Search results for: double multiple streamtube

Authors: Ida Rosada, Nurliani

Abstract:

Today, the number of women who seek additional income to help her husband is increasing. They do that in order to be able to express themselves in the midst of the family and society. Nonetheless, housewives are in charge of managing family’s income and prepare food for the family. The objective of this research is 1) to analyze the effect of the dual role of women to household income and 2) to analyze the effect of the dual role to consumption patterns. The study used a qualitative approach, data collection techniques are through observation, interviews, and documentation on farming households. The data was analysed qualitative descriptively. The results found that: 1) The revenue contribution of women who play double role in the informal sector amounted to 34.07% (less than 50%). 2) The main reason that the respondents worked in the informal sector is to be able to send their children to school (34%) and to improve household economy condition (28%). 3) After earning additional income, respondents said that they can contribute to increase the family’s income and to cover the family shortage (82%); 4) Respondents’ opinion to changes in food consumption after performing the dual role is the ability to purchase and provide the desired food (44%) and changing patterns of consumption per day (30%).

Keywords: Dual role, the informal sector, consumption patterns, household income.

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Authors: Georgi Yordanov Georgiev, Michael Daly, Erin Gombos, Amrit Vinod, Gajinder Hoonjan

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Measures of complexity and entropy have not converged to a single quantitative description of levels of organization of complex systems. The need for such a measure is increasingly necessary in all disciplines studying complex systems. To address this problem, starting from the most fundamental principle in Physics, here a new measure for quantity of organization and rate of self-organization in complex systems based on the principle of least (stationary) action is applied to a model system - the central processing unit (CPU) of computers. The quantity of organization for several generations of CPUs shows a double exponential rate of change of organization with time. The exact functional dependence has a fine, S-shaped structure, revealing some of the mechanisms of self-organization. The principle of least action helps to explain the mechanism of increase of organization through quantity accumulation and constraint and curvature minimization with an attractor, the least average sum of actions of all elements and for all motions. This approach can help describe, quantify, measure, manage, design and predict future behavior of complex systems to achieve the highest rates of self organization to improve their quality. It can be applied to other complex systems from Physics, Chemistry, Biology, Ecology, Economics, Cities, network theory and others where complex systems are present.

Keywords: Organization, self-organization, complex system, complexification, quantitative measure, principle of least action, principle of stationary action, attractor, progressive development, acceleration, stochastic.

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Authors: Yong Jun Choi, Juman Byun, Simon Berkovich

Abstract:

One of the ubiquitous routines in medical practice is searching through voluminous piles of clinical documents. In this paper we introduce a distributed system to search and exchange clinical documents. Clinical documents are distributed peer-to-peer. Relevant information is found in multiple iterations of cross-searches between the clinical text and its domain encyclopedia.

Keywords: Clinical documents, cross-search, document exchange, information retrieval, peer-to-peer.

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Authors: Benshi Zhu

Abstract:

In this paper, the existence of multiple positive solutions for a class of third-order three-point discrete boundary value problem is studied by applying algebraic topology method.

Keywords: Positive solutions, Discrete boundary value problem, Third-order, Three-point, Algebraic topology

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Authors: Wenjuan Du, Jingtian Bi, Tong Wang, Haifeng Wang

Abstract:

Grid connection of a large-scale wind farm affects power system small-signal angular stability in two aspects. Firstly, connection of the wind farm brings about the change of load flow and configuration of a power system. Secondly, the dynamic interaction is introduced by the wind farm with the synchronous generators (SGs) in the power system. This paper proposes a method to assess the two aspects of the effect of the wind farm on power system small-signal angular stability. The effect of the change of load flow/system configuration brought about by the wind farm can be examined separately by displacing wind farms with constant power sources, then the effect of the dynamic interaction of the wind farm with the SGs can be also computed individually. Thus, a clearer picture and better understanding on the power system small-signal angular stability as affected by grid connection of the large-scale wind farm are provided. In the paper, an example power system with grid connection of a wind farm is presented to demonstrate the proposed approach.

