Impact of Flexibility on Patient Satisfaction and Behavioral Intention: A Critical Reassessment and Model Development

In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Influence of Measurement System on Negative Bias Temperature Instability Characterization: Fast BTI vs Conventional BTI vs Fast Wafer Level Reliability

Negative Bias Temperature Instability (NBTI) is one of the critical degradation mechanisms in semiconductor device reliability that causes shift in the threshold voltage (Vth). However, thorough understanding of this reliability failure mechanism is still unachievable due to a recovery characteristic known as NBTI recovery. This paper will demonstrate the severity of NBTI recovery as well as one of the effective methods used to mitigate, which is the minimization of measurement system delays. Comparison was done in between two measurement systems that have significant differences in measurement delays to show how NBTI recovery causes result deviations and how fast measurement systems can mitigate NBTI recovery. Another method to minimize NBTI recovery without the influence of measurement system known as Fast Wafer Level Reliability (FWLR) NBTI was also done to be used as reference.

The Construction of a Probiotic Lactic Acid Bacterium Expressing Acid-Resistant Phytase Enzyme

The use of probiotics engineered to express specific enzymes has been the subject of considerable attention in poultry industry because of increased nutrient availability and reduced cost of enzyme supplementation. Phytase enzyme is commonly added to poultry feed to improve digestibility and availability of phosphorus from plant sources. To construct a probiotic with potential of phytate degradation, phytase gene (appA) from E. coli was cloned and transformed into two probiotic bacteria Lactobacillus salivarius and Lactococcus lactis. L. salivarous showed plasmid instability, unable to express the gene. The expression of appA gene in L. lactis was analyzed by detecting specific RNA and zymography assay. Phytase enzyme was isolated from cellular extracts of recombinant L. lactis, showing a 46 kDa band upon the SDS-PAGE analysis. Zymogram also confirmed the phytase activity of the 46 kDa band corresponding to the enzyme. An enzyme activity of 4.9U/ml was obtained in cell extracts of L. lactis. The growth of native and recombinant L. lactis was similar in the presence of two concentrations of ox bile.

Numerical Analysis of Cold-Formed Steel Shear Wall Panels Subjected to Cyclic Loading

Shear walls made of cold formed steel are used as lateral force resisting components in residential and low-rise commercial and industrial constructions. The seismic design analysis of such structures is often complex due to the slenderness of members and their instability prevalence. In this context, a simplified modeling technique across the panel is proposed by using the finite element method. The approach is based on idealizing the whole panel by a nonlinear shear link element which reflects its shear behavior connected to rigid body elements which transmit the forces to the end elements (studs) that resist the tension and the compression. The numerical model of the shear wall panel was subjected to cyclic loads in order to evaluate the seismic performance of the structure in terms of lateral displacement and energy dissipation capacity. In order to validate this model, the numerical results were compared with those from literature tests. This modeling technique is particularly useful for the design of cold formed steel structures where the shear forces in each panel and the axial forces in the studs can be obtained using spectrum analysis.

Experimental Investigations on the Mechanism of Stratified Liquid Mixing in a Cylinder

In this paper, the mechanism of stratified liquids’ mixing in a cylinder is investigated. It is focused on the effects of Rayleigh-Taylor Instability (RTI) and rotation of the cylinder on liquid interface mixing. For miscible liquids, Planar Laser Induced Fluorescence (PLIF) technique is applied to record the concentration field for one liquid. Intensity of Segregation (IOS) is used to describe the mixing status. For immiscible liquids, High Speed Camera is adopted to record the development of the interface. The experiment of RTI indicates that it plays a great role in the mixing process, and meanwhile the large-scale mixing is triggered, and subsequently the span of the stripes decreases, showing that the mesoscale mixing is coming into being. The rotation experiments show that the spin-down process has a great role in liquid mixing, during which the upper liquid falls down rapidly along the wall and crashes into the lower liquid. During this process, a lot of interface instabilities are excited. Liquids mix rapidly in the spin-down process. It can be concluded that no matter what ways have been adopted to speed up liquid mixing, the fundamental reason is the interface instabilities which increase the area of the interface between liquids and increase the relative velocity of the two liquids.

