Search results for: Dian Guan
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 72

Search results for: Dian Guan

42 Need Assessments of Midwives in Public's Health Center (Puskesmas) at Sukabumi Municipal, Province of Jawa Barat, Indonesia

Authors: Al Asyary, Meita Veruswati, Dian Ayyubi

Abstract:

Sukabumi municipal has highest rank for maternal mortality in Indonesia with 102 by 100,000 live birth with almost 80% of birth were not attended by skilled birth attendant (SBA). Although universal health coverage has been implemented, availability and sufficiency of SBA, such as midwife in this developing country, are problematic agenda for the quality of public healthcare as well as decreasing maternal mortality rate. This study aims to describe the equal distribution of midwives in Sukabumi municipal as support of government’s program named Millennium Development Goals (MDGs) that suppressed maternal mortality rate in Indonesia. We conducted an observational study with Workload Indicator of Staffing Need (WISN) analysis to present the dispersion of midwives by their activities and workloads in 37 Puskesmas. We also generated in-depth interview with several executive chief of health sections, including chief of health offices in Sukabumi municipal. It resulted inferentially that several activities in midwives’ program were differed at once of existing than needed condition ideally (ρ value = 0.002 < 0.05). Meanwhile, decision for midwives’ procurement and placement were held by un-systematically procedure such as based on where the midwife was staying, and it also progressed by neighborhood issue priorities. The absence of formal regulation in local government is a serious problem that indicated poor political commitment, while access to SBA shall be focused carefully.

Keywords: developing country, health professional resources, health policy, need assessment

Procedia PDF Downloads 139
41 Resource Orchestration Based on Two-Sides Scheduling in Computing Network Control Sytems

Authors: Li Guo, Jianhong Wang, Dian Huang, Shengzhong Feng

Abstract:

Computing networks as a new network architecture has shown great promise in boosting the utilization of different resources, such as computing, caching, and communications. To maximise the efficiency of resource orchestration in computing network control systems (CNCSs), this work proposes a dynamic orchestration strategy of a different resource based on task requirements from computing power requestors (CPRs). Specifically, computing power providers (CPPs) in CNCSs could share information with each other through communication channels on the basis of blockchain technology, especially their current idle resources. This dynamic process is modeled as a cooperative game in which CPPs have the same target of maximising long-term rewards by improving the resource utilization ratio. Meanwhile, the task requirements from CPRs, including size, deadline, and calculation, are simultaneously considered in this paper. According to task requirements, the proposed orchestration strategy could schedule the best-fitting resource in CNCSs, achieving the maximum long-term rewards of CPPs and the best quality of experience (QoE) of CRRs at the same time. Based on the EdgeCloudSim simulation platform, the efficiency of the proposed strategy is achieved from both sides of CPRs and CPPs. Besides, experimental results show that the proposed strategy outperforms the other comparisons in all cases.

Keywords: computing network control systems, resource orchestration, dynamic scheduling, blockchain, cooperative game

Procedia PDF Downloads 72
40 Quasi-Static Analysis of End Plate Beam-to-Column Connections

Authors: A. Al-Rifaie, Z. W. Guan, S. W. Jones

Abstract:

This paper presents a method for modelling and analysing end plate beam-to-column connections to obtain the quasi-static behaviour using non-linear dynamic explicit integration. In addition to its importance to study the static behaviour of a structural member, quasi-static behaviour is largely needed to be compared with the dynamic behaviour of such members in order to investigate the dynamic effect by proposing dynamic increase factors (DIFs). The beam-to-column bolted connections contain various contact surfaces at which the implicit procedure may have difficulties converging, resulting in a large number of iterations. Contrary, explicit procedure could deal effectively with complex contacts without converging problems. Hence, finite element modelling using ABAQUS/explicit is used in this study to address the dynamic effect may be produced using explicit procedure. Also, the effect of loading rate and mass scaling are discussed to investigate their effect on the time of analysis. The results show that the explicit procedure is valuable to model the end plate beam-to-column connections in terms of failure mode, load-displacement relationships. Also, it is concluded that loading rate and mass scaling should be carefully selected to avoid the dynamic effect in the solution.

Keywords: quasi-static, end plate, finite elements, connections

Procedia PDF Downloads 281
39 Higher Education Institution Students’ Perception on Educational Technology

Authors: Kuek Teik Sheng, Leaw Zee Guan, Lim Wah Kien, Ting Tin Tin

Abstract:

Educational technology such as YouTube and Kahoot have arisen as an alternative to effective learning among higher education institutions. There are many researches done in carrying out experiments to test different educational technologies and received positive feedback from students. Yet, similar study is hardly found in Malaysia especially study that includes the latest educational technologies. As a developing country, it is crucial to ensure that these emerging technologies are assisting students in learning process before it is widely adopted in institutions. This paper conducted a study to explore the perception of higher education institution students on the current educational technologies in Malaysia which include online educational games, online videos/course, social media, presentation tools and resource management tool. Some of these technologies have not been looked into its potential in effective learning process. An online survey using questionnaire is conducted among a target of 300 university/college. In the survey, the result shows that majority of the target students in Malaysia agree that the current educational technologies help them in learning, understanding and manage their studies. It is necessary to discover students’ perceptions on the educational technologies in order to provide guidelines for the educators/institutions in selecting appropriate technology to conduct the lecture/tutorial efficiently and effectively.

Keywords: education, educational technology, Facebook, PowerPoint, YouTube

Procedia PDF Downloads 219
38 Integrating Time-Series and High-Spatial Remote Sensing Data Based on Multilevel Decision Fusion

Authors: Xudong Guan, Ainong Li, Gaohuan Liu, Chong Huang, Wei Zhao

Abstract:

Due to the low spatial resolution of MODIS data, the accuracy of small-area plaque extraction with a high degree of landscape fragmentation is greatly limited. To this end, the study combines Landsat data with higher spatial resolution and MODIS data with higher temporal resolution for decision-level fusion. Considering the importance of the land heterogeneity factor in the fusion process, it is superimposed with the weighting factor, which is to linearly weight the Landsat classification result and the MOIDS classification result. Three levels were used to complete the process of data fusion, that is the pixel of MODIS data, the pixel of Landsat data, and objects level that connect between these two levels. The multilevel decision fusion scheme was tested in two sites of the lower Mekong basin. We put forth a comparison test, and it was proved that the classification accuracy was improved compared with the single data source classification results in terms of the overall accuracy. The method was also compared with the two-level combination results and a weighted sum decision rule-based approach. The decision fusion scheme is extensible to other multi-resolution data decision fusion applications.

