Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 44

Search results for: Heng Gee Lim

44 The Same Rules of Traditional Chinese Herbal Medicine in Treating Chronic Idiopathic Urticaria and Hypertension

Authors: Heng W. Chang, Mao F. Sun


Chronic Idiopathic Urticaria (CIU) and hypertension are rarely discussed together in modern and traditional Chinese medicine, and often belong to different medical departments. However, in traditional Chinese medicinal theory, the two diseases have some similar characters. For example, they are both relevant to 'wind'. This study conducted a literature review using the China National Knowledge Infrastructure to identify herbs yielding the same effect for the two diseases. The finding showed that the common herbs used most frequently is Rehmanniae. The conclusion is that the same TCM (Traditional Chinese Medicine) mechanism of the two diseases may be 'blood heat'. It requires further study to prove it in the future.

Keywords: urticaria, herbs, hypertension, Rehmanniae

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43 Relation between Initial Stability of the Dental Implant and Bone-Implant Contact Level

Authors: Jui-Ting Hsu, Heng-Li Huang, Ming-Tzu Tsai, Kuo-Chih Su, Lih-Jyh Fuh


The objectives of this study were to measure the initial stability of the dental implant (ISQ and PTV) in the artificial foam bone block with three different quality levels. In addition, the 3D bone to implant contact percentage (BIC%) was measured based on the micro-computed tomography images. Furthermore, the relation between the initial stability of dental implant (ISQ and PTV) and BIC% were calculated. The experimental results indicated that enhanced the material property of the artificial foam bone increased the initial stability of the dental implant. The Pearson’s correlation coefficient between the BIC% and the two approaches (ISQ and PTV) were 0.652 and 0.745.

Keywords: dental implant, implant stability quotient, peak insertion torque, bone-implant contact, micro-computed tomography

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42 Polymer Aerostatic Thrust Bearing under Circular Support for High Static Stiffness

Authors: Sy-Wei Lo, Chi-Heng Yu


A new design of aerostatic thrust bearing is proposed for high static stiffness. The bearing body, which is mead of polymer covered with metallic membrane, is held by a circular ring. Such a support helps form a concave air gap to grasp the air pressure. The polymer body, which can be made rapidly by either injection or molding is able to provide extra damping under dynamic loading. The smooth membrane not only serves as the bearing surface but also protects the polymer body. The restrictor is a capillary inside a silicone tube. It can passively compensate the variation of load by expanding the capillary diameter for more air flux. In the present example, the stiffness soars from 15.85 N/µm of typical bearing to 349.85 N/µm at bearing elevation 9.5 µm; meanwhile the load capacity also enhances from 346.86 N to 704.18 N.

Keywords: aerostatic, bearing, polymer, static stiffness

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41 An Analytical Method for Bending Rectangular Plates with All Edges Clamped Supported

Authors: Yang Zhong, Heng Liu


The decoupling method and the modified Naiver method are combined for accurate bending analysis of rectangular thick plates with all edges clamped supported. The basic governing equations for Mindlin plates are first decoupled into independent partial differential equations which can be solved separately. Using modified Navier method, the analytic solution of rectangular thick plate with all edges clamped supported is then derived. The solution method used in this paper leave out the complicated derivation for calculating coefficients and obtain the solution to problems directly. Numerical comparisons show the correctness and accuracy of the results at last.

Keywords: Mindlin plates, decoupling method, modified Navier method, bending rectangular plates

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40 Optimization of NaOH Thermo-Chemical Pretreatment to Enhance Solubilisation of Organic Food Waste by Response Surface Methodology

Authors: Hafizan Junoh, Kumaran Palanisamy, Yip Chan Heng, Pua Fei Ling


This study investigates the influence of low temperature thermo-chemical pretreatment of organic food waste on the performance of COD solubilisation. Both temperature and alkaline agent were reported to have an effect on solubilizing any possible biomass including organic food waste. The three independent variables considered in this pretreatment were temperature (50-90oC), pretreatment time (30-120 minutes) and alkaline concentration, sodium hydroxide, NaOH (0.7-15 g/L). The optimal condition obtained were 90oC, 15 g/L NaOH for 2 hours. Solubilisation has potential in enhancing methane production by providing a high amount of soluble components at an early stage during anaerobic digestion.

