Search results for: bernoulli cusum (BC) chart
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 319

Search results for: bernoulli cusum (BC) chart

109 Post-Traumatic Stress Disorder: Management at the Montfort Hospital

Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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108 Prevalence Pediculosis and Associated Risk Factors in Primary-School Children of Mazandaran Province, Iran, 2012-2013

Authors: Seyyed Farzad Motevalli-Haghi, Javad Rafinejad, Mahboobeh Hosseni, Jamshid Yazdani-Charati, Behzad Parsi

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Background and purpose: Pediculosis is a worldwide public health concern. This descriptive study was performed on primary-school-aged children to determine the prevalence of pediculosis and its risk factors in Mazandaran Province, Iran, on basis of geographic information system (GIS). Materials and methods: A random sampling method was used to select 45237 school-aged children from Sari to Ramsar cities during September 2012 to June 2013. Data were collected from the selected schools by five trained nursing inspectors. A detailed questionnaire was filled for each child prior to hair examination following which examination was carried out to detect head lice as well as eggs/nits. Data were analyzed chi-square test. Finally, the GIS map was obtained in province informational chart. Results: 823 primary-school children (of 45237) were infected with lice in Mazandaran Province. The mean infection prevalence was 1.4% in cities 5.64% in rural area from Sari to Ramsar. There were significant relationships between pediculosis and some factors (P<0.05). GIS map revealed that the contamination was less in west than in east and central regions. Conclusion: Increasing awareness and training of teachers and parents, as well as improving standards of personal health can significantly reduce the prevalence of pediculosis.

Keywords: pediculosis capitis, primary school children, epidemiology, geographic information system (GIS), Mazandaran, Iran

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107 An Empirical Study of the Effect of Robot Programming Education on the Computational Thinking of Young Children: The Role of Flowcharts

Authors: Wei Sun, Yan Dong

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There is an increasing interest in introducing computational thinking at an early age. Computational thinking, like mathematical thinking, engineering thinking, and scientific thinking, is a kind of analytical thinking. Learning computational thinking skills is not only to improve technological literacy, but also allows learners to equip with practicable skills such as problem-solving skills. As people realize the importance of computational thinking, the field of educational technology faces a problem: how to choose appropriate tools and activities to help students develop computational thinking skills. Robots are gradually becoming a popular teaching tool, as robots provide a tangible way for young children to access to technology, and controlling a robot through programming offers them opportunities to engage in developing computational thinking. This study explores whether the introduction of flowcharts into the robotics programming courses can help children convert natural language into a programming language more easily, and then to better cultivate their computational thinking skills. An experimental study was adopted with a sample of children ages six to seven (N = 16) participated, and a one-meter-tall humanoid robot was used as the teaching tool. Results show that children can master basic programming concepts through robotic courses. Children's computational thinking has been significantly improved. Besides, results suggest that flowcharts do have an impact on young children’s computational thinking skills development, but it only has a significant effect on the "sequencing" and "correspondence" skills. Overall, the study demonstrates that the humanoid robot and flowcharts have qualities that foster young children to learn programming and develop computational thinking skills.

Keywords: robotics, computational thinking, programming, young children, flow chart

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106 Application of Simulation of Discrete Events in Resource Management of Massive Concreting

Authors: Mohammad Amin Hamedirad, Seyed Javad Vaziri Kang Olyaei

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Project planning and control are one of the most critical issues in the management of construction projects. Traditional methods of project planning and control, such as the critical path method or Gantt chart, are not widely used for planning projects with discrete and repetitive activities, and one of the problems of project managers is planning the implementation process and optimal allocation of its resources. Massive concreting projects is also a project with discrete and repetitive activities. This study uses the concept of simulating discrete events to manage resources, which includes finding the optimal number of resources considering various limitations such as limitations of machinery, equipment, human resources and even technical, time and implementation limitations using analysis of resource consumption rate, project completion time and critical points analysis of the implementation process. For this purpose, the concept of discrete-event simulation has been used to model different stages of implementation. After reviewing the various scenarios, the optimal number of allocations for each resource is finally determined to reach the maximum utilization rate and also to reduce the project completion time or reduce its cost according to the existing constraints. The results showed that with the optimal allocation of resources, the project completion time could be reduced by 90%, and the resulting costs can be reduced by up to 49%. Thus, allocating the optimal number of project resources using this method will reduce its time and cost.

Keywords: simulation, massive concreting, discrete event simulation, resource management

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105 Perceived Determinants of Obesity among Primary School Pupils in Eti Osa Local Government Area of Lagos State, Nigeria

Authors: B. O. Diyaolu, E. A. Okebanjo

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Children in today’s world need attention and care even with their physique as obesity is also at the increased. Several factors can be responsible for obesity in children and adequate attention is paramount in other not to accommodate it into adolescent period. This study investigated perceived determinants of obesity among primary school pupils in Eti Osa Local Government area of Lagos State. Descriptive survey research design was used and population was all obese pupils in Eti Osa Local Government Area of Lagos State. 92 pupils were selected from randomly picked 12 primary schools while purposive sampling technique was used to pick primary 4-6 pupils. With the aid of body mass index (BMI) and age percentile chart the obese pupils were selected. The instrument for the study was a self-developed and structured questionnaire on perceived determinant of obesity. The questionnaire was divided into three sections. The Cronbach’s Alpha reliability coefficient of 0.74 was obtained. The hypotheses were tested at 0.05 significant levels. The completed questionnaire was collated coded and analyzed using descriptive statistics of frequency counts and percentage and inferential statistics of chi-square (X2). Findings of this study revealed that physical activities and parental influences were determinant of obesity. Physical activity is essential in reducing the rate of obesity in Eti Osa Local Government Area both at home and within the school environment. Primary schools need to create more playing ground for pupils to exercise themselves. Parents need to cater for their children diet ensuring not just the quantity but the quality as well.