Keywords: image classification, decision fusion, multi-temporal, remote sensing

Procedia PDF Downloads 101
37 Production of New Hadron States in Effective Field Theory

Authors: Qi Wu, Dian-Yong Chen, Feng-Kun Guo, Gang Li

Abstract:

In the past decade, a growing number of new hadron states have been observed, which are dubbed as XYZ states in the heavy quarkonium mass regions. In this work, we present our study on the production of some new hadron states. In particular, we investigate the processes Υ(5S,6S)→ Zb (10610)/Zb (10650)π, Bc→ Zc (3900)/Zc (4020)π and Λb→ Pc (4312)/Pc (4440)/Pc (4457)K. (1) For the production of Zb (10610)/Zb (10650) from Υ(5S,6S) decay, two types of bottom-meson loops were discussed within a nonrelativistic effective field theory. We found that the loop contributions with all intermediate states being the S-wave ground state bottom mesons are negligible, while the loops with one bottom meson being the broad B₀* or B₁' resonance could provide the dominant contributions to the Υ(5S)→ Zb⁽'⁾ π. (2) For the production of Zc (3900)/Zc (4020) from Bc decay, the branching ratios of Bc⁺→ Z (3900)⁺ π⁰ and Bc⁺→ Zc (4020)⁺ π⁰ are estimated to be of order of 10⁽⁻⁴⁾ and 10⁽⁻⁷⁾ in an effective Lagrangian approach. The large production rate of Zc (3900) could provide an important source of the production of Zc (3900) from the semi-exclusive decay of b-flavored hadrons reported by D0 Collaboration, which can be tested by the exclusive measurements in LHCb. (3) For the production of Pc (4312), Pc (4440) and Pc (4457) from Λb decay, the ratio of the branching fraction of Λb→ Pc K was predicted in a molecular scenario by using an effective Lagrangian approach, which is weakly dependent on our model parameter. We also find the ratios of the productions of the branching fractions of Λb→ Pc K and Pc→ J/ψ p can be well interpreted in the molecular scenario. Moreover, the estimated branching fractions of Λb→ Pc K are of order 10⁽⁻⁶⁾, which could be tested by further measurements in LHCb Collaboration.

Keywords: effective Lagrangian approach, hadron loops, molecular states, new hadron states

Procedia PDF Downloads 106
36 The Causes and Effects of Housing Project Abandonment in Malaysia

Authors: Abdul Aziz Abdullah, Anuar Alias, Khor Hooi Ting, Guan Ngah Mei

Abstract:

One of the major sectors which contribute significant growth to socio-economic development is the construction and development industry. This industry is most badly hurt during the 1997 and 2008 economic crisis thus causing many government and private projects to be deferred and abandoned. The purpose of this study is to examine the causes and effects of housing project abandonment in Malaysia. This objective is achieved through rigorous review of literatures and documents related to housing and abandoned housing project. The finding revealed there are several causes of housing project abandonment. The significant causes are: economic recession, inadequacy of finance, poor marketing and sales strategies, technical problems faced during construction, problems caused by compensations demanded by squatters for resettlement, insolvency of contractor, cost overrun and currency fluctuation amongst others. However the alarming effect of housing project is: house buyers of abandoned project have the monthly payment although the house is delivered to house buy. In other case house buyers have to entangle in many legal action with the financial institution. This finding provides the various ministries in the Government some insights on real causes and effects of abandoned project. Perhaps this finding can enhance the current solution the Ministry of Housing Local Government on addressing the prevailing issue of reviving existing abandoned project in the country.

Keywords: abandoned project, abandonment, housing project, ministry of housing and local government, causes and effect

Procedia PDF Downloads 508
35 Solution-Processed Threshold Switching Selectors Based on Highly Flexible, Transparent and Scratchable Silver Nanowires Conductive Films

Authors: Peiyuan Guan, Tao Wan, Dewei Chu

Abstract:

With the flash memory approaching its physical limit, the emerging resistive random-access memory (RRAM) has been considered as one of the most promising candidates for the next-generation non-volatile memory. One selector-one resistor configuration has shown the most promising way to resolve the crosstalk issue without affecting the scalability and high-density integration of the RRAM array. By comparison with other candidates of selectors (such as diodes and nonlinear devices), threshold switching selectors dominated by formation/spontaneous rupture of fragile conductive filaments have been proved to possess low voltages, high selectivity, and ultra-low current leakage. However, the flexibility and transparency of selectors are barely mentioned. Therefore, it is a matter of urgency to develop a selector with highly flexible and transparent properties to assist the application of RRAM for a diversity of memory devices. In this work, threshold switching selectors were designed using a facilely solution-processed fabrication on AgNWs@PDMS composite films, which show high flexibility, transparency and scratch resistance. As-fabricated threshold switching selectors also have revealed relatively high selectivity (~107), low operating voltages (Vth < 1 V) and good switching performance.

Keywords: flexible and transparent, resistive random-access memory, silver nanowires, threshold switching selector

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34 Multi Objective Simultaneous Assembly Line Balancing and Buffer Sizing

Authors: Saif Ullah, Guan Zailin, Xu Xianhao, He Zongdong, Wang Baoxi

Abstract:

Assembly line balancing problem is aimed to divide the tasks among the stations in assembly lines and optimize some objectives. In assembly lines the workload on stations is different from each other due to different tasks times and the difference in workloads between stations can cause blockage or starvation in some stations in assembly lines. Buffers are used to store the semi-finished parts between the stations and can help to smooth the assembly production. The assembly line balancing and buffer sizing problem can affect the throughput of the assembly lines. Assembly line balancing and buffer sizing problems have been studied separately in literature and due to their collective contribution in throughput rate of assembly lines, balancing and buffer sizing problem are desired to study simultaneously and therefore they are considered concurrently in current research. Current research is aimed to maximize throughput, minimize total size of buffers in assembly line and minimize workload variations in assembly line simultaneously. A multi objective optimization objective is designed which can give better Pareto solutions from the Pareto front and a simple example problem is solved for assembly line balancing and buffer sizing simultaneously. Current research is significant for assembly line balancing research and it can be significant to introduce optimization approaches which can optimize current multi objective problem in future.