Keywords: food waste, pretreatments, respond surface methodology, ANOVA, anaerobic digestion

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39 Robust Control of a Single-Phase Inverter Using Linear Matrix Inequality Approach

Authors: Chivon Choeung, Heng Tang, Panha Soth, Vichet Huy


This paper presents a robust control strategy for a single-phase DC-AC inverter with an output LC-filter. An all-pass filter is utilized to create an artificial β-signal so that the proposed controller can be simply used in dq-synchronous frame. The proposed robust controller utilizes a state feedback control with integral action in the dq-synchronous frame. A linear matrix inequality-based optimization scheme is used to determine stabilizing gains of the controllers to maximize the convergence rate to steady state in the presence of uncertainties. The uncertainties of the system are described as the potential variation range of the inductance and resistance in the LC-filter.

Keywords: single-phase inverter, linear matrix inequality, robust control, all-pass filter

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38 Simulation and Optimization of an Annular Methanol Reformer

Authors: Shu-Bo Yang, Wei Wu, Yuan-Heng Liu


This research aims to design a heat-exchanger type of methanol reformer coupled with a preheating design in gPROMS® environment. The endothermic methanol steam reforming reaction (MSR) and the exothermic preferential oxidation reaction (PROX) occur in the inner tube and the outer tube of the reformer, respectively. The effective heat transfer manner between the inner and outer tubes is investigated. It is verified that the countercurrent-flow type reformer provides the higher hydrogen yield than the cocurrent-flow type. Since the hot spot temperature appears in the outer tube, an improved scheme is proposed to suppress the hot spot temperature by splitting the excess air flowing into two sites. Finally, an optimization algorithm for maximizing the hydrogen yield is employed to determine optimal operating conditions.

Keywords: methanol reformer, methanol steam reforming, optimization, simulation

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37 Preparation of 3D Graphene with Microwave-Hydrothermal Assistance for Ultrahigh Performance of Capacitive Deionization

Authors: Wahid Dianbudiyanto, Shou Heng Liu


Capacitive deionization (CDI) is a prospective desalination technology, which can be operated at low voltage, low temperature and potentially consume low energy for brackish water desalination. To obtain the optimal electrosorption, an electrode should possess high electrical conductivity, large surface area, good wettability, highly mesoporous structure which provide efficient pathways for ion distribution. In this work, a 3D structure graphene was fabricated using hydrothermal method which is assisted with microwave treatments to form 3D rGO (3DG-Mw-Hyd). The prepared samples have excellent specific capacitance (189.2 F / g) and ultrahigh electrosorption capacity (30 mg/g) for the desalination of 500 mg / l NaCl. These results are superior to the electrode which is fabricated only using the hydrothermal method without microwave assistance (3DG-Hyd) and traditional reflux method. Physical characterizations such as SEM, TEM, and XRD have been used to study the property difference of the materials. The preliminary results show that 3DG-Mw-Hyd is one of the promising electrodes for CDI in the practical applications.

Keywords: capacitive deionization, graphene, microwave, hydrothermal, electrosorption

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36 The Role of Metallic Mordant in Natural Dyeing Process: Experimental and Quantum Study on Color Fastness

Authors: Bo-Gaun Chen, Chiung-Hui Huang, Mei-Ching Chiang, Kuo-Hsing Lee, Chia-Chen Ho, Chin-Ping Huang, Chin-Heng Tien


It is known that the natural dyeing of cloth results moderate color, but with poor color fastness. This study points out the correlation between the macroscopic color fastness of natural dye to the cotton fiber and the microscopic binding energy of dye molecule to the cellulose. With the additive metallic mordant, the new-formed coordination bond bridges the dye to the fiber surface and thus affects the color fastness as well as the color appearance. The density functional theory (DFT) calculation is therefore used to explore the most possible mechanism during the dyeing process. Finally, the experimental results reflect the strong effect of three different metal ions on the natural dyeing clothes.

Keywords: binding energy, color fastness, density functional theory (DFT), natural dyeing, metallic mordant

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35 College Students’ Multitasking and Its Causes

Authors: Huey-Wen Chou, Shuo-Heng Liang


This study focuses on studying college students’ multitasking with cellphones/laptops during lectures. In-class multitasking behavior is defined as the activities students engaged that are irrelevant to learning. This study aims to understand if students' learning engagement affects students' multitasking as well as to investigate the causes or motivations that contribute to the occurrence of multitasking behavior. Survey data were collected and analyzed by PLS method and multiple regression to test the research model and hypothesis. Major results include: 1. Students' multitasking motivation positively predicts students’ in-class multitasking. 2. Factors affecting multitasking in class, including efficiency, entertainment and social needs, significantly impact on multitasking. 3. Polychronic personality traits will positively predict students’ multitasking. 4. Students' classroom learning engagement negatively predicts multitasking. 5. Course attributes negatively predict student learning engagement and positively predict student multitasking.

