Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Autonomic Sonar Sensor Fault Manager for Mobile Robots

NASA, ESA, and NSSC space agencies have plans to put planetary rovers on Mars in 2020. For these future planetary rovers to succeed, they will heavily depend on sensors to detect obstacles. This will also become of vital importance in the future, if rovers become less dependent on commands received from earth-based control and more dependent on self-configuration and self-decision making. These planetary rovers will face harsh environments and the possibility of hardware failure is high, as seen in missions from the past. In this paper, we focus on using Autonomic principles where self-healing, self-optimization, and self-adaption are explored using the MAPE-K model and expanding this model to encapsulate the attributes such as Awareness, Analysis, and Adjustment (AAA-3). In the experimentation, a Pioneer P3-DX research robot is used to simulate a planetary rover. The sonar sensors on the P3-DX robot are used to simulate the sensors on a planetary rover (even though in reality, sonar sensors cannot operate in a vacuum). Experiments using the P3-DX robot focus on how our software system can be adapted with the loss of sonar sensor functionality. The autonomic manager system is responsible for the decision making on how to make use of remaining ‘enabled’ sonars sensors to compensate for those sonar sensors that are ‘disabled’. The key to this research is that the robot can still detect objects even with reduced sonar sensor capability.

Healthcare Waste Management Practices in Bangladesh: A Case Study in Dhaka City, Bangladesh

Healthcare waste (HCW) is one of the major concerns in environmental issues due to its infectious and hazardous nature that is requires specific treatment and systematic management prior to final disposal. This study aimed to assess HCW management system in Dhaka City (DC), Bangladesh, by investigating the present practices implemented by the city. In this study, five different healthcare establishments were selected in DC. Field visits and interviews with health personnel and staff who are concerned with the waste management were conducted. The information was gathered through questionnaire focus on the different aspect of HCW management like, waste segregation and collection, storage and transport, awareness as well. The results showed that a total of 7,215 kg/day (7.2 ton/day) of waste were generated, of which 79.36% (5.6 ton/day) was non-hazardous waste and 20.6% (1.5 ton/day) was hazardous waste. The rate of waste generation in these healthcare establishments (HCEs) was 2.6 kg/bed/day. There was no appropriate and systematic management of HCWs except at few private HCEs that segregate their hazardous waste. All the surveyed HCEs dumped their HCW together with the municipal waste, and some staff members were also found to be engaged in improper handling of the generated waste. Furthermore, the used sharp instruments, saline bags, blood bags and test tubes were collected for resale or reuse. Nevertheless, the lack of awareness, appropriate policy, regulation and willingness to act, were responsible for the improper management of HCW in DC. There was lack of practical training of concerned healthcare to handle the waste properly, while the nurses and staff were found to be aware of the health impacts of HCW.

Increase of Atmosphere CO2 Concentration and Its Effects on Culture/Weed Interaction

Climate change projections based on the emission of greenhouse effect gases suggest an increase in the concentration of atmospheric carbon dioxide, in up to 750 ppm. In this scenario, we have significant changes in plant development, and consequently, in agricultural systems. This study aims to evaluate the interaction between culture (Glycine max) and weed (Amaranthus viridis and Euphorbia heterophylla) in two conditions of CO2, 400 and 800 ppm. The results showed that the coexistence of culture with both weed species resulted in a mutual loss, with decrease in dry mass productivity of culture + weeds, in both conditions of CO2. However, when the culture is grown in association with E. heterophylla, total dry mass of culture + weed was smaller at 800 ppm. Soybean was more aggressive in comparison to the A. viridis in both the concentrations of CO2, but not in relation to the E. heterophylla.

