Search results for: economy effectiveness
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1899

Search results for: economy effectiveness

129 Development of a System for Measuring the Three-Axis Pedal Force in Cycling and Its Applications

Authors: Joo-Hack Lee, Jin-Seung Choi, Dong-Won Kang, Jeong-Woo Seo, Ju-Young Kim, Dae-Hyeok Kim, Seung-Tae Yang, Gye-Rae Tack

Abstract:

For cycling, the analysis of the pedal force is one of the important factors in the study of exercise ability assessment and overuse injuries. In past studies, a two-axis measurement sensor was used at the sagittal plane to measure the force only in the anterior, posterior, and vertical directions and to analyze the loss of force and the injury on the frontal plane due to the forces in the right and left directions. In this study, which is a basic study on diverse analyses of the pedal force that consider the forces on the sagittal plane and the frontal plane, a three-axis pedal force measurement sensor was developed to measure the anterior-posterior (Fx), medio-lateral (Fz), and vertical (Fy) forces. The sensor was fabricated with a size and shape similar to those of the general flat pedal, and had a 550g weight that allowed smooth pedaling. Its measurement range was ±1000 N for Fx and Fz and ±2000 N for Fy, and its non-linearity, hysteresis, and repeatability were approximately 0.5%. The data were sampled at 1000 Hz using a signal collector. To use the developed sensor, the pedaling efficiency (index of efficiency, IE) and the range of left and right (medio-lateral, ML) forces were measured with two seat heights (low and high). The results of the measurement showed that the IE was higher and the force range in the ML direction was lower with the high position than with the low position. The developed measurement sensor and its application results will be useful in understanding and explaining the complicated pedaling technique, and will enable diverse kinematic analyses of the pedal force on the sagittal plane and the frontal plane.

Keywords: Cycling, Index of effectiveness, Pedal force.

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128 Addressing Global Trauma: Somatic Interventions in PTSD Treatment and Clinician Burnout Prevention

Authors: Nina Kaufmans

Abstract:

Traditional treatments for post-traumatic stress disorder (PTSD) that rely primarily on oral narratives are partially insufficient to prevent PTSD symptoms from recurrence. As a result of the global COVID-19 pandemic, war conflicts, and economic crises, a rising proportion of users of mental health services express somatically based distress in addition to their existing mental health symptoms. Furthermore, the rapid increase in demand for mental health services has resulted in substantial burnout among mental health professionals, which may further impact the quality of services provided and the sustainability of professional life-work balance. This article examines the implications of current developments and challenges in mental health services demand and subsequent responses, as well as the effects of those responses on mental health professionals. The article examines the neurobiological mechanisms underlying traumatic experiences, then discusses the premises for "bottom-up," or somatically oriented, psychotherapy approaches, and concludes with suggestions for clinical skills and interventions to be used by practitioners who work with clients diagnosed with PTSD. In addition, we examine how somatically based psychotherapy interventions performed in sessions might reduce clinician burnout and improve their well-being. We examine how incorporating somatically based therapies into counseling will boost the efficacy of mental health recovery and maintain remission while providing mental health practitioners with chances for self-care.

Keywords: Somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment.

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127 Uncertainty Multiple Criteria Decision Making Analysis for Stealth Combat Aircraft Selection

Authors: C. Ardil

Abstract:

Fuzzy set theory and its extensions (intuitionistic fuzzy sets, picture fuzzy sets, and neutrosophic sets) have been widely used to address imprecision and uncertainty in complex decision-making. However, they may struggle with inherent indeterminacy and inconsistency in real-world situations. This study introduces uncertainty sets as a promising alternative, offering a structured framework for incorporating both types of uncertainty into decision-making processes.This work explores the theoretical foundations and applications of uncertainty sets. A novel decision-making algorithm based on uncertainty set-based proximity measures is developed and demonstrated through a practical application: selecting the most suitable stealth combat aircraft.

The results highlight the effectiveness of uncertainty sets in ranking alternatives under uncertainty. Uncertainty sets offer several advantages, including structured uncertainty representation, robust ranking mechanisms, and enhanced decision-making capabilities due to their ability to account for ambiguity.Future research directions are also outlined, including comparative analysis with existing MCDM methods under uncertainty, sensitivity analysis to assess the robustness of rankings,and broader application to various MCDM problems with diverse complexities. By exploring these avenues, uncertainty sets can be further established as a valuable tool for navigating uncertainty in complex decision-making scenarios.

Keywords: Uncertainty set, stealth combat aircraft selection multiple criteria decision-making analysis, MCDM, uncertainty proximity analysis

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126 Structure-Activity Relationship of Gold Catalysts on Alumina Supported Cu-Ce Oxides for CO and Volatile Organic Compound Oxidation

Authors: Tatyana T. Tabakova, Elitsa N. Kolentsova, Dimitar Y. Dimitrov, Krasimir I. Ivanov, Yordanka G. Karakirova, Petya Cv. Petrova, Georgi V. Avdeev

Abstract:

The catalytic oxidation of CO and volatile organic compounds (VOCs) is considered as one of the most efficient ways to reduce harmful emissions from various chemical industries. The effectiveness of gold-based catalysts for many reactions of environmental significance was proven during the past three decades. The aim of this work was to combine the favorable features of Au and Cu-Ce mixed oxides in the design of new catalytic materials of improved efficiency and economic viability for removal of air pollutants in waste gases from formaldehyde production. Supported oxides of copper and cerium with Cu: Ce molar ratio 2:1 and 1:5 were prepared by wet impregnation of g-alumina. Gold (2 wt.%) catalysts were synthesized by a deposition-precipitation method. Catalysts characterization was carried out by texture measurements, powder X-ray diffraction, temperature programmed reduction and electron paramagnetic resonance spectroscopy. The catalytic activity in the oxidation of CO, CH3OH and (CH3)2O was measured using continuous flow equipment with fixed bed reactor. Both Cu-Ce/alumina samples demonstrated similar catalytic behavior. The addition of gold caused significant enhancement of CO and methanol oxidation activity (100 % degree of CO and CH3OH conversion at about 60 and 140 oC, respectively). The composition of Cu-Ce mixed oxides affected the performance of gold-based samples considerably. Gold catalyst on Cu-Ce/γ-Al2O3 1:5 exhibited higher activity for CO and CH3OH oxidation in comparison with Au on Cu-Ce/γ-Al2O3 2:1. The better performance of Au/Cu-Ce 1:5 was related to the availability of highly dispersed gold particles and copper oxide clusters in close contact with ceria.