Keywords: power system small-signal angular stability, power system low-frequency oscillations, electromechanical oscillation modes, wind farms, double fed induction generator (DFIG)

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Authors: Daniel L. Clinciu, Ikrom Abdulaev, Brian D. Oscar

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Various personality profile tests are used to identify personality strengths and limits in individuals, helping both individuals and managers to optimize work and team effort in organizations. One such test, the Hartman’s personality profile, emphasizes four driving "core motives" influenced or affected by both strengths and limitations classified into four colors: Red - motivated by power; Blue - discipline and loyalty; White - peace; and Yellow – fun loving. Two shortcomings of Hartman’s personality test are noted; 1) only one selection for every item / situation allowed and 2) selection of an item / option even if not applicable. A test taker may be as much nurturing as he is opinionated but since “opinionated” seems less attractive the individual would likely select nurturing, causing a misidentification in personality strengths and limits. Since few individuals have a “strong” personality, it is difficult to assess their true personality strengths and limits allowing only one choice or requiring unwanted choices, undermining the potential of the test. We modified Hartman’s personality profile allowing test takers to make either multiple choices for any item / situation or leave them blank if applicable. Sixty-eight participants (38 males and 30 females), 17 - 49 years old, from countries in Asia, Europe, N. America, CIS, Africa, Latin America, and Oceania were included. 58 participants (85.3%) reported the modified test, allowing multiple / no choices better identified their personality strengths and limits, while 10 participants (14.7%) expressed the original (one choice version) was sufficient. The overall results show that our modified test enhanced the identification and balance of core personalities’ strengths and limits, aiding test takers, managers and organizations to better assess individual characteristics, particularly useful in making task-related, teamwork, and management decisions.

Keywords: Organizational behavior, personality tests, personality limitations, personality strengths, task management, team work.

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Authors: Jinwooung Kim, Jae-Hwan Jung, Seong-Jun Kim, Sung-Ah Kim

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Because the building envelope has a significant impact on the operation and maintenance stage of the building, designing the facade considering the performance can improve the performance of the building and lower the maintenance cost of the building. In general, however, optimizing two or more performance factors confronts the limits of time and computational tools. The optimization phase typically repeats infinitely until a series of processes that generate alternatives and analyze the generated alternatives achieve the desired performance. In particular, as complex geometry or precision increases, computational resources and time are prohibitive to find the required performance, so an optimization methodology is needed to deal with this. Instead of directly analyzing all the alternatives in the optimization process, applying experimental techniques (heuristic method) learned through experimentation and experience can reduce resource waste. This study proposes and verifies a method to optimize the double envelope of a building composed of a perforated panel using machine learning to the design geometry and quantitative performance. The proposed method is to achieve the required performance with fewer resources by supplementing the existing method which cannot calculate the complex shape of the perforated panel.

Keywords: Building envelope, machine learning, perforated metal, multi-factor optimization, façade.

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Authors: Rui Wu, Tapani Ristaniemi

Abstract:

In this paper, we propose a new algorithm for joint time-delay and direction-of-arrival (DOA) estimation, here called two-dimensional code acquisition, in an asynchronous directsequence code-division multiple-access (DS-CDMA) array system. This algorithm depends on eigenvector-eigenvalue decomposition of sample correlation matrix, and requires to know desired user-s training sequence. The performance of the algorithm is analyzed both analytically and numerically in uncorrelated and coherent multipath environment. Numerical examples show that the algorithm is robust with unknown number of coherent signals.

Keywords: Two-Dimensional Code Acquisition, EV-t, DSCDMA

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Authors: Réka Sárközi, Péter Iványi, Attila B. Széll

Abstract:

The aim of this paper is to present the adaptation of the dome construction tool for formex algebra to the parametric design software Grasshopper. Formex algebra is a mathematical system, primarily used for planning structural systems such like truss-grid domes and vaults, together with the programming language Formian. The goal of the research is to allow architects to plan truss-grid structures easily with parametric design tools based on the versatile formex algebra mathematical system. To produce regular structures, coordinate system transformations are used and the dome structures are defined in spherical coordinate system. Owing to the abilities of the parametric design software, it is possible to apply further modifications on the structures and gain special forms. The paper covers the basic dome types, and also additional dome-based structures using special coordinate-system solutions based on spherical coordinate systems. It also contains additional structural possibilities like making double layer grids in all geometry forms. The adaptation of formex algebra and the parametric workflow of Grasshopper together give the possibility of quick and easy design and optimization of special truss-grid domes.

