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Emergency department systems engineering: Modelling and event simulation / Salman Zayed O Alharethi
No full textEmergency department systems are meant to ensure the timely delivery for essential healthcare services through complex systems. (ED) offers various services and have several components in its parts. Examined long previous research on system engineering and quality of healthcare resulting on these are influenced by operational management. Real time data are very helpful for decision making for any systems. Patient output feedback and satisfaction can be ensured with engineered management. EDs have become evident particularly in current scenario when the world is in the grip of the deadly COVID-19. All this implies that analysis is significant for improvement of services in the emergency department. Digital health has become an essential feature of the healthcare sector specifically in present situation of COVID-19 pandemic. Capacity of ED resources are over-utilized and insufficient. Capacity management is less quality and poor specially in devolving countries. Overcrowd patients’ arrival put resources at high usages, Management readiness is not capable to mobilize available resources at very minimum time. Performance of ED is failed due to huge volume of unexpected patients. Absence of a model for simulating the KPIs of ED based on real time events to enhance advance decisions. Operational effective management is absent within Patient ambulance transfer. Abstraction of research from 2000 to 2019 to understand emergency department processes was involved to create taxonomy on emergency services and its operations management. The last twenty year’s methods, problems, solutions allocated with emergency department were abstracted. The assessment of service quality of emergency departments improved significantly with the development of new tool of system performance indicators. In this context, the formulation of sensitive assessment proved to be appropriate for simulation experiment. The new tool was validated and showed the value of Kappa to be 0.763 and reliability Cronbach’s alpha to be 0.827. a reduction of patient waiting time at emergency department specially in Saudi Arabia as 38.57 percent less than current actual waiting time at medium hazard scenarios for door-to-door service time and with 61.63 percent of ED possessing time in Malaysia. Ninety percent of simulated cases was found to be within optimal range for data was collected before COVID-19 pandemic
Women workers in the informal sector of the textiles industry in Pakistan: A grounded theory approach / Erum Shafi
No full textPost liberalisation firm-level strategic decisions are an issue of concern in developing markets, particularly since the post Agreement on Textiles and Clothing (ATC) phase of the textile industry. The issue of workers’ well-being, the post ATC phase, is well documented in terms of the employment and wage aspects for women workers. There is, however, a dearth of knowledge in understanding women workers’ experiences following from firms’ strategic decisions in the informal labour market setting, despite the rise in informal women workers. Further, the position of informal women workers, which is where they “fit” given their “voice” with their employers, has not been adequately addressed in the literature. Therefore, the aim of this study is to explore and describe the above phenomena within the stitching and ginning departments of the textile hierarchy in Pakistan to develop a substantive theory that explains the experiences of the women workers in the informal labour market. A constructivist grounded method is utilized in the conduct of the study. A sample of 25 participants is selected, comprising women workers, employers/ supervisors/human resource managers and textile workforce planners (APTMA or All Pakistan Textile Mills Association, members). The analyses cover the aspects of discovering, describing and explaining the phenomenon of “tolerance/no voice”, which women workers’ experience as a result of the interrelationships and interactions of “employer decisions”, “tradition bearing”, and “worker performance”. Based on those interactions, expectations are formed on where the informal women workers’ “fit” within the hierarchy of the facility, and the textile sector in general. An understanding of the interactions of those conditions on the development of the “voice” is then used to forward corrective strategies for positioning women workers in the informal labour market of the industrial facility. The findings of the study reveal that “employer decisions”, “tradition bearing” and “worker performance” interact to form the contextual conditions that direct the expectations of employers and women workers in the informal labour market. These expectations of a “perfect fit” of women workers within the hierarchy of the industrial facility and their profession, result in a process of internal satisfaction, thereby giving rise to a situation of “tolerance/no voice.” Women workers tend to accept their place in an environment of negative workplace behavior. Women workers also respond to this environment through a process of compliance with what they describe as traditional women worker culture. The constructed theory from the findings are dynamic in nature as it represents all facets of experiences of women workers’ in the informal labour market. The substantive theory explains a wide variation in the work experiences of the women workers. The theory also explains and accounts for a wide range of conditions and responses that the women workers experience whilst in the informal job market
Digital storytelling on air pollution to create relevance in science learning / Joan Vivienne Moo Rejoss
No full textMaking sense in science learning by establishing relevance has been in the minds of
educators since the 1980s. Science learning could make use of an instructional strategy
