Search results for: patient outcomes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 721

Search results for: patient outcomes

331 Kerma Profile Measurements in CT Chest Scans– a Comparison of Methodologies

Authors: Bruno B. Oliveira, Arnaldo P. Mourão, Teógenes A. da Silva

Abstract:

The Brazilian legislation has only established diagnostic reference levels (DRLs) in terms of Multiple Scan Average Dose (MSAD) as a quality control parameter for computed tomography (CT) scanners. Compliance with DRLs can be verified by measuring the Computed Tomography Kerma Index (Ca,100) with a pencil ionization chamber or by obtaining the kerma distribution in CT scans with radiochromic films or rod shape lithium fluoride termoluminescent dosimeters (TLD-100). TL dosimeters were used to record kerma profiles and to determine MSAD values of a Bright Speed model GE CT scanner. Measurements were done with radiochromic films and TL dosimeters distributed in cylinders positioned in the center and in four peripheral bores of a standard polymethylmethacrylate (PMMA) body CT dosimetry phantom. Irradiations were done using a protocol for adult chest. The maximum values were found at the midpoint of the longitudinal axis. The MSAD values obtained with three dosimetric techniques were compared.

Keywords: Kerma profile, CT, MSAD, patient dosimetry

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330 Placebo Effect on Psychoemotional Status and Clinical Analyses of Armenian Crohn's Disease Patients

Authors: Elya S. Pepoyan, Astghik Z. Pepoyan

Abstract:

The Zung self-depression scale and Beck Anxiety Inventory were used both to study the depression and anxiety levels of Armenian Crohn’s disease patients, and to reveal the relation between emotional status and placebo effect of these patients. On the other hand, the blood cell analyses and gut bacteria investigations were used to assess the placebo effect on ESR, and haemoglobin-s and leukocyte-s levels as well as gut commensal E. coli quantities of these patients. Despite of registered high levels of depression and anxiety, the high placebo effect on psychoemotional status for investigated patients during the investigations was described. On the other hand, no positive effect of placebo on measurements of ESP and hemoglobin-s levels of Crohn’s disease patients was revealed. The importance of use of psychotherapies for optimal outcomes during treatments of Crohn’s disease is discussed.

Keywords: Crohn's disease, emotional disorders, placebo, gut microflora and blood composition.

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329 Influence of Hygro-Chemo-Mechanical Degradation on Performance of Concrete Gravity Dam

Authors: Kalyan Kumar Mandal, Damodar Maity

Abstract:

The degradation of concrete due to various hygrochemo- mechanical actions is inevitable for the structures particularly built to store water. Therefore, it is essential to determine the material properties of dam-like structures due to ageing to predict the behavior of such structures after a certain age. The degraded material properties are calculated by introducing isotropic degradation index. The predicted material properties are used to study the behavior of aged dam at different ages. The dam is modeled by finite elements and displacement and is considered as an unknown variable. The parametric study reveals that the displacement is quite larger for comparatively lower design life of the structure because the degradation of elastic properties depends on the design life of the dam. The stresses in dam cam be unexpectedly large at any age with in the design life. The outcomes of the present study indicate the importance of the consideration ageing effect of concrete exposed to water for the safe design of dam throughout its life time.

Keywords: Hygro-chemo-mechanical, isotropic degradation, finite element method, Koyna earthquake.

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328 Impact of Four Reading and Library Factors on the Grade Average of Ugandan Secondary School Students: A Quantitative Study

Authors: Valeda Dent

Abstract:

This study explores reading and library factors related to secondary school student academic outcomes in rural areas in Uganda. This mixed methods study utilized quantitative data collected as part of a more extensive project to explore six student factors in relation to students’ school, library, and home environments. The Kitengesa Community Library in Uganda (www.kitengesalibrary.org) served as the site for this study. The factors explored for this study include reading frequency, library use frequency, library access, overall grade average (OGA), and presence and type of reading materials in the home. Results indicated that both reading frequency and certain types of reading materials read for recreational purposes are correlated with higher OGA. Reading frequency was positively correlated with student OGA for all students.

