In a time of rising demands on hospital reimbursement levels, focus on efficient operations is becoming more imperative. In health care systems, the measurement of efficiency is usually the first step in auditing individual performance of production units, e.g. hospitals, health centers, etc. It constitutes the rational framework for the distribution of human and other resources between and within health care facilities. The term efficiency is broadly used in economics and refers to the best utilization of resources in production. Typical example of efficiency is technical efficiency, referring to the effective use of resources in producing outputs. In the Farrell framework, a hospital is judged to be technically efficient if it is operating on the best practice production frontier in its hospital industry. In general, there are two main frontier methods in measuring efficiency. The first is Data Envelopment Analysis (DEA), a linear programming method which enables the measurement of efficiency consistent with the theoretically based concept of production efficiency. DEA typically examines the relationship between inputs to a production process and the outputs of that process. The second technique for assessing efficiency that is employed is Stochastic Frontier Analysis (SFA). This is an econometric technique to estimate a conventional function; with the difference being that efficiency is measured using the residuals from the estimated equation. The error term is therefore divided into a stochastic error term and a systematic inefficiency term.
MeSH terms: Efficiency; Health Facilities; Health Resources; Hospitals; Humans; Programming, Linear
Hospital Information System (HIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. This study is to describe those aspects of the implementation of hospital information system in three tertiary hospitals in Klang Valley; Serdang Hospital, Selayang Hospital and University Kebangsaan Malaysia Medical Centre (UKMMC). A qualitative study was conducted to obtain views on information system development and implementation in the hospitals mentioned above. In-depth interviews with personnel representing both the system providers and the end-users were done guided by a questionnaire. The results of the interviews were categorized into few themes namely the system development, human resource, scope of implementation, support system, user-friendly, training, hardware and security. There were differences in hospital information system development and implementation in the three hospitals. Each system has its own strengths and weaknesses that make it unique. In developing HIS, its important to ensure the system can work effectively and efficiently. Quality human resource, good support system, user-friendly and adequate training of the end-user will determine the success of implementation of HIS. Upgrading of hardware and software as needed is the basis to keep up with the pace of technology advancement and increasing number of patients. It is hoped that HIS will be implemented in all other hospitals with effective integration and networking.
MeSH terms: Hospital Information Systems; Humans; Information Systems; Malaysia; Surveys and Questionnaires; Software; Universities; Qualitative Research; Tertiary Care Centers
Mucopolysaccharidoses (MPS) are a group of inherited disorders caused by the defi ciency of specific lysosomal enzymes involved in glycosaminoglycans (GAGs) degradation. Currently, there are 11 enzyme deficiencies resulting in seven distinct MPS clinical syndromes and their subtypes. Different MPS syndromes cannot be clearly distinguished clinically due to overlapping signs and symptoms. Measurement of GAGs content in urine and separation of GAGs using high-resolution electrophoresis (HRE) are very useful initial screening tests for isotyping of MPS before specific enzyme diagnostics. In this study, we measured total urinary GAGs by a method using dimethylmethylene blue (DMB), and followed by isolation and separation of GAGs using high resolution electrophoresis (HRE)technique. Of 760 urine samples analyzed, 40 have abnormal GAGs HRE patterns. Thirty-five of these 40 cases have elevated urinary GAGs levels as well. These abnormal HRE patterns could be classified into 4 patterns: Pattern A (elevated DS and HS; suggestive of MPS I, II or VII; 16 cases), Pattern B (elevated HS and CS; suggestive of MPS III; 17 cases), and Pattern C (elevated KS and CS; suggestive of MPS IV, 5 cases), and Pattern D (elevated DS; suggestive of MPS VI; 2 cases). Based on the GAGs HRE pattern and a few discriminating clinical signs, we performed selective enzymatic investigation in 16 cases. In all except one case with MPS VII, the enzymatic diagnosis correlated well with the provisional MPS type as suggested by the abnormal HRE pattern. Our results showed that GAGs HRE is a useful, inexpensive and practical first-line screening test when MPS is suspected clinically, and it provides an important guide to further enzymatic studies on a selective basis.