Keywords: Parametric design, structural morphology, space structures, spherical coordinate system.

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Authors: Simon B. N. Thompson

Abstract:

Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people as shown in the Thompson Cortisol Hypothesis. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and poststimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: Cortisol, Electromyography, Neurology, Yawning.

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Authors: Rachel Hurdley, Jane Hopkinson

Abstract:

This article is based on observation of a cross-disciplinary, cross-institutional team that worked on an intervention called ‘Memory Mate’ for use in a UK Cancer Centre. This aimed to improve treatment outcomes for patients who had comorbid dementia or other memory impairment. Comorbid patients present ambiguous, spoiled identities, problematising the boundaries of health specialisms and frames of understanding. Memory Mate is theorised as a boundary object facilitating service transformation by changing relations between oncology and mental health care practice. It crosses the boundaries between oncology and mental health. Its introduction signifies an important step in reconfiguring relations between the specialisms. As a boundary object, it contains parallel, even contesting worlds, with potential to enable an eventual synthesis of the double stigma of cancer and dementia. Memory Mate comprises physical things, such as an animation, but its principal value is in the interaction it initiates across disciplines and services. It supports evolution of practices to address a newly emergent challenge for health service provision, namely the cancer patient with comorbid dementia/cognitive impairment. Getting clinicians from different disciplines working together on a practical solution generates a dialogue that can shift professional identity and change the culture of practice.

Keywords: Boundary object, cancer, dementia, interdisciplinary teams.

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Authors: Mazdak Zamani , Azizah A. Manaf , Rabiah B. Ahmad , Akram M. Zeki , Shahidan Abdullah

Abstract:

In this paper, we present a novel, principled approach to resolve the remained problems of substitution technique of audio steganography. Using the proposed genetic algorithm, message bits are embedded into multiple, vague and higher LSB layers, resulting in increased robustness. The robustness specially would be increased against those intentional attacks which try to reveal the hidden message and also some unintentional attacks like noise addition as well.

Keywords: Artificial Intelligence, Audio Steganography, DataHiding, Genetic Algorithm, Substitution Techniques.

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Authors: Ki-Young Kim, Jae-Ho Lim, Deok-Min Kim, Seok-Yoon Kim

Abstract:

Average current analysis checking the impact of current flow is very important to guarantee the reliability of semiconductor systems. As semiconductor process technologies improve, the coupling capacitance often become bigger than self capacitances. In this paper, we propose an analytic technique for analyzing average current on interconnects in multi-conductor structures. The proposed technique has shown to yield the acceptable errors compared to HSPICE results while providing computational efficiency.

Keywords: current moment, interconnect modeling, reliability analysis, worst-case switching

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Authors: A. Schirru, A. Irimescu, S. Merola, A. d’Adamo, S. Fontanesi

Abstract:

One of the aspects that are usually neglected during the design phase of an engine is the effect of the spark plug on the flow field inside the combustion chamber. Because of the difficulties in the experimental investigation of the mutual interaction between flow alteration and early flame kernel convection effect inside the engine combustion chamber, CFD-3D simulation is usually exploited in such cases. Experimentally speaking, a particular type of engine has to be used in order to directly observe the flame propagation process. In this study, a double electrode spark plug was fitted into an optically accessible engine and a high-speed camera was used to capture the initial stages of the combustion process. Both the arc and the kernel phases were observed. Then, a morphologic analysis was carried out and the position of the center of mass of the flame, relative to the spark plug position, was calculated. The crossflow orientation was chosen for the spark plug and the kernel growth process was observed for different air-fuel ratios. It was observed that during a normal cycle the flow field between the electrodes tends to transport the arc deforming it. Because of that, the kernel growth phase takes place away from the electrodes and the flame propagates with a preferential direction dictated by the flow field.

