid powertrain system which consisted of two continuous variable transmissions. By matching between the engine, motor, generator, and dual continuous variable transmissions, this integrated power system can take advantages of the components. The hybrid vehicle can be driven by the internal combustion engine, or electric motor alone, or by these two power sources together when the vehicle is driven in hard acceleration or high load. The energy management of this integrated hybrid system controls the power systems based on rule-based control strategy to achieve better fuel economy. When the vehicle driving power demand is low, the internal combustion engine is operating in the low efficiency region, so the internal combustion engine is shut down, and the vehicle is driven by motor only. When the vehicle driving power demand is high, internal combustion engine would operate in the high efficiency region; then the vehicle could be driven by internal combustion engine. This strategy would operate internal combustion engine only in optimal efficiency region to improve the fuel economy. In this research, the vehicle simulation model was built in MATLAB/ Simulink environment. The analysis results showed that the power coupled efficiency of the hybrid powertrain system with dual continuous variable transmissions was better than that of the Honda hybrid system on the market.

Keywords: plug-in hybrid power system, fuel economy, performance, continuously variable transmission

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

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Authors: Mimi Roy, Sriroop Chaudhuri

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Sustainable water supply is among the basic needs for human development, especially in the rural areas of the developing nations where safe water supply and basic sanitation infrastructure is direly needed. In light of the above, we propose a simple methodology to develop a composite water sustainability index (WSI) to assess the collective performance of the existing rural water supply services (RWSS) in India over time. The WSI will be computed by summarizing the details of all the different varieties of water supply schemes presently available in India comprising of 40 liters per capita per day (lpcd), 55 lpcd, and piped water supply (PWS) per household. The WSI will be computed annually, between 2010 and 2016, to elucidate changes in holistic RWSS performances. Results will be integrated within a robust geospatial framework to identify the ‘hotspots’ (states/districts) which have persistent issues over adequate RWSS coverage and warrant spatially-optimized policy reforms in future to address sustainable human development. Dataset will be obtained from the National Rural Drinking Water Program (NRDWP), operating under the aegis of the Ministry of Drinking Water and Sanitation (MoDWS), at state/district/block levels to offer the authorities a cross-sectional view of RWSS at different levels of administrative hierarchy. Due to simplistic design, complemented by spatio-temporal cartograms, similar approaches can also be adopted in other parts of the world where RWSS need a thorough appraisal.

Keywords: rural water supply services, piped water supply, sustainability, composite index, spatial, drinking water

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Authors: Hatice Özbek, Caner Çil, Ahmet Rodoplu

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Automotive lighting is the leading function in the configuration of vehicle architecture. Especially headlights and taillights from external lighting functions are among the structures that determine the stylistic character of the vehicle. At the same time, the fact that lighting functions are related to many other functions brings along difficulties in design. Customers expect maximum quality from the vehicle. In these circumstances, it is necessary to make designs that aim to keep the performance of bulbs with limited working lives at the highest level. With this study, the factors that influence the working lives of filament lamps were examined and bulb explosions that can occur sooner than anticipated in the future were prevented while the vehicle was still in the design phase by determining the relations with electrical, dynamical and static variables. Especially the filaments of the bulbs used in the front lighting of the vehicle are deformed in a shorter time due to the high voltage requirement. In addition to this, rear lighting lamps vibrate as a result of the tailgate opening and closing and cause the filaments to be exposed to high stress. With this study, the findings that cause bulb explosions were evaluated. Among the most important findings: 1. The structure of the cables to the lighting functions of the vehicle and the effect of the voltage values are drawn; 2. The effect of the vibration to bulb throughout the life of the vehicle; 3 The effect of the loads carried to bulb while the vehicle doors are opened and closed. At the end of the study, the maximum performance was established in the bulb lifetimes with the optimum changes made in the vehicle architecture based on the findings obtained.

Keywords: vehicle architecture, automotive lighting functions, filament lamps, bulb lifetime

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Authors: Michael Zimba

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A duplicated image region may be subjected to a number of attacks such as noise addition, compression, reflection, rotation, and scaling with the intention of either merely mating it to its targeted neighborhood or preventing its detection. In this paper, we present an effective and robust method of detecting duplicated regions inclusive of those affected by the various attacks. In order to reduce the dimension of the image, the proposed algorithm firstly performs discrete wavelet transform, DWT, of a suspicious image. However, unlike most existing copy move image forgery (CMIF) detection algorithms operating in the DWT domain which extract only the low frequency sub-band of the DWT of the suspicious image thereby leaving valuable information in the other three sub-bands, the proposed algorithm simultaneously extracts features from all the four sub-bands. The extracted features are not only more accurate representation of image regions but also robust to additive noise, JPEG compression, and affine transformation. Furthermore, principal component analysis-eigenvalue decomposition, PCA-EVD, is applied to reduce the dimension of the features. The extracted features are then sorted using the more computationally efficient Radix Sort algorithm. Finally, same affine transformation selection, SATS, a duplication verification method, is applied to detect duplicated regions. The proposed algorithm is not only fast but also more robust to attacks compared to the related CMIF detection algorithms. The experimental results show high detection rates.

Keywords: affine transformation, discrete wavelet transform, radix sort, SATS

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Authors: Cupian

Abstract:

The expansion of Islamic banking industry seems to emphasize the banking competition in Indonesia where conventional and Islamic banks coexist. In addition, the 2007/2008 global financial crisis and deregulation have the effect on competitive conditions in Islamic banking market. In this context, this study aims at investigating competitive conditions and market power of Islamic banks in Indonesia using firm level data over the period 2006-2013. The study also attempts to identify the factors that represent the power of banking market to better study the degree of competition in this banking industry. Using samples of 27 Islamic commercial banks, the study uses a variety of structural and non-structural measures related to the traditional approach and the new empirical approach of the industrial organization (NEIO). The methodology is based on the set of measures of the competition and market power. The first measure is a set of concentration ratios (CR4) and Herfindahl-Hirschman index (HHI).The second measures are the Panzar and Ross H-statistic and the Lerner index based on econometric estimations with the aim of evaluating the market structure and measuring its power in terms of price setting. The results of the competition analysis suggest that the Islamic banking markets in Indonesia cannot be characterized by the bipolar cases of either perfect competition or monopoly over 2006-2013. That is, banks earned their revenues operating under conditions of monopolistic competition in that period. Overall, Islamic banks in Indonesia operate in a relatively less competitive environment or in high market power. It is also indicated that Islamic bank that hope to achieve higher returns should operate in the competitive environment.

Keywords: bank competition, islamic banks, market structure, profitability

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