Critical Analysis of Heat Exchanger Cycle for its Maintainability Using Failure Modes and Effect Analysis and Pareto Analysis

The Failure Modes and Effect Analysis (FMEA) is an efficient evaluation technique to identify potential failures in products, processes, and services. FMEA is designed to identify and prioritize failure modes. It proves to be a useful method for identifying and correcting possible failures at its earliest possible level so that one can avoid consequences of poor performance. In this paper, FMEA tool is used in detection of failures of various components of heat exchanger cycle and to identify critical failures of the components which may hamper the system’s performance. Further, a detailed Pareto analysis is done to find out the most critical components of the cycle, the causes of its failures, and possible recommended actions. This paper can be used as a checklist which will help in maintainability of the system.

Experimental Investigation on Freeze-Concentration Process Desalting for Highly Saline Brines

Using the freeze-melting process for the disposing of high saline brines was the aim of the paper by confirming the performance estimation of the treatment system. A laboratory bench scale freezing technique test unit was designed, constructed, and tested at Doha Research Plant (DRP) in Kuwait. The principal unit operations that have been considered for the laboratory study are: ice crystallization, separation, washing, and melting. The applied process is characterized as “the secondary-refrigerant indirect freezing”, which is utilizing normal freezing concept. The high saline brine was used as definite feed water, i.e. average TDS of 250,000 ppm. Kuwait desalination plants were carried out in the experimental study to measure the performance of the proposed treatment system. Experimental analysis shows that the freeze-melting process is capable of dropping the TDS of the feed water from 249,482 ppm to 56,880 ppm of the freeze-melting process in the two-phase’s course, whereas overall recovery results of the salt passage and salt rejection are 31.11%, 19.05%, and 80.95%, correspondingly. Therefore, the freeze-melting process is encouraging for the proposed application, as it shows on the results, which approves the process capability of reducing a major amount of the dissolved salts of the high saline brine with reasonable sensible recovery. This process might be reasonable with other brine disposal processes.

Performance Assessment of the Gold Coast Desalination Plant Offshore Multiport Brine Diffuser during ‘Hot Standby’ Operation

Alongside the rapid expansion of Seawater Reverse Osmosis technologies there is a concurrent increase in the production of hypersaline brine by-products. To minimize environmental impact, these by-products are commonly disposed into open-coastal environments via submerged diffuser systems as inclined dense jet outfalls. Despite the widespread implementation of this process, diffuser designs are typically based on small-scale laboratory experiments under idealistic quiescent conditions. Studies concerning diffuser performance in the field are limited. A set of experiments were conducted to assess the near field characteristics of brine disposal at the Gold Coast Desalination Plant offshore multiport diffuser. The aim of the field experiments was to determine the trajectory and dilution characteristics of the plume under various discharge configurations with production ranging 66 – 100% of plant operative capacity. The field monitoring system employed an unprecedented static array of temperature and electrical conductivity sensors in a three-dimensional grid surrounding a single diffuser port. Complimenting these measurements, Acoustic Doppler Current Profilers were also deployed to record current variability over the depth of the water column and wave characteristics. Recorded data suggested the open-coastal environment was highly active over the experimental duration with ambient velocities ranging 0.0 – 0.5 m∙s-1, with considerable variability over the depth of the water column observed. Variations in background electrical conductivity corresponding to salinity fluctuations of ± 1.7 g∙kg-1 were also observed. Increases in salinity were detected during plant operation and appeared to be most pronounced 10 – 30 m from the diffuser, consistent with trajectory predictions described by existing literature. Plume trajectories and respective dilutions extrapolated from salinity data are compared with empirical scaling arguments. Discharge properties were found to adequately correlate with modelling projections. Temporal and spatial variation of background processes and their subsequent influence upon discharge outcomes are discussed with a view to incorporating the influence of waves and ambient currents in the design of brine outfalls into the future.

Investigation of the Main Trends of Tourist Expenses in Georgia

The main purpose of the article is to make complex statistical analysis of tourist expenses of foreign visitors. We used mixed technique of selection that implies rules of random and proportional selection. Computer software SPSS was used to compute statistical data for corresponding analysis. Corresponding methodology of tourism statistics was implemented according to international standards. Important information was collected and grouped from the major Georgian airports. Techniques of statistical observation were prepared. A representative population of foreign visitors and a rule of selection of respondents were determined. We have a trend of growth of tourist numbers and share of tourists from post-soviet countries constantly increases. Level of satisfaction with tourist facilities and quality of service has grown, but still we have a problem of disparity between quality of service and prices. The design of tourist expenses of foreign visitors is diverse; competitiveness of tourist products of Georgian tourist companies is higher.