Keywords: feeding pattern, obese pupils, parental influence, physical activities

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104 Investigation of the Functional Impact of Amblyopia on Visual Skills in Children

Authors: Chinmay V. Deshpande

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Purpose: To assess the efficiency of visual functions and visual skills in strabismic & anisometropic amblyopes and to assess visual acuity and contrast sensitivity in anisometropic amblyopes with spectacles & contact lenses. Method: In a prospective clinical study, 32 children ageing from 5 to 15 years presenting with amblyopia in a pediatric department of Shri Ganapati Netralaya Jalna, India, were assessed for a period of three & half months. Visual acuity was measured with Snellen’s and Bailey-Lovie log MAR charts whereas contrast sensitivity was measured with Pelli-Robson chart with spectacles and contact lenses. Saccadic movements were assessed with SCCO scoring criteria and accommodative facility was checked with ±1.50 DS flippers. Stereopsis was assessed with TNO test. Results: By using Wilcoxon sign rank test p-value < 0.05 (< 0.001), the mean linear visual acuity was 0.29 (≈ 6/21) and mean single optotype visual acuity found to be 0.36 (≈ 6/18). Mean visual acuity of 0.27(≈ 6/21) with spectacles improved to 0.33 (≈ 6/18) with contact lenses in amblyopic eyes. The mean Log MAR visual acuity with spectacles and contact lens were found to be 0.602( ≈6/24) and 0.531(≈ 6/21) respectively. The contrast threshold out of 20 amblyopic eyes shows that mean contrast threshold changed in 9 patients from spectacles 0.27 to contact lens 0.19 respectively. The mean accommodative facility assessed was 5.31(± 2.37). 24 subjects (75%) revealed marked saccadic defects on the test applied. 78% subjects didn’t show even gross stereoscopic ability on TNO test. Conclusion: This study supports the facts about amblyopia and associated deficits in visual skills which are claimed in previous studies. In addition, anisometropic amblyopia can be managed better with contact lenses.

Keywords: strabismus, anisometropia, amblyopia, contrast sensitivity, saccades, stereopsis

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103 Willingness of Spanish Wineries to Implement Renewable Energies in Their Vineyards and Wineries, as Well as the Limitations They Perceive for Their Implementation

Authors: Javier Carroquino, Nieves García-Casarejos, Pilar Gargallo

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Climate change, depletion of non-renewable resources in the current energies, pollution from them, the greater ecological awareness of the population, are factors that suggest the change of energy sources in business. The agri-food industry is a growth sector, concerned about product innovation, process and with a clear awareness of what climate change may mean for it. This sector is supposed to have a high receptivity to the implementation of clean energy, as this favors not only the environment but also the essence of its business. This work, through surveys, aims to know the willingness of Spanish wineries to implement renewable energies in their vineyards, as well as the limitations they perceive for their implementation. This questionnaire allows the characterization of the sector in terms of its geographical typologies, their activity levels, their perception of environmental issues, the degree of implementation of measures to mitigate climate change and improve energy efficiency, and its uses and energy consumption. The analysis of data proves that the penetration of renewable energies is still at low levels, being the most used energies, solar thermal, photovoltaic and biomass. The initial investment seems to be at the origin of the lack of implantation of this type of energy in the wineries, and not so much the costs of operations and maintenance. The environmental management of the wineries is still at an embryonic stage within the company's organization chart, because these services are either outsourced or, if technicians are available, they are not exclusively dedicated to these tasks. However, there is a strong environmental awareness, as evidenced by the number of climate change mitigation and energy efficiency measures already adopted. The gap between high awareness and low achievement is probably due to the lack of knowledge about how to do it or the perception of a high cost.

Keywords: survey, renewable energy, winery, Spanish case

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102 Design an Assessment Model of Research and Development Capabilities with the New Product Development Approach: A Case Study of Iran Khodro Company

Authors: Hamid Hanifi, Adel Azar, Alireza Booshehri

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In order to know about the capability level of R & D units in automotive industry, it is essential that organizations always compare themselves with standard level and higher than themselves so that to be improved continuously. In this research, with respect to the importance of this issue, we have tried to present an assessment model for R & D capabilities having reviewed on new products development in automotive industry of Iran. Iran Khodro Company was selected for the case study. To this purpose, first, having a review on the literature, about 200 indicators effective in R & D capabilities and new products development were extracted. Then, of these numbers, 29 indicators which were more important were selected by industry and academia experts and the questionnaire was distributed among statistical population. Statistical population was consisted of 410 individuals in Iran Khodro Company. We used the 410 questionnaires for exploratory factor analysis and then used the data of 308 questionnaires from the same population randomly for confirmatory factor analysis. The results of exploratory factor analysis led to categorization of dimensions in 9 secondary dimensions. Naming the dimensions was done according to a literature review and the professors’ opinion. Using structural equation modeling and AMOS software, confirmatory factor analysis was conducted and ultimate model with 9 secondary dimensions was confirmed. Meanwhile, 9 secondary dimensions of this research are as follows: 1) Research and design capability, 2) Customer and market capability, 3) Technology capability, 4) Financial resources capability, 5) Organizational chart, 6) Intellectual capital capability, 7) NPD process capability, 8) Managerial capability and 9) Strategy capability.