Experimental Investigation into Chaotic Features of Flow Gauges in Automobile Fuel Metering System

Chaotic system may lead to instability, extreme sensitivity and performance reduction in control systems. It is therefore important to understand the causes of such undesirable characteristics in control system especially in the automobile fuel gauges. This is because without accurate fuel gauges in automobile systems, it will be difficult if not impossible to embark on a journey whether during odd hours of the day or where fuel is difficult to obtain. To this end, this work studied the impacts of fuel tank rust and faulty component of fuel gauge system (voltage stabilizer) on the chaotic characteristics of fuel gauges. The results obtained were analyzed using Graph iSOFT package. Over the range of experiments conducted, the results obtained showed that rust effect of the fuel tank would alter the flow density, consequently the fluid pressure and ultimately the flow velocity of the fuel. The responses of the fuel gauge pointer to the faulty voltage stabilizer were erratic causing noticeable instability of gauge measurands indicated. The experiment also showed that the fuel gauge performed optimally by indicating the highest degree of accuracy when combined the effect of rust free tank and non-faulty voltage stabilizer conditions (± 6.75% measurand error) as compared to only the rust free tank situation (± 15% measurand error) and only the non-faulty voltage stabilizer condition (± 40% measurand error). The study concludes that both the fuel tank rust and the faulty voltage stabilizer gauge component have a significant effect on the sensitivity of fuel gauge and its accuracy ultimately. Also, by the reason of literature, our findings can also be said to be valid for all other fluid meters and gauges applicable in plant machineries and most hydraulic systems.

High Performance of Direct Torque and Flux Control of a Double Stator Induction Motor Drive with a Fuzzy Stator Resistance Estimator

In order to have stable and high performance of direct torque and flux control (DTFC) of double star induction motor drive (DSIM), proper on-line adaptation of the stator resistance is very important. This is inevitably due to the variation of the stator resistance during operating conditions, which introduces error in estimated flux position and the magnitude of the stator flux. Error in the estimated stator flux deteriorates the performance of the DTFC drive. Also, the effect of error in estimation is very important especially at low speed. Due to this, our aim is to overcome the sensitivity of the DTFC to the stator resistance variation by proposing on-line fuzzy estimation stator resistance. The fuzzy estimation method is based on an on-line stator resistance correction through the variations of the stator current estimation error and its variations. The fuzzy logic controller gives the future stator resistance increment at the output. The main advantage of the suggested algorithm control is to avoid the drive instability that may occur in certain situations and ensure the tracking of the actual stator resistance. The validity of the technique and the improvement of the whole system performance are proved by the results.

Hydrogen Production at the Forecourt from Off-Peak Electricity and Its Role in Balancing the Grid

The rapid growth of renewable energy sources and their integration into the grid have been motivated by the depletion of fossil fuels and environmental issues. Unfortunately, the grid is unable to cope with the predicted growth of renewable energy which would lead to its instability. To solve this problem, energy storage devices could be used. Electrolytic hydrogen production from an electrolyser is considered a promising option since it is a clean energy source (zero emissions). Choosing flexible operation of an electrolyser (producing hydrogen during the off-peak electricity period and stopping at other times) could bring about many benefits like reducing the cost of hydrogen and helping to balance the electric systems. This paper investigates the price of hydrogen during flexible operation compared with continuous operation, while serving the customer (hydrogen filling station) without interruption. The optimization algorithm is applied to investigate the hydrogen station in both cases (flexible and continuous operation). Three different scenarios are tested to see whether the off-peak electricity price could enhance the reduction of the hydrogen cost. These scenarios are: Standard tariff (1 tier system) during the day (assumed 12 p/kWh) while still satisfying the demand for hydrogen; using off-peak electricity at a lower price (assumed 5 p/kWh) and shutting down the electrolyser at other times; using lower price electricity at off-peak times and high price electricity at other times. This study looks at Derna city, which is located on the coast of the Mediterranean Sea (32° 46′ 0 N, 22° 38′ 0 E) with a high potential for wind resource. Hourly wind speed data which were collected over 24½ years from 1990 to 2014 were in addition to data on hourly radiation and hourly electricity demand collected over a one-year period, together with the petrol station data.