Keywords: CO and VOCs oxidation, copper oxide, ceria, gold catalysts.

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125 Entrepreneurial Intention and Social Entrepreneurship among Students in Malaysian Higher Education

Authors: Radin Siti Aishah Radin A Rahman, Norasmah Othman, Zaidatol Akmaliah Lope Pihie, Hariyaty Ab. Wahid

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The recent instability in economy was found to be influencing the situation in Malaysia whether directly or indirectly. Taking that into consideration, the government needs to find the best approach to balance its citizen’s socio-economic strata level urgently. Through education platform is among the efforts planned and acted upon for the purpose of balancing the effects of the influence, through the exposure of social entrepreneurial activity towards youth especially those in higher institution level. Armed with knowledge and skills that they gained, with the support by entrepreneurial culture and environment while in campus; indirectly, the students will lean more on making social entrepreneurship as a career option when they graduate. Following the issues of marketability and workability of current graduates that are becoming dire, research involving how far the willingness of student to create social innovation that contribute to the society without focusing solely on personal gain is relevant enough to be conducted. With that, this research is conducted with the purpose of identifying the level of entrepreneurial intention and social entrepreneurship among higher institution students in Malaysia. Stratified random sampling involves 355 undergraduate students from five public universities had been made as research respondents and data were collected through surveys. The data was then analyzed descriptively using min score and standard deviation. The study found that the entrepreneurial intention of higher education students are on moderate level, however it is the contrary for social entrepreneurship activities, where it was shown on a high level. This means that while the students only have moderate level of willingness to be a social entrepreneur, they are very committed to created social innovation through the social entrepreneurship activities conducted. The implication from this study can be contributed towards the higher institution authorities in prediction the tendency of student in becoming social entrepreneurs. Thus, the opportunities and facilities for realizing the courses related to social entrepreneurship must be created expansively so that the vision of creating as many social entrepreneurs as possible can be achieved.

Keywords: Entrepreneurial intention, higher education institutions (HEIs), social entrepreneurship, social entrepreneurial activity, gender.

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124 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh

Authors: Mannan Mridha, Mohammad S. Islam

Abstract:

Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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123 Effectiveness of a Malaysian Workplace Intervention Study on Physical Activity Levels

Authors: M. Z. Bin Mohd Ghazali, N. C. Wilson, A. F. Bin Ahmad Fuad, M. A. H. B. Musa, M. U. Mohamad Sani, F. Zulkifli, M. S. Zainal Abidin

Abstract:

Physical activity levels are low in Malaysia and this study was undertaken to determine if a four week work-based intervention program would be effective in changing physical activity levels. The study was conducted in a Malaysian Government Department and had three stages: baseline data collection, four-week intervention and two-month post intervention data collection. During the intervention and two-month post intervention phases, physical activity levels (determined by a pedometer) and basic health profiles (BMI, abdominal obesity, blood pressure) were measured. Staff (58 males, 47 females) with an average age of 33 years completed baseline data collection. Pedometer steps averaged 7,102 steps/day at baseline, although male step counts were significantly higher than females (7,861 vs. 6114). Health profiles were poor: over 50% were overweight/obese (males 66%, females 40%); hypertension (males 23%, females 6%); excess waist circumference (males 52%, females 17%). While 86 staff participated in the intervention, only 49 regularly reported their steps. There was a significant increase (17%) in average daily steps from 8,965 (week 1) to 10,436 (week 4). Unfortunately, participation in the intervention program was avoided by the less healthy staff. Two months after the intervention there was no significant difference in average steps/day, despite the fact that 89% of staff reporting they planned to make long-term changes to their lifestyle. An unexpected average increase of 2kg in body weight occurred in participants, although this was less than the 5.6kg in non-participants. A number of recommendations are made for future interventions, including the conclusion that pedometers were a useful tool and popular with participants.

Keywords: Pedometers, walking, health, intervention.

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122 Fire Resilient Cities: The Impact of Fire Regulations, Technological and Community Resilience

Authors: Fanny Guay

Abstract:

Building resilience, sustainable buildings, urbanization, climate change, resilient cities, are just a few examples of where the focus of research has been in the last few years. It is obvious that there is a need to rethink how we are building our cities and how we are renovating our existing buildings. However, the question remaining is how can we assure that we are building sustainable yet resilient cities? There are many aspects one can touch upon when discussing resilience in cities, but after the event of Grenfell in June 2017, it has become clear that fire resilience must be a priority. We define resilience as a holistic approach including communities, society and systems, focusing not only on resisting the effects of a disaster, but also how it will cope and recover from it. Cities are an example of such a system, where components such as buildings have an important role to play. A building on fire will have an impact on the community, the economy, the environment, and so the entire system. Therefore, we believe that fire and resilience go hand in hand when we discuss building resilient cities. This article aims at discussing the current state of the concept of fire resilience and suggests actions to support the built of more fire resilient buildings. Using the case of Grenfell and the fire safety regulations in the UK, we will briefly compare the fire regulations in other European countries, more precisely France, Germany and Denmark, to underline the difference and make some suggestions to increase fire resilience via regulation. For this research, we will also include other types of resilience such as technological resilience, discussing the structure of buildings itself, as well as community resilience, considering the role of communities in building resilience. Our findings demonstrate that to increase fire resilience, amending existing regulations might be necessary, for example, how we performed reaction to fire tests and how we classify building products. However, as we are looking at national regulations, we are only able to make general suggestions for improvement. Another finding of this research is that the capacity of the community to recover and adapt after a fire is also an essential factor. Fundamentally, fire resilience, technological resilience and community resilience are closely connected. Building resilient cities is not only about sustainable buildings or energy efficiency; it is about assuring that all the aspects of resilience are included when building or renovating buildings. We must ask ourselves questions as: Who are the users of this building? Where is the building located? What are the components of the building, how was it designed and which construction products have been used? If we want to have resilient cities, we must answer these basic questions and assure that basic factors such as fire resilience are included in our assessment.