Keywords: engagement, monochronic personality, multitasking, learning, personality traits

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34 Study on Moisture-Induced-Damage of Semi-Rigid Base under Hydrodynamic Pressure

Authors: Baofeng Pan, Heng Liu


Because of the high strength and large carrying capacity, the semi-rigid base is widely used in modern road engineering. However, hydrodynamic pressure, which is one of the main factors to cause early damage of semi-rigid base, cannot be avoided in the nature environment when pavement is subjected to some loadings such as the passing vehicles. In order to investigating how moisture-induced-damage of semi-rigid base influenced by hydrodynamic pressure, a new and effective experimental research method is provided in this paper. The results show that: (a) The washing action of high hydrodynamic pressure is the direct cause of strength reducing of road semi-rigid base. (b) The damage of high hydrodynamic pressure mainly occurs at the beginning of the scoring test and with the increasing of testing time the influence reduces. (c) Under the same hydrodynamic pressure, the longer the specimen health age, the stronger ability to resist moisture induced damage.

Keywords: semi-rigid base, hydrodynamic pressure, moisture-induced-damage, experimental research

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33 Finite Element Method for Calculating Temperature Field of Main Cable of Suspension Bridge

Authors: Heng Han, Zhilei Liang, Xiangong Zhou


In this paper, the finite element method is used to study the temperature field of the main cable of the suspension bridge, and the calculation method of the average temperature of the cross-section of the main cable suitable for the construction control of the cable system is proposed; By comparing and analyzing the temperature field of the main cable with five diameters, a reasonable diameter limit for calculating the average temperature of the cross section of the main cable by finite element method is proposed. The results show that the maximum error of this method is less than 1℃, which meets the requirements of construction control accuracy; For the main cable with a diameter greater than 400mm, the surface temperature measuring points combined with the finite element method shall be used to calculate the average cross-section temperature.

Keywords: suspension bridge, main cable, temperature field, finite element

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32 A Study on Using Network Coding for Packet Transmissions in Wireless Sensor Networks

Authors: Rei-Heng Cheng, Wen-Pinn Fang


A wireless sensor network (WSN) is composed by a large number of sensors and one or a few base stations, where the sensor is responsible for detecting specific event information, which is sent back to the base station(s). However, how to save electricity consumption to extend the network lifetime is a problem that cannot be ignored in the wireless sensor networks. Since the sensor network is used to monitor a region or specific events, how the information can be reliably sent back to the base station is surly important. Network coding technique is often used to enhance the reliability of the network transmission. When a node needs to send out M data packets, it encodes these data with redundant data and sends out totally M + R packets. If the receiver can get any M packets out from these M + R packets, it can decode and get the original M data packets. To transmit redundant packets will certainly result in the excess energy consumption. This paper will explore relationship between the quality of wireless transmission and the number of redundant packets. Hopefully, each sensor can overhear the nearby transmissions, learn the wireless transmission quality around it, and dynamically determine the number of redundant packets used in network coding.

Keywords: energy consumption, network coding, transmission reliability, wireless sensor networks

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31 Machine Learning Invariants to Detect Anomalies in Secure Water Treatment

Authors: Jonathan Heng, Yoong Cheah Huei


A strategic model that does not trigger any false alarms to detect anomalies in Secure Water Treatment (SWaT) test bed is presented. This model uses machine learning invariants formulated from streamlining the general form of Auto-Regressive models with eXogenous input. A creative generalized CUSUM algorithm to integrate the invariants and the detection strategy technique is successfully developed and tested in the SWaT Programmable Logic Controllers (PLCs). Three steps to fine-tune parameters, b and τ in the generalized algorithm are stated and an example used to demonstrate the tuning process is discussed. This approach can swiftly and effectively detect various scopes of cyber-attacks such as multiple points single stage and multiple points multiple stages in SWaT. This technique can be applied in water treatment plants and other cyber physical systems like power and gas plants too.

