Patient Perspectives on Telehealth during the Pandemic in the United States

Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.

Telehealth Ecosystem: Challenge and Opportunity

Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Pinch Analysis of Triple Pressure Reheat Supercritical Combined Cycle Power Plant

In this study, supercritical steam is introduced to Combined Cycle Power Plant (CCPP) in an attempt to further optimize energy recovery. Subcritical steam is commonly used in the CCPP, operating at maximum pressures around 150-160 bar. Supercritical steam is an alternative to increase heat recovery during vaporization period of water. The idea of improvement using supercritical steam is further examined with the use of exergy, pinch analysis and Aspen Plus simulation.

Sustainable Development of Medium Strength Concrete Using Polypropylene as Aggregate Replacement

Plastic as an environmental burden is a well-rehearsed topic in the research area. This is due to its global demand and destructive impacts on the environment, which has been a significant concern to the governments. Typically, the use of plastic in the construction industry is seen across low-density, non-structural applications due to its diverse range of benefits including high strength-to-weight ratios, manipulability and durability. It can be said that with the level of plastic consumption experienced in the construction industry, an ongoing responsibility is shown for this sector to continually innovate alternatives for application of recycled plastic waste such as using plastic made replacement from polyethylene, polystyrene, polyvinyl and polypropylene in the concrete mix design. In this study, the impact of partially replaced fine aggregate with polypropylene in the concrete mix design was investigated to evaluate the concrete’s compressive strength by conducting an experimental work which comprises of six concrete mix batches with polypropylene replacements ranging from 0.5 to 3.0%. The results demonstrated a typical decline in the compressive strength with the addition of plastic aggregate, despite this reduction generally mitigated as the level of plastic in the concrete mix increased. Furthermore, two of the six plastic-containing concrete mixes tested in the current study exceeded the ST5 standardised prescribed concrete mix compressive strength requirement at 28-days containing 1.50% and 2.50% plastic aggregates, which demonstrated the potential for use of recycled polypropylene in structural applications, as a partial by mass, fine aggregate replacement in the concrete mix.

First and Second Analysis on the Reheat Organic Rankine Cycle

In recent years the increasing use of fossil fuels has led to various environmental problems including urban pollution, ozone layer depletion and acid rains. Moreover, with the increased number of industrial centers and higher consumption of these fuels, the end point of the fossil energy reserves has become more evident. Considering the environmental pollution caused by fossil fuels and their limited availability, renewable sources can be considered as the main substitute for non-renewable resources. One of these resources is the Organic Rankine Cycles (ORCs). These cycles while having high safety, have low maintenance requirements. Combining the ORCs with other systems, such as ejector and reheater will increase overall cycle efficiency. In this study, ejector and reheater are used to improve the thermal efficiency (ηth), exergy efficiency (η_ex) and net output power (w_net); therefore, the ORCs with reheater (RORCs) are proposed. A computational program has been developed to calculate the thermodynamic parameters required in Engineering Equations Solver (EES). In this program, the analysis of the first and second law in RORC is conducted, and a comparison is made between them and the ORCs with Ejector (EORC). R245fa is selected as the working fluid and water is chosen as low temperature heat source with a temperature of 95 °C and a mass transfer rate of 1 kg/s. The pressures of the second evaporator and reheater are optimized in terms of maximum exergy efficiency. The environment is at 298.15 k and at 101.325 kpa. The results indicate that the thermodynamic parameters in the RORC have improved compared to EORC.

Comparing the Educational Effectiveness of eHealth to Deliver Health Knowledge between Higher Literacy Users and Lower Literacy Users

eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.

Analyses and Optimization of Physical and Mechanical Properties of Direct Recycled Aluminium Alloy (AA6061) Wastes by ANOVA Approach

The present study is aimed at investigating microhardness and density of aluminium alloy chips when subjected to various settings of preheating temperature and preheating time. Three values of preheating temperature were taken as 450 °C, 500 °C, and 550 °C. On the other hand, three values of preheating time were chosen (1, 2, 3) hours. The influences of the process parameters (preheating temperature and time) were analyzed using Design of Experiments (DOE) approach whereby full factorial design with center point analysis was adopted. The total runs were 11 and they comprise of two factors of full factorial design with 3 center points. The responses were microhardness and density. The results showed that the density and microhardness increased with decreasing the preheating temperature. The results also found that the preheating temperature is more important to be controlled rather than the preheating time in microhardness analysis while both the preheating temperature and preheating time are important in density analysis. It can be concluded that setting temperature at 450 °C for 1 hour resulted in the optimum responses.