Keywords: Buildings, cities, fire, resilience.

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121 Modeling and Simulation of Honeycomb Steel Sandwich Panels under Blast Loading

Authors: Sayed M. Soleimani, Nader H. Ghareeb, Nourhan H. Shaker, Muhammad B. Siddiqui

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Honeycomb sandwich panels have been widely used as protective structural elements against blast loading. The main advantages of these panels include their light weight due to the presence of voids, as well as their energy absorption capability. Terrorist activities have imposed new challenges to structural engineers to design protective measures for vital structures. Since blast loading is not usually considered in the load combinations during the design process of a structure, researchers around the world have been motivated to study the behavior of potential elements capable of resisting sudden loads imposed by the detonation of explosive materials. One of the best candidates for this objective is the honeycomb sandwich panel. Studying the effects of explosive materials on the panels requires costly and time-consuming experiments. Moreover, these type of experiments need permission from defense organizations which can become a hurdle. As a result, modeling and simulation using an appropriate tool can be considered as a good alternative. In this research work, the finite element package ABAQUS® is used to study the behavior of hexagonal and squared honeycomb steel sandwich panels under the explosive effects of different amounts of trinitrotoluene (TNT). The results of finite element modeling of a specific honeycomb configuration are initially validated by comparing them with the experimental results from literature. Afterwards, several configurations including different geometrical properties of the honeycomb wall are investigated and the results are compared with the original model. Finally, the effectiveness of the core shape and wall thickness are discussed, and conclusions are made.

Keywords: Blast loading, finite element modeling, steel honeycomb sandwich panel.

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120 An Intelligent Cascaded Fuzzy Logic Based Controller for Controlling the Room Temperature in Hydronic Heating System

Authors: Vikram Jeganathan, A. V. Sai Balasubramanian, N. Ravi Shankar, S. Subbaraman, R. Rengaraj

Abstract:

Heating systems are a necessity for regions which brace extreme cold weather throughout the year. To maintain a comfortable temperature inside a given place, heating systems making use of- Hydronic boilers- are used. The principle of a single pipe system serves as a base for their working. It is mandatory for these heating systems to control the room temperature, thus maintaining a warm environment. In this paper, the concept of regulation of the room temperature over a wide range is established by using an Adaptive Fuzzy Controller (AFC). This fuzzy controller automatically detects the changes in the outside temperatures and correspondingly maintains the inside temperature to a palatial value. Two separate AFC's are put to use to carry out this function: one to determine the quantity of heat needed to reach the prospective temperature required and to set the desired temperature; the other to control the position of the valve, which is directly proportional to the error between the present room temperature and the user desired temperature. The fuzzy logic controls the position of the valve as per the requirement of the heat. The amount by which the valve opens or closes is controlled by 5 knob positions, which vary from minimum to maximum, thereby regulating the amount of heat flowing through the valve. For the given test system data, different de-fuzzifier methods have been implemented and the results are compared. In order to validate the effectiveness of the proposed approach, a fuzzy controller has been designed by obtaining a test data from a real time system. The simulations are performed in MATLAB and are verified with standard system data. The proposed approach can be implemented for real time applications.

Keywords: Adaptive fuzzy controller, Hydronic heating system

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119 Long Term Examination of the Profitability Estimation Focused on Benefits

Authors: Stephan Printz, Kristina Lahl, René Vossen, Sabina Jeschke

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Strategic investment decisions are characterized by high innovation potential and long-term effects on the competitiveness of enterprises. Due to the uncertainty and risks involved in this complex decision making process, the need arises for well-structured support activities. A method that considers cost and the long-term added value is the cost-benefit effectiveness estimation. One of those methods is the “profitability estimation focused on benefits – PEFB”-method developed at the Institute of Management Cybernetics at RWTH Aachen University. The method copes with the challenges associated with strategic investment decisions by integrating long-term non-monetary aspects whilst also mapping the chronological sequence of an investment within the organization’s target system. Thus, this method is characterized as a holistic approach for the evaluation of costs and benefits of an investment. This participation-oriented method was applied to business environments in many workshops. The results of the workshops are a library of more than 96 cost aspects, as well as 122 benefit aspects. These aspects are preprocessed and comparatively analyzed with regards to their alignment to a series of risk levels. For the first time, an accumulation and a distribution of cost and benefit aspects regarding their impact and probability of occurrence are given. The results give evidence that the PEFB-method combines precise measures of financial accounting with the incorporation of benefits. Finally, the results constitute the basics for using information technology and data science for decision support when applying within the PEFB-method.

Keywords: Cost-benefit analysis, multi-criteria decision, profitability estimation focused on benefits, risk and uncertainty analysis.