Keywords: machine learning invariants, generalized CUSUM algorithm with invariants and detection strategy, scope of cyber attacks, strategic model, tuning parameters

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30 Audio-Visual Recognition Based on Effective Model and Distillation

Authors: Heng Yang, Tao Luo, Yakun Zhang, Kai Wang, Wei Qin, Liang Xie, Ye Yan, Erwei Yin


Recent years have seen that audio-visual recognition has shown great potential in a strong noise environment. The existing method of audio-visual recognition has explored methods with ResNet and feature fusion. However, on the one hand, ResNet always occupies a large amount of memory resources, restricting the application in engineering. On the other hand, the feature merging also brings some interferences in a high noise environment. In order to solve the problems, we proposed an effective framework with bidirectional distillation. At first, in consideration of the good performance in extracting of features, we chose the light model, Efficientnet as our extractor of spatial features. Secondly, self-distillation was applied to learn more information from raw data. Finally, we proposed a bidirectional distillation in decision-level fusion. In more detail, our experimental results are based on a multi-model dataset from 24 volunteers. Eventually, the lipreading accuracy of our framework was increased by 2.3% compared with existing systems, and our framework made progress in audio-visual fusion in a high noise environment compared with the system of audio recognition without visual.

Keywords: lipreading, audio-visual, Efficientnet, distillation

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29 Compilation of Load Spectrum of Loader Drive Axle

Authors: Wei Yongxiang, Zhu Haoyue, Tang Heng, Yuan Qunwei


In order to study the preparation method of gear fatigue load spectrum for loaders, the load signal of four typical working conditions of loader is collected. The signal that reflects the law of load change is obtained by preprocessing the original signal. The torque of the drive axle is calculated by using the rain flow counting method. According to the operating time ratio of each working condition, the two-dimensional load spectrum based on the real working conditions of the drive axle of loader is established by the cycle extrapolation and synthesis method. The two-dimensional load spectrum is converted into one-dimensional load spectrum by means of the mean of torque equal damage method. Torque amplification includes the maximum load torque of the main reduction gear. Based on the theory of equal damage, the accelerated cycles are calculated. In this way, the load spectrum of the loading condition of the drive axle is prepared to reflect loading condition of the loader. The load spectrum can provide reference for fatigue life test and life prediction of loader drive axle.

Keywords: load spectrum, axle, torque, rain-flow counting method, extrapolation

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28 Data-Driven Approach to Predict Inpatient's Estimated Discharge Date

Authors: Ayliana Dharmawan, Heng Yong Sheng, Zhang Xiaojin, Tan Thai Lian


To facilitate discharge planning, doctors are presently required to assign an Estimated Discharge Date (EDD) for each patient admitted to the hospital. This assignment of the EDD is largely based on the doctor’s judgment. This can be difficult for cases which are complex or relatively new to the doctor. It is hypothesized that a data-driven approach would be able to facilitate the doctors to make accurate estimations of the discharge date. Making use of routinely collected data on inpatient discharges between January 2013 and May 2016, a predictive model was developed using machine learning techniques to predict the Length of Stay (and hence the EDD) of inpatients, at the point of admission. The predictive performance of the model was compared to that of the clinicians using accuracy measures. Overall, the best performing model was found to be able to predict EDD with an accuracy improvement in Average Squared Error (ASE) by -38% as compared to the first EDD determined by the present method. It was found that important predictors of the EDD include the provisional diagnosis code, patient’s age, attending doctor at admission, medical specialty at admission, accommodation type, and the mean length of stay of the patient in the past year. The predictive model can be used as a tool to accurately predict the EDD.

Keywords: inpatient, estimated discharge date, EDD, prediction, data-driven

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27 Blockchain-Based Approach on Security Enhancement of Distributed System in Healthcare Sector

Authors: Loong Qing Zhe, Foo Jing Heng


A variety of data files are now available on the internet due to the advancement of technology across the globe today. As more and more data are being uploaded on the internet, people are becoming more concerned that their private data, particularly medical health records, are being compromised and sold to others for money. Hence, the accessibility and confidentiality of patients' medical records have to be protected through electronic means. Blockchain technology is introduced to offer patients security against adversaries or unauthorised parties. In the blockchain network, only authorised personnel or organisations that have been validated as nodes may share information and data. For any change within the network, including adding a new block or modifying existing information about the block, a majority of two-thirds of the vote is required to confirm its legitimacy. Additionally, a consortium permission blockchain will connect all the entities within the same community. Consequently, all medical data in the network can be safely shared with all authorised entities. Also, synchronization can be performed within the cloud since the data is real-time. This paper discusses an efficient method for storing and sharing electronic health records (EHRs). It also examines the framework of roles within the blockchain and proposes a new approach to maintain EHRs with keyword indexes to search for patients' medical records while ensuring data privacy.