Solar Seawater Desalination Still with Seawater Preheater Using Efficient Heat Transfer Oil: Numerical Investigation and Data Verification

The feasibility of improving the performance of the proposed solar still unit which operated in very hot climate is investigated numerically and verified with experimental data. This solar desalination unit with proposed auxiliary device as seawater preheating system using petrol based textherm oil was used to produce pure fresh water from seawater. The effective evaporation area of basin is about 1 m2. The unit was tested in two main operation modes which are normal and with seawater preheating system. The results showed that, there is good agreement between the theoretical data and the experimental data; this means that the numerical model can be accurately dependable for predicting the proposed solar still performance and design parameters. The results also showed that the fresh water productivity of the solar still in the modified preheating case which is higher than normal case, leads to an increase in productivity of 42%.

Timescape-Based Panoramic View for Historic Landmarks

Providing a panoramic view of famous landmarks around the world offers artistic and historic value for historians, tourists, and researchers. Exploring the history of famous landmarks by presenting a comprehensive view of a temporal panorama merged with geographical and historical information presents a unique challenge of dealing with images that span a long period, from the 1800’s up to the present. This work presents the concept of temporal panorama through a timeline display of aligned historic and modern images for many famous landmarks. Utilization of this panorama requires a collection of hundreds of thousands of landmark images from the Internet comprised of historic images and modern images of the digital age. These images have to be classified for subset selection to keep the more suitable images that chronologically document a landmark’s history. Processing of historic images captured using older analog technology under various different capturing conditions represents a big challenge when they have to be used with modern digital images. Successful processing of historic images to prepare them for next steps of temporal panorama creation represents an active contribution in cultural heritage preservation through the fulfillment of one of UNESCO goals in preservation and displaying famous worldwide landmarks.

Study on the Integration Schemes and Performance Comparisons of Different Integrated Solar Combined Cycle-Direct Steam Generation Systems

The integrated solar combined cycle (ISCC) system has a series of advantages such as increasing the system power generation, reducing the cost of solar power generation, less pollutant and CO2 emission. In this paper, the parabolic trough collectors with direct steam generation (DSG) technology are considered to replace the heat load of heating surfaces in heat regenerator steam generation (HRSG) of a conventional natural gas combined cycle (NGCC) system containing a PG9351FA gas turbine and a triple pressure HRSG with reheat. The detailed model of the NGCC system is built in ASPEN PLUS software and the parabolic trough collectors with DSG technology is modeled in EBSILON software. ISCC-DSG systems with the replacement of single, two, three and four heating surfaces are studied in this paper. Results show that: (1) the ISCC-DSG systems with the replacement heat load of HPB, HPB+LPE, HPE2+HPB+HPS, HPE1+HPE2+ HPB+HPS are the best integration schemes when single, two, three and four stages of heating surfaces are partly replaced by the parabolic trough solar energy collectors with DSG technology. (2) Both the changes of feed water flow and the heat load of the heating surfaces in ISCC-DSG systems with the replacement of multi-stage heating surfaces are smaller than those in ISCC-DSG systems with the replacement of single heating surface. (3) ISCC-DSG systems with the replacement of HPB+LPE heating surfaces can increase the solar power output significantly. (4) The ISCC-DSG systems with the replacement of HPB heating surfaces has the highest solar-thermal-to-electricity efficiency (47.45%) and the solar radiation energy-to-electricity efficiency (30.37%), as well as the highest exergy efficiency of solar field (33.61%).