Keywords: research and development, new products development, structural equations, exploratory factor analysis, confirmatory factor analysis

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101 Winkler Springs for Embedded Beams Subjected to S-Waves

Authors: Franco Primo Soffietti, Diego Fernando Turello, Federico Pinto

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Shear waves that propagate through the ground impose deformations that must be taken into account in the design and assessment of buried longitudinal structures such as tunnels, pipelines, and piles. Conventional engineering approaches for seismic evaluation often rely on a Euler-Bernoulli beam models supported by a Winkler foundation. This approach, however, falls short in capturing the distortions induced when the structure is subjected to shear waves. To overcome these limitations, in the present work an analytical solution is proposed considering a Timoshenko beam and including transverse and rotational springs. The present research proposes ground springs derived as closed-form analytical solutions of the equations of elasticity including the seismic wavelength. These proposed springs extend the applicability of previous plane-strain models. By considering variations in displacements along the longitudinal direction, the presented approach ensures the springs do not approach zero at low frequencies. This characteristic makes them suitable for assessing pseudo-static cases, which typically govern structural forces in kinematic interaction analyses. The results obtained, validated against existing literature and a 3D Finite Element model, reveal several key insights: i) the cutoff frequency significantly influences transverse and rotational springs; ii) neglecting displacement variations along the structure axis (i.e., assuming plane-strain deformation) results in unrealistically low transverse springs, particularly for wavelengths shorter than the structure length; iii) disregarding lateral displacement components in rotational springs and neglecting variations along the structure axis leads to inaccurately low spring values, misrepresenting interaction phenomena; iv) transverse springs exhibit a notable drop in resonance frequency, followed by increasing damping as frequency rises; v) rotational springs show minor frequency-dependent variations, with radiation damping occurring beyond resonance frequencies, starting from negative values. This comprehensive analysis sheds light on the complex behavior of embedded longitudinal structures when subjected to shear waves and provides valuable insights for the seismic assessment.

Keywords: shear waves, Timoshenko beams, Winkler springs, sol-structure interaction

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100 Views from Shores Past: Palaeogeographic Reconstructions as an Aid for Interpreting the Movement of Early Modern Humans on and between the Islands of Wallacea

Authors: S. Kealy, J. Louys, S. O’Connor

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The island archipelago that stretches between the continents of Sunda (Southeast Asia) and Sahul (Australia - New Guinea) and comprising much of modern-day Indonesia as well as Timor-Leste, represents the biogeographic region of Wallacea. The islands of Wallaea are significant archaeologically as they have never been connected to the mainlands of either Sunda or Sahul, and thus the colonization by early modern humans of these islands and subsequently Australia and New Guinea, would have necessitated some form of water crossings. Accurate palaeogeographic reconstructions of the Wallacean Archipelago for this time are important not only for modeling likely routes of colonization but also for reconstructing likely landscapes and hence resources available to the first colonists. Here we present five digital reconstructions of coastal outlines of Wallacea and Sahul (Australia and New Guinea) for the periods 65, 60, 55, 50, and 45,000 years ago using the latest bathometric chart and a sea-level model that is adjusted to account for the average uplift rate known from Wallacea. This data was also used to reconstructed island areal extent as well as topography for each time period. These reconstructions allowed us to determine the distance from the coast and relative elevation of the earliest archaeological sites for each island where such records exist. This enabled us to approximate how much effort exploitation of coastal resources would have taken for early colonists, and how important such resources were. These reconstructions also allowed us to estimate visibility for each island in the archipelago, and to model how intervisible each island was during the period of likely human colonisation. We demonstrate how these models provide archaeologists with an important basis for visualising this ancient landscape and interpreting how it was originally viewed, traversed and exploited by its earliest modern human inhabitants.

Keywords: Wallacea, palaeogeographic reconstructions, islands, intervisibility

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99 A Prevalence of Phonological Disorder in Children with Specific Language Impairment

Authors: Etim, Victoria Enefiok, Dada, Oluseyi Akintunde, Bassey Okon

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Phonological disorder is a serious and disturbing issue to many parents and teachers. Efforts towards resolving the problem have been undermined by other specific disabilities which were hidden to many regular and special education teachers. It is against this background that this study was motivated to provide data on the prevalence of phonological disorders in children with specific language impairment (CWSLI) as the first step towards critical intervention. The study was a survey of 15 CWSLI from St. Louise Inclusive schools, Ikot Ekpene in Akwa Ibom State of Nigeria. Phonological Processes Diagnostic Scale (PPDS) with 17 short sentences, which cut across the five phonological processes that were examined, were validated by experts in test measurement, phonology and special education. The respondents were made to read the sentences with emphasis on the targeted sounds. Their utterances were recorded and analyzed in the language laboratory using Praat Software. Data were also collected through friendly interactions at different times from the clients. The theory of generative phonology was adopted for the descriptive analysis of the phonological processes. Data collected were analyzed using simple percentage and composite bar chart for better understanding of the result. The study found out that CWSLI exhibited the five phonological processes under investigation. It was revealed that 66.7%, 80%, 73.3%, 80%, and 86.7% of the respondents have severe deficit in fricative stopping, velar fronting, liquid gliding, final consonant deletion and cluster reduction, respectively. It was therefore recommended that a nationwide survey should be carried out to have national statistics of CWSLI with phonological deficits and develop intervention strategies for effective therapy to remediate the disorder.