Keywords: assembly line balancing, buffer sizing, Pareto solutions

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33 Cytotoxic Activity of Acetone and Ethanol Overripe Tempe Extracts against MCF-7 Breast Cancer Cells and Their Antioxidant Property

Authors: Dian Muzdalifah, Anastasia F. Devi, Zatil A. Athaillah, Linar Z. Udin

Abstract:

Tempe is a functional food prepared from soybeans through Rhizopus spp fermentation. It is well known as functional food, originated from Indonesia. Most studies on tempe functionalities refer to ripe (48 h fermentation) tempe and only limited studies discuss overripe tempe while longer fermentation time possibly increased tempe health benefit. Hence, the present study was performed to investigate the cytotoxic activity againts MCF-7 breast cancer cells and antioxidant property of tempe prepared from 0–156 h of fermentation. Tempe samples were dried and extracted with acetone and ethanol, respectively. Their extracts were used for subsequent analysis. The cytotoxic activity was assessed on MCF 7 breast cancer cells using Alamar Blue method. The antioxidant activity was determined by DPPH free radical scavenging assay. The results indicated that acetone extracts of 108 h tempe had a potent cytotoxic activity against MCF-7 breast cancer cells (IC50 = 2.54 ± 0,30 μg/mL). Ethanol extracts of 108 h tempe also showed the potency, but at slightly higher IC50 (5.20 ± 1.01 μg/mL). Both acetone and ethanol extracts of 108 and 120 h tempe showed high antioxidant activity expressed as percent inhibition with no significant difference. However, acetone extracts of 120 h tempe (81.31 ± 3.70 %) had better ability to inhibit oxidation reaction than that of ethanol extracts (75.77 ± 6.00 %). It can be concluded that the cytotoxic activity of tempe from 0–156 h of fermentation is positively correlated to their corresponding antioxidant property. Longer fermentation time, up to 108 h, increased the ability of tempe to inhibit the growth of MCF-7 breast cancer cells and oxidative reaction. But extended fermentation time, up to 156 h, tends to decrease its ability. Further studies are encouraged to identify the active components contained in each extract.

Keywords: antioxidant property, cytotoxic activity, extracts, overripe tempeh

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32 Revitalization of the Chinese Residential at Lasem, Indonesia

Authors: Nurtati Soewarno, Dian Duhita

Abstract:

The existence of civilization from the past is recognized by the left objects such as monuments, buildings or even a town. The relics were designed and made well, using the good quality material so it could persist a long period of time. At this moment, those relics are cultural heritage that must be preserved and the authenticity maintained. Indonesia, a country consist of various tribes with many cultural heritages, one of them is the city of Lasem. Lasem city lies in the northern part of Central Java since the Majapahit kingdom era (13th century) poses as a busy harbor city and a trading center. Lasem is one of the residences of Chinese immigrants in Java, seen by the domination of Chinese architectural building styles. The residential was built since the 15th century and the building has the courtyard which is different from other China’s building in another part of Java. This city loses ground since the trade activity experience difficulties during the Japanese colonial era and continues after the Indonesian independence time. Many Chinese people left Lasem city and let the buildings empty not maintained. This paper will present the result of observation to Chinese architectural style buildings in Lasem city which still hold out until this moment. Using typo morphology method, the case study is chosen based on the transformation type. The occurring transformation is parallel with adaptive reuse concept as an effort to revitalize the existence of the buildings. With this concept, it is expected that the buildings could be re functioned and the glory of the foretime Lasem city could be experienced again. Intervention from the local government is expected, issuing regulations, hoping the new building functions won’t ruin the cultural heritage but instead beautifies it.

Keywords: adaptive re-use, brown field area, building transformation, Lasem city

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31 Reliability Qualification Test Plan Derivation Method for Weibull Distributed Products

Authors: Ping Jiang, Yunyan Xing, Dian Zhang, Bo Guo

Abstract:

The reliability qualification test (RQT) is widely used in product development to qualify whether the product meets predetermined reliability requirements, which are mainly described in terms of reliability indices, for example, MTBF (Mean Time Between Failures). It is widely exercised in product development. In engineering practices, RQT plans are mandatorily referred to standards, such as MIL-STD-781 or GJB899A-2009. But these conventional RQT plans in standards are not preferred, as the test plans often require long test times or have high risks for both producer and consumer due to the fact that the methods in the standards only use the test data of the product itself. And the standards usually assume that the product is exponentially distributed, which is not suitable for a complex product other than electronics. So it is desirable to develop an RQT plan derivation method that safely shortens test time while keeping the two risks under control. To meet this end, for the product whose lifetime follows Weibull distribution, an RQT plan derivation method is developed. The merit of the method is that expert judgment is taken into account. This is implemented by applying the Bayesian method, which translates the expert judgment into prior information on product reliability. Then producer’s risk and the consumer’s risk are calculated accordingly. The procedures to derive RQT plans are also proposed in this paper. As extra information and expert judgment are added to the derivation, the derived test plans have the potential to shorten the required test time and have satisfactory low risks for both producer and consumer, compared with conventional test plans. A case study is provided to prove that when using expert judgment in deriving product test plans, the proposed method is capable of finding ideal test plans that not only reduce the two risks but also shorten the required test time as well.

Keywords: expert judgment, reliability qualification test, test plan derivation, producer’s risk, consumer’s risk

Procedia PDF Downloads 99
30 Cytotoxic Activity against MCF-7 Breast Cancer Cells and Antioxidant Property of Aqueous Tempe Extracts from Extended Fermentation

Authors: Zatil Athaillah, Anastasia Devi, Dian Muzdalifah, Wirasuwasti Nugrahani, Linar Udin

Abstract:

During tempe fermentation, some chemical changes occurred and they contributed to sensory, appearance, and health benefits of soybeans. Many studies on health properties of tempe have specialized on their isoflavones. In this study, other components of tempe, particularly water soluble chemicals, was investigated for their biofunctionality. The study was focused on the ability to suppress MCF-7 breast cancer cell growth and antioxidant activity, as expressed by DPPH radical scavenging activity, total phenols and total flavonoids, of the water extracts. Fermentation time of tempe was extended up to 120 hr to increase the possibility to find the functional components. Extraction yield and soluble nitrogen content were also quantified as accompanying data. Our findings suggested that yield of water extraction of tempe increased as fermentation was extended up to 120 hr, except for a slight decrease at 72 hr. Water extracts of tempe showed inhibition of MCF-7 breast cancer cell growth, as shown by lower IC50 values when compared to control (unfermented soybeans). Among the varied fermentation timescales, 60-hr period showed the highest activity (IC50 of 8.7 ± 4.95 µg/ml). The anticancer activity of extracts obtained from different fermentation time was positively correlated with total soluble nitrogens, but less relevant with antioxidant data. During 48-72 hr fermentation, at which cancer suppression activity was significant, the antioxidant properties from the three assays were not higher than control. These findings indicated that water extracts of tempe from extended fermentation could inhibit breast cancer cell growth but further study to determine the mechanism and compounds that play important role in the activity should be conducted.