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118 Evaluation and Analysis of Lean-Based Manufacturing Equipment and Technology System for Jordanian Industries

Authors: Mohammad D. AL-Tahat, Shahnaz M. Alkhalil

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International markets driven forces are changing continuously, therefore companies need to gain a competitive edge in such markets. Improving the company's products, processes and practices is no longer auxiliary. Lean production is a production management philosophy that consolidates work tasks with minimum waste resulting in improved productivity. Lean production practices can be mapped into many production areas. One of these is Manufacturing Equipment and Technology (MET). Many lean production practices can be implemented in MET, namely, specific equipment configurations, total preventive maintenance, visual control, new equipment/ technologies, production process reengineering and shared vision of perfection.The purpose of this paper is to investigate the implementation level of these six practices in Jordanian industries. To achieve that a questionnaire survey has been designed according to five-point Likert scale. The questionnaire is validated through pilot study and through experts review. A sample of 350 Jordanian companies were surveyed, the response rate was 83%. The respondents were asked to rate the extent of implementation for each of practices. A relationship conceptual model is developed, hypotheses are proposed, and consequently the essential statistical analyses are then performed. An assessment tool that enables management to monitor the progress and the effectiveness of lean practices implementation is designed and presented. Consequently, the results show that the average implementation level of lean practices in MET is 77%, Jordanian companies are implementing successfully the considered lean production practices, and the presented model has Cronbach-s alpha value of 0.87 which is good evidence on model consistency and results validation.

Keywords: Lean Production, SME applications, Visual Control, New equipment/technologies, Specific equipment configurations, Jordan

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117 Development of a Catchment Water Quality Model for Continuous Simulations of Pollutants Build-up and Wash-off

Authors: Iqbal Hossain, Dr. Monzur Imteaz, Dr. Shirley Gato-Trinidad, Prof. Abdallah Shanableh

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Estimation of runoff water quality parameters is required to determine appropriate water quality management options. Various models are used to estimate runoff water quality parameters. However, most models provide event-based estimates of water quality parameters for specific sites. The work presented in this paper describes the development of a model that continuously simulates the accumulation and wash-off of water quality pollutants in a catchment. The model allows estimation of pollutants build-up during dry periods and pollutants wash-off during storm events. The model was developed by integrating two individual models; rainfall-runoff model, and catchment water quality model. The rainfall-runoff model is based on the time-area runoff estimation method. The model allows users to estimate the time of concentration using a range of established methods. The model also allows estimation of the continuing runoff losses using any of the available estimation methods (i.e., constant, linearly varying or exponentially varying). Pollutants build-up in a catchment was represented by one of three pre-defined functions; power, exponential, or saturation. Similarly, pollutants wash-off was represented by one of three different functions; power, rating-curve, or exponential. The developed runoff water quality model was set-up to simulate the build-up and wash-off of total suspended solids (TSS), total phosphorus (TP) and total nitrogen (TN). The application of the model was demonstrated using available runoff and TSS field data from road and roof surfaces in the Gold Coast, Australia. The model provided excellent representation of the field data demonstrating the simplicity yet effectiveness of the proposed model.

Keywords: Catchment, continuous pollutants build-up, pollutants wash-off, runoff, runoff water quality model.

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116 The Challenges of Cloud Computing Adoption in Nigeria

Authors: Chapman Eze Nnadozie

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Cloud computing, a technology that is made possible through virtualization within networks represents a shift from the traditional ownership of infrastructure and other resources by distinct organization to a more scalable pattern in which computer resources are rented online to organizations on either as a pay-as-you-use basis or by subscription. In other words, cloud computing entails the renting of computing resources (such as storage space, memory, servers, applications, networks, etc.) by a third party to its clients on a pay-as-go basis. It is a new innovative technology that is globally embraced because of its renowned benefits, profound of which is its cost effectiveness on the part of organizations engaged with its services. In Nigeria, the services are provided either directly to companies mostly by the key IT players such as Microsoft, IBM, and Google; or in partnership with some other players such as Infoware, Descasio, and Sunnet. This action enables organizations to rent IT resources on a pay-as-you-go basis thereby salvaging them from wastages accruable on acquisition and maintenance of IT resources such as ownership of a separate data centre. This paper intends to appraise the challenges of cloud computing adoption in Nigeria, bearing in mind the country’s peculiarities’ in terms of infrastructural development. The methodologies used in this paper include the use of research questionnaires, formulated hypothesis, and the testing of the formulated hypothesis. The major findings of this paper include the fact that there are some addressable challenges to the adoption of cloud computing in Nigeria. Furthermore, the country will gain significantly if the challenges especially in the area of infrastructural development are well addressed. This is because the research established the fact that there are significant gains derivable by the adoption of cloud computing by organizations in Nigeria. However, these challenges can be overturned by concerted efforts in the part of government and other stakeholders.

Keywords: Cloud computing, data centre, infrastructure, IT resources, network, servers, virtualization.

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115 A Comparative Understanding of Critical Problems Faced by Pakistani and Indian Transportation Industry

Authors: Saleh Abduallah Saleh, Mohammad Basir Bin Saud, Mohd Azwardi Md Isa

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It is very important for a developing nation to developing their infrastructure on the prime priority because their infrastructure particularly their roads and transportation functions as a blood in the system. Almost 1.1 billion populations share the travel and transportation industry in India. On the other hand, the Pakistan transportation industry is also extensive and elevating about 170 million users of transportation. Indian and Pakistani specifically within bus industry are well connected within and between the urban and rural areas. The transportation industry is radically helping the economic alleviation of both countries. Due to high economic instability, unemployment and poverty rate both countries governments are very serious and committed to help for boosting their economy. They believe that any form of transportation development would play a vital role in the development of land, infrastructure which could indirectly support many other industries’ developments, such as tourism, freighting and shipping businesses, just to mention a few. However, it seems that their previous transportation planning in the due course has failed to meet the fast growing demand. As with the span of time, both the countries are looking forward to a long-term, and economical solutions, because the demand is from time to time keep appreciating and reacting according to other key economic drivers. Content analysis method and case study approach is used in this paper and secondary data from the bureau of statistic is used for case analysis. The paper focused on the mobility concerns of the lower and middle-income people in India and Pakistan. The paper is aimed to highlight the weaknesses, opportunities and limitations resulting from low priority industry for a government, which is making the either country's public suffer. The paper has concluded that the main issue is identified as the slow, inappropriate, and unfavorable decisions which are not in favor of long-term country’s economic development and public interest. The paper also recommends to future research avenues for public and private transportation, which is continuously failing to meet the public expectations.

