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

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.

Development of Numerical Model to Compute Water Hammer Transients in Pipe Flow

Water hammer is a hydraulic transient problem which is commonly encountered in the penstocks of hydropower plants. The numerical model was developed to estimate the transient behavior of pressure waves in pipe systems. The computational algorithm was proposed to model the water hammer phenomenon in a pipe system with pump shutdown at midstream and sudden valve closure at downstream. To predict the pressure head and flow velocity as a function of time as a result of rapidly closing a valve and pump shutdown, two boundary conditions at the ends considering pump operation and valve control can be implemented as specified equations of the pressure head and flow velocity based on the characteristics method. It was shown that the effects of transient flow make it determine the needs for protection devices, such as surge tanks, surge relief valves, or air valves, at various points in the system against overpressure and low pressure. It produced reasonably good performance with the results of the proposed transient model for pipeline systems. The proposed numerical model can be used as an efficient tool for the safety assessment of hydropower plants due to water hammer.

Outbound Tourism in Developed Countries: Analysis of the Trends, Behavior and the Transformation of the Moroccan Demand for International Travels

Outbound tourism in Morocco, as in the majority of developing countries, reveals some of the aspects of inequality between the north and the south. Considered by some researchers as one of the facets of the development crisis, access to tourism and especially international tourism is a chance for a small minority with financial means, while the vast portions of the population dream rather of immigrating to a developed country for the sake of improving their standard of living. The right to travel is also limited by visa requirements, procedures in host countries, security and technical measures and creates discrimination in the practice of tourism. These conditions do not seem to be favorable to the democratization of the practice of international tourism for the populations of the southern countries. This paper is a contribution to the reading of the trends of outbound tourism in developing countries through the example of Morocco. It highlights the different aspects of Moroccan outbound tourism, destinations and the behavior of tourists through an analysis of the offer of a sample of 50 travel agencies. In the same vein, it offers a reading grid of the possibilities offered for the development of outbound tourism and the various existing obstacles to the democratization of international outbound tourism in the southern countries. This reading reveals the transformation in the behavior of Moroccan international tourists as well as the profound changes in Moroccan society, through a model of statistical analysis.

Dynamic Variation in Nano-Scale CMOS SRAM Cells Due to LF/RTS Noise and Threshold Voltage

The dynamic variation in memory devices such as the Static Random Access Memory can give errors in read or write operations. In this paper, the effect of low-frequency and random telegraph noise on the dynamic variation of one SRAM cell is detailed. The effect on circuit noise, speed, and length of time of processing is examined, using the Supply Read Retention Voltage and the Read Static Noise Margin. New test run methods are also developed. The obtained results simulation shows the importance of noise caused by dynamic variation, and the impact of Random Telegraph noise on SRAM variability is examined by evaluating the statistical distributions of Random Telegraph noise amplitude in the pull-up, pull-down. The threshold voltage mismatch between neighboring cell transistors due to intrinsic fluctuations typically contributes to larger reductions in static noise margin. Also the contribution of each of the SRAM transistor to total dynamic variation has been identified.

The Fracture Resistance of Zirconia Based Dental Crowns from Cyclic Loading: A Function of Relative Wear Depth

This in vitro study focused on investigating the fatigue resistance of veneered zirconia molar crowns with different veneering ceramic thicknesses, simulating the relative wear depths under simulated cyclic loading. A mandibular first molar was prepared and then scanned using computer-aided design/computer-aided manufacturing (CAD/CAM) technology to fabricate 32 zirconia copings of uniform 0.5 mm thickness. The manufactured copings then veneered with 1.5 mm, 1.0 mm, 0.5 mm, and 0.0 mm representing 0%, 33%, 66%, and 100% relative wear of a normal ceramic thickness of 1.5 mm. All samples were thermally aged to 6000 thermo-cycles for 2 minutes with distilled water between 5 ˚C and 55 ˚C. The samples subjected to cyclic fatigue and fracture testing using SD Mechatronik chewing simulator. These samples are loaded up to 1.25x10⁶ cycles or until they fail. During fatigue, testing, extensive cracks were observed in samples with 0.5 mm veneering layer thickness. Veneering layer thickness 1.5-mm group and 1.0-mm group were not different in terms of resisting loads necessary to cause an initial crack or final failure. All ceramic zirconia-based crown restorations with varying occlusal veneering layer thicknesses appeared to be fatigue resistant. Fracture load measurement for all tested groups before and after fatigue loading exceeded the clinical chewing forces in the posterior region. In general, the fracture loads increased after fatigue loading and with the increase in the thickness of the occlusal layering ceramic.