A Performance Analysis Study of an Active Solar Still Integrating Fin at the Basin Plate

Water is one of the most important and vulnerable natural resources due to human activities and climate change. Water-level continues declining year after year and it is primarily caused by sustained, extensive, and traditional usage methods. Improving water utilization becomes an urgent issue in order satisfy the increasing population needs. Desalination of seawater or brackish water could help in increasing water potential. However, a cost-effective desalination process is required. The most appropriate method for performing this desalination is solar-driven distillation, given its simplicity, low cost and especially the availability of the solar energy source. The main objective of this paper is to demonstrate the influence of coupling integrated basin plate by fins with preheating by solar collector on the performance of solar still. The energy balance equations for the various elements of the solar still are introduced. A numerical example is used to show the efficiency of the proposed solution.

Gamification of eHealth Business Cases to Enhance Rich Learning Experience

Introduction of games has expanded the application area of computer-aided learning tools to wide variety of age groups of learners. Serious games engage the learners into a real-world -type of simulation and potentially enrich the learning experience. Institutional background of a Bachelor’s level engineering program in Information and Communication Technology is introduced, with detailed focus on one of its majors, Health Technology. As part of a Customer Oriented Software Application thematic semester, one particular course of “eHealth Business and Solutions” is described and reflected in a gamified framework. Learning a consistent view into vast literature of business management, strategies, marketing and finance in a very limited time enforces selection of topics relevant to the industry. Health Technology is a novel and growing industry with a growing sector in consumer wearable devices and homecare applications. The business sector is attracting new entrepreneurs and impatient investor funds. From engineering education point of view the sector is driven by miniaturizing electronics, sensors and wireless applications. However, the market is highly consumer-driven and usability, safety and data integrity requirements are extremely high. When the same technology is used in analysis or treatment of patients, very strict regulatory measures are enforced. The paper introduces a course structure using gamification as a tool to learn the most essential in a new market: customer value proposition design, followed by a market entry game. Students analyze the existing market size and pricing structure of eHealth web-service market and enter the market as a steering group of their company, competing against the legacy players and with each other. The market is growing but has its rules of demand and supply balance. New products can be developed with an R&D-investment, and targeted to market with unique quality- and price-combinations. Product cost structure can be improved by investing to enhanced production capacity. Investments can be funded optionally by foreign capital. Students make management decisions and face the dynamics of the market competition in form of income statement and balance sheet after each decision cycle. The focus of the learning outcome is to understand customer value creation to be the source of cash flow. The benefit of gamification is to enrich the learning experience on structure and meaning of financial statements. The paper describes the gamification approach and discusses outcomes after two course implementations. Along the case description of learning challenges, some unexpected misconceptions are noted. Improvements of the game or the semi-gamified teaching pedagogy are discussed. The case description serves as an additional support to new game coordinator, as well as helps to improve the method. Overall, the gamified approach has helped to engage engineering student to business studies in an energizing way.

Energy Efficiency Analysis of Discharge Modes of an Adiabatic Compressed Air Energy Storage System

Efficient energy storage is a crucial factor in facilitating the uptake of renewable energy resources. Among the many options available for energy storage systems required to balance imbalanced supply and demand cycles, compressed air energy storage (CAES) is a proven technology in grid-scale applications. This paper reviews the current state of micro scale CAES technology and describes a micro-scale advanced adiabatic CAES (A-CAES) system, where heat generated during compression is stored for use in the discharge phase. It will also describe a thermodynamic model, developed in EES (Engineering Equation Solver) to evaluate the performance and critical parameters of the discharge phase of the proposed system. Three configurations are explained including: single turbine without preheater, two turbines with preheaters, and three turbines with preheaters. It is shown that the micro-scale A-CAES is highly dependent upon key parameters including; regulator pressure, air pressure and volume, thermal energy storage temperature and flow rate and the number of turbines. It was found that a micro-scale AA-CAES, when optimized with an appropriate configuration, could deliver energy input to output efficiency of up to 70%.