Keywords: Bus transportation industries, transportation demand, government parallel initiatives, road and traffic congestions.

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114 A National Survey of Clinical Psychology Graduate Student Attitudes toward Psychotherapy Treatment Manuals: A Replication Study

Authors: B. Bergström, A. Ladd, A. Jones, L. Rosso, P. Michael

Abstract:

Attitudes toward treatment manuals serve as a meaningful predictor of general attitudes toward evidence-based practice. Despite demonstrating high effectiveness in treating many mental disorders, manualized treatments have been underutilized by practitioners. Thus, one can assess the state of the field regarding the adoption of evidence-based practices by surveying practitioner attitudes towards manualized treatments. This study is an adapted replication that assesses psychology graduate student attitudes towards manualized treatments, as a general marker for attitudes towards evidence-based practice. Training programs provide future clinicians with the foundation for critical skills in clinical practice. Research demonstrates that post-graduate continuing education has little to no effect on clinical practice; thus, graduate programs serve as the primary, and often final platform for all future practice. However, there are little empirical data identifying the attitudes and training of graduate students in utilizing manualized treatments. The empirical analysis of this study indicates an increase in positive attitudes among graduate student attitudes towards manualized treatments (within the United States), when compared to past surveys of professional psychologists. Findings from this study may inform graduate programs of barriers for students in developing positive attitudes toward manualized treatments and evidence-based practice. This study also serves as a preliminary predictor of the state-of-the field, in regards to professional psychologists attitudes towards evidence-based practice, if attitudes remain stable. This study indicates that the attitudes toward utilizing evidence-based practices, such as treatment manuals, has become more positive since year 2000.

Keywords: Evidence based treatment, Future of clinical science, Manualized treatment, Student attitudes towards evidence based treatments.

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113 Matrix-Based Linear Analysis of Switched Reluctance Generator with Optimum Pole Angles Determination

Authors: Walid A. M. Ghoneim, Hamdy A. Ashour, Asmaa E. Abdo

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In this paper, linear analysis of a Switched Reluctance Generator (SRG) model is applied on the most common configurations (4/2, 6/4 and 8/6) for both conventional short-pitched and fully-pitched designs, in order to determine the optimum stator/rotor pole angles at which the maximum output voltage is generated per unit excitation current. This study is focused on SRG analysis and design as a proposed solution for renewable energy applications, such as wind energy conversion systems. The world’s potential to develop the renewable energy technologies through dedicated scientific researches was the motive behind this study due to its positive impact on economy and environment. In addition, the problem of rare earth metals (Permanent magnet) caused by mining limitations, banned export by top producers and environment restrictions leads to the unavailability of materials used for rotating machines manufacturing. This challenge gave authors the opportunity to study, analyze and determine the optimum design of the SRG that has the benefit to be free from permanent magnets, rotor windings, with flexible control system and compatible with any application that requires variable-speed operation. In addition, SRG has been proved to be very efficient and reliable in both low-speed or high-speed applications. Linear analysis was performed using MATLAB simulations based on the (Modified generalized matrix approach) of Switched Reluctance Machine (SRM). About 90 different pole angles combinations and excitation patterns were simulated through this study, and the optimum output results for each case were recorded and presented in detail. This procedure has been proved to be applicable for any SRG configuration, dimension and excitation pattern. The delivered results of this study provide evidence for using the 4-phase 8/6 fully pitched SRG as the main optimum configuration for the same machine dimensions at the same angular speed.

Keywords: Generalized matrix approach, linear analysis, renewable applications, switched reluctance generator, SRG.

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112 The Applications of Toyota Production System to Reduce Wastes in Agricultural Products Packing Process: A Study of Onion Packing Plant

Authors: Paisarn Larpsomboonchai

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Agro-industry is one of major industries that have strong impacts on national economic incomes, growth, stability, and sustainable development. Moreover, this industry also has strong influences on social, cultural and political issues. Furthermore, this industry, as producing primary and secondary products, is facing challenges from such diverse factors such as demand inconsistency, intense international competition, technological advancements and new competitors. In order to maintain and to improve industry’s competitiveness in both domestics and international markets, science and technology are key factors. Besides hard sciences and technologies, modern industrial engineering concepts such as Just in Time (JIT) Total Quality Management (TQM), Quick Response (QR), Supply Chain Management (SCM) and Lean can be very effective to support to increase efficiency and effectiveness of these agricultural products on world stage. Onion is one of Thailand’s major export products which bring back national incomes. But, it is also facing challenges in many ways. This paper focused its interests in onion packing process and its related activities such as storage and shipment from one of major packing plant and storage in Mae Wang District, Chiang Mai, Thailand, by applying Toyota Production System (TPS) or Lean concepts, to improve process capability throughout the entire packing and distribution process which will be profitable for the whole onion supply chain. And it will be beneficial to other related agricultural products in Thailand and other ASEAN countries.

Keywords: Lean Concepts, Lean in Agro-industries Activities, Packing Process, Toyota Production System (TPS), Waste Reduction.