Keywords: Rural village libraries, secondary school students, reading, academic achievement.

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327 Pulse Oximeter Concept for Vascular Occlusion Test

Authors: Fatanah M. Suhaimi, J. Geoffrey Chase, Christopher G. Pretty, Rodney Elliott, Geoffrey M. Shaw

Abstract:

Microcirculatory dysfunction is very common in sepsis and may results in organ failure and increased risk of death. Analyzing oxygen utilization can potentially assess microcirculation function of an individual. In this study, a modified pulse oximeter is used to extract information signals due to absorption of red (R) and infrared (IR) light. IR and R signal are related to the overall blood volume and reduced hemoglobin, respectively. Differences between these two signals thus represent the amount of oxygenated hemoglobin. Avascular occlusion test has been conducted on healthy individuals to validate the pulse oximeter concept. In this test, both R and IR signals rapidly changed according to the occlusion process. The pulse oximeter concept presented is capable of extracting valuable information to assess microcirculation condition. Implementing this concept on ICU patients has the potential to aid sepsis diagnosis and provide more accurate tracking of patient state and sepsis status.

Keywords: Microcirculation, sepsis, sepsis diagnosis, oxygen extraction.

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326 Experimental Set-Up for Investigation of Fault Diagnosis of a Centrifugal Pump

Authors: Maamar Ali Saud Al Tobi, Geraint Bevan, K. P. Ramachandran, Peter Wallace, David Harrison

Abstract:

Centrifugal pumps are complex machines which can experience different types of fault. Condition monitoring can be used in centrifugal pump fault detection through vibration analysis for mechanical and hydraulic forces. Vibration analysis methods have the potential to be combined with artificial intelligence systems where an automatic diagnostic method can be approached. An automatic fault diagnosis approach could be a good option to minimize human error and to provide a precise machine fault classification. This work aims to introduce an approach to centrifugal pump fault diagnosis based on artificial intelligence and genetic algorithm systems. An overview of the future works, research methodology and proposed experimental setup is presented and discussed. The expected results and outcomes based on the experimental work are illustrated.

Keywords: Centrifugal pump setup, vibration analysis, artificial intelligence, genetic algorithm.

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325 Word Stemming Algorithms and Retrieval Effectiveness in Malay and Arabic Documents Retrieval Systems

Authors: Tengku Mohd T. Sembok

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Documents retrieval in Information Retrieval Systems (IRS) is generally about understanding of information in the documents concern. The more the system able to understand the contents of documents the more effective will be the retrieval outcomes. But understanding of the contents is a very complex task. Conventional IRS apply algorithms that can only approximate the meaning of document contents through keywords approach using vector space model. Keywords may be unstemmed or stemmed. When keywords are stemmed and conflated in retrieving process, we are a step forwards in applying semantic technology in IRS. Word stemming is a process in morphological analysis under natural language processing, before syntactic and semantic analysis. We have developed algorithms for Malay and Arabic and incorporated stemming in our experimental systems in order to measure retrieval effectiveness. The results have shown that the retrieval effectiveness has increased when stemming is used in the systems.

Keywords: Information Retrieval, Natural Language Processing, Artificial Intelligence.

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324 The Visual Inspection of Surgical Tasks Using Machine Vision: Applications to Robotic Surgery

Authors: M. Ovinis, D. Kerr, K. Bouazza-Marouf, M. Vloeberghs

Abstract:

In this paper, the feasibility of using machine vision to assess task completion in a surgical intervention is investigated, with the aim of incorporating vision based inspection in robotic surgery systems. The visually rich operative field presents a good environment for the development of automated visual inspection techniques in these systems, for a more comprehensive approach when performing a surgical task. As a proof of concept, machine vision techniques were used to distinguish the two possible outcomes i.e. satisfactory or unsatisfactory, of three primary surgical tasks involved in creating a burr hole in the skull, namely incision, retraction, and drilling. Encouraging results were obtained for the three tasks under consideration, which has been demonstrated by experiments on cadaveric pig heads. These findings are suggestive for the potential use of machine vision to validate successful task completion in robotic surgery systems. Finally, the potential of using machine vision in the operating theatre, and the challenges that must be addressed, are identified and discussed.