Keywords: language disorders, phonology, phonological processes, specific language impairment

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98 Supervisory Controller with Three-State Energy Saving Mode for Induction Motor in Fluid Transportation

Authors: O. S. Ebrahim, K. O. Shawky, M. O. S. Ebrahim, P. K. Jain

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Induction Motor (IM) driving pump is the main consumer of electricity in a typical fluid transportation system (FTS). It was illustrated that changing the connection of the stator windings from delta to star at no load could achieve noticeable active and reactive energy savings. This paper proposes a supervisory hysteresis liquid-level control with three-state energy saving mode (ESM) for IM in FTS including storage tank. The IM pump drive comprises modified star/delta switch and hydromantic coupler. Three-state ESM is defined, along with the normal running, and named analog to computer ESMs as follows: Sleeping mode in which the motor runs at no load with delta stator connection, hibernate mode in which the motor runs at no load with a star connection, and motor shutdown is the third energy saver mode. A logic flow-chart is synthesized to select the motor state at no-load for best energetic cost reduction, considering the motor thermal capacity used. An artificial neural network (ANN) state estimator, based on the recurrent architecture, is constructed and learned in order to provide fault-tolerant capability for the supervisory controller. Sequential test of Wald is used for sensor fault detection. Theoretical analysis, preliminary experimental testing and, computer simulations are performed to show the effectiveness of the proposed control in terms of reliability, power quality and energy/coenergy cost reduction with the suggestion of power factor correction.

Keywords: ANN, ESM, IM, star/delta switch, supervisory control, FT, reliability, power quality

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97 A Clinical Study of Tracheobronchopathia Osteochondroplastica: Findings from a Large Chinese Cohort

Authors: Ying Zhu, Ning Wu, Hai-Dong Huang, Yu-Chao Dong, Qin-Ying Sun, Wei Zhang, Qin Wang, Qiang Li

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Background and study aims: Tracheobronchopathia osteochondroplastica (TO) is an uncommon disease of the tracheobronchial system that leads to narrowing of the airway lumen from cartilaginous and/or osseous submucosal nodules. The aim of this study is to perform a detailed review of this rare disease in a large cohort of patients with TO proven by fiberoptic bronchoscopy from China. Patients and Methods: Retrospective chart review was performed on 41,600 patients who underwent bronchoscopy in the Department of Respiratory Medicine of Changhai Hospital between January 2005 and December 2012. Cases of TO were identified based on characteristic features during bronchoscopic examination. Results: 22 cases of bronchoscopic TO were identified. Among whom one-half were male and the mean age was 47.45 ±10.91 years old. The most frequent symptoms at presentation were chronic cough (n=14) and increased sputum production (n=10). Radiographic abnormalities were observed in 3/18 patients and findings on computed tomography consistent with TO such as beaded intraluminal calcifications and/or increased luminal thickenings were observed in 18/22 patients. Patients were classified into the following categories based on the severity of bronchoscopic findings: Stage I (n=2), Stage II (n=6) and Stage III(n=14). The result that bronchoscopic improvement was observed in 2 patients administered with inhaled corticosteroids suggested that resolution of this disease is possible. Conclusions: TO is a benign disease with slow progression, which could be roughly divided into 3 stages on the basis of the characteristic endoscopic features and histopathologic findings. Chronic inflammation was thought to be more important than the other existing plausible hypotheses in the course of TO. Inhaled corticosteroids might have some impact on patients at Stage I/II.

Keywords: airway obstruction, bronchoscopy, etiology, Tracheobronchopathia osteochondroplastica (TO), treatment

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96 Optimal Pressure Control and Burst Detection for Sustainable Water Management

Authors: G. K. Viswanadh, B. Rajasekhar, G. Venkata Ramana

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Water distribution networks play a vital role in ensuring a reliable supply of clean water to urban areas. However, they face several challenges, including pressure control, pump speed optimization, and burst event detection. This paper combines insights from two studies to address these critical issues in Water distribution networks, focusing on the specific context of Kapra Municipality, India. The first part of this research concentrates on optimizing pressure control and pump speed in complex Water distribution networks. It utilizes the EPANET- MATLAB Toolkit to integrate EPANET functionalities into the MATLAB environment, offering a comprehensive approach to network analysis. By optimizing Pressure Reduce Valves (PRVs) and variable speed pumps (VSPs), this study achieves remarkable results. In the Benchmark Water Distribution System (WDS), the proposed PRV optimization algorithm reduces average leakage by 20.64%, surpassing the previous achievement of 16.07%. When applied to the South-Central and East zone WDS of Kapra Municipality, it identifies PRV locations that were previously missed by existing algorithms, resulting in average leakage reductions of 22.04% and 10.47%. These reductions translate to significant daily Water savings, enhancing Water supply reliability and reducing energy consumption. The second part of this research addresses the pressing issue of burst event detection and localization within the Water Distribution System. Burst events are a major contributor to Water losses and repair expenses. The study employs wireless sensor technology to monitor pressure and flow rate in real time, enabling the detection of pipeline abnormalities, particularly burst events. The methodology relies on transient analysis of pressure signals, utilizing Cumulative Sum and Wavelet analysis techniques to robustly identify burst occurrences. To enhance precision, burst event localization is achieved through meticulous analysis of time differentials in the arrival of negative pressure waveforms across distinct pressure sensing points, aided by nodal matrix analysis. To evaluate the effectiveness of this methodology, a PVC Water pipeline test bed is employed, demonstrating the algorithm's success in detecting pipeline burst events at flow rates of 2-3 l/s. Remarkably, the algorithm achieves a localization error of merely 3 meters, outperforming previously established algorithms. This research presents a significant advancement in efficient burst event detection and localization within Water pipelines, holding the potential to markedly curtail Water losses and the concomitant financial implications. In conclusion, this combined research addresses critical challenges in Water distribution networks, offering solutions for optimizing pressure control, pump speed, burst event detection, and localization. These findings contribute to the enhancement of Water Distribution System, resulting in improved Water supply reliability, reduced Water losses, and substantial cost savings. The integrated approach presented in this paper holds promise for municipalities and utilities seeking to improve the efficiency and sustainability of their Water distribution networks.