Keywords: Combustion, Kernel growth, optically accessible engine, spark-ignition engine, spark plug orientation.

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Authors: Sheroz Khan, A. F. Salami, W. A. Lawal, AHM Zahirul Alam, Shihab Abdel Hameed, M. J. E.Salami

Abstract:

In this paper, a multi-branch power line is modeled using ABCD matrix to show its worth as a communication channel. The model is simulated using MATLAB in an effort to investigate the effects of multiple loading, multipath, and those as a result of load mismatching. The channel transfer function is obtained and investigated using different cable lengths, and different number of bridge taps under given loading conditions.

Keywords: Power line Communication, Transfer Function, Channel Modeling, Signal Transmission.

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Authors: Richard A. Wasniowski

Abstract:

In this paper we propose a framework for multisensor intrusion detection called Fuzzy Agent-Based Intrusion Detection System. A unique feature of this model is that the agent uses data from multiple sensors and the fuzzy logic to process log files. Use of this feature reduces the overhead in a distributed intrusion detection system. We have developed an agent communication architecture that provides a prototype implementation. This paper discusses also the issues of combining intelligent agent technology with the intrusion detection domain.

Keywords: Intrusion detection, fuzzy logic, agents, networksecurity.

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Authors: Nagmani Lnu

Abstract:

Test automation is a vital requirement of any organization to release products faster to their customers. In most cases, an organization has an approach to developing automation but struggles to maintain it. It results in an increased number of flaky tests, reducing return on investments and stakeholders’ confidence. Challenges grow in multiple folds when automation is for User Interface (UI) behaviors. This paper describes the approaches taken to identify the root cause of automation instability in an extensive payments application and the best practices to address that using processes, tools, and technologies, resulting in a 75% reduction of effort.

Keywords: Automation stability, test stability, flaky test, test quality, test automation quality.

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Authors: K. R. V. Manikantachari, Vasudevan Raghavan, K. Srinivasan

Abstract:

Present study focuses on studying the oscillatory behavior of jet diffusion flames. At a particular jet exit velocity, the flames are seen to exhibit natural flickering. Initially the flickering process is not continuous. In this transition region as well as in the continuous flickering regime, the flickering displays multiple frequency oscillations. The response of the flame to the exit velocity profile of the burner is also studied using three types of burners. The entire range of natural flickering is investigated by capturing high speed digital images and processing them using a MATLAB code.

Keywords: Diffusion flames, Natural flickering, flickering frequency, intermittent flickering

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Authors: Yan Shuang Zhang, Taehan Lee, Byung Ho Jeong

Abstract:

A DEA model can generally evaluate the performance using multiple inputs and outputs for the same period. However, it is hard to avoid the production lead time phenomenon some times, such as long-term project or marketing activity. A couple of models have been suggested to capture this time lag issue in the context of DEA. This paper develops a dual-MPO model to deal with time lag effect in evaluating efficiency. A numerical example is also given to show that the proposed model can be used to get efficiency and reference set of inefficient DMUs and to obtain projected target value of input attributes for inefficient DMUs to be efficient.

Keywords: DEA, efficiency, time lag, dual problem.

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Authors: Sing-Han Wang, Shiang-Hwua Yu, Chih-Po Yang

Abstract:

Repetitive control and feedback dithering modulation are applied to a single-phase voltage source inverter, with an aim to eliminate harmonics and stabilize the inverter under load variations. The proposed control and modulation scheme comprise multiple loops of feedback, which helps improve inverter performance and robustness. Experimental results show that the designed inverter exhibits very low distortion at its output with THD of about 0.3% under different load variations.

Keywords: Feedback dithering modulation, repetitive control, state feedback, inverter, harmonics elimination.