Keywords: Machine vision, robotic surgery, visual inspection.

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323 Comparative Study of Transformed and Concealed Data in Experimental Designs and Analyses

Authors: K. Chinda, P. Luangpaiboon

Abstract:

This paper presents the comparative study of coded data methods for finding the benefit of concealing the natural data which is the mercantile secret. Influential parameters of the number of replicates (rep), treatment effects (τ) and standard deviation (σ) against the efficiency of each transformation method are investigated. The experimental data are generated via computer simulations under the specified condition of the process with the completely randomized design (CRD). Three ways of data transformation consist of Box-Cox, arcsine and logit methods. The difference values of F statistic between coded data and natural data (Fc-Fn) and hypothesis testing results were determined. The experimental results indicate that the Box-Cox results are significantly different from natural data in cases of smaller levels of replicates and seem to be improper when the parameter of minus lambda has been assigned. On the other hand, arcsine and logit transformations are more robust and obviously, provide more precise numerical results. In addition, the alternate ways to select the lambda in the power transformation are also offered to achieve much more appropriate outcomes.

Keywords: Experimental Designs, Box-Cox, Arcsine, Logit Transformations.

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322 Dual-Response Approach to Work Stress: An Investigation of Stressors and Wellbeing Outcomes

Authors: J. R. C. Kuntz, Katharina Näswall, Frances Walls

Abstract:

This study sought to uncover the complex role of stress in the workplace by investigating both positive (eustress) and negative (distress) stress responses. In particular, the study tested a mediation model in which organisational stressors (person-job fit and role overload) influence employee affective wellbeing, both directly and indirectly through stress responses. Participants were recruited from retail and finance organisations in Australia and New Zealand, and asked to complete an anonymous online questionnaire. A total of 140 individuals returned completed questionnaires. The results show that person-job fit influenced eustress, which in turn had a positive effect on employee affective wellbeing; and role overload impacted distress, which in turn held a negative influence on affective wellbeing. These findings indicate that different organisational stressors have unique relationships with eustress and distress responses. Limitations and implications of the study are discussed.

Keywords: Distress, Eustress, Role Overload, Wellbeing.

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321 Inflammatory Markers in the Blood and Chronic Periodontitis

Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

Abstract:

Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: Chronic periodontitis, atherosclerosis, risk factor, inflammatory markers.

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320 Development of Organizational Justice in Incentive Allocation of the Thai Public Sector

Authors: Kalayanee Koonmee

Abstract:

An incentive for performance, as one subsystem of a new performance management system, has been implemented in the Thai public sector since 2004. This research investigates the development of organizational justice in the incentive allocation by comparing the roles of distributive and procedural justice on national personnel-s attitudinal outcomes (incentive satisfaction and job performance) between 2 periods, i.e. 2006 and 2008. The data were collected via self-administered questionnaires completed by national government officers and employees. They were stratified using multistage sampling with 2,600 usable samples or 72.0% response rate in 2006, and 1,969 usable samples or 59.3% in 2008. The findings are: (1) There is no difference in means between the two periods relating to distributive justice, procedural justice, incentive satisfaction and job performance. (2) Distributive justice and procedural justice played more important roles in predicting incentive satisfaction and job performance in 2008 than in 2006.

Keywords: Distributive justice, incentive allocation, proceduraljustice, Thai public sector.