Creating Smart and Healthy Cities by Exploring the Potentials of Emerging Technologies and Social Innovation for Urban Efficiency: Lessons from the Innovative City of Boston

The wide-spread adoption of the Smart City concept has introduced a new era of computing paradigm with opportunities for city administrators and stakeholders in various sectors to re-think the concept of urbanization and development of healthy cities. With the world population rapidly becoming urban-centric especially amongst the emerging economies, social innovation will assist greatly in deploying emerging technologies to address the development challenges in core sectors of the future cities. In this context, sustainable health-care delivery and improved quality of life of the people is considered at the heart of the healthy city agenda. This paper examines the Boston innovation landscape from the perspective of smart services and innovation ecosystem for sustainable development, especially in transportation and healthcare. It investigates the policy implementation process of the Healthy City agenda and eHealth economy innovation based on the experience of Massachusetts’s City of Boston initiatives. For this purpose, three emerging areas are emphasized, namely the eHealth concept, the innovation hubs, and the emerging technologies that drive innovation. This was carried out through empirical analysis on results of public sector and industry-wide interviews/survey about Boston’s current initiatives and the enabling environment. The paper highlights few potential research directions for service integration and social innovation for deploying emerging technologies in the healthy city agenda. The study therefore suggests the need to prioritize social innovation as an overarching strategy to build sustainable Smart Cities in order to avoid technology lock-in. Finally, it concludes that the Boston example of innovation economy is unique in view of the existing platforms for innovation and proper understanding of its dynamics, which is imperative in building smart and healthy cities where quality of life of the citizenry can be improved.

High Efficiency Solar Thermal Collectors Utilization in Process Heat: A Case Study of Textile Finishing Industry

Solar energy, since it is available every day, is seen as one of the most valuable renewable energy resources. Thus, the energy of sun should be efficiently used in various applications. The most known applications that use solar energy are heating water and spaces. High efficiency solar collectors need appropriate selective surfaces to absorb the heat. Selective surfaces (Selektif-Sera) used in this study are applied to flat collectors, which are produced by a roll to roll cost effective coating of nano nickel layers, developed in Selektif Teknoloji Co. Inc. Efficiency of flat collectors using Selektif-Sera absorbers are calculated in collaboration with Institute for Solar Technik Rapperswil, Switzerland. The main cause of high energy consumption in industry is mostly caused from low temperature level processes. There is considerable effort in research to minimize the energy use by renewable energy sources such as solar energy. A feasibility study will be presented to obtain the potential of solar thermal energy utilization in the textile industry using these solar collectors. For the feasibility calculations presented in this study, textile dyeing and finishing factory located at Kahramanmaras is selected since the geographic location was an important factor. Kahramanmaras is located in the south east part of Turkey thus has a great potential to have solar illumination much longer. It was observed that, the collector area is limited by the available area in the factory, thus a hybrid heating generating system (lignite/solar thermal) was preferred in the calculations of this study to be more realistic. During the feasibility work, the calculations took into account the preheating process, where well waters heated from 15 °C to 30-40 °C by using the hot waters in heat exchangers. Then the preheated water was heated again by high efficiency solar collectors. Economic comparison between the lignite use and solar thermal collector use was provided to determine the optimal system that can be used efficiently. The optimum design of solar thermal systems was studied depending on the optimum collector area. It was found that the solar thermal system is more economic and efficient than the merely lignite use. Return on investment time is calculated as 5.15 years.

Thermo-Mechanical Processing of Armor Steel Plates

The steel contains 0.3% C and 0.004% B, beside Mn, Cr, Mo, and Ni. The alloy was processed by using 20-ton capacity electric arc furnace (EAF), and then refined by ladle furnace (LF). Liquid steel was cast as rectangular ingots. Dilatation test showed the critical transformation temperatures Ac1, Ac3, Ms and Mf as 716, 835, 356, and 218 °C. The ingots were austenitized and soaked and then rough rolled to thin slabs with 80 mm thickness. The thin slabs were then reheated and soaked for finish rolling to 6.0 mm thickness plates. During the rough rolling, the roll force increases as a result of rolling at temperatures less than recrystallization temperature. However, during finish rolling, the steel reflects initially continuous static recrystallization after which it shows strain hardening due to fall of temperature. It was concluded that, the steel plates were successfully heat treated by quenching-tempering at 250 ºC for 20 min.

Analytics Model in a Telehealth Center Based on Cloud Computing and Local Storage

Some of the main goals about telecare such as monitoring, treatment, telediagnostic are deployed with the integration of applications with specific appliances. In order to achieve a coherent model to integrate software, hardware, and healthcare systems, different telehealth models with Internet of Things (IoT), cloud computing, artificial intelligence, etc. have been implemented, and their advantages are still under analysis. In this paper, we propose an integrated model based on IoT architecture and cloud computing telehealth center. Analytics module is presented as a solution to control an ideal diagnostic about some diseases. Specific features are then compared with the recently deployed conventional models in telemedicine. The main advantage of this model is the availability of controlling the security and privacy about patient information and the optimization on processing and acquiring clinical parameters according to technical characteristics.