Keywords: tempe, anticancer, antioxidant, phenolic compounds

Procedia PDF Downloads 219
29 Surface Modification of Titanium Alloy with Laser Treatment

Authors: Nassier A. Nassir, Robert Birch, D. Rico Sierra, S. P. Edwardson, G. Dearden, Zhongwei Guan

Abstract:

The effect of laser surface treatment parameters on the residual strength of titanium alloy has been investigated. The influence of the laser surface treatment on the bonding strength between the titanium and poly-ether-ketone-ketone (PEKK) surfaces was also evaluated and compared to those offered by titanium foils without surface treatment to optimize the laser parameters. Material characterization using an optical microscope was carried out to study the microstructure and to measure the mean roughness value of the titanium surface. The results showed that the surface roughness shows a significant dependency on the laser power parameters in which surface roughness increases with the laser power increment. Moreover, the results of the tensile tests have shown that there is no significant dropping in tensile strength for the treated samples comparing to the virgin ones. In order to optimize the laser parameter as well as the corresponding surface roughness, single-lap shear tests were conducted on pairs of the laser treated titanium stripes. The results showed that the bonding shear strength between titanium alloy and PEKK film increased with the surface roughness increment to a specific limit. After this point, it is interesting to note that there was no significant effect for the laser parameter on the bonding strength. This evidence suggests that it is not necessary to use very high power of laser to treat titanium surface to achieve a good bonding strength between titanium alloy and the PEKK film.

Keywords: bonding strength, laser surface treatment, PEKK, poly-ether-ketone-ketone, titanium alloy

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28 Effects of Alternative Opportunities and Compensation on Turnover Intention of Singapore PMET

Authors: Han Guan Chew, Keith Yong Ngee Ng, Shan-Wei Fan

Abstract:

In Singapore, talent retention is one of the most persistent and real issue companies have to grapple with due to the tight labour market. Being resource-scarce, Singapore depends solely on its talented pool of high quality human resource to sustain its competitive advantage in the global economy. But the complex and multifaceted nature of turnover phenomenon makes the prescription of effective talent retention strategies in such a competitive labour market very challenging, especially when it comes to monetary incentives, companies struggle to answer the question of “How much is enough?” By examining the interactive effects of perceived alternative employment opportunities, annual salary and satisfaction with compensation on the turnover intention of 102 Singapore Professionals, Managers, Executives and Technicians (PMET) through correlation analyses and multiple regressions, important insights into the psyche of the Singapore talent pool can be drawn. It is found that annual salary influence turnover intention indirectly through mediation and moderation effects on PMET’s satisfaction on compensation. PMET are also found to be heavily swayed by better external opportunities. This implies that talent retention strategies should not adopt a purely monetary based blanket approach but rather a comprehensive and holistic one that considers the dynamics of prevailing market conditions.

Keywords: employee turnover, high performers, knowledge workers, perceived alternative employment opportunities salary, satisfaction on compensation, Singapore PMET, talent retention

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27 Three Dimensional Large Eddy Simulation of Blood Flow and Deformation in an Elastic Constricted Artery

Authors: Xi Gu, Guan Heng Yeoh, Victoria Timchenko

Abstract:

In the current work, a three-dimensional geometry of a 75% stenosed blood vessel is analysed. Large eddy simulation (LES) with the help of a dynamic subgrid scale Smagorinsky model is applied to model the turbulent pulsatile flow. The geometry, the transmural pressure and the properties of the blood and the elastic boundary were based on clinical measurement data. For the flexible wall model, a thin solid region is constructed around the 75% stenosed blood vessel. The deformation of this solid region was modelled as a deforming boundary to reduce the computational cost of the solid model. Fluid-structure interaction is realised via a two-way coupling between the blood flow modelled via LES and the deforming vessel. The information of the flow pressure and the wall motion was exchanged continually during the cycle by an arbitrary lagrangian-eulerian method. The boundary condition of current time step depended on previous solutions. The fluctuation of the velocity in the post-stenotic region was analysed in the study. The axial velocity at normalised position Z=0.5 shows a negative value near the vessel wall. The displacement of the elastic boundary was concerned in this study. In particular, the wall displacement at the systole and the diastole were compared. The negative displacement at the stenosis indicates a collapse at the maximum velocity and the deceleration phase.

Keywords: Large Eddy Simulation, Fluid Structural Interaction, constricted artery, Computational Fluid Dynamics

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26 Influence of Food Microbes on Horizontal Transfer of β-Lactam Resistance Genes between Salmonella Strains in the Mouse Gut

Authors: M. Ottenbrite, G. Yilmaz, J. Devenish, M. Kang, H. Dan, M. Lin, C. Lau, C. Carrillo, K. Bessonov, J. Nash, E. Topp, J. Guan

Abstract:

Consumption of food contaminated by antibiotic-resistant (AR) bacteria may lead to the transmission of AR genes in the gut microbiota and cause AR bacterial infection, a significant public health concern. However, information is limited on if and how background microbes from the food matrix (food microbes) may influence resistance transmission. Thus, we assessed the colonization of a β-lactam resistant Salmonella Heidelberg strain (donor) and a β-lactam susceptible S. Typhimurium strain (recipient) and the transfer of the resistance genes in the mouse gut in the presence or absence of food microbes that were derived from washing freshly-harvested carrots. Mice were pre-treated with streptomycin and then inoculated with both donor and recipient bacteria or recipient only. Fecal shedding of the donor, recipient, and transconjugant bacteria was enumerated using selective culture techniques. Transfer of AR genes was confirmed by whole genome sequencing. Gut microbial composition was determined by 16s rRNA amplicon sequencing. Significantly lower numbers of donors and recipients were shed from mice that were inoculated with food microbes compared to those without food microbe inoculation. S. Typhimurium transconjugants were only recovered from mice without inoculation of food microbes. A significantly higher survival rate was in mice with vs. without inoculation of food microbes. The results suggest that the food microbes may compete with both the donor and recipient Salmonella, limit their growth and reduce transmission of the β-lactam resistance gene in the mouse gut.