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319 Segmenting Ultrasound B-Mode Images Using RiIG Distributions and Stochastic Optimization

Authors: N. Mpofu, M. Sears

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In this paper, we propose a novel algorithm for delineating the endocardial wall from a human heart ultrasound scan. We assume that the gray levels in the ultrasound images are independent and identically distributed random variables with different Rician Inverse Gaussian (RiIG) distributions. Both synthetic and real clinical data will be used for testing the algorithm. Algorithm performance will be evaluated using the expert radiologist evaluation of a soft copy of an ultrasound scan during the scanning process and secondly, doctor’s conclusion after going through a printed copy of the same scan. Successful implementation of this algorithm should make it possible to differentiate normal from abnormal soft tissue and help disease identification, what stage the disease is in and how best to treat the patient. We hope that an automated system that uses this algorithm will be useful in public hospitals especially in Third World countries where problems such as shortage of skilled radiologists and shortage of ultrasound machines are common. These public hospitals are usually the first and last stop for most patients in these countries.

Keywords: Endorcardial Wall, Rician Inverse Distributions, Segmentation, Ultrasound Images.

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318 BER Analysis of Energy Detection Spectrum Sensing in Cognitive Radio Using GNU Radio

Authors: B. Siva Kumar Reddy, B. Lakshmi

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Cognitive Radio is a turning out technology that empowers viable usage of the spectrum. Energy Detector-based Sensing is the most broadly utilized spectrum sensing strategy. Besides, it's a lot of generic as receivers doesn't would like any information on the primary user's signals, channel data, of even the sort of modulation. This paper puts forth the execution of energy detection sensing for AM (Amplitude Modulated) signal at 710 KHz, FM (Frequency Modulated) signal at 103.45 MHz (local station frequency), Wi-Fi signal at 2.4 GHz and WiMAX signals at 6 GHz. The OFDM/OFDMA based WiMAX physical layer with convolutional channel coding is actualized utilizing USRP N210 (Universal Software Radio Peripheral) and GNU Radio based Software Defined Radio (SDR). Test outcomes demonstrated the BER (Bit Error Rate) augmentation with channel noise and BER execution is dissected for different Eb/N0 (the energy per bit to noise power spectral density ratio) values.

Keywords: BER, Cognitive Radio, GNU Radio, OFDM, SDR, WiMAX.

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317 Real-Time Visual Simulation and Interactive Animation of Shadow Play Puppets Using OpenGL

Authors: Tan Kian Lam, Abdullah Zawawi bin Haji Talib, Mohd. Azam Osman

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This paper describes a method of modeling to model shadow play puppet using sophisticated computer graphics techniques available in OpenGL in order to allow interactive play in real-time environment as well as producing realistic animation. This paper proposes a novel real-time method is proposed for modeling of puppet and its shadow image that allows interactive play of virtual shadow play using texture mapping and blending techniques. Special effects such as lighting and blurring effects for virtual shadow play environment are also developed. Moreover, the use of geometric transformations and hierarchical modeling facilitates interaction among the different parts of the puppet during animation. Based on the experiments and the survey that were carried out, the respondents involved are very satisfied with the outcomes of these techniques.

Keywords: Animation, blending, hierarchical modeling, interactive play, real-time, shadow play, visual simulation.

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316 Probe of Crack Initiate at the Toe of Concrete Gravity Dam using Numerical Analysis

Authors: M. S. Salimi, H. Kiamanesh, N. Hedayat

Abstract:

In this survey the process of crack propagation at the toe of concrete gravity dam is investigated by applying principals and criteria of linear elastic fracture mechanic. Simulating process of earthquake conditions for three models of dam with different geometrical condition, in empty reservoir under plain stress is calculated through special fracture mechanic software FRANNC2D [1] for determining fracture mechanic criteria. The outcomes showed that in spite of the primary expectations, the simultaneous existence of fillet in both toe and heel area (model 3), the rate of maximum principal stress has not been decreased; however, even the maximum principal stress has increased, so it caused stress intensity factors increase which is undesirable. On the other hand, the dam with heel fillet has shown the best attitude and it is because of items like decreasing the rates of maximum and minimum principal stresses and also is related to decreasing the rates of stress intensity factors for 1st & 2nd modes of the model.

Keywords: Stress intensity factor, concrete gravity dam, numerical analysis, geometry of toe.