Experimental Study on Dehumidification Performance of Supersonic Nozzle

Supersonic nozzles are commonly used to purify natural gas in gas processing technology. As an innovated technology, it is employed to overcome the deficit of the traditional method, related to gas dynamics, thermodynamics and fluid dynamics theory. An indoor test rig is built to study the dehumidification process of moisture fluid. Humid air was chosen for the study. The working fluid was circulating in an open loop, which had provision for filtering, metering, and humidifying. A stainless steel supersonic separator is constructed together with the C-D nozzle system. The result shows that dehumidification enhances as NPR increases. This is due to the high intensity in the turbulence caused by the shock formation in the divergent section. Such disturbance strengthens the centrifugal force, pushing more particles toward the near-wall region. In return return, the pressure recovery factor, defined as the ratio of the outlet static pressure of the fluid to its inlet value, decreases with NPR.

Type–2 Fuzzy Programming for Optimizing the Heat Rate of an Industrial Gas Turbine via Absorption Chiller Technology

Terms set in power purchase agreements (PPA) challenge power utility companies in balancing between the returns (from maximizing power production) and securing long term supply contracts at capped production. The production limitation set in the PPA has driven efforts to maximize profits through efficient and economic power production. In this paper, a combined industrial-scale gas turbine (GT) - absorption chiller (AC) system is considered to cool the GT air intake for reducing the plant’s heat rate (HR). This GT-AC system is optimized while considering power output limitations imposed by the PPA. In addition, the proposed formulation accounts for uncertainties in the ambient temperature using Type-2 fuzzy programming. Using the enhanced chaotic differential evolution (CEDE), the Pareto frontier was constructed and the optimization results are analyzed in detail.

Perception of TQM Implementation and Perceived Cost of Poor Quality: A Case Study of Local Automotive Company’s Supplier

The confirmatory of Total Quality Management (TQM) implementation is most vital in quality management. This paper focuses on employees' perceptions towards TQM implementation in a local automotive company supplier. The objectives of this study are first and foremost to determine the perception of TQM implementation among the staff, and secondly to ascertain the correlation between the variables, and lastly to identify the relative influence of the 10 TQM variables on the cost of poor quality (COPQ). The TQM implementation is perceived to be moderate. All correlation is found to be significant and five variables having positively moderate to high correlation. Out of 10 variables, quality system improvement, reward and recognition and customer focus influence the perceived COPQ. This study extended a discussion on these three variables contribution to TQM in general and the human resource development in the organization. A significant recommendation to lowering costs of internal error, such as trouble shooting and scraps are also discussed. Certain components of further research that would add value to this study have also been suggested and perhaps could be implemented at policy-level initiatives.

The Model to Calculate the Cost of Money to the Breakdown of Deposits and Banking Service

The present study aimed to assess the cost of money based on separating deposits and identifying actions and costs affecting in the process of cost of money in EN Bank of Iran (also known as Eghtesad Novin Bank). The method to calculate the cost of money is based on Activity-Based Costing (ABC). To conduct the study, the required data including deposits in banks and absorbed costs related to the same deposits were extracted from the financial statements of the bank. In order to cost the bank services properly as well as determining the commercial strategies required by commercial units, the data are precisely studied and the cost of each deposit is calculated according to the ABC. Eventually, the factors helping to improve the cost management and also a new model to calculate the cost of money in the bank are presented by some applicable formulas. Furthermore, some offers have been provided for users of both sections, in the practical section in commercial units and the theoretical one in universities.