FZP Design Considering Spherical Wave Incidence

Fresnel Zone Plates (FZPs) are widely used in many areas, such as optics, microwaves or acoustics. On the design of FZPs, plane wave incidence is typically considered, but that is not usually the case in ultrasounds, especially in applications where a piston emitter is placed at a certain distance from the lens. In these cases, having control of the focal distance is very important, and with the usual Fresnel equation a focal displacement from the theoretical distance is observed due to the plane wave supposition. In this work, a comparison between FZP with plane wave incidence design and FZP with point source design in the case of piston emitter is presented. Influence of the main parameters of the piston in the final focalization profile has been studied. Numerical models and experimental results are shown, and they prove that when spherical wave incidence is considered for the piston case, it is possible to have a fine control of the focal distance in comparison with the classical design method.

Psychometric Examination of the QUEST-25: An Online Assessment of Intellectual Curiosity and Scientific Epistemology

The current study reports an examination of the QUEST-25 (Q-Assessment of Undergraduate Epistemology and Scientific Thinking) online version for assessing the dispositional attitudes toward scientific thinking and intellectual curiosity among undergraduate students. The QUEST-25 consists of scientific thinking (SIQ-25) and intellectual curiosity (ICIQ-25), which were correlated in hypothesized directions with the Religious Commitment Inventory, Curiosity and Exploration Inventory, Belief in Science scale, and measures of academic self-efficacy. Additionally, concurrent validity was established by the resulting significant differences between those identifying the centrality of religious belief in their lives and those who do not self-identify as being guided daily by religious beliefs. This study demonstrates the utility of the QUEST-25 for research, evaluation, and theory development.

Phenotypic Characterization of the Zebu Cattle in Tajikistan

This article deals with the genetic characteristics of samples Schwyz-zebu cattle from three farms of the Republic of Tajikistan on 10 microsatellite markers (STS). Hence, the present study was carried out to evaluate the heterozygosity in the population and to characterize this breed by identifying DNA markers using microstatellites. Microsatellites often have multiple alleles and may have heterozygosity frequencies of 70% or more. This makes them highly informative for genetic analysis. A total of ten microsatellite primers were used for microsatellite analysis in genomic DNA of Zebu cattle. The amplified products were analysed for polymorphic alleles and their frequencies. The resulting information can be used in dealing with the conservation and sustainable use of genetic resources of the Tajik Schwyz-zebu cattle.

Functionally Graded MEMS Piezoelectric Energy Harvester with Magnetic Tip Mass

Role of piezoelectric energy harvesters has gained interest in supplying power for micro devices such as health monitoring sensors. In this study, in order to enhance the piezoelectric energy harvesting in capturing energy from broader range of excitation and to improve the mechanical and electrical responses, bimorph piezoelectric energy harvester beam with magnetic mass attached at the end is presented. In view of overcoming the brittleness of piezo-ceramics, functionally graded piezoelectric layers comprising of both piezo-ceramic and piezo-polymer is employed. The nonlinear equations of motions are derived using energy method and then solved analytically using perturbation scheme. The frequency responses of the forced vibration case are obtained for the near resonance case. The nonlinear dynamic responses of the MEMS scaled functionally graded piezoelectric energy harvester in this paper may be utilized in different design scenarios to increase the efficiency of the harvester.

Toward Sustainable Building Design in Hot and Arid Climate with Reference to Riyadh City, Saudi Arabia

One of the most common and traditional strategies in architecture is to design buildings passively. This is a way to ensure low building energy reliance with respect to specific micro-building locations. There are so many ways where buildings can be designed passively, some of which are applying thermal insulation, thermal mass, courtyard and glazing to wall ratio. This research investigates the impact of each of these aspects with respect to the hot and dry climate of the capital of Riyadh. Thermal Analysis Simulation (TAS) will be utilized which is powered by Environmental Design Simulation Limited company (EDSL). It is considered as one of the most powerful tools to predict energy performance in buildings. There are three primary building designs and methods which are using courtyard, thermal mass and thermal insulation. The same building size and fabrication properties have been applied to all designs. Riyadh city which is the capital of the country was taken as a case study of the research. The research has taken into account various zone directions within the building as it has a large contribution to indoor energy and thermal performance. It is revealed that it is possible to achieve nearly zero carbon building in the hot and dry region in winter with minimum reliance on energy loads for building zones facing south, west and east. Moreover, using courtyard is more beneficial than applying construction materials into building envelope. Glazing to wall ratio is recommended to be 10% and not exceeding 30% in all directions in hot and arid regions.