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111 Snails and Fish as Pollution Biomarkers in Lake Manzala and Laboratory B: Lake Manzala Fish

Authors: Hanaa M. M. El-Khayat, Hanan S. Gaber, Hoda Abdel-Hamid, Kadria M. A. Mahmoud, Hoda M. A. Abu Taleb

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This work aimed to examine Oreochromis niloticus fish from Lake Manzala in Port Said, Dakahlya and Damietta governorates, Egypt, as a bio-indicator for the lake water pollution through recording alterations in their hematological, physiological, and histopathological parameters. All fish samples showed a significant increase in levels of alkaline phosphatase (ALP), creatinine and glutathione-S-transferase (GST); only Dakahlya samples showed a significant increase (p<0.01) in aspartate aminotransferase (AST) level and most Dakahlya and Damietta samples showed reversed albumin and globulin ratio and a significant increase in γ-glutamyltransferase (GGT) level. Port-Said and Damietta samples showed a significant decrease of hemoglobin (Hb) while Dakahlya samples showed a significant decrease in white blood cell (WBC) count. Histopathological investigation for different fish organs showed that Port-Said and Dakahlya samples were more altered than Damietta. The muscle and gill followed by intestine were the most affected organs. The muscle sections showed severe edema, neoplasia, necrotic change, fat vacuoles and splitting of muscle fiber. The gill sections showed dilated blood vessels of the filaments, curling of gill lamellae, severe hyperplasia, edema and blood vessels congestion of filaments. The intestine sections revealed degeneration, atrophy, dilation in blood vessels and necrotic changes in sub-mucosa and mucosa with edema in between. The recorded significant alterations, in most of the physiological and histological parameters in O. niloticus samples from Lake Manzala, were alarming for water pollution impacts on lake fish community, which constitutes the main diet and the main source of income for the people inhabiting these areas, and were threatening their public health and economy. Also, results evaluate the use of O. niloticus fish as important bio-indicator for their habitat stressors.

Keywords: Lake Manzala, Oreochromis niloticus fish, water pollution, physiological, hematological and histopathological parameters.

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110 Analysis of Linked in Series Servers with Blocking, Priority Feedback Service and Threshold Policy

Authors: Walenty Oniszczuk

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The use of buffer thresholds, blocking and adequate service strategies are well-known techniques for computer networks traffic congestion control. This motivates the study of series queues with blocking, feedback (service under Head of Line (HoL) priority discipline) and finite capacity buffers with thresholds. In this paper, the external traffic is modelled using the Poisson process and the service times have been modelled using the exponential distribution. We consider a three-station network with two finite buffers, for which a set of thresholds (tm1 and tm2) is defined. This computer network behaves as follows. A task, which finishes its service at station B, gets sent back to station A for re-processing with probability o. When the number of tasks in the second buffer exceeds a threshold tm2 and the number of task in the first buffer is less than tm1, the fed back task is served under HoL priority discipline. In opposite case, for fed backed tasks, “no two priority services in succession" procedure (preventing a possible overflow in the first buffer) is applied. Using an open Markovian queuing schema with blocking, priority feedback service and thresholds, a closed form cost-effective analytical solution is obtained. The model of servers linked in series is very accurate. It is derived directly from a twodimensional state graph and a set of steady-state equations, followed by calculations of main measures of effectiveness. Consequently, efficient expressions of the low computational cost are determined. Based on numerical experiments and collected results we conclude that the proposed model with blocking, feedback and thresholds can provide accurate performance estimates of linked in series networks.

Keywords: Blocking, Congestion control, Feedback, Markov chains, Performance evaluation, Threshold-base networks.

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109 Evaluation of Linear and Geometrically Nonlinear Static and Dynamic Analysis of Thin Shells by Flat Shell Finite Elements

Authors: Djamel Boutagouga, Kamel Djeghaba

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The choice of finite element to use in order to predict nonlinear static or dynamic response of complex structures becomes an important factor. Then, the main goal of this research work is to focus a study on the effect of the in-plane rotational degrees of freedom in linear and geometrically non linear static and dynamic analysis of thin shell structures by flat shell finite elements. In this purpose: First, simple triangular and quadrilateral flat shell finite elements are implemented in an incremental formulation based on the updated lagrangian corotational description for geometrically nonlinear analysis. The triangular element is a combination of DKT and CST elements, while the quadrilateral is a combination of DKQ and the bilinear quadrilateral membrane element. In both elements, the sixth degree of freedom is handled via introducing fictitious stiffness. Secondly, in the same code, the sixth degrees of freedom in these elements is handled differently where the in-plane rotational d.o.f is considered as an effective d.o.f in the in-plane filed interpolation. Our goal is to compare resulting shell elements. Third, the analysis is enlarged to dynamic linear analysis by direct integration using Newmark-s implicit method. Finally, the linear dynamic analysis is extended to geometrically nonlinear dynamic analysis where Newmark-s method is used to integrate equations of motion and the Newton-Raphson method is employed for iterating within each time step increment until equilibrium is achieved. The obtained results demonstrate the effectiveness and robustness of the interpolation of the in-plane rotational d.o.f. and present deficiencies of using fictitious stiffness in dynamic linear and nonlinear analysis.

Keywords: Flat shell, dynamic analysis, nonlinear, Newmark, drilling rotation.

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108 Forecasting Foreign Direct Investment with Modified Diffusion Model

Authors: Bi-Huei Tsai

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Prior research has not effectively investigated how the profitability of Chinese branches affect FDIs in China [1, 2], so this study for the first time incorporates realistic earnings information to systematically investigate effects of innovation, imitation, and profit factors of FDI diffusions from Taiwan to China. Our nonlinear least square (NLS) model, which incorporates earnings factors, forms a nonlinear ordinary differential equation (ODE) in numerical simulation programs. The model parameters are obtained through a genetic algorithms (GA) technique and then optimized with the collected data for the best accuracy. Particularly, Taiwanese regulatory FDI restrictions are also considered in our modified model to meet the realistic conditions. To validate the model-s effectiveness, this investigation compares the prediction accuracy of modified model with the conventional diffusion model, which does not take account of the profitability factors. The results clearly demonstrate the internal influence to be positive, as early FDI adopters- consistent praises of FDI attract potential firms to make the same move. The former erects a behavior model for the latter to imitate their foreign investment decision. Particularly, the results of modified diffusion models show that the earnings from Chinese branches are positively related to the internal influence. In general, the imitating tendency of potential consumers is substantially hindered by the losses in the Chinese branches, and these firms would invest less into China. The FDI inflow extension depends on earnings of Chinese branches, and companies will adjust their FDI strategies based on the returns. Since this research has proved that earning is an influential factor on FDI dynamics, our revised model explicitly performs superior in prediction ability than conventional diffusion model.