Keywords: antibiotic resistance, gene transfer, gut microbiota, Salmonella infection

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25 High-Resolution Flood Hazard Mapping Using Two-Dimensional Hydrodynamic Model Anuga: Case Study of Jakarta, Indonesia

Authors: Hengki Eko Putra, Dennish Ari Putro, Tri Wahyu Hadi, Edi Riawan, Junnaedhi Dewa Gede, Aditia Rojali, Fariza Dian Prasetyo, Yudhistira Satya Pribadi, Dita Fatria Andarini, Mila Khaerunisa, Raditya Hanung Prakoswa

Abstract:

Catastrophe risk management can only be done if we are able to calculate the exposed risks. Jakarta is an important city economically, socially, and politically and in the same time exposed to severe floods. On the other hand, flood risk calculation is still very limited in the area. This study has calculated the risk of flooding for Jakarta using 2-Dimensional Model ANUGA. 2-Dimensional model ANUGA and 1-Dimensional Model HEC-RAS are used to calculate the risk of flooding from 13 major rivers in Jakarta. ANUGA can simulate physical and dynamical processes between the streamflow against river geometry and land cover to produce a 1-meter resolution inundation map. The value of streamflow as an input for the model obtained from hydrological analysis on rainfall data using hydrologic model HEC-HMS. The probabilistic streamflow derived from probabilistic rainfall using statistical distribution Log-Pearson III, Normal and Gumbel, through compatibility test using Chi Square and Smirnov-Kolmogorov. Flood event on 2007 is used as a comparison to evaluate the accuracy of model output. Property damage estimations were calculated based on flood depth for 1, 5, 10, 25, 50, and 100 years return period against housing value data from the BPS-Statistics Indonesia, Centre for Research and Development of Housing and Settlements, Ministry of Public Work Indonesia. The vulnerability factor was derived from flood insurance claim. Jakarta's flood loss estimation for the return period of 1, 5, 10, 25, 50, and 100 years, respectively are Rp 1.30 t; Rp 16.18 t; Rp 16.85 t; Rp 21.21 t; Rp 24.32 t; and Rp 24.67 t of the total value of building Rp 434.43 t.

Keywords: 2D hydrodynamic model, ANUGA, flood, flood modeling

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24 Design and Implementation of Collaborative Editing System Based on Physical Simulation Engine Running State

Authors: Zhang Songning, Guan Zheng, Ci Yan, Ding Gangyi

Abstract:

The application of physical simulation engines in collaborative editing systems has an important background and role. Firstly, physical simulation engines can provide real-world physical simulations, enabling users to interact and collaborate in real time in virtual environments. This provides a more intuitive and immersive experience for collaborative editing systems, allowing users to more accurately perceive and understand various elements and operations in collaborative editing. Secondly, through physical simulation engines, different users can share virtual space and perform real-time collaborative editing within it. This real-time sharing and collaborative editing method helps to synchronize information among team members and improve the efficiency of collaborative work. Through experiments, the average model transmission speed of a single person in the collaborative editing system has increased by 141.91%; the average model processing speed of a single person has increased by 134.2%; the average processing flow rate of a single person has increased by 175.19%; the overall efficiency improvement rate of a single person has increased by 150.43%. With the increase in the number of users, the overall efficiency remains stable, and the physical simulation engine running status collaborative editing system also has horizontal scalability. It is not difficult to see that the design and implementation of a collaborative editing system based on physical simulation engines not only enriches the user experience but also optimizes the effectiveness of team collaboration, providing new possibilities for collaborative work.

Keywords: physics engine, simulation technology, collaborative editing, system design, data transmission

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23 CFD Study of Subcooled Boiling Flow at Elevated Pressure Using a Mechanistic Wall Heat Partitioning Model

Authors: Machimontorn Promtong, Sherman C. P. Cheung, Guan H. Yeoh, Sara Vahaji, Jiyuan Tu

Abstract:

The wide range of industrial applications involved with boiling flows promotes the necessity of establishing fundamental knowledge in boiling flow phenomena. For this purpose, a number of experimental and numerical researches have been performed to elucidate the underlying physics of this flow. In this paper, the improved wall boiling models, implemented on ANSYS CFX 14.5, were introduced to study subcooled boiling flow at elevated pressure. At the heated wall boundary, the Fractal model, Force balance approach and Mechanistic frequency model are given for predicting the nucleation site density, bubble departure diameter, and bubble departure frequency. The presented wall heat flux partitioning closures were modified to consider the influence of bubble sliding along the wall before the lift-off, which usually happens in the flow boiling. The simulation was performed based on the Two-fluid model, where the standard k-ω SST model was selected for turbulence modelling. Existing experimental data at around 5 bars were chosen to evaluate the accuracy of the presented mechanistic approach. The void fraction and Interfacial Area Concentration (IAC) are in good agreement with the experimental data. However, the predicted bubble velocity and Sauter Mean Diameter (SMD) are over-predicted. This over-prediction may be caused by consideration of only dispersed and spherical bubbles in the simulations. In the future work, the important physical mechanisms of bubbles, such as merging and shrinking during sliding on the heated wall will be incorporated into this mechanistic model to enhance its capability for a wider range of flow prediction.

Keywords: subcooled boiling flow, computational fluid dynamics (CFD), mechanistic approach, two-fluid model

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22 Record Peak Current Density in AlN/GaN Double-Barrier Resonant Tunneling Diodes on Free-Standing Gan Substrates by Modulating Barrier Thickness

Authors: Fang Liu, Jia Jia Yao, Guan Lin Wu, Ren Jie Liu, Zhuang Guo

Abstract:

Leveraging plasma-assisted molecular beam epitaxy (PA-MBE) on c-plane free-standing GaN substrates, this work demonstrates high-performance AlN/GaN double-barrier resonant tunneling diodes (RTDs) featuring stable and repeatable negative differential resistance (NDR) characteristics at room temperature. By scaling down the barrier thickness of AlN and the lateral mesa size of collector, a record peak current density of 1551 kA/cm2 is achieved, accompanied by a peak-to-valley current ratio (PVCR) of 1.24. This can be attributed to the reduced resonant tunneling time under thinner AlN barrier and the suppressed external incoherent valley current by reducing the dislocation number contained in the RTD device with the smaller size of collector. Statistical analysis of the NDR performance of RTD devices with different AlN barrier thicknesses reveals that, as the AlN barrier thickness decreases from 1.5 nm to 1.25 nm, the average peak current density increases from 145.7 kA/cm2 to 1215.1 kA/cm2, while the average PVCR decreases from 1.45 to 1.1, and the peak voltage drops from 6.89 V to 5.49 V. The peak current density obtained in this work represents the highest value reported for nitride-based RTDs to date, while maintaining a high PVCR value simultaneously. This illustrates that an ultra-scaled RTD based on a vertical quantum-well structure and lateral collector size is a valuable approach for the development of nitride-based RTDs with excellent NDR characteristics, revealing their great potential applications in high-frequency oscillation sources and high-speed switch circuits.