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Authors: Ahmad Aroziki Abdul Aziz, Sakinah Mohd Alauddin, Ruzitah Mohd Salleh, Mohammed Iqbal Shueb

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This paper illustrates the effect of nano Magnesium Hydroxide (MH) loading on the thermal properties of Low Density Polyethylene (LDPE)/Poly (ethylene-co vinyl acetate) (EVA) nano composite. Thermal studies were conducted, as it understanding is vital for preliminary development of new polymeric systems. Thermal analysis of nanocomposite was conducted using thermo gravimetric analysis (TGA), and differential scanning calorimetry (DSC). Major finding of TGA indicated two main stages of degradation process found at (350 ± 25oC) and (480 ± 25oC) respectively. Nano metal filler expressed better fire resistance as it stand over high degree of temperature. Furthermore, DSC analysis provided a stable glass temperature around 51 (±1oC) and captured double melting point at 84 (±2oC) and 108 (±2oC). This binary melting point reflects the modification of nano filler to the polymer matrix forming melting crystals of folded and extended chain. The percent crystallinity of the samples grew vividly with increasing filler content. Overall, increasing the filler loading improved the degradation temperature and weight loss evidently and a better process and phase stability was captured in DSC.

Keywords: Cable and Wire, LDPE/EVA, Nano MH, Nano Particles, Thermal properties.

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Authors: K. Reitner, F. Staberhofer, W. Ortner, M. Gerschberger

Abstract:

The purpose of this paper is to identify the main challenges faced by companies in the timber construction sector and to provide improvement opportunities that can be implemented on a short-, medium- and long-term basis. To identify the challenges and propose actions for each company a literature review and a multiple case research were conducted using the Quick Scan Audit Methodology. Finally, the findings and outcomes are compared with each other to support companies in the timer construction sector when implementing and restructuring their day-to-day activities.

Keywords: Supply chain management, supply chain challenges and opportunities, timber construction sector.

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Authors: Zhouhong Li, Jiming Yang

Abstract:

In this paper, a class of predator-prey-chain model with harvesting terms are studied. By using Mawhin-s continuation theorem of coincidence degree theory and some skills of inequalities, some sufficient conditions are established for the existence of eight positive periodic solutions. Finally, an example is presented to illustrate the feasibility and effectiveness of the results.

Keywords: Positive periodic solutions, Predator-prey-chain model, coincidence degree, harvesting term.

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Authors: Qiuling Xie, Shanliang Zhu, Zongdi Sun

Abstract:

In this paper, we analyzed the correlation relationship among PM2.5 from other five Air Quality Indices (AQIs) based on the grey relational degree, and built a multivariate nonlinear regression equation model of PM2.5 and the five monitoring indexes. For the optimal control problem of PM2.5, we took the partial large Cauchy distribution of membership equation as satisfaction function. We established a nonlinear programming model with the goal of maximum performance to price ratio. And the optimal control scheme is given.

Keywords: Grey relational degree, multiple linear regression, membership function, nonlinear programming.

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Authors: Adel Hamad Rafa

Abstract:

This paper, proposes a control system for use with microgrid consiste of  multiple small scale embedded generation networks (SSEG networks) connected to the 33kV distribution network. The proposed controller controls power flow in the grid-connected mode of operation, enables voltage and frequency control when the SSEG networks are islanded, and resynchronises the SSEG networks with the utility before reconnecting them. The performance of the proposed controller has been tested in simulations using PSCAD.

Keywords: Microgrid, Small scale embedded generation, island mode, resynchronisation.

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Authors: Chandrashekhar Bhat, Dilifa J. Noronha, Faber A. Saldanha

Abstract:

Transportation of long turbine blades from one place to another is a difficult process. Hence a feasibility study of modularization of wind turbine blade was taken from structural standpoint through finite element analysis. Initially, a non-segmented blade is modeled and its structural behavior is evaluated to serve as reference. The resonant, static bending and fatigue tests are simulated in accordance with IEC61400-23 standard for comparison purpose. The non-segmented test blade is separated at suitable location based on trade off studies and the segments are joined with an innovative double strap bonded joint configuration. The adhesive joint is modeled by adopting cohesive zone modeling approach in ANSYS. The developed blade model is analyzed for its structural response through simulation. Performances of both the blades are found to be similar, which indicates that, efficient segmentation of the long blade is possible which facilitates easy transportation of the blades and on site reassembling. The location selected for segmentation and adopted joint configuration has resulted in an efficient segmented blade model which proves the methodology adopted for segmentation was quite effective. The developed segmented blade appears to be the viable alternative considering its structural response specifically in fatigue within considered assumptions.