that matches the current learning trend and allow the students to relate with what they
are learning. The narrative elements of digital stories incorporate real life issues to be
conveyed in a relatable way in science learning. This research explored the potential of
digital storytelling in establishing relevancy in science learning by focusing on the
process and product of digital storytelling that were done based on a societal issue that
is air pollution. Students generate digital stories and it is a complementary strategy that
can be used both inside and outside of the science classroom. This research also
described the experience and challenges of using digital storytelling in creating
relevancy for science learning. This research adopted a qualitative research design
where convenience sampling was used to select the samples who are the Form One
students from a rural school in Sabah, Malaysia. Students were introduced to digital
storytelling through a workshop and were asked to produce digital stories regarding air
pollution. Construction of the digital stories were guided by a Five Stage storyboard
and Microsoft Photo Story 3 was used to create the digital stories. Observation,
interviews, and digital artifact analysis were used to collect the findings. This research
concluded that digital stories produced by students on air pollution topic has potential
to create relevance in science learning through offering one of a kind experience that is
authentic, emotional, and empowering experience on air pollution. It was found that
students could gain benefits but also face several challenges from digital storytelling
experience in creating relevance for science learning. Some implications and
recommendations for future research were also discussed
Effects of a single mutation in Chikungunya virus non-structural protein on virus infection in Aedes albopictus and mammalian cell lines / Jolene Fu Yin Ling
Get PDFChikungunya virus (CHIKV) has caused large-scale epidemics of fever, rash and
arthritis since 2004. This unprecedented re-emergence has been mainly associated with
mutations in genes encoding structural envelope proteins, providing increased fitness in
the secondary vector Aedes (Ae.) albopictus. In the 2008-2013 CHIKV outbreaks across
Southeast Asia, an R82S mutation in non-structural protein 4 (nsP4) emerged early in
Malaysia or Singapore and quickly became predominant. To determine whether this
nsP4-R82S mutation provides a selective advantage in host cells which may have
contributed to the epidemic, the fitness of infectious clone-derived CHIKV with nsP4-
82R and nsP4-82S were compared in Ae. albopictus and mammalian cell lines. Viral
infectivity, dissemination and transmission in Ae. albopictus were not affected by the
mutation when the two variants were tested separately. In competition, the nsP4-82R
variant showed an advantage over nsP4-82S in dissemination to the salivary glands, but
only in late infection (10 days). In human rhabdomyosarcoma (RD) and embryonic
kidney (HEK-293T) cell lines coinfected at a 1:1 ratio, wild-type nsP4-82R virus was
rapidly outcompeted by nsP4-82S virus as early as one passage (3 days). However, this
fitness advantage was not observed in Vero cells. In conclusion, the nsP4-R82S
mutation provides a greater selective advantage in human cells than in Ae. albopictus,
which may explain its apparent natural selection during CHIKV spread in Southeast
Asia. This is an unusual example of a naturally occurring mutation in a non-structural
protein which may have facilitated epidemic transmission of CHIKV
Functional significance of senescence and autophagy in cancer-associated fibroblasts from oral squamous cell carcinoma / Tan May Leng
Get PDFOral squamous cell carcinoma (OSCC) is a malignancy that arises from the epithelial
cells within the oral cavity. It accounts for approximately 355,000 new cases worldwide
and is exceptionally prevalent in particular geographical areas such as Papua New
Guinea, the Indian subcontinent and South-East Asian countries. Despite advances in
surgical management and therapeutic approaches, the five-year survival rate of OSCC
patients has not improved significantly over the past few decades. The mortality
associated with OSCC is particularly high often due to late presentation, locoregional
recurrence, distant metastases and the development of second primary tumours. A
comprehensive understanding of the molecular pathogenesis of OSCC is required to
identify new druggable targets and inform innovations in the therapeutic approach.
OSCCs are a heterogeneous group of tumours and, whilst the majority of tumours are
aggressive and genetically unstable (GU-OSCC), a subset of genetically stable cancers
(GS-OSCC) has been identified that have a more favourable prognosis. Intriguingly,
cancer-associated fibroblasts (CAFs) from these tumours are phenotypically and
functionally distinct. Many of the characteristics ascribed to CAFs are shared by
autophagic and senescent fibroblasts, suggesting that these stress responses contribute to
the tumour-promoting properties of CAFs. The present study was designed to
investigate the possible link between autophagy and senescence in CAFs from OSCCs
and normal oral fibroblasts as well as to investigate the functional significance of these
CAF phenotypes in terms of promoting tumour growth, migration and invasion. The
results showed that autophagic and senescent phenotypes were closely related and CAFs
from GU-OSCCs were shown to be more senescent and also displayed impaired
autophagic flux than normal oral fibroblasts and CAFs from GS-OSCCs. Next, the
contribution of autophagy to the activated and senescent phenotypes of oral fibroblasts
was investigated using TGF-β1 as an inducer of myofibroblast differentiation and
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senescence, together with inhibitors of autophagy. The results demonstrated that altered
autophagy could regulate the activated and senescent phenotypes in oral fibroblasts.