Analysis of Heat Exchanger Network of Distillation Unit of Shiraz Oil Refinery

The reduction of energy consumption through improvements in energy efficiency has become an important goal for all industries, in order to improve the efficiency of the economy, and to reduce the emissions of Co2 caused by power generation. The objective of this paper is to investigate opportunities to increase process energy efficiency at the distillation unit of Shiraz oil refinery in south of Iran. The main aim of the project is to locate energy savings by use of pinch technology and to assess them. At first all the required data of hot and cold streams in preheating section of distillation unit has been extracted from the available flow sheets and then pinch analysis has been conducted. The present case study is a threshold one which does not need any utilities. After running range, targeting several heat exchanger networks were designed with respect to operating conditions and different ΔTmin. The optimal value of ΔTmin was calculated to be 22.3 °C. Based on this optimal value, there will be 5% reduction in annual total cost of heat exchanger network.

Comparative Efficacy of Pomegranate Juice, Peel and Seed Extract in the Stabilization of Corn Oil under Accelerated Conditions

Antioxidant-rich extracts were prepared from pomegranate peels, seeds and juice using methanol and ethanol and their antioxidant activity was evaluated by the 1,1-diphenyl-2-picrylhydrazine (DPPH) radical scavenging and Ferric Reducing Antioxidant Power (FRAP) method. Both analytical methods indicated a higher antioxidant activity in extracts prepared from peels, which was comparable to that of butylated hydroxytoluene (BHT). Furthermore, the antioxidant activity was correlated to the phenolic and flavonoid content of the various extracts. The antioxidant effectiveness of the extracts was also assessed using corn oil as the oxidation substrate. More specifically, preheated corn oil samples stabilized with extracts at a concentration of 250 ppm, 500 ppm or 1,000 ppm were subjected to accelerated aging (100 oC, 10 days) and the extent of oxidative alteration was followed by the measurement of the peroxide, conjugated dienes and trienes, as well as p-aniside value. BHT at its legal limit (200 ppm) served as standard besides the control sample. Results from the different parameters were in agreement with each other suggesting that pomegranate extracts can stabilize corn oil effectively under accelerated conditions, at all concentrations tested. However, the magnitude of oil stabilization depended strongly on the amount of extract added and this was positively correlated with their phenolic content. Pomegranate peel extracts, which exhibited the highest not only phenolic and flavonoid content but also antioxidant activity, were more potent in inhibiting oxidative deterioration. Both methanolic and ethanolic peel extracts at a concentration of 500 ppm exerted a stabilizing effect comparable to that of BHT, while at a concentration of 1000 ppm they exhibited higher stabilization efficiency in comparison to BHT. Finally, heating oil samples resulted in a time dependent decrease in their antioxidant capacity. Samples containing peel extracts appeared to retain their antioxidant capacity for a longer period, indicating that these extracts contained active compounds that offered superior antioxidant protection to corn oil.

Influence of Titanium Addition on Wear Properties of AM60 Magnesium Alloy

This study aimed for improving wear resistance of AM60 magnesium alloy by Ti addition (0, 0.2, 0.5, 1wt%Ti). An electric resistance furnace was used to produce alloys. Pure Mg together with Al, Al-Ti and Al-Mn were melted at 750 0C in a stainless steel crucible under controlled Ar gas atmosphere and then poured into a metal mould preheated at 250 0C. Microstructure characterizations were performed by light optical (LOM) and scanning electron microscope (SEM) after the wear test. Wear rates and friction coefficients were measured with a pin-on-disk type UTS-10 Tribometer test device under a load of 20N. The results showed that Ti addition altered the morphology and the amount of b-Mg17Al12 phase in the microstructure of AM60 alloy. b-Mg17Al12 phases on the grain boundaries were refined with increasing amount of Ti. An improvement in wear resistance of AM60 alloy was observed due to the alteration in the microstructure by Ti addition.