Exploring Students’ Self-Evaluation on Their Learning Outcomes through an Integrated Cumulative Grade Point Average Reporting Mechanism

An Integrated Cumulative Grade Point Average (iCGPA) is a mechanism and strategy to ensure the curriculum of an academic programme is constructively aligned to the expected learning outcomes and student performance based on the attainment of those learning outcomes that is reported objectively in a spider web. Much effort and time has been spent to develop a viable mechanism and trains academics to utilize the platform for reporting. The question is: How well do learners conceive the idea of their achievement via iCGPA and whether quality learner attributes have been nurtured through the iCGPA mechanism? This paper presents the architecture of an integrated CGPA mechanism purported to address a holistic evaluation from the evaluation of courses learning outcomes to aligned programme learning outcomes attainment. The paper then discusses the students’ understanding of the mechanism and evaluation of their achievement from the generated spider web. A set of questionnaires were distributed to a group of students with iCGPA reporting and frequency analysis was used to compare the perspectives of students on their performance. In addition, the questionnaire also explored how they conceive the idea of an integrated, holistic reporting and how it generates their motivation to improve. The iCGPA group was found to be receptive to what they have achieved throughout their study period. They agreed that the achievement level generated from their spider web allows them to develop intervention and enhance the programme learning outcomes before they graduate.

Report of Happiness in the Iranian Educational System: A Qualitative Research

The purpose of this study is to understand the current situation of happiness in the Iranian educational system from the perspective of students, teachers and educational administrators. This research is done in qualitative paradigm. Data collection is done by in-depth interview method. Research participants were selected purposively according to sampling rules, with maximum variation and reaching the saturation point. According to most participants in this study, schools in Iran are not usually happy. This lack of happiness is associated with and related to the educational system, curriculum, teaching method, physical environment of schools and their facilities.

Sanitary Measures in Piggeries, Awareness and Risk Factors of African Swine Fever in Benue State, Nigeria

A study was conducted to determine the level of compliance with sanitary measures in piggeries, and awareness and risk factors of African swine fever in Benue State, Nigeria. Questionnaires were distributed to 74 respondents consisting of piggery owners and attendants in different piggeries across 12 LGAs to collect data for this study. Sanitary measures in piggeries were observed to be generally very poor, though respondents admitted being aware of ASF. Piggeries located within a 1 km radius of a slaughter slab (OR=9.2, 95% CI - 3.0-28.8), piggeries near refuse dump sites (OR=3.0, 95% CI - 1.0-9.5) and piggeries where farm workers wear their work clothes outside of the piggery premises (OR=0.2, 95% CI - 0.1-0.7) showed higher chances of ASFV infection and were significantly associated (p < 0.0001), (p < 0.05) and (p < 0.01), and were identified as potential risk factors. The study concluded that pigs in Benue State are still at risk of an ASF outbreak. Proper sanitary and hygienic practices is advocated and emphasized in piggeries, while routine surveillance for ASFV antibodies in pigs in Benue State is strongly recommended to provide a reliable reference data base to plan for the prevention of any devastating ASF outbreak.

Text Mining of Twitter Data Using a Latent Dirichlet Allocation Topic Model and Sentiment Analysis

Twitter is a microblogging platform, where millions of users daily share their attitudes, views, and opinions. Using a probabilistic Latent Dirichlet Allocation (LDA) topic model to discern the most popular topics in the Twitter data is an effective way to analyze a large set of tweets to find a set of topics in a computationally efficient manner. Sentiment analysis provides an effective method to show the emotions and sentiments found in each tweet and an efficient way to summarize the results in a manner that is clearly understood. The primary goal of this paper is to explore text mining, extract and analyze useful information from unstructured text using two approaches: LDA topic modelling and sentiment analysis by examining Twitter plain text data in English. These two methods allow people to dig data more effectively and efficiently. LDA topic model and sentiment analysis can also be applied to provide insight views in business and scientific fields.

Scientific Production on Lean Supply Chains Published in Journals Indexed by SCOPUS and Web of Science Databases: A Bibliometric Study

Lean Supply Chain Management (LSCM) is an emerging research field in Operations Management (OM). As a strategic model that focuses on reduced cost and waste with fulfilling the needs of customers, LSCM attracts great interest among researchers and practitioners. The purpose of this paper is to present an overview of Lean Supply Chains literature, based on bibliometric analysis through 57 papers published in indexed journals by SCOPUS and/or Web of Science databases. The results indicate that the last three years (2015, 2016, and 2017) were the most productive on LSCM discussion, especially in Supply Chain Management and International Journal of Lean Six Sigma journals. India, USA, and UK are the most productive countries; nevertheless, cross-country studies by collaboration among researchers were detected, by social network analysis, as a research practice, appearing to play a more important role on LSCM studies. Despite existing limitation, such as limited indexed journal database, bibliometric analysis helps to enlighten ongoing efforts on LSCM researches, including most used technical procedures and collaboration network, showing important research gaps, especially, for development countries researchers.