Keywords: diffusion model, genetic algorithms, nonlinear leastsquares (NLS) model, prediction error.

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107 A Traditional Settlement in a Modernized City: Yanbu, Saudi Arabia

Authors: Hisham Mortada

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Transition in the urban configuration of Arab cities has never been as radical and visible as it has been since the turn of the last century. The emergence of new cities near historical settlements of Arabia has spawned a series of developments in and around the old city precincts. New developments are based on advanced technology and conform to globally prevalent standards of city planning, superseding the vernacular arrangements based on traditional norms that guided so-called ‘city planning’. Evidence to this fact are the extant Arab buildings present at the urban core of modern cities, which inform us about intricate spatial organization. Organization that subscribed to multiple norms such as, satisfying gender segregation and socialization, economic sustainability, and ensuring security and environmental coherence etc., within settlement compounds. Several participating factors achieved harmony in such an inclusive city—an organization that was challenged and apparently replaced by the new planning order in the face of growing needs of globalized, economy-centric and high-tech models of development. Communities found it difficult to acclimatize with the new western planning models that were implemented at a very large scale throughout the Kingdom, which later experienced spatial re-structuring to suit users’ needs. A closer look the ancient city of Yanbu, now flanked with such new developments, allows us to differentiate and track the beginnings of this unprecedented transition in settlement formations. This paper aims to elaborate the Arabian context offered to both the ‘traditional’ and ‘modern’ planning approaches, in order to understand challenges and solutions offered by both at different times. In the process it will also establish the inconsistencies and conflicts that arose with the shift in planning paradigm, from traditional-'cultural norms’, to modern-'physical planning', in the Arabian context. Thus, by distinguishing the two divergent planning philosophies, their impact of the Arabian morphology, relevance to lifestyle and suitability to the biophysical environment, it concludes with a perspective on sustainability particularly for in case of Yanbu.

Keywords: Yanbu, traditional architecture, Hijaz, coral building, Saudi Arabia.

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106 A Retrospective Cross-Sectional Study on the Prevalence and Factors Associated with Virological Non-Suppression among HIV-Positive Adult Patients on Antiretroviral Therapy in Woliso Town, Oromia, Ethiopia

Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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105 MFCA: An Environmental Management Accounting Technique for Optimal Resource Efficiency in Production Processes

Authors: Omolola A. Tajelawi, Hari L. Garbharran

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Revenue leakages are one of the major challenges manufacturers face in production processes, as most of the input materials that should emanate as products from the lines are lost as waste. Rather than generating income from material input which is meant to end-up as products, losses are further incurred as costs in order to manage waste generated. In addition, due to the lack of a clear view of the flow of resources on the lines from input to output stage, acquiring information on the true cost of waste generated have become a challenge. This has therefore given birth to the conceptualization and implementation of waste minimization strategies by several manufacturing industries. This paper reviews the principles and applications of three environmental management accounting tools namely Activity-based Costing (ABC), Life-Cycle Assessment (LCA) and Material Flow Cost Accounting (MFCA) in the manufacturing industry and their effectiveness in curbing revenue leakages. The paper unveils the strengths and limitations of each of the tools; beaming a searchlight on the tool that could allow for optimal resource utilization, transparency in production process as well as improved cost efficiency. Findings from this review reveal that MFCA may offer superior advantages with regards to the provision of more detailed information (both in physical and monetary terms) on the flow of material inputs throughout the production process compared to the other environmental accounting tools. This paper therefore makes a case for the adoption of MFCA as a viable technique for the identification and reduction of waste in production processes, and also for effective decision making by production managers, financial advisors and other relevant stakeholders.

Keywords: MFCA, environmental management accounting, resource efficiency, waste reduction, revenue losses.

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104 Parametric Approach for Reserve Liability Estimate in Mortgage Insurance

Authors: Rajinder Singh, Ram Valluru

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Chain Ladder (CL) method, Expected Loss Ratio (ELR) method and Bornhuetter-Ferguson (BF) method, in addition to more complex transition-rate modeling, are commonly used actuarial reserving methods in general insurance. There is limited published research about their relative performance in the context of Mortgage Insurance (MI). In our experience, these traditional techniques pose unique challenges and do not provide stable claim estimates for medium to longer term liabilities. The relative strengths and weaknesses among various alternative approaches revolve around: stability in the recent loss development pattern, sufficiency and reliability of loss development data, and agreement/disagreement between reported losses to date and ultimate loss estimate. CL method results in volatile reserve estimates, especially for accident periods with little development experience. The ELR method breaks down especially when ultimate loss ratios are not stable and predictable. While the BF method provides a good tradeoff between the loss development approach (CL) and ELR, the approach generates claim development and ultimate reserves that are disconnected from the ever-to-date (ETD) development experience for some accident years that have more development experience. Further, BF is based on subjective a priori assumption. The fundamental shortcoming of these methods is their inability to model exogenous factors, like the economy, which impact various cohorts at the same chronological time but at staggered points along their life-time development. This paper proposes an alternative approach of parametrizing the loss development curve and using logistic regression to generate the ultimate loss estimate for each homogeneous group (accident year or delinquency period). The methodology was tested on an actual MI claim development dataset where various cohorts followed a sigmoidal trend, but levels varied substantially depending upon the economic and operational conditions during the development period spanning over many years. The proposed approach provides the ability to indirectly incorporate such exogenous factors and produce more stable loss forecasts for reserving purposes as compared to the traditional CL and BF methods.

Keywords: Actuarial loss reserving techniques, logistic regression, parametric function, volatility.