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315 Attachment and Emotion Regulation among Adults with versus without Somatic Symptom Disorder

Authors: Natalia Constantinescu

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This cross-sectional study aims to explore the differences among adults with somatic symptom disorder (SSD) versus adults without SSD, in terms of attachment and emotion regulation strategies. A total sample of 80 participants (40 people with SSD and 40 healthy controls), aged 20-57 years old (M = 31.69, SD = 10.55), were recruited from institutions and online groups. They completed the Romanian version of the Experiences in Close Relationships Scale – Short Form (ECR-S), Regulation of Emotion Systems Survey (RESS), Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Disorder – B Criteria Scale (SSD-12). The results indicate significant differences between the two groups in terms of attachment and emotion regulation strategies. Adults with SSD have a higher level of attachment anxiety and avoidance compared to the nonclinical group. Moreover, people with SSD are more prone to use rumination and suppression and less prone to use reevaluation compared to healthy people. Implications for SSD prevention and treatment are discussed.

Keywords: adult attachment, emotion regulation strategies, psychosomatic disorders, somatic symptom disorder

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314 Strategies of Entrepreneurs to Collaborate with Alliances for Commercializing Technology and New Product Innovation: A Practical Learning in Thailand

Authors: Kusumaphorn Sompong, Helen Lawton Smith, Barbara Igel

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This paper provides a key driver-based conceptual framework that can be used to improve a firm-s success in commercializing technology and in new product innovation resulting from collaboration with other organizations through strategic alliances. Based on a qualitative study using an interview approach, strategic alliances of entrepreneurs in the food processing industry in Thailand are explored. This paper describes factors affecting decisions to collaborate through alliances. It identifies four issues: maintaining the efficiency of the value chain for production capability, adapting to present and future competition, careful assessment of value of outcomes, and management of innovation. We consider five driving factors: resource orientation, assessment of risk, business opportunity, sharing of benefits and confidence in alliance partners. These factors will be of interest to entrepreneurs and policy makers with regard to further understanding of the direction of business strategies.

Keywords: Managing collaboration, strategic alliance, technology commercialization, innovation.

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313 The Significance of Cultural Risks for Western Consultants Executing Gulf Cooperation Council Megaprojects

Authors: Alan Walsh, Peter Walker

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Differences in commercial, professional and personal cultural traditions between western consultants and project sponsors in the Gulf Cooperation Council (GCC) region are potentially significant in the workplace, and this can impact on project outcomes. These cultural differences can, for example, result in conflict amongst senior managers, which can negatively impact the megaproject. New entrants to the GCC often experience ‘culture shock’ as they attempt to integrate into their unfamiliar environments. Megaprojects are unique ventures with individual project characteristics, which need to be considered when managing their associated risks. Megaproject research to date has mostly ignored the significance of the absence of cultural congruence in the GCC, which is surprising considering that there are large volumes of megaprojects in various stages of construction in the GCC. An initial step to dealing with cultural issues is to acknowledge culture as a significant risk factor (SRF). This paper seeks to understand the criticality for western consultants to address these risks. It considers the cultural barriers that exist between GCC sponsors and western consultants and examines the cultural distance between the key actors. Initial findings suggest the presence to a certain extent of ethnocentricity. Other cultural clashes arise out of a lack of appreciation of the customs, practices and traditions of ‘the Other’, such as the need for avoiding public humiliation and the hierarchal significance rankings. The concept and significance of cultural shock as part of the integration process for new arrivals are considered. Culture shock describes the state of anxiety and frustration resulting from the immersion in a culture distinctly different from one's own. There are potentially substantial project risks associated with underestimating the process of cultural integration. This paper examines two distinct but intertwined issues: the societal and professional culture differences associated with expatriate assignments. A case study examines the cultural congruences between GCC sponsors and American, British and German consultants, over a ten-year cycle. This provides indicators as to which nationalities encountered the most profound cultural issues and the nature of these. GCC megaprojects are typically intensive fast track demanding ventures, where consultant turnover is high. The study finds that building trust-filled relationships is key to successful project team integration and therefore, to successful megaproject execution. Findings indicate that both professional and social inclusion processes have steep learning curves. Traditional risk management practice is to approach any uncertainty in a structured way to mitigate the potential impact on project outcomes. This research highlights cultural risk as a significant factor in the management of GCC megaprojects. These risks arising from high staff turnover typically include loss of project knowledge, delays to the project, cost and disruption in replacing staff. This paper calls for cultural risk to be recognised as an SRF, as the first step to developing risk management strategies, and to reduce staff turnover for western consultants in GCC megaprojects.

