Patient’s Knowledge and Use of Sublingual Glyceryl Trinitrate Therapy in Taiping Hospital, Malaysia

Background: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self-administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

New Insight into Fluid Mechanics of Lorenz Equations

New physical insights into the nonlinear Lorenz equations related to flow resistance is discussed in this work. The chaotic dynamics related to Lorenz equations has been studied in many papers, which is due to the sensitivity of Lorenz equations to initial conditions and parameter uncertainties. However, the physical implication arising from Lorenz equations about convectional motion attracts little attention in the relevant literature. Therefore, as a first step to understand the related fluid mechanics of convectional motion, this paper derives the Lorenz equations again with different forced conditions in the model. Simulation work of the modified Lorenz equations without the viscosity or buoyancy force is discussed. The time-domain simulation results may imply that the states of the Lorenz equations are related to certain flow speed and flow resistance. The flow speed of the underlying fluid system increases as the flow resistance reduces. This observation would be helpful to analyze the coupling effects of different fluid parameters in a convectional model in future work.

Development of Light-Weight Fibre-Based Materials for Building Envelopes

Thin-walled elements with a matrix set on a base of high-valuable Portland cement with dispersed reinforcement from alkali-resistant glass fibres are used in a range of applications as claddings of buildings and infrastructure constructions as well as various architectural elements of residential buildings. Even though their elementary thickness and therefore total weight is quite low, architects and building companies demand on even further decreasing of the bulk density of these fibre-cement elements for the reason of loading elimination of connected superstructures and easier assembling in demand conditions. By the means of various kinds of light-weight aggregates it is possible to achieve light-weighing of these composite elements. From the range of possible fillers with different material properties granulated expanded glass worked the best. By the means of laboratory testing an effect of two fillers based on expanded glass on the fibre reinforced cement composite was verified. Practical applicability was tested in the production of commonly manufactured glass fibre reinforced concrete elements, such as channels for electrical cable deposition, products for urban equipment and especially various cladding elements. Even though these are not structural elements, it is necessary to evaluate also strength characteristics and resistance to environment for their durability in certain applications.

Comparison of Multivariate Adaptive Regression Splines and Random Forest Regression in Predicting Forced Expiratory Volume in One Second

Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients resulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF25, PEF, FEF25-75, FEF50 and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects) with the aforementioned input features. It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, as well as yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Thermal Characterization of Smart and Large-Scale Building Envelope System in a Subtropical Climate

The thermal behavior of a large-scale, phase change material (PCM) enhanced building envelope system was studied in regard to the need for pre-fabricated construction in subtropical regions. The proposed large-scale envelope consists of a reinforced aluminum skin, insulation core, phase change material and reinforced gypsum board. The PCM impact on an energy efficiency of an enveloped room was resolved by validation of the EnergyPlus numerical scheme and optimization of a smart material location in the core. The PCM location was optimized by a minimization method of a cooling energy demand. It has been shown that there is good agreement between the test and simulation results. The optimal location of the PCM layer in Hong Kong summer conditions has been then recomputed for core thicknesses of 40, 60 and 80 mm. A non-dimensional value of the optimal PCM location was obtained to be same for all the studied cases and the considered external and internal conditions.

Development of a Real-Time Simulink Based Robotic System to Study Force Feedback Mechanism during Instrument-Object Interaction

Robotic surgery is used to enhance minimally invasive surgical procedure. It provides greater degree of freedom for surgical tools but lacks of haptic feedback system to provide sense of touch to the surgeon. Surgical robots work on master-slave operation, where user is a master and robotic arms are the slaves. Current, surgical robots provide precise control of the surgical tools, but heavily rely on visual feedback, which sometimes cause damage to the inner organs. The goal of this research was to design and develop a realtime Simulink based robotic system to study force feedback mechanism during instrument-object interaction. Setup includes three VelmexXSlide assembly (XYZ Stage) for three dimensional movement, an end effector assembly for forceps, electronic circuit for four strain gages, two Novint Falcon 3D gaming controllers, microcontroller board with linear actuators, MATLAB and Simulink toolboxes. Strain gages were calibrated using Imada Digital Force Gauge device and tested with a hard-core wire to measure instrument-object interaction in the range of 0-35N. Designed Simulink model successfully acquires 3D coordinates from two Novint Falcon controllers and transfer coordinates to the XYZ stage and forceps. Simulink model also reads strain gages signal through 10-bit analog to digital converter resolution of a microcontroller assembly in real time, converts voltage into force and feedback the output signals to the Novint Falcon controller for force feedback mechanism. Experimental setup allows user to change forward kinematics algorithms to achieve the best-desired movement of the XYZ stage and forceps. This project combines haptic technology with surgical robot to provide sense of touch to the user controlling forceps through machine-computer interface.