Keywords: pressure reduce valve, complex networks, variable speed pump, wavelet transform, burst detection, CUSUM (Cumulative Sum), water pipeline monitoring

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95 Exploring Environmental, Social, and Governance (ESG) Standards for Space Exploration

Authors: Rachael Sullivan, Joshua Berman

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The number of satellites orbiting earth are in the thousands now. Commercial launches are increasing, and civilians are venturing into the outer reaches of the atmosphere. As the space industry continues to grow and evolve, so too will the demand on resources, the disparities amongst socio-economic groups, and space company governance standards. Outside of just ensuring that space operations are compliant with government regulations, export controls, and international sanctions, companies should also keep in mind the impact their operations will have on society and the environment. Those looking to expand their operations into outer space should remain mindful of both the opportunities and challenges that they could encounter along the way. From commercial launches promoting civilian space travel—like the recent launches from Blue Origin, Virgin Galactic, and Space X—to regulatory and policy shifts, the commercial landscape beyond the Earth's atmosphere is evolving. But practices will also have to become sustainable. Through a review and analysis of space industry trends, international government regulations, and empirical data, this research explores how Environmental, Social, and Governance (ESG) reporting and investing will manifest within a fast-changing space industry.Institutions, regulators, investors, and employees are increasingly relying on ESG. Those working in the space industry will be no exception. Companies (or investors) that are already engaging or plan to engage in space operations should consider 1) environmental standards and objectives when tackling space debris and space mining, 2) social standards and objectives when considering how such practices may impact access and opportunities for different socioeconomic groups to the benefits of space exploration, and 3) how decision-making and governing boards will function ethically, equitably, and sustainably as we chart new paths and encounter novel challenges in outer space.

Keywords: climate, environment, ESG, law, outer space, regulation

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94 Openness to Linguistic and Value Diversity as a Key Factor in the Development of a Learning Community

Authors: Caterina Calicchio, Talia Sbardella

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The ability to move through geographical and symbolic spaces is key for building new nodes and social relationships. Especially in the framework of language learning, accepting and valuing diversity can help to create a constructive atmosphere of cooperation, innovation, and creativity. Thus, it is important to outline the stages of forming a learning community, focusing on the characteristics that can favor its development. It is known that elements like curiosity and motivation are significant for individual language learning; hence, the study attempts to investigate how factors like openness to diversity and cultural immersion could improve Italian learning and teaching. This paper aims to indicate the factors that could be significant for the development of a Learning Community by presenting a case study on a course on Italian as a second language for beginners: first, the theoretical matrices underlying social learning will be outlined. Secondly, a quantitative study will be described based on an adaptation of the openness to diversity and some insights psychometric scale questionnaire developed at the Umbra Institute. The questionnaire was delivered to 52 American college students with open-ended and closed-ended questions. Students were asked to specify their level of agreement to a set of statements on a six-point Likert scale ranging from (1) Strongly disagree to (6) Strongly agree. The data has been analyzed with a quantitative and qualitative method and has been represented in a pie chart and in a histogram. Moreover, mean and frequency have been calculated. The research findings demonstrate that openness to diversity and challenge enhances cross-cutting skills such as intercultural and communicative competence: through cultural immersion and the facility of speaking with locals, the participants have been able to develop their own Italian L2 language community. The goal is to share with the scientific community some insights to trace possible future lines of research.

Keywords: Italian as second language, language learning, learning community, openness to diversity

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93 C-eXpress: A Web-Based Analysis Platform for Comparative Functional Genomics and Proteomics in Human Cancer Cell Line, NCI-60 as an Example

Authors: Chi-Ching Lee, Po-Jung Huang, Kuo-Yang Huang, Petrus Tang

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Background: Recent advances in high-throughput research technologies such as new-generation sequencing and multi-dimensional liquid chromatography makes it possible to dissect the complete transcriptome and proteome in a single run for the first time. However, it is almost impossible for many laboratories to handle and analysis these “BIG” data without the support from a bioinformatics team. We aimed to provide a web-based analysis platform for users with only limited knowledge on bio-computing to study the functional genomics and proteomics. Method: We use NCI-60 as an example dataset to demonstrate the power of the web-based analysis platform and data delivering system: C-eXpress takes a simple text file that contain the standard NCBI gene or protein ID and expression levels (rpkm or fold) as input file to generate a distribution map of gene/protein expression levels in a heatmap diagram organized by color gradients. The diagram is hyper-linked to a dynamic html table that allows the users to filter the datasets based on various gene features. A dynamic summary chart is generated automatically after each filtering process. Results: We implemented an integrated database that contain pre-defined annotations such as gene/protein properties (ID, name, length, MW, pI); pathways based on KEGG and GO biological process; subcellular localization based on GO cellular component; functional classification based on GO molecular function, kinase, peptidase and transporter. Multiple ways of sorting of column and rows is also provided for comparative analysis and visualization of multiple samples.