Keywords: Cohesive zone modeling, fatigue, segmentation, wind turbine blade.

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Authors: Hsin-Yun Lee

Abstract:

The previous proposed evacuation routing approaches usually divide the space into multiple interlinked zones. However, it may be harder to clearly and objectively define the margins of each zone. This paper proposes an approach that connects locations of necessary guidance into a spatial network. In doing so, evacuation routes can be constructed based on the links between starting points, turning nodes, and terminal points. This approach more conforms to the real-life evacuation behavior. The feasibility of the proposed approach is evaluated through a case of one floor in a hospital building. Results indicate that the proposed approach provides valuable suggestions for evacuation planning.

Keywords: Evacuation, spatial network, simulation.

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Authors: Teerada Apibunyopas, Nithinant Thammakoranonta

Abstract:

Many organizations bring e-Learning to use as a tool in their training and human development department. It is getting more popular because it is easy to access to get knowledge all the time and also it provides a rich content, which can develop the employees’ skill efficiently. This study is focused on the factors that affect using e-Learning efficiently, so it will make job satisfaction increasing. The questionnaires were sent to employees in large commercial banks, which use e-Learning located in Bangkok, the results from multiple linear regression analysis showed that employee’s characteristics, characteristics of e-Learning, learning and growth have influence on job satisfaction.

Keywords: e-Learning, Job Satisfaction, Learning and growth.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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Authors: M. Izzat Md. Nor, N. Jaffar, N. Zaitulakma Md. Zain, N. Izyanti Mohd Suppian, S. Balakrishnan, G. Kandavello

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During the Coronavirus (COVID-19) pandemic, Malaysia has been focusing on building herd immunity by introducing vaccination programs into the community. Hospital Standard Operating Procedures (SOP) were developed to prevent inpatient transmission. In this study, we focus on the positivity rate of inpatient Person Under Surveillance (PUS) becoming COVID-19 positive and compare this to the national rate in order to see the outcomes of the patient who becomes COVID-19 positive in relation to their vaccination status. This is a retrospective observational study carried out from 1 January until 30 March 2022 in Institut Jantung Negara (IJN). There were 5,255 patients admitted during the time of this study. Pre-admission Polymerase Chain Reaction (PCR) swab was done for all patients. Patients with positive PCR on pre-admission screening were excluded. The patients who had exposure to COVID-19-positive staff or patients during hospitalization were defined as PUS and were quarantined and monitored for potential COVID-19 infection. Their frequency and risk of exposure (WHO definition) were recorded. On the final day of quarantine, a second PCR swab was performed on PUS patients who exhibit clinical deterioration, whether or not they exhibit COVID-19 symptoms. The severity of COVID-19 infection was defined as category 1-5A. All patients' vaccination status was recorded, and they were divided into three groups: fully immunised, partially immunised, and unvaccinated. We analysed the positivity rate of PUS patients becoming COVID-positive, outcomes, and correlation with the vaccination status. The ratio of positive inpatient PUS to the total inpatient PUS is 492; only 13 became positive, giving a positivity rate of 2.6%. Eight (62%) had multiple exposures. The majority, 8/13(72.7%), had a high-risk exposure, and the remaining 5 had medium-risk exposure. Four (30.8%) were boosted, 7(53.8%) were fully vaccinated, and 2(15.4%) were partial/unvaccinated. Eight patients were in categories 1-2, whilst 38% were in categories 3-5. Vaccination status did not correlate with COVID-19 Category (P = 0.641). One (7.7%) patient died due to COVID-19 complications and sepsis. Within the first quarter of 2022, our institution's positivity rate (2.6%) is significantly lower than the country's (14.4%). High-risk exposure and multiple exposures to positive COVID-19 cases increased the risk of PUS becoming COVID-19 positive despite their underlying vaccination status.

Keywords: COVID-19, boosted, high risk, Malaysia, quarantine, vaccination status.

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