The Effect of CPU Location in Total Immersion of Microelectronics

Meeting the growth in demand for digital services such as social media, telecommunications, and business and cloud services requires large scale data centres, which has led to an increase in their end use energy demand. Generally, over 30% of data centre power is consumed by the necessary cooling overhead. Thus energy can be reduced by improving the cooling efficiency. Air and liquid can both be used as cooling media for the data centre. Traditional data centre cooling systems use air, however liquid is recognised as a promising method that can handle the more densely packed data centres. Liquid cooling can be classified into three methods; rack heat exchanger, on-chip heat exchanger and full immersion of the microelectronics. This study quantifies the improvements of heat transfer specifically for the case of immersed microelectronics by varying the CPU and heat sink location. Immersion of the server is achieved by filling the gap between the microelectronics and a water jacket with a dielectric liquid which convects the heat from the CPU to the water jacket on the opposite side. Heat transfer is governed by two physical mechanisms, which is natural convection for the fixed enclosure filled with dielectric liquid and forced convection for the water that is pumped through the water jacket. The model in this study is validated with published numerical and experimental work and shows good agreement with previous work. The results show that the heat transfer performance and Nusselt number (Nu) is improved by 89% by placing the CPU and heat sink on the bottom of the microelectronics enclosure.

Role of Technological Innovation in Improving Manufacturing Performance: A Review

MSMEs are regarded as the sunrise sector of the Indian economy in view of its large potential for growth and likely socio economic impact specifically on employment and income generation. In today’s competitive business environment, global competition forces companies to continuously seek ways of improving their products and services. The pressure on organizations to adapt to new technologies and external threats requires resourcefulness, creativity and innovation. Market has become more open, competitive and customers more demanding. Without continuous technology innovation, no organization can ever remain competitive. Innovations reflect a critical way in which organizations respond to either technological or market challenges. The need of the market is to deliver high quality products through continuous changing in features in product, improve existing products, reduce their cost, and improve employee skills, training, technology infrastructure and financial policies. Therefore, the key factor of organization’s ability to change is innovation. The study presents a detailed review of literature on the role of technology innovation in improving manufacturing performance of industries.

Numerical Evaluation of Nusselt Number on the Hot Wall in Square Enclosure Filled with Nanofluid

In this paper, effects of using Alumina-water nanofluid on the rate of heat transfer have been investigated numerically. Physical model is a square enclosure with insulated top and bottom horizontal walls, while the vertical walls are kept at different constant temperatures. Two appropriate models are used to evaluate the viscosity and thermal conductivity of nanofluid. The governing stream-vorticity equations are solved using a second order central finite difference scheme, coupled to the conservation of mass and energy. The study has been carried out for the Richardson number 0.1 to 10 and the solid volume fraction 0 to 0.04. Results are presented by isotherms lines, average Nusselt number and normalized Nusselt number in different range of φ and Ri for forced, combined and natural convection dominated regime. It is found that higher heat transfer rate is predicted when the effects of nanoparticle is taken into account.

The Effects of Alkalization to the Mechanical Properties of the Ijuk Fiber Reinforced PLA Biocomposites

Today, the pollution due to non-degradable material such as plastics, has led to studies about the development of environmental-friendly material. Because of biodegradability obtained from natural sources, polylactid acid (PLA) and ijuk fiber are interesting to modify into a composite. This material is also expected to reduce the impact of environmental pollution. Surface modification of ijuk fiber through alkalinization with 0.25 M NaOH solution for 30 minutes was aimed to enhance its compatibility to PLA, in order to improve properties of the composite such as the mechanical properties. Alkalinization of the ijuk fibers annihilates some surface components such as lignin, wax and hemicelloluse, so the pore on the surface clearly appeared, decreasing of the density and diameter of the ijuk fibers. The change of the ijuk fiber properties leads to increase the mechanical properties of PLA composites reinforced the ijuk fibers through strengthening of the mechanical interlocking with the PLA matrix. An addition to enhance the distribution of the fibers in the PLA matrix, the stirring during DCM solvent evaporation from the mixture of the ijuk fibers and the dissolved-PLA can reduce amount of the trapped-voids and fibers pull-out phenomena, which can decrease the mechanical properties of the composite.

Experimental Study on the Creep Characteristics of FRC Base for Composite Pavement System

The composite pavement system considered in this paper is composed of a functional surface layer, a fiber reinforced asphalt middle layer and a fiber reinforced lean concrete base layer. The mix design of the fiber reinforced lean concrete corresponds to the mix composition of conventional lean concrete but reinforced by fibers. The quasi-absence of research on the durability or long-term performances (fatigue, creep, etc.) of such mix design stresses the necessity to evaluate experimentally the long-term characteristics of this layer composition. This study tests the creep characteristics as one of the long-term characteristics of the fiber reinforced lean concrete layer for composite pavement using a new creep device. The test results reveal that the lean concrete mixed with fiber reinforcement and fly ash develops smaller creep than the conventional lean concrete. The results of the application of the CEB-FIP prediction equation indicate that a modified creep prediction equation should be developed to fit with the new mix design of the layer.