Keywords: Western consultants in megaprojects, national culture impacts on GCC Megaprojects, significant risk factors in megaprojects, professional culture in megaprojects.

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312 A Novel Architecture for Wavelet based Image Fusion

Authors: Susmitha Vekkot, Pancham Shukla

Abstract:

In this paper, we focus on the fusion of images from different sources using multiresolution wavelet transforms. Based on reviews of popular image fusion techniques used in data analysis, different pixel and energy based methods are experimented. A novel architecture with a hybrid algorithm is proposed which applies pixel based maximum selection rule to low frequency approximations and filter mask based fusion to high frequency details of wavelet decomposition. The key feature of hybrid architecture is the combination of advantages of pixel and region based fusion in a single image which can help the development of sophisticated algorithms enhancing the edges and structural details. A Graphical User Interface is developed for image fusion to make the research outcomes available to the end user. To utilize GUI capabilities for medical, industrial and commercial activities without MATLAB installation, a standalone executable application is also developed using Matlab Compiler Runtime.

Keywords: Filter mask, GUI, hybrid architecture, image fusion, Matlab Compiler Runtime, wavelet transform.

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311 Authentic Leadership, Trust and Work Engagement

Authors: Arif Hassan, Forbis Ahmed

Abstract:

The issue of leadership has been investigated from several perspectives; however, very less from ethical perspective. With the growing number of corporate scandals and unethical roles played by business leaders in several parts of the world, the need to examine leadership from ethical perspective cannot be over emphasized. The importance of leadership credibility has been discussed in the authentic model of leadership. Authentic leaders display high degree of integrity, have deep sense of purpose, and committed to their core values. As a result they promote a more trusting relationship in their work groups that translates into several positive outcomes. The present study examined how authentic leadership contribute to subordinates- trust in leadership and how this trust, in turn, predicts subordinates- work engagement. A sample of 395 employees was randomly selected from several local banks operating in Malaysia. Standardized tools such as ALQ, OTI, and EEQ were employed. Results indicated that authentic leadership promoted subordinates- trust in leader, and contributed to work engagement. Also, interpersonal trust predicted employees- work engagement as well as mediated the relationship between this style of leadership and employees- work engagement.

Keywords: Authentic Leadership, Interpersonal Trust, WorkEngagement

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310 Towards Better Quality in Healthcare and Operations Management: A Developmental Literature Review

Authors: Towards Better Quality in Healthcare, Operations Management: A Developmental Literature Review

Abstract:

This work presents the various perspectives, dimensions, components and definitions given to quality in the operations management (OM) and healthcare services (HCS) literature in time, highlighting gaps and learning opportunities between the two disciplines through a thorough search into their rich and distinct body of knowledge. Greater and new insights about the general nature of quality are obtained with findings such as in OM, quality has been approached in six fairly distinct paradigms (excellence, value, conformity to specifications, attributes, satisfaction and meeting or exceeding customer expectations), whereas in HCS, two approaches are prominent (Donabedian’s structure, process and outcomes model and Lohr and Schroeder’s circumscribed definition). The two disciplines views on quality seem to have progressed much in parallel with little cross-learning from each other. This work then proposes an encompassing definition of quality as a lever and suggests further research and development avenues for a better use of the concept of quality by academics and practitioners alike toward the goals of greater organizational performance and improved management in healthcare and possibly other service domains.

Keywords: Healthcare, management, operations, quality, services.