Electoral Mathematics and Asymmetrical Treatment to Political Parties: The Mexican Case

The Mexican Chamber of Deputies is composed of 500 representatives: 300 of them elected by relative majority and another 200 ones elected through proportional representation in five electoral clusters (constituencies) with 40 representatives each. In this mixed-member electoral system, the seats distribution of proportional representation is not independent of the election by relative majority, as it attempts to correct representation imbalances produced in single-member districts. This two-fold structure has been maintained in the successive electoral reforms carried out along the last three decades (eight from 1986 to 2014). In all of them, the election process of 200 seats becomes complex: Formulas in the Law are difficult to understand and to be interpreted. This paper analyzes the Mexican electoral system after the electoral reform of 2014, which was applied for the first time in 2015. The research focuses on contradictions and issues of applicability, in particular situations where seats allocation is affected by ambiguity in the law and where asymmetrical treatment of political parties arises. Due to these facts, a proposal of electoral reform will be presented. It is intended to be simpler, clearer, and more enduring than the current system. Furthermore, this model is more suitable for producing electoral outcomes free of contradictions and paradoxes. This approach would allow a fair treatment of political parties and as a result an improved opportunity to exercise democracy.

Friction Calculation and Simulation of Column Electric Power Steering System

This study presents a procedure for friction calculation of column electric power steering (C-EPS) system which affects handling and comfort in driving. The friction losses estimation is obtained from experimental tests and mathematical calculation. Parts in C-EPS mainly involved in friction losses are bearings and worm gear. In the theoretical approach, the gear geometry and Hertz law were employed to measure the normal load and the sliding velocity and contact areas from the worm gears driving conditions. The viscous friction generated in the worm gear was obtained with a theoretical approach and the result was applied to model the friction in the steering system. Finally, by viscous friction coefficient and Coulomb friction coefficient, values of friction in worm gear were calculated. According to the Bearing Company and the characteristics of each bearing, the friction torques due to load and due to speed were calculated. A MATLAB Simulink model for calculating the friction in bearings and worm gear in C-EPS were done and the total friction value was estimated.

Pervious Concrete for Road Intersection Drainage

Road performance and traffic safety are highly influenced by improper water drainage system performance, particularly within intersection areas. So, the aim of the presented paper is the evaluation of pervious concrete made with two types and two aggregate fractions for potential utilization in intersection drainage areas. Although the studied pervious concrete mixtures achieved proper drainage but lower strength characteristics, this pervious concrete has a good potential for enhancing pavement drainage systems if it is embedded on limited intersection areas.

Teaching Material, Books, Publications versus the Practice: Myths and Truths about Installation and Use of Downhole Safety Valve

The paper is related to the safety of oil wells and environmental preservation on the planet, because they require great attention and commitment from oil companies and people who work with these equipments. This must occur from drilling the well until it is abandoned in order to safeguard the environment and prevent possible damage. The project had as main objective the constitution resulting from comparatives made among books, articles and publications with information gathered in technical visits to operational bases of Petrobras. After the visits, the information from methods of utilization and present managements, which were not available before, became available to the general audience. As a result, it is observed a huge flux of incorrect and out-of-date information that comprehends not only bibliographic archives, but also academic resources and materials. During the gathering of more in-depth information on the manufacturing, assembling, and use aspects of DHSVs, several issues that were previously known as correct, customary issues were discovered to be uncertain and outdated. Information of great importance resulted in affirmations about subjects as the depth of the valve installation that was before installed to 30 meters from the seabed (mud line). Despite this, the installation should vary in conformity to the ideal depth to escape from area with the biggest tendency to hydrates formation according to the temperature and pressure. Regarding to valves with nitrogen chamber, in accordance with books, they have their utilization linked to water line ≥ 700 meters, but in Brazilian exploratory fields, their use occurs from 600 meters of water line. The valves used in Brazilian fields are able to be inserted to the production column and self-equalizing, but the use of screwed valve in the column of production and equalizing is predominant. Although these valves are more expensive to acquire, they are more reliable, efficient, with a bigger shelf life and they do not cause restriction to the fluid flux. It follows that based on researches and theoretical information confronted to usual forms used in fields, the present project is important and relevant. This project will be used as source of actualization and information equalization that connects academic environment and real situations in exploratory situations and also taking into consideration the enrichment of precise and easy to understand information to future researches and academic upgrading.