Ambient Vibration Testing of Existing Buildings in Madinah

The elastic period has a primary role in the seismic assessment of buildings. Reliable calculations and/or estimates of the fundamental frequency of a building and its site are essential during analysis and design process. Various code formulas based on empirical data are generally used to estimate the fundamental frequency of a structure. For existing structures, in addition to code formulas and available analytical tools such as modal analyses, various methods of testing including ambient and forced vibration testing procedures may be used to determine dynamic characteristics. In this study, the dynamic properties of the 32 buildings located in the Madinah of Saudi Arabia were identified using ambient motions recorded at several, spatially-distributed locations within each building. Ambient vibration measurements of buildings have been analyzed and the fundamental longitudinal and transverse periods for all tested buildings are presented. The fundamental mode of vibration has been compared in plots with codes formulae (Saudi Building Code, EC8, and UBC1997). The results indicate that measured periods of existing buildings are shorter than that given by most empirical code formulas. Recommendations are given based on the common design and construction practice in Madinah city.

Current Strategic Trends – A Comparative Analysis of Hungarian Corporations

This paper deals with current strategic challenges related to the reshaping of the basic conditions of corporate operations. Through the experimental analysis of some domestic corporations, it presents how and to what extent Hungarian corporations are prepared for the current strategic challenges. The study examines how strategic directions and answer opportunities have changed in the following interrelated areas in the past five years: economic globalization, corporate sustainability, IT applications, labor force diversity and ethical competences. The conclusions of the empirical survey give a reliable basis on which economic organizations and enterprises can formulate their strategy.

Parameters Used in Gateway Selection Schemes for Internet Connected MANETs: A Review

The wide use of the Internet-based applications bring many challenges to the researchers to guarantee the continuity of the connections needed by the mobile hosts and provide reliable Internet access for them. One of proposed solutions by Internet Engineering Task Force (IETF) is to connect the local, multi-hop, and infrastructure-less Mobile Ad hoc Network (MANET) with Internet structure. This connection is done through multi-interface devices known as Internet Gateways. Many issues are related to this connection like gateway discovery, handoff, address auto-configuration and selecting the optimum gateway when multiple gateways exist. Many studies were done proposing gateway selection schemes with a single selection criterion or weighted multiple criteria. In this research, a review of some of these schemes is done showing the differences, the features, the challenges and the drawbacks of each of them.

Relations between Human Capital Investments and Business Excellence in Croatian Companies

Living today in turbulent business environment forces companies to distinguish from each other, securing sustainable competitive growth and competitive advantage. The best possible solution is to invest (effort and financial resources) within companies’ different practices of human resource management (HRM), more specifically in employees’ knowledge, skills and abilities. Applying this approach companies will create enviable level of human capital securing its economic growth. Employees become human capital for their employers at the moment when they contribute with their own knowledge and abilities in creating material and non-material value of the company. The main aim of this research is to explore the relations between human capital investments and business excellence of Croatian companies. Furthermore, the differences in the level of human capital investments with regard to several companies’ characteristics (e.g. size of the company, ownership and type of the industry) are investigated.

Thermal Regions for Unmanned Aircraft Systems Route Planning

Unmanned Aircraft Systems (UAS) become indispensable parts of modern airpower as force multiplier. One of the main advantages of UAS is long endurance. UAS have to take extra payloads to accomplish different missions but these payloads decrease endurance of aircraft because of increasing drag. There are continuing researches to increase the capability of UAS. There are some vertical thermal air currents, which can cause climb and increase endurance, in nature. Birds and gliders use thermals to gain altitude with no effort. UAS have wide wings which can use thermals like birds and gliders. Thermal regions, which is area of 2000-3000 meter (1 NM), exist all around the world. It is natural and infinite source. This study analyses if thermal regions can be adopted and implemented as an assistant tool for UAS route planning. First and second part of study will contain information about the thermal regions and current applications about UAS in aviation and climbing performance with a real example. Continuing parts will analyze the contribution of thermal regions to UAS endurance. Contribution is important because planning declaration of UAS navigation rules will be in 2015.