Stability Enhancement of a Large-Scale Power System Using Power System Stabilizer Based on Adaptive Neuro Fuzzy Inference System

A large-scale power system (LSPS) consists of two or more sub-systems connected by inter-connecting transmission. Loading pattern on an LSPS always changes from time to time and varies depend on consumer need. The serious instability problem is appeared in an LSPS due to load fluctuation in all of the bus. Adaptive neuro-fuzzy inference system (ANFIS)-based power system stabilizer (PSS) is presented to cover the stability problem and to enhance the stability of an LSPS. The ANFIS control is presented because the ANFIS control is more effective than Mamdani fuzzy control in the computation aspect. Simulation results show that the presented PSS is able to maintain the stability by decreasing peak overshoot to the value of −2.56 × 10−5 pu for rotor speed deviation Δω2−3. The presented PSS also makes the settling time to achieve at 3.78 s on local mode oscillation. Furthermore, the presented PSS is able to improve the peak overshoot and settling time of Δω3−9 to the value of −0.868 × 10−5 pu and at the time of 3.50 s for inter-area oscillation.

Analysis of the Gait Characteristics of Soldier between the Normal and Loaded Gait

The purpose of this research is to analyze the gait strategy between the normal and loaded gait. To this end, five male participants satisfied two conditions: the normal and loaded gait (backpack load 25.2 kg). As expected, results showed that additional loads elicited not a proportional increase in vertical and shear ground reaction force (GRF) parameters but also increase of the impulse, momentum and mechanical work. However, in case of the loaded gait, the time duration of the double support phase was increased unexpectedly. It is because the double support phase which is more stable than the single support phase can reduce instability of the loaded gait. Also, the directions of the pre-collision and after-collision were moved upward and downward compared to the normal gait. As a result, regardless of the additional backpack load, the impulse-momentum diagram during the step-to-step transition was maintained such as the normal gait. It means that human walk efficiently to keep stability and minimize total net works in case of the loaded gait.

Control of Underactuated Biped Robots Using Event Based Fuzzy Partial Feedback Linearization

Underactuated biped robots control is one of the interesting topics in robotics. The main difficulties are its highly nonlinear dynamics, open-loop instability, and discrete event at the end of the gait. One of the methods to control underactuated systems is the partial feedback linearization, but it is not robust against uncertainties and disturbances that restrict its performance to control biped walking and running. In this paper, fuzzy partial feedback linearization is presented to overcome its drawback. Numerical simulations verify the effectiveness of the proposed method to generate stable and robust biped walking and running gaits.

The Effect of Development of Two-Phase Flow Regimes on the Stability of Gas Lift Systems

Flow instability during gas lift operation is caused by three major phenomena – the density wave oscillation, the casing heading pressure and the flow perturbation within the two-phase flow region. This paper focuses on the causes and the effect of flow instability during gas lift operation and suggests ways to control it in order to maximise productivity during gas lift operations. A laboratory-scale two-phase flow system to study the effects of flow perturbation was designed and built. The apparatus is comprised of a 2 m long by 66 mm ID transparent PVC pipe with air injection point situated at 0.1 m above the base of the pipe. This is the point where stabilised bubbles were visibly clear after injection. Air is injected into the water filled transparent pipe at different flow rates and pressures. The behavior of the different sizes of the bubbles generated within the two-phase region was captured using a digital camera and the images were analysed using the advanced image processing package. It was observed that the average maximum bubbles sizes increased with the increase in the length of the vertical pipe column from 29.72 to 47 mm. The increase in air injection pressure from 0.5 to 3 bars increased the bubble sizes from 29.72 mm to 44.17 mm and then decreasing when the pressure reaches 4 bars. It was observed that at higher bubble velocity of 6.7 m/s, larger diameter bubbles coalesce and burst due to high agitation and collision with each other. This collapse of the bubbles causes pressure drop and reverse flow within two phase flow and is the main cause of the flow instability phenomena.