In this multiple-subject study, intrinsic couplings between the primary motor (M1) and supplementary motor areas (SMA) were investigated. Unilateral (UNIright and UNIleft) self-paced tapping of hand fingers were performed to activate M1 and SMA. The intrinsic couplings were analysed using statistical parametric mapping, dynamic causal modeling (DCM) and Bayesian model analysis. Brain activation observed for UNIright and UNIleft showed contralateral and ipsilateral involvement of M1 and SMA. Ten full connectivity models were constructed with right and left M1 and SMA as processing centres. DCM indicated that all subjects prefer M1 as the intrinsic input for UNIright and UNIleft as indicated by a large group Bayes factor (GBF). Positive evidence ratio (PER) that showed strong evidence of Model 3 and Model 6 against other models in at least 12 out of 16 subjects, supported GBF results. The GBF and PER results were later found to be consistent with that of BMS for group studies with high expected posterior probability and exceedance probability. It was concluded that during unilateral finger tapping, the contralateral M1 would act as the input centre which in turn triggered the propagation of signals to SMA in the same hemisphere and to M1 and SMA in the opposite hemisphere.
MeSH terms: Bayes Theorem; Fingers; Motor Cortex; Probability; Precipitating Factors
The receptor-interacting protein 140 (RIP 140) is a well known nuclear repressor and has been shown to be crucial for female reproduction and metabolism. However, the function of this repressor in developmental processes is still unknown. We conducted a study to investigate the expression patterns of RIP 140 in developing zebrafish embryos. Semi-quantitative RT-PCR analysis revealed that RIP140 was highly expressed in the eye, swim bladder, reproductive and metabolic organs of adult zebrafish. During embryogenesis, RIP 140 mRNA was continuously expressed throughout all the developmental stages with the highest expression at 24 hours of post-fertilization (hpf). Furthermore, in situ hybridization whole-mounts revealed that the expression of this gene was mainly localized in the eyes, mid-brain, pectoral fin buds and somites. Therefore, this present study has provided a starting point for future investigations to examine the role of RIP 140 in the development of these organs.
In this paper, an improved method of reducing ambient noise in speech signals is introduced. The proposed noise canceller was developed using a computationally efficient (DFT) filter bank to decompose input signals into sub-bands. The filter bank was based on a prototype filter optimized for minimum output distortion. A variable step-size version of the (LMS) filter was used to reduce the noise in individual branches. The subband noise canceller was aimed to overcome problems associated with the use of the conventional least mean square (LMS) adaptive algorithm in noise cancellation setups. Mean square error convergence was used as a measure of performance under white and ambient interferences. Compared to conventional as well as recently developed techniques, fast initial convergence and better noise cancellation performances were obtained under actual speech and ambient noise.
Two sequential statistical experimental designs were used to screen and investigate the dependence of the amount of biodegradation of Procion Red MX-8B (PR-MX8B) on the fermentation variables. Fourteen factors were screened using the Plackett-Burman design. Among these factors, the most significant variables which included yeast extract, corn steep solids and starch influencing PR-MX8B decolourisation were statistically elucidated for optimization. The optimum concentrations of 5.00 g/l yeast extract, 2.99 g/l starch and 1.89 g/l corn steep solids were predicted by applying the Box-Behnken design to the second order polynomial model fitted to the results obtained. The best predicted optimal conditions verified experimentally yielded 72.11% while the predicted value from the polynomial model was 79.17%. The experimental values were in good agreement with the predicted values with a 90.81% degree of accuracy.
A preliminary study was carried out to fabricate a three electrode system based on electrochemical sensoring. The cyclic voltammetry (CV) technique was chosen to select the type of metal suitable for evaporation and to compare the results produced from the fabricated gold electrode with the conventional macro-electrode system. The methodology and apparatus used involved low cost apparatus and methodology such as soft lithography, wet-etching, thermal evaporation, direct current sputtering, polymethylmethacrylate moulding and polydimethylsiloxane coating. The experiment was conducted at a fixed scan rate of 100 mV/s by using 0.01 M K3Fe(CN)6 in 0.1M KCl and well known method using Randles-Sevcik equation, peak current ratio and voltage separation was used to analyze the characterization on the fabricated sensors. Electrodes of 6.5 mm2 and 0.26 mm2 were fabricated to prove the adsorption effect of the reactant and the influence of the electrode area on the value of the peak current. CV analysis proved that the fabricated sensor was reliable for a range of 24 h at 25ºC room temperature.