Keywords: healthcare sectors, distributed system, blockchain, electronic health records (EHR)

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26 Radial Distortion Correction Based on the Concept of Verifying the Planarity of a Specimen

Authors: Shih-Heng Tung, Ming-Hsiang Shih, Wen-Pei Sung


Because of the rapid development of digital camera and computer, digital image correlation method has drawn lots of attention recently and has been applied to a variety of fields. However, the image distortion is inevitable when the image is captured through a lens. This image distortion problem can result in an innegligible error while using digital image correlation method. There are already many different ways to correct the image distortion, and most of them require specific image patterns or precise control points. A new distortion correction method is proposed in this study. The proposed method is based on the fact that a flat surface should keep flat when it is measured using three-dimensional (3D) digital image measurement technique. Lens distortion can be divided into radial distortion, decentering distortion and thin prism distortion. Because radial distortion has a more noticeable influence than the other types of distortions, this method deals only with radial distortion. The simplified 3D digital image measurement technique is adopted to measure the surface coordinates of a flat specimen. Then the gradient method is applied to find the best correction parameters. A few experiments are carried out in this study to verify the correctness of this method. The results show that this method can achieve a good accuracy and it is suitable for both large and small distortion conditions. The most important advantage is that it requires neither mark with specific pattern nor precise control points.

Keywords: 3D DIC, radial distortion, distortion correction, planarity

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25 Experimental Investigation for the Overtopping Wave Force of the Vertical Breakwater

Authors: Jin Song Gui, Han Li, Rui Jin Zhang, Heng Jiang Cai


There is a large deviation between the measured wave power at the vertical breast wall and the calculated one according to current specification in the case of overtopping. In order to investigate the reasons for the deviation, the wave forces of vertical breast wall under overtopping conditions have been measured through physical model experiment and compared with the calculated results. The effect of water depth, period and the wave height on the wave forces of the vertical breast wall have been also investigated. The distribution of wave pressure under different wave actions was tested based on the force sensor which is installed in the vertical breakwater. By comparing and analyzing the measured values and norms calculated values, the applicability of the existing norms recommended method were discussed and a reference for the design of vertical breakwater was provided. Experiment results show that with the decrease of the water depth, the gap is growing between the actual wave forces and the specification values, and there are no obvious regulations between these two values with the variation of period while wave force greatly reduces with the overtopping reducing. The amount of water depth and wave overtopping has a significant impact on the wave force of overtopping section while the period has no obvious influence on the wave force. Finally, some favorable recommendations for the overtopping wave force design of the vertical breakwater according to the model experiment results are provided.

Keywords: overtopping wave, physical model experiment, vertical breakwater, wave forces

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24 Maximisation of Consumer Welfare in the Enforcement of Intellectual Property Rights in Competition Guidelines: The Malaysian Experience

Authors: Ida Madieha Abdul Ghani Azmi, Heng Gee Lim, Adlan Abdul Razak, Nasaruddin Abdul Rahman


The objective of competition law is to maximise consumer welfare through the regulation of anti-competitive behaviour that results in the distortion of the market. Intellectual property law also seeks to enhance consumer welfare in the long run by encouraging the development of useful devices and processes. Nevertheless, in some circumstances, the IP owners behave in such a way that makes it difficult for rival companies to sell substitute products and technology in the market. Intellectual property owners may also reach a dominant position in the market such that they are able to dictate unfair terms and conditions on other market players. Among the two major categories of anti-competitive behavior is the use of horizontal and vertical agreement to constrain effective competition and abuse of dominant position. As a result, many countries have regulated the conduct of the IP owners that are considered as anti-competitive including the US, Canada, and Singapore. This paper visits the proposed IP Guidelines recently drafted by the Malaysian Competition Commission and investigates to what extent it resolves most of the anti-competitive behavior of the IP owners. The paper concludes by suggesting some of the rules that could be prescribed by the Competition Commission in order to maintain the relevancy of competition law as the main check against the abuse of rights by the intellectual property owners.