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309 A Conceptual Framework for Supply Chain Competitiveness

Authors: Ajay Verma, Nitin Seth

Abstract:

The purpose of this paper is to highlight the importance of the concept of competitiveness in the supply chain and to present a conceptual framework for Supply Chain Competitiveness (SCC). The framework is based on supply chain activities, which are inputs, necessary for SCC and the benefits which are the outputs of SCC. A literature review is conducted on key supply chain competitiveness issues, its determinants, its various dimensions followed by exploration for SCC. Based on the insights gained, a conceptual framework for SCC is presented based on activities for SCC, SCC environment and outcomes of SCC. The information flow in the conceptual framework is bi-directional at all levels and the activities are interrelated in a global competitive environment. The activities include the activities of suppliers, manufacturers and distributors, giving more emphasis on manufacturers- activities. Further, implications of various factors such as economic, politicolegal, technical, socio-cultural, competition, demographic etc. are also highlighted. The SCC framework is an attempt to cover the relatively less explored area of supply chain competitiveness. It is expected that this work will further motivate researchers, academicians and practitioners to work in this area and offers conceptual help in providing a directions for supply chain competitiveness which leads to improvement in the supply chain and supply chain performance.

Keywords: Competitive advantage, supply chain, SCC, supplychain management.

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308 DTMF Based Robot Assisted Tele Surgery

Authors: Vikas Pandey, T. L. Joshy, Vyshak Vijayan, N. Babu

Abstract:

A new and cost effective robotic device was designed for remote tele surgery using dual tone multi frequency technology (DTMF). Tele system with Dual Tone Multiple Frequency has a large capability in sending and receiving of data in hardware and software. The robot consists of DC motors for arm movements and it is controlled manually through a mobile phone through DTMF Technology. The system enables the surgeon from base station to send commands through mobile phone to the patient’s robotic system which includes two robotic arms that translate the input into actual instrument manipulation. A mobile phone attached to the microcontroller 8051 which can activate robot through relays. The Remote robot-assisted tele surgery eliminates geographic constraints for getting surgical expertise where it is needed and allows an expert surgeon to teach or proctor the performance of surgical technique by real-time intervention.

Keywords: Robot, Microcontroller, DTMF, Tele surgery.

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307 Diversity and Public Decision Making

Authors: Karin Hansson, Göran Cars, Mats Danielson, Love Ekenberg, Aron Larsson

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Within the realm of e-government, the development has moved towards testing new means for democratic decisionmaking, like e-panels, electronic discussion forums, and polls. Although such new developments seem promising, they are not problem-free, and the outcomes are seldom used in the subsequent formal political procedures. Nevertheless, process models offer promising potential when it comes to structuring and supporting transparency of decision processes in order to facilitate the integration of the public into decision-making procedures in a reasonable and manageable way. Based on real-life cases of urban planning processes in Sweden, we present an outline for an integrated framework for public decision making to: a) provide tools for citizens to organize discussion and create opinions; b) enable governments, authorities, and institutions to better analyse these opinions; and c) enable governments to account for this information in planning and societal decision making by employing a process model for structured public decision making.

Keywords: Negotiation games, Agenda setting, Multi-criteria decision analysis, Elicitation method.

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306 Parametric Urban Comfort Envelope an Approach toward a Responsive Sustainable Urban Morphology

Authors: Mohamed M. Saleh, Khalid S. Al-Hagla

Abstract:

By taking advantage of computer-s processing power, an unlimited number of variations and parameters in both spatial and environmental can be provided while following the same set of rules and constraints. This paper focuses on using the tools of parametric urbanism towards a more responsive environmental and sustainable urban morphology. It presents an understanding to Parametric Urban Comfort Envelope (PUCE) as an interactive computational assessment urban model. In addition, it investigates the applicability potentials of this model to generate an optimized urban form to Borg El Arab city (a new Egyptian Community) concerning the human comfort values specially wind and solar envelopes. Finally, this paper utilizes its application outcomes -both visual and numerical- to extend the designer-s limitations by decrease the concern of controlling and manipulation of geometry, and increase the designer-s awareness about the various potentials of using the parametric tools to create relationships that generate multiple geometric alternatives.