Recovering the Boundary Data in the Two Dimensional Inverse Heat Conduction Problem Using the Ritz-Galerkin Method

This article presents a numerical method to find the heat flux in an inhomogeneous inverse heat conduction problem with linear boundary conditions and an extra specification at the terminal. The method is based upon applying the satisfier function along with the Ritz-Galerkin technique to reduce the approximate solution of the inverse problem to the solution of a system of algebraic equations. The instability of the problem is resolved by taking advantage of the Landweber’s iterations as an admissible regularization strategy. In computations, we find the stable and low-cost results which demonstrate the efficiency of the technique.

Vibration and Parametric Instability Analysis of Delaminated Composite Beams

This paper revisits the free vibration problem of delaminated composite beams. It is shown that during the vibration of composite beams the delaminated parts are subjected to the parametric excitation. This can lead to the dynamic buckling during the motion of the structure. The equation of motion includes time-dependent stiffness and so it leads to a system of Mathieu-Hill differential equations. The free vibration analysis of beams is carried out in the usual way by using beam finite elements. The dynamic buckling problem is investigated locally, and the critical buckling forces are determined by the modified harmonic balance method by using an imposed time function of the motion. The stability diagrams are created, and the numerical predictions are compared to experimental results. The most important findings are the critical amplitudes at which delamination buckling takes place, the stability diagrams representing the instability of the system, and the realistic mode shape prediction in contrast with the unrealistic results of models available in the literature.

Proxisch: An Optimization Approach of Large-Scale Unstable Proxy Servers Scheduling

Nowadays, big companies such as Google, Microsoft, which have adequate proxy servers, have perfectly implemented their web crawlers for a certain website in parallel. But due to lack of expensive proxy servers, it is still a puzzle for researchers to crawl large amounts of information from a single website in parallel. In this case, it is a good choice for researchers to use free public proxy servers which are crawled from the Internet. In order to improve efficiency of web crawler, the following two issues should be considered primarily: (1) Tasks may fail owing to the instability of free proxy servers; (2) A proxy server will be blocked if it visits a single website frequently. In this paper, we propose Proxisch, an optimization approach of large-scale unstable proxy servers scheduling, which allow anyone with extremely low cost to run a web crawler efficiently. Proxisch is designed to work efficiently by making maximum use of reliable proxy servers. To solve second problem, it establishes a frequency control mechanism which can ensure the visiting frequency of any chosen proxy server below the website’s limit. The results show that our approach performs better than the other scheduling algorithms.

Peeling Behavior of Thin Elastic Films Bonded to Rigid Substrate of Random Surface Topology

We study the fracture mechanics of peeling of thin films perfectly bonded to a rigid substrate of any random surface topology using an analytical formulation. A generalized theoretical model has been developed to determine the peel strength of thin elastic films. It is demonstrated that an improvement in the peel strength can be achieved by modifying the surface characteristics of the rigid substrate. Characterization study has been performed to analyze the effect of different parameters on effective peel force from the rigid surface. Different surface profiles such as circular and sinusoidal has been considered to demonstrate the bonding characteristics of film-substrate interface. Condition for the instability in the debonding of the film is analyzed, where the localized self-debonding arises depending upon the film and surface characteristics. This study is towards improved adhesion strength of thin films to rigid substrate using different textured surfaces.

Stability of Concrete Moment Resisting Frames in View of Current Codes Requirements

In this study, the different approaches currently followed by design codes to assess the stability of buildings utilizing concrete moment resisting frames structural system are evaluated. For such purpose, a parametric study was performed. It involved analyzing group of concrete moment resisting frames having different slenderness ratios (height/width ratios), designed for different lateral loads to vertical loads ratios and constructed using ordinary reinforced concrete and high strength concrete for stability check and overall buckling using code approaches and computer buckling analysis. The objectives were to examine the influence of such parameters that directly linked to frames’ lateral stiffness on the buildings’ stability and evaluates the code approach in view of buckling analysis results. Based on this study, it was concluded that, the most susceptible buildings to instability and magnification of second order effects are buildings having high aspect ratios (height/width ratio), having low lateral to vertical loads ratio and utilizing construction materials of high strength. In addition, the study showed that the instability limits imposed by codes are mainly mathematical to ensure reliable analysis not a physical ones and that they are in general conservative. Also, it has been shown that the upper limit set by one of the codes that second order moment for structural elements should be limited to 1.4 the first order moment is not justified, instead, the overall story check is more reliable.