In agricultural systems, animals play a very important multifunctional role for developing communities
throughout the world. This is reflected in the generation of value-added products like meat, milk and eggs for food security; socio-economic benefits like increased income, security and survival, and an infinite variety of services such as the supply of draught power and dung for soil fertility. However, and despite this importance, the situation is awesome since the projected total meat and milk consumption levels in 2020 are far in excess of anticipated supply, and projections of both meat and milk will have to be doubled by 2050 to meet human requirements. Strategies for productivity growth from animals are therefore urgent, and are discussed in the context of the scenario of waning agriculture, extreme poverty and hunger, food crisis, the current contributions from the components of the animal industries, prevailing constraints, opportunities and strategies for improved production. Current trends suggest that the non-ruminant pig and poultry industries will continue to contribute the major share of meat and all of egg production to meet projected human needs. With ruminants by comparison, overall meat production continues to come mainly from the slaughter of numbers. Strategic opportunities exist for maximising productivity in improved production systems. These include targeting rainfed areas, development of small farms, integrated crop-animal systems, intensive application of productivity-enhancing technologies, promoting intensive use of crop residues and expanding the R&D frontiers with interdisciplinarity and farming
systems perspectives. The issues, together with increased investments and institutional commitment, provide for expanded animal production systems and productivity which can forcefully impact on improved human welfare in Asia in the immediate tomorrow.
Several binary and ternary medium- and long-chain triacylglycerol (MLCT)-enriched margarine formulations were examined for their solid fat content, heating profile, polymorphism and textural properties. MLCT feedstock was produced through enzymatic esterification of capric and stearic acids with glycerol. The binary formulations were produced by mixing MLCT feedstock blend (40%–90%) and palm olein (10%–60%) with 10% increments (w/w). Solid fat profiles of commercial margarines were used as a reference to determine the suitability of the formulations for margarine production. The solid fat content of the binary formulations of MO 82 and MO 91 (M, MLCT, O, palm olein) were similar to the commercial margarines at 25°C which met the basic requirement for efficient dough consistency. Ternary formulations using reduced MLCT feedstock blend proportion (from 80%–90% to 60%–70%) were also developed. The reduction of MLCT feedstock blend was
done as it had the highest production cost (3USD/kg) in comparison to palm olein (0.77USD/kg) and palm stearin (0.7USD/kg). The proportions of 5%–15% of palm stearin were substituted with palm olein in MO 64 and MO 73 (M, MLCT; O, palm olein) formulations with 5% increment (w/w). As a result, MOS 702010 and MOS 603010 (M, MLCT; O, palm olein; S, palm stearin) margarine formulations showed similar SFC % to the commercial margarines at 25ºC. These formulations were subsequently chosen to produce margarines. The onset melting and complete melting points of MLCT-enriched margarine formulations were high (51.04ºC –57.93ºC) due to the presence of a high amount of long chain saturated fatty acids. Most of the formulations showed β΄- crystals. MOS 702010 was selected as the best formulation due to values for textural parameters comparable (P
In this paper, the problem of steady laminar boundary layer flow of an incompressible viscous fluid over a moving thin needle is considered. The governing boundary layer equations were first transformed into non-dimensional forms. These non-dimensional equations were then transformed into similarity equations using the similarity variables, which were solved numerically using an implicit finite-difference scheme known as the Keller-box method. The solutions were obtained for a blunt-nosed needle. Numerical computations were carried out for various values of the dimensionless parameters of the problem which included the Prandtl number Pr and the parameter a representing the needle size. It was found that the heat transfer characteristics were significantly
influenced by these parameters. However, the Prandtl number had no effect on the flow characteristics due to the decoupled boundary layer equations.
MeSH terms: Hot Temperature; Needles; Nose; Paper; Pharmaceutical Solutions; Hydrodynamics
Frequency hopping spread spectrum (FHSS) systems with partial band interference require appropriate compounding of spread spectrum modulation, error correcting code, diversity and decoding method to receive improved transmission signal. In this paper, a fast FHSS system with regular low-density parity-check codes was employed to cater some anti-jamming competence by using good waterfall and error floor performance. The performance evalution of the previously mentioned system was conducted in the presence of partial band noise jamming. The best possible design of the system was achieved with the combination of diversity level L=2 with a probability rate of at 0.7 dB which showed the robustness of the system.