This had functional significance because conditioned media collected from oral
fibroblasts with altered autophagy significantly enhanced migration and invasion of
OSCC cells in vitro. These data indicate that the autophagy-regulated secretion by
fibroblasts might be responsible, at least in part, for modulating the malignant
phenotypes of OSCC cells. Lastly, an in vitro model to conditionally induce senescence
in normal oral fibroblasts was established. Using this model that allowed synchronous
induction of senescence in normal fibroblasts, it was demonstrated that the secretome
from senescent fibroblasts enhanced OSCC cell migration and invasion. Taken together,
the results of the present study suggest that the physiological states of CAFs within the
OSCC tumour microenvironment might reflect different stages of the same sequential
pathway and/or be part of a unified biological programme in which autophagy precedes
activation and subsequent senescence during the acquisition of pro-tumorigenic CAF
phenotypes. These physiological stages of oral CAF transdifferentiation could possibly
be targeted therapeutically in the future for the better clinical management of patients
with OSCC
Clinicopathological study of oral lichen planus and oral linchenoid reaction / Eb Robson Gubod
Get PDFIntroduction: Oral lichen planus is a chronic inflammatory disease that affects the
mucosa of the oral cavity. Oral lichenoid reactions/ lesions share many clinical and
histopathological features with oral lichen planus, and represent a response to extrinsic or
causative factors (drugs, allergens). Aim: The purpose of this study was to evaluate the
clinical and histopathological features of oral lichen planus and oral lichenoid reactions/
lesions. Objectives: The objectives of this study were to assess the clinical and
histopathological features of patients diagnosed with oral lichen planus and oral lichenoid
reaction/ lesions. This study also sought to investigate the association between
clinicopathological characteristics and patients with/ without exposure to causative
factors. Finally, this study compared the ratio of plasma cells to lymphocytes in patients
with/ without exposure to causative factors. Methods: This study was conducted in a
retrospective manner in patients who have been diagnosed with oral lichen planus and
oral lichenoid reaction/ lesions in Faculty of Dentistry, University of Malaya. A total of
122 patients that met the inclusion criteria were studied. Socio-demographic and clinical
data for each case were obtained from clinical folders in Oral medicine clinic and
histopathology reports in Oral Pathology Research and Diagnostic Laboratory (OPDRL).
Histopathological data was extracted from the archived hematoxylin and eosin stained
slides in OPDRL. Histopathological scoring of plasma cells and lymphocytes was done
using 3D Histech and QuPath softwares. Data was analyzed using chi-square, logistic
regression, and receiver operating curve analysis. Results: There were significant
differences in plasma cells to lymphocytes ratio between patients who were exposed to
causative factors and those who were not (p=0.043 and p=0.031). Plasma cells to
lymphocytes ratio in patients exposed to causative factors was higher than those who were
not (p=0.048 and p=0.032). Presence of eosinophils was significantly associated with
exposure to causative factors (p=0.016 and p=0.011), deeper inflammatory infiltrate
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(p=0.016), and epithelial atrophy (p=0.043). Conclusion: This study demonstrated
association between the presence of eosinophils and exposure to causative factors, which
were consumption of medications that had been associated with oral lichenoid reaction,
and also presence of restorative materials adjacent to lesions. Moreover, this study
demonstrated higher plasma cells to lymphocytes ratio in patients exposed to causative
factors than those who were not. These findings strongly support the role of causative
factors, mainly the drugs and dental restorative materials in the etiology of oral lichenoid
reactions/ lesions, although it is difficult to pinpoint. Thus, in clinical settings, together
with proper history and clinical findings, these features may facilitate clinicians in
planning appropriate management for patients
Thermodynamic analysis and optimization of organic Rankine cycles using 1-butylpyridinium tetrafluoroborate as a geothermal fluid / Shabnam Kazemi
Get PDFOrganic Rankine cycle (ORC) is a promising technology for electricity generation by utilizing heat sources at low to moderate temperature that ranges between 80-350° C. In the present work, an ionic liquid (1-butylpyridinium tetrafluoroborate, C9H14NBF4), a known green chemical and non-volatile compound with good thermal and chemical stability, significant heat capacity, low vapor pressure and a wide liquid temperature range (25 to 459 °C), is utilized as a geothermal fluid. Simulation and optimization were conducted for a basic organic Rankine cycle (basic ORC), a regenerative organic Rankine cycle (RORC) and a two-stage evaporative organic Rankine cycle (TSORC) by maximizing exergy efficiency and minimizing specific investment cost. The operating parameters considered in the optimization exercise were evaporative and regenerative temperatures, pinch point temperature difference of evaporators and the degree of superheat. Peng Robinson equation of state was used, and isobutane (R-600a) and butane (R-600) were selected as working fluids. Comparisons were made between the performance of ORCs when C9H14NBF4 and water were individually used as a geothermal fluid. Utilization of an ionic liquid improved the performance of the three ORC configurations with the best performance generated from a basic ORC with exergy efficiency of 82.35% (R-600) and 87.70 %(R-600a). From an economic viewpoint, the amount of specific investment cost (SIC) is comparatively lower when ionic liquid is used as a geothermal fluid