Keywords: Assessment model, human comfort, parametric urbanism, sustainable urban morphology.

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305 Wireless Based System for Continuous Electrocardiography Monitoring during Surgery

Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

Abstract:

This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: Electrocardiography, monitoring, surgery, wireless system.

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304 Modeling and Analysis of a Cycling Prosthetic

Authors: John Tolentino, Yong Seok Park

Abstract:

There are currently many people living with limb loss in the USA. The main causes for amputation can range from vascular disease, to trauma, or cancer. This number is expected increase over the next decade. Many patients have a single prosthetic for the first year but end up getting a second one to accommodate their changing physique. Afterwards, the prosthesis gets replaced every three to five years depending on how often it is used. This could cost the patient up to $500,000 throughout their lifetime. Complications do not end there, however. Due to the absence of nerves, it becomes more difficult to traverse terrain with a prosthetic. Moving on an incline or decline becomes difficult, thus curbs and stairs can be a challenge. Certain physical activities, such as cycling, could be even more strenuous. It will need to be relearned to accommodate for the change in weight, center of gravity, and transfer of energy from the leg to the pedal. The purpose of this research project is to develop a new, alternate below-knee cycling prosthetic using Dieter & Schmidt’s design process approach. It will be subjected to fatigue analysis under dynamic loading to observe the limitations as well as the strengths and weaknesses of the prosthetic. Benchmark comparisons will be made between existing prosthetics and the proposed one, examining the benefits and disadvantages. The resulting prosthetic will be 3D printed using acrylonitrile butadiene styrene (ABS) or polycarbonate (PC) plastic.

Keywords: 3D printing, cycling, prosthetic design, synthetic design.

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303 A 3-Year Evaluation Study on Fine Needle Aspiration Cytology and Corresponding Histology

Authors: Amjad Al Shammari, Ashraf Ibrahim, Laila Seada

Abstract:

Background and Objectives: Incidence of thyroid carcinoma has been increasing world-wide. In the present study, we evaluated diagnostic accuracy of Fine needle aspiration (FNA) and its efficiency in early detecting neoplastic lesions of thyroid gland over a 3-year period. Methods: Data have been retrieved from pathology files in King Khalid Hospital. For each patient, age, gender, FNA, site & size of nodule and final histopathologic diagnosis were recorded. Results: Study included 490 cases where 419 of them were female and 71 male. Male to female ratio was 1:6. Mean age was 43 years for males and 38 for females. Cases with confirmed histopathology were 131. In 101/131 (77.1%), concordance was found between FNA and histology. In 30/131 (22.9%), there was discrepancy in diagnosis. Total malignant cases were 43, out of which 14 (32.5%) were true positive and 29 (67.44%) were false negative. No false positive cases could be found in our series. Conclusion: FNA could diagnose benign nodules in all cases, however, in malignant cases, ultrasound findings have to be taken into consideration to avoid missing of a microcarcinoma in the contralateral lobe.

Keywords: FNA, hail, histopathology, thyroid.

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302 A Taxonomy of Behavior for a Medical Coordinator by Utlizing Leadership Styles

Authors: Aryana Collins Jackson, Elisabetta Bevacqua, Pierre De Loor, Ronan Querrec

Abstract:

This paper presents a taxonomy of non-technical skills, communicative intentions, and behavior for an individual acting as a medical coordinator. In medical emergency situations, a leader among the group is imperative to both patient health and team emotional and mental health. Situational Leadership is used to make clear and easy-to-follow guidelines for behavior depending on circumstantial factors. Low-level leadership behaviors belonging to two different styles, directive and supporting, are identified from literature and are included in the proposed taxonomy. The high-level information in the taxonomy consists of the necessary non-technical skills belonging to a medical coordinator: situation awareness, decision making, task management, and teamwork. Finally, communicative intentions, dimensions, and functions are included. Thus this work brings high-level and low-level information - medical non-technical skills, communication capabilities, and leadership behavior - into a single versatile taxonomy of behavior.

Keywords: Medical, leadership styles, taxonomy, human behavior.

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