Keywords: abuse of dominant position, consumer welfare, intellectual property rights, vertical and horizontal agreements

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23 Disaster Adaptation Mechanism and Disaster Prevention Adaptation Planning Strategies for Industrial Parks in Response to Climate Change and Different Socio-Economic Disasters

Authors: Jen-Te Pai, Jao-Heng Liu, Shin-En Pai


The impact of climate change has intensified in recent years, causing Taiwan to face higher frequency and serious natural disasters. Therefore, it is imperative for industrial parks manufacturers to promote adaptation policies in response to climate change. On the other hand, with the rise of the international anti-terrorism situation, once a terrorist attack occurs, it will attract domestic and international media attention, especially the strategic and economic status of the science park. Thus, it is necessary to formulate adaptation and mitigation strategies under climate change and social economic disasters. After reviewed the literature about climate change, urban disaster prevention, vulnerability assessment, and risk communication, the study selected 62 industrial parks compiled by the Industrial Bureau of the Ministry of Economic Affairs of Taiwan as the research object. This study explored the vulnerability and disaster prevention and disaster relief functional assessment of these industrial parks facing of natural and socio-economic disasters. Furthermore, this study explored planned adaptation of industrial parks management section and autonomous adaptation of corporate institutions in the park. The conclusion of this study is that Taiwan industrial parks with a higher vulnerability to natural and socio-economic disasters should employ positive adaptive behaviours.

Keywords: adaptive behaviours, analytic network process, vulnerability, industrial parks

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

Authors: Xi Gu, Guan Heng Yeoh, Victoria Timchenko


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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21 Therapeutic Potential of mAb KP52 in Human and Feline Cancers

Authors: Abigail Tan, Heng Liang Tan, Vanessa Ding, James Hui, Eng Hin Lee, Andre Choo


Introduction: Comparative oncology investigates the similarities in spontaneous carcinogenesis between humans and animals, in order to identify treatments that can benefit these patients. Companion animals (CA), like canines and felines, are of special interest when it comes to studying human cancers due to their exposure to the same environmental factors and develop tumours with similar features. The purpose of this study is to explore the cross-reactivity of monoclonal antibodies (mAbs) across cancers in humans and CA. Material and Methods: A panel of CA mAbs generated in the lab was screened on multiple human cancer cell lines through flow cytometry to identify for positive binders. Shortlisted candidates were then characterised by biochemical and functional assays e.g., antibody-drug conjugate (ADC) and western blot assays, including glycan studies. Results: Candidate mAb KP52 was generated from whole-cell immunisation using feline mammary carcinoma. KP52 showed strong positive binding to human cancer cells, such as breast cancer and ovarian cancer. Furthermore, KP52 demonstrated strong killing ( > 50%) as an ADC with Saporin as the payload. Western blot results revealed the molecular weight of the antigen targets to be approximately 45kD and 50kD under reduced conditions. Glycan studies suggest that the epitope is glycan in nature, specifically an O-linked glycan. Conclusion: Candidate mAb KP52 has a therapeutic potential as an ADC against feline mammary cancer, human ovarian cancer, human mammary cancer, human pancreatic cancer, and human gastric cancer.

Keywords: ADC, comparative oncology, mAb, therapeutic

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20 Development and Validation of Family Outcome Survey – Revised Taiwan Version

Authors: Shih-Heng Sun, Hsiu-Yu Chang


“Family centered service model” becomes mainstream in early intervention. Family outcome should be evaluated in addition child improvement in terms of outcome evaluation in early intervention. The purpose of this study is to develop a surveys to evaluate family outcomes in early intervention. Method: “Family Outcomes Survey- Revised Taiwan Version” (FOS-RT) was developed through translation, back-translation, and review by the original author. Expert meeting was held to determine the content validity. Two hundred and eighty six parent-child dyads recruited from 10 local Early Intervention Resource Centers (EIRC) participated in the study after they signed inform consent. The results showed both parts of FOS-RT exhibits good internal consistency and test-retest reliability. The result of confirmatory factor analysis indicated moderate fit of 5 factor structure of part A and 3 factor structure of part B of FOS-RT. The correlation between different sessions reached moderate to high level reveals some sessions measure similar latent trait of family outcomes. Correlation between FOS-RT and Parents‘ Perceived Parenting Skills Questionnaire was calculated to determine the convergence validity. The moderate correlation indicates the two assessments measure different parts of early intervention outcome although both assessments have similar sub-scales. The results of this study support FOS-RT is a valid and reliable tool to evaluate family outcome after the family and children with developmental disability receive early intervention services.