Keywords: cancer, visualization, database, functional annotation

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92 Implementing the Quality of Care Partnership to Reduce the Cost of Screenings for Sexually Transmitted Infections on a Southeastern College Campus

Authors: Amy Guidera, Steven Busby, Christian Williams, David Phillippi

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College students are a priority preventative healthcare population that can engage in high-risk behaviors which may concurrently increase the potential for unsafe sexual practices, including contracting sexually transmitted infections (STIs). Early education, screening, treatment, and partner notification are important interventions for breaking the chain of transmission and recurrence in relation to preventing poor health outcomes and mitigating college dropout rates. The aim of this quality improvement project was to determine if the reduction in STI screening costs for college students (aged 18-30 years old) would increase the amount of STI screenings conducted at a university health center over the course of an academic semester while evaluating our ability to achieve an improved quality of care at a reduced cost, along with improved STI reporting and documentation. This study was conducted through retrospective chart reviews of STI-related visits and utilized the RADAR matrix to provide a guiding, iterative mechanism to continuously reassess goals and outcomes defined in a memorandum of agreement (MOA) between a university health center and the state department of health (DOH) laboratory. The project failed to increase the amount of STI screenings, most likely due to the emergence of COVID-19, but resulted in improved quality of care for students, improved STI-related visit documentation and reporting, and significantly reduced costs for STI screening for collegiate students at a southeastern private university campus.

Keywords: college health, college students, preventive health, reproductive health, sexually transmitted infections, young adults

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91 The Adoption of Leagility in Healthcare Services

Authors: Ana L. Martins, Luis Orfão

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Healthcare systems have been subject to various research efforts aiming at process improvement under a lean approach. Another perspective, agility, has also been used, though in a lower scale, in order to analyse the ability of different hospital services to adapt to demand uncertainties. Both perspectives have a common denominator, the improvement of effectiveness and efficiency of the services in a healthcare setting context. Mixing the two approached allows, on one hand, to streamline the processes, and on the other hand the required flexibility to deal with demand uncertainty in terms of both volume and variety. The present research aims to analyse the impacts of the combination of both perspectives in the effectiveness and efficiency of an hospital service. The adopted methodology is based on a case study approach applied to the process of the ambulatory surgery service of Hospital de Lamego. Data was collected from direct observations, formal interviews and informal conversations. The analyzed process was selected according to three criteria: relevance of the process to the hospital, presence of human resources, and presence of waste. The customer of the process was identified as well as his perception of value. The process was mapped using flow chart, on a process modeling perspective, as well as through the use of Value Stream Mapping (VSM) and Process Activity Mapping. The Spaghetti Diagram was also used to assess flow intensity. The use of the lean tools enabled the identification of three main types of waste: movement, resource inefficiencies and process inefficiencies. From the use of the lean tools improvement suggestions were produced. The results point out that leagility cannot be applied to the process, but the application of lean and agility in specific areas of the process would bring benefits in both efficiency and effectiveness, and contribute to value creation if improvements are introduced in hospital’s human resources and facilities management.

Keywords: case study, healthcare systems, leagility, lean management

Procedia PDF Downloads 172
90 Predictors of Survival of Therapeutic Hypothermia Based on Analysis of a Consecutive American Inner City Population over 4 Years

Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

Abstract:

Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

Procedia PDF Downloads 187
89 Damping Optimal Design of Sandwich Beams Partially Covered with Damping Patches

Authors: Guerich Mohamed, Assaf Samir

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The application of viscoelastic materials in the form of constrained layers in mechanical structures is an efficient and cost-effective technique for solving noise and vibration problems. This technique requires a design tool to select the best location, type, and thickness of the damping treatment. This paper presents a finite element model for the vibration of beams partially or fully covered with a constrained viscoelastic damping material. The model is based on Bernoulli-Euler theory for the faces and Timoshenko beam theory for the core. It uses four variables: the through-thickness constant deflection, the axial displacements of the faces, and the bending rotation of the beam. The sandwich beam finite element is compatible with the conventional C1 finite element for homogenous beams. To validate the proposed model, several free vibration analyses of fully or partially covered beams, with different locations of the damping patches and different percent coverage, are studied. The results show that the proposed approach can be used as an effective tool to study the influence of the location and treatment size on the natural frequencies and the associated modal loss factors. Then, a parametric study regarding the variation in the damping characteristics of partially covered beams has been conducted. In these studies, the effect of core shear modulus value, the effect of patch size variation, the thickness of constraining layer, and the core and the locations of the patches are considered. In partial coverage, the spatial distribution of additive damping by using viscoelastic material is as important as the thickness and material properties of the viscoelastic layer and the constraining layer. Indeed, to limit added mass and to attain maximum damping, the damping patches should be placed at optimum locations. These locations are often selected using the modal strain energy indicator. Following this approach, the damping patches are applied over regions of the base structure with the highest modal strain energy to target specific modes of vibration. In the present study, a more efficient indicator is proposed, which consists of placing the damping patches over regions of high energy dissipation through the viscoelastic layer of the fully covered sandwich beam. The presented approach is used in an optimization method to select the best location for the damping patches as well as the material thicknesses and material properties of the layers that will yield optimal damping with the minimum area of coverage.

Keywords: finite element model, damping treatment, viscoelastic materials, sandwich beam

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88 Myomectomy and Blood Loss: A Quality Improvement Project

Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu

Abstract:

Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.

Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid

Procedia PDF Downloads 57
87 The Role of Businesses in Peacebuilding in Nigeria: A Stakeholder Approach

Authors: Jamila Mohammed Makarfi, Yontem Sonmez

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Developing countries like Nigeria have recently been affected by conflicts characterized by violence, high levels of risk and insecurity, resulting in loss of lives, livelihoods, displacement of communities, degradation of health, educational and social infrastructure as well as economic underdevelopment. The Nigerian government’s response to most of these conflicts has mainly been reactionary in the form of military deployments, as against precautionary to prevent or address the root causes of the conflicts. Several studies have shown that at various points of a conflict, conflict regions can benefit from the resources and expertise available outside the government, mainly from the private sector through mechanisms such as corporate social responsibility (CSR) by businesses. The main aim of this study is to examine the role of businesses in peacebuilding in Northern Nigeria through CSR in the last decade. The expected contributions from this will answer research questions, such as the key business motivations to engage in peacebuilding, as well as the degree of influence exerted from various stakeholder groups on the business decision to engage. The methodology of the study adopts a multiple case study of over 120 businesses of various sizes, ranging from small, medium and large-scale. A mixed method enabled the collection of quantitative and qualitative primary data to augment the secondary data. The results indicated that the most important business motivations to engage in peacebuilding were the negative effects of the conflict on economic stability, as well as stakeholder-driven motives. On the other hand, out of the 12 identified stakeholders, micro-, small- and medium-scale enterprises (MSMEs) considered the chief executive officer’s interest to be the most important factor, while large companies rated the government and community pressure as the highest. Overall, the foreign stakeholders scored low on the influence chart for all business types.

Keywords: conflict, corporate social responsibility, peacebuilding, stakeholder

Procedia PDF Downloads 190
86 Comfort in Green: Thermal Performance and Comfort Analysis of Sky Garden, SM City, North EDSA, Philippines

Authors: Raul Chavez Jr.

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Green roof's body of knowledge appears to be in its infancy stage in the Philippines. To contribute to its development, this study intends to answer the question: Does the existing green roof in Metro Manila perform well in providing thermal comfort and satisfaction to users? Relatively, this study focuses on thermal sensation and satisfaction of users, surface temperature comparison, weather data comparison of the site (Sky Garden) and local weather station (PAG-ASA), and its thermal resistance capacity. Initially, the researcher conducted a point-in-time survey in parallel with weather data gathering from PAG-ASA and Sky Garden. In line with these, ambient and surface temperature are conducted through the use of a digital anemometer, with humidity and temperature, and non-contact infrared thermometer respectively. Furthermore, to determine the Sky Garden's overall thermal resistance, materials found on site were identified and tabulated based on specified locations. It revealed that the Sky Garden can be considered comfortable based from PMV-PPD Model of ASHRAE Standard 55 having similar results from thermal comfort and thermal satisfaction survey, which is contrary to the actual condition of the Sky Garden by means of a psychrometric chart which falls beyond the contextualized comfort zone. In addition, ground floor benefited the most in terms of lower average ambient temperature and humidity compared to the Sky Garden. Lastly, surface temperature data indicates that the green roof portion obtained the highest average temperature yet performed well in terms of heat resistance compared to other locations. These results provided the researcher valuable baseline information of the actual performance of a certain green roof in Metro Manila that could be vital in locally enhancing the system even further and for future studies.

Keywords: Green Roof, Thermal Analysis, Thermal Comfort, Thermal Performance

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85 Mike Hat: Coloured-Tape-in-Hat as a Head Circumference Measuring Instrument for Early Detection of Hydrocephalus in an Infant

Authors: Nyimas Annissa Mutiara Andini

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Every year, children develop hydrocephalus during the first year of life. If it is not treated, hydrocephalus can lead to brain damage, a loss in mental and physical abilities, and even death. To be treated, first, we have to do a proper diagnosis using some examinations especially to detect hydrocephalus earlier. One of the examination that could be done is using a head circumference measurement. Increased head circumference is a first and main sign of hydrocephalus, especially in infant (0-1 year age). Head circumference is a measurement of a child's head largest area. In this measurement, we want to get the distance from above the eyebrows and ears and around the back of the head using a measurement tape. If the head circumference of an infant is larger than normal, this infant might potentially suffer hydrocephalus. If early diagnosis and timely treatment of hydrocephalus could be done most children can recover successfully. There are some problems with early detection of hydrocephalus using regular tape for head circumference measurement. One of the problem is the infant’s comfort. We need to make the infant feel comfort along the head circumference measurement to get a proper result of the examination. For that, we can use a helpful stuff, like a hat. This paper is aimed to describe the possibility of using a head circumference measuring instrument for early detection of hydrocephalus in an infant with a mike hat, coloured-tape-in-hat. In the first life, infants’ head size is about 35 centimeters. First three months after that infants will gain 2 centimeters each month. The second three months, infant’s head circumference will increase 1 cm each month. And for the six months later, the rate is 0.5 cm per month, and end up with an average of 47 centimeters. This formula is compared to the WHO’s head circumference growth chart. The shape of this tape-in-hat is alike an upper arm measurement. This tape-in-hat diameter is about 47 centimeters. It contains twelve different colours range by age. If it is out of the normal colour, the infant potentially suffers hydrocephalus. This examination should be done monthly. If in two times of measurement there still in the same range abnormal of head circumference, or a rapid growth of the head circumference size, the infant should be referred to a pediatrician. There are the pink hat for girls and blue hat for boys. Based on this paper, we know that this measurement can be used to help early detection of hydrocephalus in an infant.