MeSH terms: Algorithms; Environment; Female; Humans; Noise; Parity; Probability
Elevated temperature affects marine benthic algae by reducing growth and limits the transport of electron or carbon fixation which may reduce the ability of the cell to use light. This resulting excess light energy may cause photoinhibition. In this study, the photosystem II of the benthic microalgal communities from Casey, eastern Antarctic were relatively unaffected by significant changes in temperatures up to 8ºC, along with high PAR level (450 μmol photons m–2 s–1). Similarly, the community was able to photosynthesize as the temperature was reduced to –5ºC. Recovery from saturating and photoinhibiting irradiances was not significantly influenced by temperatures at both –5ºC and 8ºC. These responses were consistent with those recorded by past experiments on Antarctic benthic diatoms and temperate diatoms which showed that climate change did not have a significant impact on the ability of benthic microalgae to recover from photoinhibitory temperature stress.
This research was focused on the thermoluminescence (TL) response of commercially produced single-mode telecommunication optical fibre manufactured by INOCORP (Canada). The fibres were either in the form of pure silica (SiO2) or as SiO2 doped with Ge or Al at concentrations appropriate for total internal reflection, as required for telecommunication purposes. Each of these INOCORP fibres had a core diameter of 125 ± 0.1 μm. It was noted that dopant concentration was not included among the data provided in the accompanying product data sheet. A particularly important parameter for obtaining the highest TL yield in this study was the dopant concentration of the SiO2 fibre. The dopants tended to diffuse during the production of the optical fibre. To obtain this parameter, proton induced X-ray emission (PIXE) analysis was utilised. PIXE while having limited depth resolution could unambiguously identify elements and analyse trace elements with a detection limit approaching μg g–1. For Al-doped fibres, dopant concentrations in the range of 0.98 – 2.93 mol% had been estimated, the equivalent range for Ge-doped fibres was 0.53 – 0.71 mol%. A linear dose response was observed following 2.5 MeV proton irradiation for Ge- and Al-doped fibres for up to 7 min exposure.
In this study polymer electrolytes composed of poly(methyl methacrylate) (PMMA) as a host polymer and ethylene carbonate (EC) as a plasticizer complexed with different lithium salts, i.e. lithium tetrafluoroborate (LiBF4) and lithium triflate (LiCF3SO3) were prepared by the solution casting technique. The conductivities of the films were characterized by impedance spectroscopy. At room temperature, the highest conductivities were 4.07 × 10–7S cm–1 and 3.40 × 10–5 S cm–1 achieved, respectively from the films containing 30 wt% LiBF4 in the PMMA-EC-LiBF4 system and 35 wt% LiCF3SO3 in the PMMA-EC-LiCF3SO3 system. The conductivity-temperature dependence of the films seemed to obey the Arrhenius equation in which the ion transport in these materials was thermally assisted. Scanning electron microscopy analysis showed that the surface of PMMA-EC-LiCF3SO3 film was smooth and homogeneous, hence lithium ions could traverse through the PMMA-EC-LiCF3SO3 film more easily compared to the PMMA-EC-LiBF4 film. X-Ray diffraction studies revealed that complexation had occurred and the complexes formed were amorphous.
In this study the effects of phosphorus and nitrogen levels, temperature and light-dark cycle on the algal growth potential (AGP) of an Antarctic Chlorococcum isolated from an ephemeral stream at Reeve Hill, Antarctica was investigated. The highest AGP was attained when the cultures were grown at high nitrogen concentration (329.87 mg NO3-N/l) and low phosphorus concentration (2.6 mg PO4-P/l) at 4ºC on a 12 h:12 h light-dark cycle. The results showed that Chlorococcum sp. required a high concentration of nitrogen, low concentration of phosphorus, low temperature with equal lengths of light and dark period (12 h:12 h) for optimum growth.