Keywords: early intervention, family service, outcome evaluation, parenting skills, family centered

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19 A Primary Care Diagnosis of Middle-Aged Men with Oral Cancer Who Underwent Extensive Resection and Flap Repair: A Case Report

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang


This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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18 Pricing and Economic Benefits of Commercial Insurance Incorporated into Home-based Hospice Care

Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin


Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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17 The Impact of Neighbourhood Built-Environment on the Formulation and Facilitation of Bottom-up Mutual Help Networks for Senior Residents in Singapore

Authors: Wei Zhang, Chye Kiang Heng, John Chye Fung


Background: The world’s demographics is currently undergoing the largest wave of both rapid ageing and dramatic urbanisation in human history. As one of the most rapidly ageing countries, Singapore will see about one in four residents aged 65 years and above by 2030 in its high-rise and high-density urban environment. Research questions: To support urban seniors ageing in place and interdependence among senior residents and their informal caregivers, this study argues a community-based care model with bottom-up mutual help networks and asks how neighbourhood built-environment influences the formulation and facilitation of bottom-up mutual help networks in Singapore. Methods: Two public housing communities with different physical environment and rich age-friendly neighbourhood initiatives were chosen as the case studies. The categories, participants and places of bottom-up mutual help activities will be obtained via field observation, non-structural interviews of participants, service providers and managers of care facilities, and documents. Mapping and content analysis will be used to explore the influences of neighbourhood built-environment on the formulation and facilitation of bottom-up mutual help networks. Results and conclusions: The results showed that neighbourhood design, place programming, and place governance have a confluence on the bottom-up mutual help networks for senior residents. Significance: The outcomes of this study will provide fresh evidence for paradigm shifts of community-based care for the elderly and neighbourhood planning. In addition, the research findings will shed light on meaningful implications of urban planners and policy makers as they tackle with the issues arising from the ageing society.

Keywords: Built environment, Mutual help, Neighbourhood, Senior residents, Singapore

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16 The Prevalence and Associated Factors of Frailty and Its Relationship with Falls in Patients with Schizophrenia

Authors: Bo-Jian Wu, Si-Heng Wu


Objectives: Frailty is a condition of a person who has chronic health problems complicated by a loss of physiological reserve and deteriorating functional abilities. The frailty syndrome was defined by Fried and colleagues, i.e., weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. However, to our best knowledge, there have been rare studies exploring the prevalence of frailty and its association with falls in patients with schizophrenia. Methods: A total of 559 hospitalized patients were recruited from a public psychiatric hospital in 2013. The majority of the subjects were males (361, 64.6%). The average age was 53.5 years. All patients received the assessment of frailty status defined by Fried and colleagues. The status of a fall within one year after the assessment of frailty, clinical and demographic data was collected from medical records. Logistic regression was used to calculate the odds ratio of associated factors. Results : A total of 9.2% of the participants met the criteria of frailty. The percentage of patients having a fall was 7.2%. Age were significantly associated with frailty (odds ratio = 1.057, 95% confidence interval = 1.025-1.091); however, sex was not associated with frailty (p = 0.17). After adjustment for age and sex, frailty status was associated with a fall (odds ratio = 3.62, 95% confidence interval = 1.58-8.28). Concerning the components of frailty, decreased grip strength (odds ratio = 2.44, 95% confidence interval = 1.16-5.14), slow gait speed (odds ratio = 2.82, 95% confidence interval = 1.21-6.53), and low physical activity (odds ratio = 2.64, 95% confidence interval = 1.21-5.78) were found to be associated with a fall. Conclusions: Our findings suggest the prevalence of frailty was about 10% in hospitalized patients with chronic patients with schizophrenia, and frailty status was significant with a fall in this group. By using the status of frailty, it may be beneficial to potential target candidates having fallen in the future as early as possible. The effective intervention of prevention of further falls may be given in advance. Our results bridge this gap and open a potential avenue for the prevention of falls in patients with schizophrenia. Frailty is certainly an important factor for maintaining wellbeing among these patients.

Keywords: fall, frailty, schizophrenia, Taiwan

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15 Using Multi-Specialist Team to Care for a Breast Cancer Patient Who Received Total Mastectomy during Pregnancy

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen


This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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