Keywords: GaN resonant tunneling diode, peak current density, peak-to-valley current ratio, negative differential resistance

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21 Analysis of Factors Influencing the Response Time of an Aspirating Gaseous Agent Concentration Detection Method

Authors: Yu Guan, Song Lu, Wei Yuan, Heping Zhang

Abstract:

Gas fire extinguishing system is widely used due to its cleanliness and efficiency, and since its spray will be affected by many factors such as convection and obstacles in jetting region, so in order to evaluate its effectiveness, detecting concentration distribution in the jetting area is indispensable, which is commonly achieved by aspirating concentration detection technique. During the concentration measurement, the response time of detector is a very important parameter, especially for those fire-extinguishing systems with rapid gas dispersion. Long response time will not only underestimate its concentration but also prolong the change of concentration with time. Therefore it is necessary to analyze the factors influencing the response time. In the paper, an aspirating concentration detection method was introduced, which is achieved by using a small critical nozzle and a laminar flowmeter, and because of the response time is mainly related to the gas transport process from sampling site to the sensor, the effects of exhaust pipe size, gas flow rate, and gas concentration on its response time were analyzed. During the research, Bromotrifluoromethane (CBrF₃) was used. The effect of the sampling tube was investigated with different length of 1, 2, 3, 4 and 5 m (5mm in pipe diameter) and different pipe diameter of 3, 4, 5, 6 and 8 mm (3m in length). The effect of gas flow rate was analyzed by changing the throat diameter of the critical nozzle with 0.5, 0.682, 0.75, 0.8, 0.84 and 0.88 mm. The effect of gas concentration on response time was studied with the concentration range of 0-25%. The result showed that the response time increased with the increase of both the length and diameter of the sampling pipe, and the effect of length on response time was linear, but for the effect of diameter, it was exponential. It was also found that as the throat diameter of critical nozzle increased, the response time reduced a lot, in other words, gas flow rate has a great influence on response time. For the effect of gas concentration, the response time increased with the increase of the CBrF₃ concentration, and the slope of the curve was reduced.

Keywords: aspirating concentration detection, fire extinguishing, gaseous agent, response time

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20 Lymphomas as Estrogen-Regulated Cancers

Authors: M. S. Hasni, J. Guan, K. Yakimchuk, M. Berglund, B. Sander, G. Enblad, R. M. Amini, S. Okret

Abstract:

Lymphomas are generally not considered as endocrine-related cancers. However, most lymphoid malignancies show gender differences in incidence and show prognosis with males being more affected. Furthermore, some epidemiological data indicate a protective role of estrogens against Non-Hodgkin lymphomas. Recent studies have demonstrated estrogen receptor β (ERβ) to be the major ER expressed in normal and malignant cells of lymphoid origin. We have analyzed the effects of estradiol and selective ERα and ERβ agonists on lymphoma growth in culture and in vivo. Treating lymphoma cells with estradiol or ERα selective agonist had minor or no effect on cell growth while selective ERβ agonist treatment showed an antiproliferative effect. When grafting mice with murine T lymphoma cells, male mice developed larger tumors compared to female mice, a difference that was abolished following ovariectomy, demonstrating estrogen-dependent growth in vivo. When subcutaneously grafting lymphoma cells to mice, so far growth of all tested human B lymphoma tumors (Raji and Ramos Burkitt lymphoma, SU.DHL4 (GC) and U2932 (ABC) DLBCL, Granta-519, Maver1 and Z138 MCL cells), were reduced following treatment with ERβ selective agonist (ref. 2 and unpublished). Moreover, the number and size of liver foci of disseminating Raji cells was reduced. We have identified target genes and mechanism that could explain the above effects of ERβ agonists. This included effects on angio and lymphangiogenesis. Now we have further analyzed effects of ERβ agonists on Ibrutinib-sensitive and -insensitive MCL cells in xenograft experiments as well as ERβ expression in primary lymphoma material (DLBCL). Preliminary statistical analysis has been done correlating ERβ expression to other biomarkers and clinical data.

Keywords: lymphomas, estrogen receptors, cancer, liver foci

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19 Re-Differentiation Effect of Sesquiterpene Farnesol on De-Differentiated Rabbit Chondrocytes

Authors: Chun Hsien Wu, Guan Xuan Wu, Hsia Ying Cheng, Shyh Ming Kuo

Abstract:

Articular cartilage is composed of chondrocytes and extracellular matrix, such as collagen fibers, glycosaminoglycans, etc., which play an important role in lubricating and cushion joint activities. The phenotypic expression and metabolic activity of chondrocytes are extremely important in maintaining the functions of articular cartilage. In in vitro passaged culture of chondrocytes, chondrocytes gradually lose their original cell phenotype and morphology, which is called dedifferentiation. After continuous passaged culture of chondrocytes or induction by inflammatory factor IL-1, chondrocytes changed their phenotype and morphology. Also, the extracellular matrix type II collagen and GAG secretion were significantly reduced, while type I and X collagen were synthesized. Farnesol is an anti-inflammatory and antioxidant sesquiterpene compound that has the specific property of promoting collagen production. The purpose of this study was to investigate whether farnesol could restore the original type II collagen synthesis and, furthermore, the mechanisms of farnesol on the synthesis of type II collagen from the de-differentiated chondrocytes. The obtained results showed that the de-differentiated chondrocytes significantly restored to secret type II collagen and GAG (2.5-folds increases), and the secretion of collagen I and X and PGE2 synthesis were also significantly reduced after being treated with farnesol, indicating that farnesol had a restoration/re-differentiation effect on de-differentiated chondrocytes. The de-differentiated chondrocytes exhibited decreased expression of PPAR-γ and upregulated TGF-β expression to increase the MMP-13 expression. Higher expression of MMP-13 caused chondrocytes to secret type X collagen. On the contrary, increasing the expression of PPAR-γ would benefit the production of type II collagen. As shown, the PPAR-γ expression increased, and MMP-13 expression decreased after being treated with farnesol, indicating a possible signal pathway of farnesol to restore the production of type II collagen. However, more detailed mechanisms still need to evaluate.