Keywords: head circumference, hydrocephalus, infant, mike hat

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84 Sustainable Crop Mechanization among Small Scale Rural Farmers in Nigeria: The Hurdles

Authors: Charles Iledun Oyewole

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The daunting challenge that the ‘man with the hoe’ is going to face in the coming decades will be complex and interwoven. With global population already above 7 billion people, it has been estimated that food (crop) production must more than double by 2050 to meet up with the world’s food requirements. Nigeria population is also expected to reach over 240 million people by 2050, at the current annual population growth of 2.61 per cent. The country’s farming population is estimated at over 65 per cent, but the country still depends on food importation to complement production. The small scale farmer, who depends on simple hand tools: hoes and cutlasses, remains the centre of agricultural production, accounting for 90 per cent of the total agricultural output and 80 per cent of the market flow. While the hoe may have been a tool for sustainable development at a time in human history, this role has been smothered by population growth, which has brought too many mouths to be fed (over 170 million), as well as many industries to fuel with raw materials. It may then be argued that the hoe is unfortunately not a tool for the coming challenges and that agricultural mechanization should be the focus. However, agriculture as an enterprise is a ‘complete wheel’ which does not work when broken, particularly, in respect to mechanization. Generally, mechanization will prompt increase production, where land is readily available; increase production, will require post-harvest handling mechanisms, crop processing and subsequent storage. An important aspect of this is readily available and favourable markets for such produce; fuel by good agricultural policies. A break in this wheel will lead to the process of mechanization crashing back to subsistence production, and probably reversal to the hoe. The focus of any agricultural policy should be to chart a course for sustainable mechanization that is environmentally friendly, that may ameliorate Nigeria’s food and raw material gaps. This is the focal point of this article.

Keywords: Crop production, Farmer, Hoes, Mechanization, Policy framework, Population, Growth, Rural areas

Procedia PDF Downloads 186
83 Tibial Hemimelia Type VIIa: A Case Report

Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

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Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

Procedia PDF Downloads 133
82 Application of Multivariate Statistics and Hydro-Chemical Approach for Groundwater Quality Assessment: A Study on Birbhum District, West Bengal, India

Authors: N. C. Ghosh, Niladri Das, Prolay Mondal, Ranajit Ghosh

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Groundwater quality deterioration due to human activities has become a prime factor of modern life. The major concern of the study is to access spatial variation of groundwater quality and to identify the sources of groundwater chemicals and its impact on human health of the concerned area. Multivariate statistical techniques, cluster, principal component analysis, and hydrochemical fancies are been applied to measure groundwater quality data on 14 parameters from 107 sites distributed randomly throughout the Birbhum district. Five factors have been extracted using Varimax rotation with Kaiser Normalization. The first factor explains 27.61% of the total variance where high positive loading have been concentrated in TH, Ca, Mg, Cl and F (Fluoride). In the studied region, due to the presence of basaltic Rajmahal trap fluoride contamination is highly concentrated and that has an adverse impact on human health such as fluorosis. The second factor explains 24.41% of the total variance which includes Na, HCO₃, EC, and SO₄. The last factor or the fifth factor explains 8.85% of the total variance, and it includes pH which maintains the acidic and alkaline character of the groundwater. Hierarchical cluster analysis (HCA) grouped the 107 sampling station into two clusters. One cluster having high pollution and another cluster having less pollution. Moreover hydromorphological facies viz. Wilcox diagram, Doneen’s chart, and USSL diagram reveal the quality of the groundwater like the suitability of the groundwater for irrigation or water used for drinking purpose like permeability index of the groundwater, quality assessment of groundwater for irrigation. Gibb’s diagram depicts that the major portion of the groundwater of this region is rock dominated origin, as the western part of the region characterized by the Jharkhand plateau fringe comprises basalt, gneiss, granite rocks.

Keywords: correlation, factor analysis, hydrological facies, hydrochemistry

Procedia PDF Downloads 185
81 Reduction of Defects Using Seven Quality Control Tools for Productivity Improvement at Automobile Company

Authors: Abdul Sattar Jamali, Imdad Ali Memon, Maqsood Ahmed Memon

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Quality of production near to zero defects is an objective of every manufacturing and service organization. In order to maintain and improve the quality by reduction in defects, Statistical tools are being used by any organizations. There are many statistical tools are available to assess the quality. Keeping in view the importance of many statistical tools, traditional 7QC tools has been used in any manufacturing and automobile Industry. Therefore, the 7QC tools have been successfully applied at one of the Automobile Company Pakistan. Preliminary survey has been done for the implementation of 7QC tool in the assembly line of Automobile Industry. During preliminary survey two inspection points were decided to collect the data, which are Chassis line and trim line. The data for defects at Chassis line and trim line were collected for reduction in defects which ultimately improve productivity. Every 7QC tools has its benefits observed from the results. The flow charts developed for better understanding about inspection point for data collection. The check sheets developed for helps for defects data collection. Histogram represents the severity level of defects. Pareto charts show the cumulative effect of defects. The Cause and Effect diagrams developed for finding the root causes of each defects. Scatter diagram developed the relation of defects increasing or decreasing. The P-Control charts developed for showing out of control points beyond the limits for corrective actions. The successful implementation of 7QC tools at the inspection points at Automobile Industry concluded that the considerable amount of reduction on defects level, as in Chassis line from 132 defects to 13 defects. The total 90% defects were reduced in Chassis Line. In Trim line defects were reduced from 157 defects to 28 defects. The total 82% defects were reduced in Trim Line. As the Automobile Company exercised only few of the 7 QC tools, not fully getting the fruits by the application of 7 QC tools. Therefore, it is suggested the company may need to manage a mechanism for the application of 7 QC tools at every section.

Keywords: check sheet, cause and effect diagram, control chart, histogram

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80 Outcome of Patients Undergoing Hemicraniectomy for Malignant Middle Cerebral Artery Infarction: A 5 Year Retrospective Study at Perpetual Succour Hospital, Cebu City, Philippines

Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

Procedia PDF Downloads 299