Ordered microporous NaY zeolite and mesoporous copper oxide are high performance material as catalysts and adsorbents. The copper oxide-NaY zeolite modification in combination of their physicochemical properties could provide excellent opportunities for the creation of new gas adsorbents. In this study, modified NaY zeolite properties and methane adsorptive characteristics were investigated by dispersing copper oxide onto the NaY zeolite structure using the thermal dispersion method. The structures of the copper oxide modified zeolites were characterized by powder X-ray diffraction and Micromeritics ASAP 2000, while the methane adsorption characteristics were analyzed using a thermogravimetric analyzer. The results revealed that types of copper oxide, copper oxide loading concentration, calcination temperature and calcination time greatly affected the modified zeolite structure and gas methane adsorption characteristics.
Introducing CO2 flux as the carbonate source had an effect on the carbonate content of carbonate apatite (CAp) synthesized by solid state reaction. The reactants were CaCO3 and beta-tricalcium phosphate (β-TCP) and the heat treatment in air was performed at 1250ºC followed by instant cooling in CO2 flux for temperatures ranging from 800ºC room temperature (RT) . The influence of CO2 flux at various temperature drop differences in the cooling process (1250ºC RT, 1250ºC–500ºC, 1250ºC–600ºC, 1250ºC–700ºC, and 1250ºC–800ºC) was tested to optimize the carbonation degree and subsequent effects on the physical and mechanical properties of CAp. Thermally treated samples revealed an increasing degree of carbonation, achieving a maximum of 5.2 wt% at the highest (1250ºC RT) and a minimum of 2.7 wt% at the lowest (1250ºC–800ºC) temperature drop differences, respectively. This showed that the carbonate content was correlated with the increase in exposure to CO2 flux. However, consistent compressive strength, tensile strength, density and porosity were observed against increasing temperature drop differences which indicated that the degree of carbonation exerted no influence on the physical and mechanical properties of CAp. This method enabled the synthesis of solid state CAp simply by exposing calcium phosphate mixtures to CO2 flux. It also allowed the control of carbonate content for desired medical applications.
Stem cells from human extracted deciduous teeth (SHED) have the ability to multiply much faster and double their population in culture at a greater rate, indicating that it may be in a more immature state than other type of adult stem cells. Mesenchymal stem cells (MSC) from human primary molars were isolated and cultured in media supplemented with 20% fetal bovine serum. The MSCs were confirmed using CD 105 and CD 166 and the identification of the osteoblast cells were done using reverse transcriptase polymerase chain reaction (RT-PCR) analysis. Differentiated osteoblast cells (DOC) were characterized by alkaline phosphotase and von Kossa staining followed by immunocytochemistry staining using osteocalcin and osteonectin antibodies. Further validation of SHED was done by RT-PCR to detect the presence of insulin-like growth factor 2 (IGF-2) and discoidin domain tyrosine kinase-2 (DDTK-2) transcripts, while the presence of Runx-2 mRNA was used to characterize DOC. The results showed that SHED was found positive for CD 105 and CD 166 and could differentiate into osteoblast, bone forming cells. The findings revealed the presence of distinct MSC population which had the capability to generate living human cells that could be a possible source for tissue engineering in the future.
Studies conducted on the various geometric properties of skeletons of water bodies have shown highly promising results. However, these studies were made under the assumption that water bodies were static objects and that they remained constant over time. Water bodies are actually dynamic objects; they go through significant spatio-temporal changes due to drought and flood. In this study, the characterization of skeletons of simulated drought and flood of water bodies was performed. It was observed that as the drought level increased from 1 to 9, the average length of the skeletons decreased due to reduction in the size of the water bodies and increase in the number of water bodies. As the drought level increased from 9 to 15, the average length of the skeletons increased further due to vanishing of small water bodies. Flood caused an increase in the average length of the skeletons due to merging of adjacent water bodies. Power law relationships were observed between the average length of the skeletons of the simulated drought/flood and the level of drought/flood. The scaling exponent of these power laws which was named as a fractal dimension, indicated the rate of change of the average length of the skeletons of simulated drought/flood of water bodies over varying levels of drought/flood. However, errors observed in the goodness of fit of the plots indicated that monofractals were not sufficient to characterise the skeletons of simulated drought and flood of water bodies. Multifractals and lacunarity analysis were required for more accurate characterisation.