Keywords: chondrocytes, de-differentiation, farnesol, re-differentiation

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18 The Evaluation of Adjuvant Effects of CD154 in a Subunit Vaccine against Classical Swine Fever Virus

Authors: Yu-Chieh Chen, Li-Yun Wang, Chi-Chih Chen, Huy Hùng Đào, Ya-Mei Chen, Ming-Chu Cheng, Wen-Bin Chung, Hso-Chi Chaung, Guan-Ming Ke

Abstract:

Many recent researches have demonstrated that CD154, a protein primarily expressed on activated T cell molecules, has potentially acted as a molecular adjuvant to improve the immunogenicity of subunit vaccines against viral infections. Classical swine fever (CSF) affects the swine industry worldwide that is one of the most devastating and highly contagious pig diseases. It is listed by the World Organization for Animal Health (OIE) as an infectious animal disease that must be reported. Although pigs vaccinated with subunit vaccines can be differentially diagnosed from those infected animals, subunit vaccines usually need adjuvants to enhance and elicit immune responses. In this study, CD154 was linked with CSFV E2 sequences and then expressed in CHO cells to produce the fusion protein as E2-CD154. The porcine specific CpG adjuvant was also used in one of the formulations. The specific pathogen-free pigs (SPF) at the age of 4-week-old were randomly separated into four groups, vaccinated with E2-CpG, E2-CD154, E2-CD154-CpG or the commercial Bayovac® CSF-E2 vaccine and boosted two weeks after primary vaccination. The results showed that the percentages of CD4+ and CD4+IL2+ in peripheral blood mononuclear cells (PBMC) in E2-CD154 vaccinated piglets seven days after primary vaccination were gained by 1-5% relative to the control group. In addition, the percentages of CD4+IFNγ+ T cells had slightly edged up 0.1-0.3% compared with the control group. Also, increased E2-specific IFNγ levels had edged up CD4+CD8+ T cells found in E2-CD154 and E2-CD154-CpG groups, particularly in the E2-CD154-CpG group. These results implicate that CD154 may enhance cellular immunity and synergistically act with species-specific CpG adjuvant as a dual-phase adjuvant. Therefore, the CD154 may be beneficial as a promising adjuvant in subunit vaccines.

Keywords: CD154, CpG adjuvant, cellular immunity, subunit vaccine, pig

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17 Effect of Al Addition on Microstructure and Properties of NbTiZrCrAl Refractory High Entropy Alloys

Authors: Xiping Guo, Fanglin Ge, Ping Guan

Abstract:

Refractory high entropy alloys are alternative materials expected to be employed at high temperatures. The comprehensive changes of microstructure and properties of NbTiZrCrAl refractory high entropy alloys are systematically studied by adjusting Al content. Five kinds of button alloy ingots with different contents of Al in NbTiZrCrAlX (X=0, 0.2, 0.5, 0.75, 1.0) were prepared by vacuum non-consumable arc melting technology. The microstructure analysis results show that the five alloys are composed of BCC solid solution phase rich in Nb and Ti and Laves phase rich in Cr, Zr, and Al. The addition of Al changes the structure from hypoeutectic to hypereutectic, increases the proportion of Laves phase, and changes the structure from cubic C15 to hexagonal C14. The hardness and fracture toughness of the five alloys were tested at room temperature, and the compressive mechanical properties were tested at 1000℃. The results showed that the addition of Al increased the proportion of Laves phase and decreased the proportion of the BCC phase, thus increasing the hardness and decreasing the fracture toughness at room temperature. However, at 1000℃, the strength of 0.5Al and 0.75Al alloys whose composition is close to the eutectic point is the best, which indicates that the eutectic structure is of great significance for the improvement of high temperature strength of NbTiZrCrAl refractory high entropy alloys. The five alloys were oxidized for 1 h and 20 h in static air at 1000℃. The results show that only the oxide film of 0Al alloy falls off after oxidizing for 1 h at 1000℃. After 20h, the oxide film of all the alloys fell off, but the oxide film of alloys containing Al was more dense and complete. By producing protective oxide Al₂O₃, inhibiting the preferential oxidation of Zr, promoting the preferential oxidation of Ti, and combination of Cr₂O₃ and Nb₂O₅ to form CrNbO₄, Al significantly improves the high temperature oxidation resistance of NbTiZrCrAl refractory high entropy alloys.

Keywords: NbTiZrCrAl, refractory high entropy alloy, al content, microstructural evolution, room temperature mechanical properties, high temperature compressive strength, oxidation resistance

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16 Exploration Study of Civet Coffee: Amino Acids Composition and Cup Quality

Authors: Murna Muzaifa, Dian Hasni, Febriani, Anshar Patria, Amhar Abubakar

Abstract:

Coffee flavour is influenced by many factors such as processing techniques. Civet coffee is known as one of premium coffee due to its unique processing technique and its superior cupping quality. The desirable aroma of coffee is foremost formed during roasting step at a high temperature from precursors that are present in the green bean. Sugars, proteins, acids and trigonelline are the principal flavor precursors compounds in green coffee bean. It is now widely accepted that amino acids act as precursors of the Maillard reaction during which the colour and aroma are formed. To investigate amino acids on civet coffee, concentration of 20 amino acids (L-Isoleucine, L-Valine, L-Proline, L-Phenylalanine, L-Arginine, L-Asparagine, L-Threonine, L-Tryptophan, L-Leucine, L-Serine, L-Glutamine, L-Methionine, L-Histidine, Aspartic acid, L-Tyrosine, L-Lysine, L-Glutamic acid, and L-Cysteine, L-Alanine and Glycine) were determined in green and roasted bean of civet coffee by LCMS analysis. The cup quality of civet coffee performed using professional Q-grader followed SCAA standard method. The measured parameters were fragrance/aroma, flavor, acidity, body, uniformity, clean up, aftertaste, balance, sweetness and overall. The work has been done by collecting samples of civet coffee from six locations in Gayo Higland, Aceh-Indonesia. The results showed that 18 amino acids were detected in green bean of civet coffee (L-Isoleucine, L-Valine, L-Proline, L-Phenylalanine, L-Arginine, L-Asparagine, L-Threonine, L-Tryptophan, L-Leucine, L-Serine, L-Glutamine, L-Methionine, L-Histidine, Aspartic acid, L-Tyrosine, L-Lysine, L-Glutamic acid, and L-Cysteine) and 2 amino acids were not detected (L-Alanine and Glycine). On the other hand, L-Tyrosine and Glycine were not detected in roasted been of civet coffee. Glutamic acid is the amino acid with highest concentration in both green and roasted bean (21,02 mg/g and 24,60 mg/g), followed by L- Valine (19,98 mg/g and 20,22 mg/g) and Aspartic acid (14,93 mg/g and 18,58 mg/g). Civet coffee has a fairly high cupping value (cup quality), ranging from 83.75 to 84.75, categorized as speciality coffee. Moreover, civet coffee noted to have nutty, chocolaty, fishy, herby and watery.