The Principle of the Protection of Legitimate Expectation: Analysis the Adjudications of Thailand Court

In reference to the legal state in the Thai legal system, most people understand the minor principles of the legal state form, which are the principles that can be explained and understood easily and the results can be seen clearly, especially in the legitimacy of administrative acts. Therefore, there is no awareness of justice, which is the fundamental value of Thai law. The legitimacy of administrative acts requires the administration to adhere to the constitution and legislative laws in enforcement of the laws. If it appears that the administrative acts are illegitimate, the administrative court, as the court of justice, will revoke those acts as if they had never been set in the legal system, this will affect people’s trust as they are unaware as to whether the administrative acts that appoint their lives are legitimate or not. Regarding the revocation of administrative orders by the administrative court as if those orders had never existed, the common individual surely cannot be expected to comprehend the security of their juristic position. Therefore, the legal state does not require a revocation of the government’s acts to terminate its legal results merely because those acts are illegitimate, but there should be considerations and realizations regarding the “The Principle of the Protection of Legitimate Expectation,” which is a minor principle in the legal state’s content that focuses on supporting and protecting legitimate expectations of the juristic position of an individual and maintaining justice, which is the fundamental value of Thai law.

Parametric Investigation of Aircraft Door’s Emergency Power Assist System (EPAS)

Fluid viscous damping systems are well suited for many air vehicles subjected to shock and vibration. These damping system work with the principle of viscous fluid throttling through the orifice to create huge pressure difference between compression and rebound chamber and obtain the required damping force. One application of such systems is its use in aircraft door system to counteract the door’s velocity and safely stop it. In exigency situations like crash or emergency landing where the door doesn’t open easily, possibly due to unusually tilting of fuselage or some obstacles or intrusion of debris obstruction to move the parts of the door, such system can be combined with other systems to provide needed force to forcefully open the door and also securely stop it simultaneously within the required time i.e. less than 8 seconds. In the present study, a hydraulic system called snubber along with other systems like actuator, gas bottle assembly which together known as emergency power assist system (EPAS) is designed, built and experimentally studied to check the magnitude of angular velocity, damping force and time required to effectively open the door. Whenever needed, the gas pressure from the bottle is released to actuate the actuator and at the same time pull the snubber’s piston to operate the emergency opening of the door. Such EPAS installed in the suspension arm of the aircraft door is studied explicitly changing parameters like orifice size, oil level, oil viscosity and bypass valve gap and its spring of the snubber at varying temperature to generate the optimum design case. Comparative analysis of the EPAS at several cases is done and conclusions are made. It is found that during emergency condition, the system opening time and angular velocity, when snubber with 0.3mm piston and shaft orifice and bypass valve gap of 0.5 mm with its original spring is used, shows significant improvement over the old ones.

Modelling of Organic Rankine Cycle for Waste Heat Recovery Process in Supercritical Condition

Organic Rankine Cycle (ORC) is the most commonly used method for recovering energy from small sources of heat. The investigation of the ORC in supercritical condition is a new research area as it has a potential to generate high power and thermal efficiency in a waste heat recovery system. This paper presents a steady state ORC model in supercritical condition and its simulations with a real engine’s exhaust data. The key component of ORC, evaporator, is modelled using finite volume method, modelling of all other components of the waste heat recovery system such as pump, expander and condenser are also presented. The aim of this paper is to investigate the effects of mass flow rate and evaporator outlet temperature on the efficiency of the waste heat recovery process. Additionally, the necessity of maintaining an optimum evaporator outlet temperature is also investigated. Simulation results show that modification of mass flow rate is the key to changing the operating temperature at the evaporator outlet.

Effectiveness of Biopesticide against Insects Pest and Its Quality of Pomelo (Citrus maxima Merr.)

Effect of biopesticide from wood vinegar and extracted substances from 3 medicinal plants such as: non taai yak (Stemona tuberosa Lour), boraphet (Tinospora crispa Mier) and derris (Derris elliptica Roxb) were tested on the age five years of pomelo. The selected pomelo was carried out for insects’ pest control and its quality. The experimental site was located at farmer’s orchard in Phichit Province, Thailand. This study was undertaken during the drought season (December to March). The extracted from plants and wood vinegar were evaluated in 6 treatments: 1) water as control; 2) wood vinegar; 3) S. tuberosa Lour; 4) T. crispa Mier; 5) D. elliptica Roxb; 6) mixed (wood vinegar + S. tuberosa Lour + T. crispa Mier + D. elliptica Roxb). The experiment was RCB with 6 treatments and 3 replications per treatment. The results showed that T. crispa Mier was the highest effectiveness for reduction population of thrips (Scirtothrips dorsalis Hood) and citrus leaf miner (Phyllocnistis citrella Stainton) at 14.10 and 15.37 respectively, followed by treatment of mixed, D. elliptica Roxb, S. tuberosa Lour and wood vinegar with significance different. Additionally, T. crispa Mier promoted the high quality of harvested pomelo in term of thickness of skin at 12.45 mm and S. tuberosa Lour gave the high quality of the pomelo in term of firmness (276.5 kg/cm2) and brix (11.0%).