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103 Enhance Construction Visual As-Built Schedule Management Using BIM Technology

Authors: Shu-Hui Jan, Hui-Ping Tserng, Shih-Ping Ho

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Construction project control attempts to obtain real-time as-built schedule information and to eliminate project delays by effectively enhancing dynamic schedule control and management. Suitable platforms for enhancing an as-built schedule visually during the construction phase are necessary and important for general contractors. As the application of building information modeling (BIM) becomes more common, schedule management integrated with the BIM approach becomes essential to enhance visual construction management implementation for the general contractor during the construction phase. To enhance visualization of the updated as-built schedule for the general contractor, this study presents a novel system called the Construction BIM-assisted Schedule Management (ConBIM-SM) system for general contractors in Taiwan. The primary purpose of this study is to develop a web ConBIM-SM system for the general contractor to enhance visual as-built schedule information sharing and efficiency in tracking construction as-built schedule. Finally, the ConBIM-SM system is applied to a case study of a commerce building project in Taiwan to verify its efficacy and demonstrate its effectiveness during the construction phase. The advantages of the ConBIM-SM system lie in improved project control and management efficiency for general contractors, and in providing BIM-assisted as-built schedule tracking and management, to access the most current as-built schedule information through a web browser. The case study results show that the ConBIM-SM system is an effective visual as-built schedule management platform integrated with the BIM approach for general contractors in a construction project.

Keywords: BIM, Building information modeling, construction schedule management, as-built schedule management, BIM schedule updating mechanism.

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102 Novel Hybrid Approaches For Real Coded Genetic Algorithm to Compute the Optimal Control of a Single Stage Hybrid Manufacturing Systems

Authors: M. Senthil Arumugam, M.V.C. Rao

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This paper presents a novel two-phase hybrid optimization algorithm with hybrid genetic operators to solve the optimal control problem of a single stage hybrid manufacturing system. The proposed hybrid real coded genetic algorithm (HRCGA) is developed in such a way that a simple real coded GA acts as a base level search, which makes a quick decision to direct the search towards the optimal region, and a local search method is next employed to do fine tuning. The hybrid genetic operators involved in the proposed algorithm improve both the quality of the solution and convergence speed. The phase–1 uses conventional real coded genetic algorithm (RCGA), while optimisation by direct search and systematic reduction of the size of search region is employed in the phase – 2. A typical numerical example of an optimal control problem with the number of jobs varying from 10 to 50 is included to illustrate the efficacy of the proposed algorithm. Several statistical analyses are done to compare the validity of the proposed algorithm with the conventional RCGA and PSO techniques. Hypothesis t – test and analysis of variance (ANOVA) test are also carried out to validate the effectiveness of the proposed algorithm. The results clearly demonstrate that the proposed algorithm not only improves the quality but also is more efficient in converging to the optimal value faster. They can outperform the conventional real coded GA (RCGA) and the efficient particle swarm optimisation (PSO) algorithm in quality of the optimal solution and also in terms of convergence to the actual optimum value.

Keywords: Hybrid systems, optimal control, real coded genetic algorithm (RCGA), Particle swarm optimization (PSO), Hybrid real coded GA (HRCGA), and Hybrid genetic operators.

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101 Comparison of Adsorbents for Ammonia Removal from Mining Wastewater

Authors: Farooq A. Al-Sheikh, Carol Moralejo, Mark Pritzker, William A. Anderson, Ali Elkamel

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Ammonia in mining wastewater is a significant problem, and treatment can be especially difficult in cold climates where biological treatment is not feasible. An adsorption process is one of the alternative processes that can be used to reduce ammonia concentrations to acceptable limits, and therefore a LEWATIT resin strongly acidic H+ form ion exchange resin and a Bowie Chabazite Na form AZLB-Na zeolite were tested to assess their effectiveness. For these adsorption tests, two packed bed columns (a mini-column constructed from a 32-cm long x 1-cm diameter piece of glass tubing, and a 60-cm long x 2.5-cm diameter Ace Glass chromatography column) were used containing varying quantities of the adsorbents. A mining wastewater with ammonia concentrations of 22.7 mg/L was fed through the columns at controlled flowrates. In the experimental work, maximum capacities of the LEWATIT ion exchange resin were 0.438, 0.448, and 1.472 mg/g for 3, 6, and 9 g respectively in a mini column and 1.739 mg/g for 141.5 g in a larger Ace column while the capacities for the AZLB-Na zeolite were 0.424, and 0.784 mg/g for 3, and 6 g respectively in the mini column and 1.1636 mg/g for 38.5 g in the Ace column. In the theoretical work, Thomas, Adams-Bohart, and Yoon-Nelson models were constructed to describe a breakthrough curve of the adsorption process and find the constants of the above-mentioned models. In the regeneration tests, 5% hydrochloric acid, HCl (v/v) and 10% sodium hydroxide, NaOH (w/v) were used to regenerate the LEWATIT resin and AZLB-Na zeolite with 44 and 63.8% recovery, respectively. In conclusion, continuous flow adsorption using a LEWATIT ion exchange resin and an AZLB-Na zeolite is efficient when using a co-flow technique for removal of the ammonia from wastewater. Thomas, Adams-Bohart, and Yoon-Nelson models satisfactorily fit the data with R2 closer to 1 in all cases.

Keywords: AZLB-Na zeolite, continuous adsorption, LEWATIT resin, models, regeneration.

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100 Thiopental-Fentanyl versus Midazolam-Fentanyl for Emergency Department Procedural Sedation and Analgesia in Patients with Shoulder Dislocation and Distal Radial Fracture-Dislocation: A Randomized Double-Blind Controlled Trial

Authors: D. Farsi, Gh. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

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Background and aim: It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FT versus fentanyl-midazolam (FM) in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods: In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccessful rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: Procedural Sedation and Analgesia, Thiopental, Fentanyl, Midazolam, Orthopedic Procedure, Emergency Department, Pain.

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