Production Optimization through Ejector Installation at ESA Platform Offshore North West Java Field

The offshore facilities condition of Pertamina Hulu Energi Offshore North West Java (PHE ONWJ) varies greatly from place to place, depending on the characteristics of the presently installed facilities. In some locations, such as ESA platform, gas trap is mainly caused by the occurrence of flash gas phenomenon which is known as mechanical-physical separation process of multiphase flow. Consequently, the presence of gas trap at main oil line would accumulate on certain areas result in a reduced oil stream throughout the pipeline. Any presence of discrete gaseous along continuous oil flow represents a unique flow condition under certain specific volume fraction and velocity field. From gas lift source, a benefit line is used as a motive flow for ejector which is designed to generate a syphon effect to minimize the gas trap phenomenon. Therefore, the ejector’s exhaust stream will flow to the designated point without interfering other systems.

In vitro Effects of Viscum album on the Functionality of Rabbit Spermatozoa

This study aimed to assess the in vitro effects of different concentrations of the Viscum album extract on the motility, viability, and reactive oxygen species (ROS) production by rabbit spermatozoa during different time periods (0, 2, and 8h). Spermatozoa motility was assessed by using the CASA (Computer aided sperm analysis) system. Cell viability was evaluated by using the metabolic activity MTT assay, and the luminol-based luminometry was applied to quantify the ROS formation. The CASA analysis revealed that low Viscum concentrations were able to prevent a rapid decline of spermatozoa motility, especially in the case of concentrations ranging between 1 and 5 µg/mL (P

Development of Prediction Models of Day-Ahead Hourly Building Electricity Consumption and Peak Power Demand Using the Machine Learning Method

To encourage building owners to purchase electricity at the wholesale market and reduce building peak demand, this study aims to develop models that predict day-ahead hourly electricity consumption and demand using artificial neural network (ANN) and support vector machine (SVM). All prediction models are built in Python, with tool Scikit-learn and Pybrain. The input data for both consumption and demand prediction are time stamp, outdoor dry bulb temperature, relative humidity, air handling unit (AHU), supply air temperature and solar radiation. Solar radiation, which is unavailable a day-ahead, is predicted at first, and then this estimation is used as an input to predict consumption and demand. Models to predict consumption and demand are trained in both SVM and ANN, and depend on cooling or heating, weekdays or weekends. The results show that ANN is the better option for both consumption and demand prediction. It can achieve 15.50% to 20.03% coefficient of variance of root mean square error (CVRMSE) for consumption prediction and 22.89% to 32.42% CVRMSE for demand prediction, respectively. To conclude, the presented models have potential to help building owners to purchase electricity at the wholesale market, but they are not robust when used in demand response control.

Haematology and Serum Biochemical Profile of Laying Chickens Reared on Deep Litter System with or without Access to Grass or Legume Pasture under Humid Tropical Climate

There has been a growing interest on the effects of access to pasture on poultry health status. However, there is a paucity of data on the relative benefits of grass and legume pastures. An experiment was conducted to determine the effects of rearing systems {deep litter system (DL), deep litter with access to legumes (LP) or grass (GP) pastures} haematology and serum chemistry of ISA Brown layers. The study involved the use of two hundred and forty 12 weeks old pullets. The birds were reared until 60 weeks of age. Eighty birds were assigned to each treatment; each treatment had four replicates of 20 birds each. Blood samples (2.5 ml) were collected from the wing vein of two birds per replicate and serum chemistry and haematological parameters were determined. The results showed that there were no significant differences between treatments in all the parameters considered at 18 weeks of age. At 24 weeks old, the percentage of heterophyl (HET) in DL and LP were similar but higher than that of GP. The ratio of H:L was higher (P