Strain improvement of Pleurotus giganteus (BERK.) Karunarathna & K. D. Hyde Via conventional mating techniques / Ha Kwan Yun
Get PDFRecently, a commercial strain of Pleurotus giganteus (Berk.) Karunarathna & K.D. Hyde from China has been cultivated in Malaysia. Pleurotus giganteus was prone to insect infestation which led to heavy losses for farmers. The aim of this study was to generate new hybrids of P. giganteus that maybe resistant to pest and contamination. The commercial strain of P. giganteus from China (KLU-M 1227) and a wild strain from Malaysia (KLU-M 1391) were subjected to intraspecific breeding. Of the 56 combinations, 16 hybrids were obtained. All the 16 hybrids together with the parents were subjected to radial and linear growth study. Based on the median value, the hybrids were grouped into slow-growing with radial growth rate < 0.715 cm/day and linear growth rate < 0.295 cm/day, and fast-growing with radial growth rate ≥0.715 cm/day and linear growth rate ≥ 0.295 cm/day. The fast-growing strains with higher linear growth rate were tested for susceptibility to Trichoderma saturnisporum. The parents and three hybrids which were least susceptible to T. saturnisporum were cultivated. The parents and hybrids showed variation in the number of days for primordia formation and number of fruit bodies formed. Hybrid IH 32 gave the highest yield. The average biological efficiency of hybrid IH 32 for all the three generations was 479.66% higher compared to the parent KLU-M 1227 and 32.35% higher compared to the parent KLU-M 1391. The hybrid IH 32 had high nutritive values as it contained per 100g (dry weight): protein (16.3g), very high carbohydrate (6.8g), dietary fiber (2.73g), essential fatty acid, minerals, essential amino acids and vitamin B1 (7.8mg) and vitamin B3 (73.1mg)
Musical activities between father and toddler in local music centre in Klang Valley / Kang Yee Farn
Get PDFHistorically, different forms of musical activities, including singing, was one of the earliest ways of parents to bond with their children. Lullaby or other forms of singing has been used for ages to encourage or teach children necessary skills required in future. As recent studies signify, the effects of the music education from the early ages can have very positive effects on the children. Meanwhile, by growing the popularity of musical early childhood programs the number of researches on outcome of these classes are increasing. However, there are not many researches in which the focus specifically aim the effects of such courses on the emotional bonding between children and their fathers. Due to the modern life style, busy schedule, and the main role of the fathers as the provider for family, the number of mothers who attending the classes with their children are more than the fathers. Therefore, observing fathers who continuously attend the musical activity classes with their children can be much harder task for the researcher. Nevertheless, this matter should not be an obstacle to prevent researching the effects of the music and movement courses on the paternal bonding. This research contributes to raise the awareness of both fathers and the educators of the musical activity courses about the effects of the music and movement courses for children between 11 to 30 months on the paternal bonding. This research looks forward to help fathers to understand that what are the positive effects of musical activities on their emotional connections with their children. Furthermore, this research can be a reference for educators and course designers to gain a better insight of fathers standpoints about these current activities and what they believe is the most helpful part of these courses
Zulkifli Yusoff’s “Don’t Play during Maghrib” installation art: A visual interpretation based on social interactionism / Nursyakirin Zolkiflee
Get PDFZulkifli is a world class artist who can create social criticism art based on culture, education and economical stagnancy. “Don’t Play During Maghrib, Dialogue Series 2” (DPDM) is an exceptional artwork which represented him at the Venice Biennale in 1997. There is no written research about this artwork and also there are very limited references and materials on Malaysian installation art. This led the researcher to embark on this topic as a dissertation. Since, this research focuses on the installation artwork, it is appropriate to explore and study Zulkifli Yusoff’s artwork. It is qualitative research which aims at exploring the art elements and principles of his work that leads to the understanding of his style in depicting DPDM. It is also aims at understanding the social commentary according to Zulkifli’s personal views and experiences. Mead’s “Social Interactionism” approach will be used in analyzing DPDM. It is hoped that this thesis will reflect his thoughts and interpretation about Malay culture and Malaysian identity