Keywords: amino acids, civet coffee, cupping quality, luwak

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15 Synergistic Anti-Proliferation Effect of PLK-1 Inhibitor and Livistona Chinensis Fruit Extracts on Lung Adenocarcinoma A549 Cells

Authors: Min-Chien Su, Tzu-Hsuan Hsu, Guan-Xuan Wu, Shyh-Ming Kuo

Abstract:

Lung cancer is one of the clinically challenging malignant diseases worldwide. For efficient therapeutics in cancer, combination therapy has developed to acquire a better outcome. PLK-1 was one of the major factors affecting cell mitosis in cancer cells, its inhibitor Bi6727 was proven effective in treating several different cancers namely oral cancer, colon cancer and lung cancer. Despite its low toxicity toward normal cells compared to traditional chemotherapy, it is still yet to be evaluated in detail. Livistona Chinensis (LC) is a Chinese herb that used as a traditional prescription to treat lung cancer. Due to the uncertainty of the efficacy of LC, we utilized a water extraction method to extract the Livistona Chinensis and then lyophilized into powder for further study. In this study we investigated the antiproliferation activities of Bi6727 and LC extracts (LCE) on A549 non-small lung cancer cells. The IC50 of Bi6727 and LCE on A549 are 60 nM and 0.8 mg/mL, respectively. The fluorescent staining images shown nucleolus damage in cells treated with Bi6727 and mitochondrial damage after treated with LCE. A549 cells treated with Bi6727 and LCE showed increased expression of Bax, Caspase-3 and Caspase-9 proteins from Western blot assay. LCE also inhibited A549 cells growth keeping cells at G2-M phase from cell cycle assay. Apoptosis assay results showed that LCE induced late apoptosis of A549 cells. JC-1 assay showed that the mitochondria damaged at the LCE concentration of 0.4 mg/mL. In our preliminary anti-proliferation test of combined LCE and Bi-6727 on A549 cells, we found a dramatically decrease in proliferation after treated with LCE first for 24-h and then Bi-6727 for extra 24-h. This was an important finding regarding synergistic anti-proliferation effect of these drugs, However, the usage, the application sequence of LCE and Bi-6727 on A549 cells and their related mechanisms still need to be evaluated. In summary, the drugs exerted anti-proliferation effect on A549 cells independently. We hopefully combine the usage of these two drugs will bring a different and potential outcome in treating lung cancer.

Keywords: anti-proliferation, A549, Livistona Chinensis fruit extracts, PLK-1 inhibitor

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14 A Case Study on the Effect of a Mobility Focused Exercise Training in Rehabilitation of an Elite Weightlifter with Shoulder Pain and Weakness

Authors: Lingling Li, Peng Zhao, Runze Guan, Alice Jones, Tao Yu

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Background: Shoulder pain and weakness are associated with complex pathologies and often precludes weightlifters from participation in training. The role and mode of exercise training in weightlifters with shoulder pathology remains unclear. Objectives: This case report described an exercise program in management of an elite weightlifter with primary complaint of right shoulder pain and weakness. Methods: A 22-year-old weightlifter presented with 2-year duration of right shoulder pain and weakness which was worsened by routine weightlifting training, and symptoms were not relieved with steroid injection, manual therapy nor usual physiotherapy. There was a limitation in all active range of motion especially horizontal extension (13ᵒ) and external rotation (41ᵒ) with pain intensity at 4/10 and 10/10 (numeric pain rating score) respectively. Muscle weakness was most significant at supraspinatus and teres minor, 38% and 27% respectively compared to his left shoulder (hand-held dynamometry, Micro FET2). An exercise training program focusing on improving mobility was designed for this athlete following a comprehensive physical assessment. Exercises included specific stretching, muscle activating and scapular stability training; once per day, and for 60 minutes each session. All exercises were completed under instruction as pain allowed. Quantitative assessment was conducted at the end of each week for 3 weeks. Outcomes: After the program, the athlete was pain-free in all movements except the O’Brien active compression internal rotation test, the pain was however reduced from 10/10 to 3/10. The horizontal extension and external rotation range increased to 79ᵒ to 120ᵒ respectively, and strength of all rotator cuff muscles returned to normal. At 1-month follow up, the athlete was totally pain-free and had returned to normal function and weightlifting training activities. The outcomes sustained through 6-month and one year. Conclusion: This case report supports the use of a mobility-focused exercise program for management of shoulder pain and weakness in an elite weightlifter athlete.

Keywords: exercise training, mobility, rehabilitation, shoulder pain, weightlifting

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13 Comparison of Patient Satisfaction and Observer Rating of Outpatient Care among Public Hospitals in Shanghai

Authors: Tian Yi Du, Guan Rong Fan, Dong Dong Zou, Di Xue

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Background: The patient satisfaction survey is becoming of increasing importance for hospitals or other providers to get more reimbursement and/or more governmental subsidies. However, when the results of patient satisfaction survey are compared among medical institutions, there are some concerns. The primary objectives of this study were to evaluate patient satisfaction in tertiary hospitals of Shanghai and to compare the satisfaction rating on physician services between patients and observers. Methods: Two hundred outpatients were randomly selected for patient satisfaction survey in each of 28 public tertiary hospitals of Shanghai. Four or five volunteers were selected to observe 5 physicians’ practice in each of above hospitals and rated observed physicians’ practice. The outpatients that the volunteers observed their physician practice also filled in the satisfaction questionnaires. The rating scale for outpatient survey and volunteers’ observation was: 1 (very dissatisfied) to 6 (very satisfied). If the rating was equal to or greater than 5, we considered the outpatients and volunteers were satisfied with the services. The validity and reliability of the measure were assessed. Multivariate regressions for each of the 4 dimensions and overall of patient satisfaction were used in analyses. Paired t tests were applied to analyze the rating agreement on physician services between outpatients and volunteers. Results: Overall, 90% of surveyed outpatients were satisfied with outpatient care in the tertiary public hospitals of Shanghai. The lowest three satisfaction rates were seen in the items of ‘Restrooms were sanitary and not crowded’ (81%), ‘It was convenient for the patient to pay medical bills’ (82%), and ‘Medical cost in the hospital was reasonable’ (84%). After adjusting the characteristics of patients, the patient satisfaction in general hospitals was higher than that in specialty hospitals. In addition, after controlling the patient characteristics and number of hospital visits, the hospitals with higher outpatient cost per visit had lower patient satisfaction. Paired t tests showed that the rating on 6 items in the dimension of physician services (total 14 items) was significantly different between outpatients and observers, in which 5 were rated lower by the observers than by the outpatients. Conclusions: The hospital managers and physicians should use patient satisfaction and observers’ evaluation to detect the room for improvement in areas such as social skills cost control, and medical ethics.

Keywords: patient satisfaction, observation, quality, hospital

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