Designing Creative Events with Deconstructivism Approach

Deconstruction is an approach that is entirely incompatible with the traditional prevalent architecture. Considering the fact that this approach attempts to put architecture in sharp contrast with its opposite events and transpires with attending to the neglected and missing aspects of architecture and deconstructing its stable structures. It also recklessly proceeds beyond the existing frameworks and intends to create a different and more efficient prospect for space. The aim of deconstruction architecture is to satisfy both the prospective and retrospective visions as well as takes into account all tastes of the present in order to transcend time. Likewise, it ventures to fragment the facts and symbols of the past and extract new concepts from within their heart, which coincide with today’s circumstances. Since this approach is an attempt to surpass the limits of the prevalent architecture, it can be employed to design places in which creative events occur and imagination and ambition flourish. Thought-provoking artistic events can grow and mature in such places and be represented in the best way possible to all people. The concept of event proposed in the plan grows out of the interaction between space and creation. In addition to triggering surprise and high impressions, it is also considered as a bold journey into the suspended realms of the traditional conflicts in architecture such as architecture-landscape, interior-exterior, center-margin, product-process, and stability-instability. In this project, at first, through interpretive-historical research method and examining the inputs and data collection, recognition and organizing takes place. After evaluating the obtained data using deductive reasoning, the data is eventually interpreted. Given the fact that the research topic is in its infancy and there is not a similar case in Iran with limited number of corresponding instances across the world, the selected topic helps to shed lights on the unrevealed and neglected parts in architecture. Similarly, criticizing, investigating and comparing specific and highly prized cases in other countries with the project under study can serve as an introduction into this architecture style.

Selection of Wind Farms to Add Virtual Inertia Control to Assist the Power System Frequency Regulation

Due to the randomness and uncertainty of wind energy, modern power systems integrating large-scale wind generation will be significantly impacted in terms of system performance and technical challenges. System inertia with high wind penetration is decreasing when conventional thermal generators are gradually replaced by wind turbines, which do not naturally contribute to inertia response. The power imbalance caused by wind power or demand fluctuations leads to the instability of system frequency. Accordingly, the need to attach the supplementary virtual inertia control to wind farms (WFs) strongly arises. When multi-wind farms are connected to the grid simultaneously, the selection of which critical WFs to install the virtual inertia control is greatly important to enhance the stability of system frequency. By building the small signal model of wind power systems considering frequency regulation, the installation locations are identified by the geometric measures of the mode observability of WFs. In addition, this paper takes the impacts of grid topology and selection of feedback control signals into consideration. Finally, simulations are conducted on a multi-wind farms power system and the results demonstrate that the designed virtual inertia control method can effectively assist the frequency regulation.

Neuromuscular Control and Performance during Sudden Acceleration in Subjects with and without Unilateral Acute Ankle Sprains

Neuromuscular control of posture as understood through studies of responses to mechanical sudden acceleration automatically has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of acute condition has not been previously explored specially in a sudden acceleration. The aim of this study was to determine neuromuscular control pattern in those with and without unilateral acute ankle sprains. Design: Case - control. Setting: University research laboratory. The sinker–card protocol with surface translation was be used as a sudden acceleration protocol with study of EMG upon 4 posture stabilizer muscles in two sides of the body in response to sudden acceleration in forward and backward directions. 20 young adult women in two groups (10 LAS; 23.9 ± 2.03 yrs and 10 normal; 26.4 ± 3.2 yrs). The data of EMG were assessed by using multivariate test and one-way repeated measures 2×2×4 ANOVA (P< 0.05). The results showed a significant muscle by direction interaction. Higher TA activity of left and right side in LAS group than normal group in forward direction significantly be showed. Higher MGR activity in normal group than LAS group in backward direction significantly showed. These findings suggest that compared two sides of the body in two directions for 4 muscles EMG activities between and within group for neuromuscular control of posture in avoiding fall. EMG activations of two sides of the body in lateral ankle sprain (LAS) patients were symmetric significantly. Acute ankle instability following once ankle sprains caused to coordinated temporal spatial patterns and strategy selection.