Graph Cuts Segmentation Approach Using a Patch-Based Similarity Measure Applied for Interactive CT Lung Image Segmentation

Lung CT image segmentation is a prerequisite in lung CT image analysis. Most of the conventional methods need a post-processing to deal with the abnormal lung CT scans such as lung nodules or other lesions. The simplest similarity measure in the standard Graph Cuts Algorithm consists of directly comparing the pixel values of the two neighboring regions, which is not accurate because this kind of metrics is extremely sensitive to minor transformations such as noise or other artifacts problems. In this work, we propose an improved version of the standard graph cuts algorithm based on the Patch-Based similarity metric. The boundary penalty term in the graph cut algorithm is defined Based on Patch-Based similarity measurement instead of the simple intensity measurement in the standard method. The weights between each pixel and its neighboring pixels are Based on the obtained new term. The graph is then created using theses weights between its nodes. Finally, the segmentation is completed with the minimum cut/Max-Flow algorithm. Experimental results show that the proposed method is very accurate and efficient, and can directly provide explicit lung regions without any post-processing operations compared to the standard method.

Assessment of Tourist and Community Perception with Regard to Tourism Sustainability Indicators: A Case Study of Sinharaja World Heritage Rainforest, Sri Lanka

The purpose of this study was to determine tourist and community perception-based sustainable tourism indicators as well as Human Pressure Index (HPI) and Tourist Activity Index (TAI). Study was carried out in Sinharaja forest which is considered as one of the major eco-tourism destination in Sri Lanka. Data were gathered using a pre-tested semi-structured questionnaire as well as records from Forest department. Convenient sampling technique was applied. For the majority of issues, the responses were obtained on multi-point Likert-type scales. Visual portrayal was used for display analyzed data. The study revealed that the host community of the Kudawa gets many benefits from tourism. Also, tourism has caused negative impacts upon the environment and community. The study further revealed the need of proper waste management and involvement of local cultural events for the tourism business in the Kudawa conservation center. The TAI, which accounted to be 1.27 and monthly evolution of HPI revealed that congestion can be occurred in the Sinharaja rainforest during peak season. The results provide useful information to any party involved with tourism planning anywhere, since such attempts would be more effective once the people’s perceptions on these aspects are taken into account.

Experimental Study of Flow Effects of Solid Particles’ Size in Porous Media

Transpiration cooling combined to regenerative cooling is a technique that could be used to cool the porous walls of the future ramjet combustion chambers; it consists of using fuel that will flow through the pores of the porous material consisting of the chamber walls, as coolant. However, at high temperature, the fuel is pyrolysed and generates solid coke particles inside the porous materials. This phenomenon can lead to a significant decrease of the material permeability and can affect the efficiency of the cooling system. In order to better understand this phenomenon, an experimental laboratory study was undertaken to determine the transport and deposition of particles in a sintered porous material subjected to steady state flow. The test bench composed of a high-pressure autoclave is used to study the transport of different particle size (35

Separation Characteristics of the Hollow Fiber Membrane Module Using Water Mixed with Small Sized Bubbles Composed of Synthesized Exhalations

Fish can breathe freely under water using dissolved oxygen and survive for a long time without going out of the water. A human can also survive under water using dissolved oxygens, if properly used. He needs more dissolved oxygens than the fish, so efficient separation device is required. Since the amount of oxygen contained in water is weak, a person needs a lot of surface area to breathe in water, which leads to a large-sized device. It can be applied to various fields if it is developed as a device which is advantageous to carry in small size. In this paper, we have carried out a study on the effective use of exhalations and proposed the separation characteristics of the gas containing dissolved oxygen in the state of mixed gas considering the components of exhalation. The system was configured to have a fine bubble when the gas mixture injected into the front end of the separator. While the fluid containing the fine bubbles was supplied to the separator, the dissolved gas contained in water was separated using a vacuum pump. The gas separation amount of the separating apparatus with respect to the supplied mixed gas was measured. The amounts of separation of dissolved gas were increased as the amounts of mixed gas supplied were increased.

Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score

Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.