Patient satisfaction plays a crucial role in assessing the quality of services provided by healthcare services. The purpose of the present study was to determine the factors influencing patient satisfaction towards services of a specialist medical centre. A cross sectional study was conducted among 300 patients attending a semi-private multidisciplinary specialist centre in Malaysia. They were provided with a set of self-administered questionnaires on patient satisfaction with the services received at the facility. Patient satisfaction was divided into three main components: patient characteristics, delivery of services and hospital characteristics. Additional qualitative comments were also obtained. The mainstay of the analysis was multivariate logistic regression. Altogether, 273 (91.2%) of the patients rated their overall satisfaction as “good” or “very good”. Hospital characteristics (i.e., cleanliness; OR: 30.58 (95% CI: 3.52 – 265.79), hospital appearance; OR: 12.69 (95% CI; 1.51 – 106.53) had the strongest influence on the patient’s overall satisfaction. The findings revealed that the reason a majority of patients liked the hospital was related to good quality of services (18.7%), comfort (21.9%) and the friendly staff (8.8%). Hence, hospital characteristics are the most important determinants of overall patient satisfaction. In addition, the quality of delivery services and a friendly staff should also be considered when improving hospital services in a multidisciplinary specialist centre.
In this study, residual oil from oil palm decanter cake (OPDC) was recovered using n-hexane through Soxhlet extraction process. The residual oil recovered was analysed for its physical and chemical properties. The oil content, moisture, Free Fatty Acid (FFA), Peroxide Value (PV), Iodine Value (IV), Deterioration of Bleachability Index (DOBI) and carotene were measured as 15.43±0.45% (dry), 70.96±0.14%, 6.42±0.11%, 4.37±0.04 meq/kg, 53.28±0.02 g/100 g, 1.93±0.03 and 833.20±39 ppm respectively. The results showed that its fatty acid composition, carotene and IV were comparable with the Malaysian Palm Oil Board (MPOB) standard for crude palm oil (CPO), whilst the properties of the other value had slightly exceeded due to oxidation during the extraction process.
A new smart grid system is widely used for energy supply system because it is simple, available, low cost, high efficiency and environmentally friendly. Conventionally, inverter techniques are utilised to convert input DC into output AC with the same frequency and phase. This process suffers the same problem which is a higher harmonic distortion, phase synchronisation, lower quality of waveform and long distance, among others. In this paper, three phase synchronous inverters (PSI) were used to direct synchronous PWM control, LCL filter, three phase RLC load, three phase Yg-Delta transformer, 5 km feeder with 2 MW load. PWM was used to generate the pulse signal for synchronisation. However, LCL filters were used to remove the noise in inverter output and transformer output side of the design. A balanced three phase load (10 kVAR) and also the input DC voltage 500 V were considered in this design. Three phase transformer (100kVA/260V/25kV) was used to increase the inverter output voltage and current with the fundamental frequency (50 Hz). The system conversion efficiency was 99.96% and phase synchronous error for each phase was approximately 4.5 degrees.
In this paper, a micropropagation protocol of sugar palm (Arenga pinnata Wurmb Merr) through callogenesis and somatic embryogenesis was examined. Callus induction frequency and somatic embryogenesis response were dependent on plant growth regulators (PGRs) and genotype. Semi-compact and compact embryogenic calluses were induced from excised immature zygotic embryo (IZE) cultured on semi-solid MS (Murashige & Skoog, 1962) medium supplemented with various concentration and combination of 2,4-dichlorophenoxyacetic acid (2,4-D) and 6-benzyl aminopurine acid (BAP). MS medium supplemented with 0.4 mg/L 2,4-D and 0.5 mg/L BAP was found optimum to induce 100% rate of embryogenic calluses and maximum degree of callus formation after 8 and 12 weeks of culture. The incorporation of increased sucrose concentration (60.0 g/L) and 2.0 g/L casein hydrolysate (CH) to the culture medium with similar PGRs composition enhanced the induction of globular somatic embryos (SEs), while addition of silver nitrate (AgNO3) produced SEs of different stages. SEs maturated in MS medium containing 1.0 mg/L BAP and 1.0 mg/L naphthalene-acetic acid (NAA) formed cotyledon-stage embryos. Clonal roots regeneration was obtained on half-strength MS devoid of PGRs after 4 months of culture. Frequent subcultures increased embryogenesis rate favourably.
This paper looks at electrical power generation from solar concentrator using thermoelectric generator. An experiment was conducted on a concentrator thermoelectric generator (CTEG) utilising solar thermal energy. The CTEG used a parabolic dish as concentrator with thermoelectric device installed at the focal point to convert thermal energy to generate electricity. The investigation covered the cooling effect of the cold side of the thermoelectric generator using natural and forced convection cooling for optimum output. Forced convection cooling with a fan provided 69% more power output from the CTEG system as the temperature difference across the TEG was greater than the system cooled by natural convection. The outcome of this project showed maximum power output was obtained for the CTEG system cooled by forced convection cooling.
MeSH terms: Body Temperature; Cold Temperature; Electricity; Hot Temperature; Temperature; Convection; Physical Phenomena
A prototype of three-fingered robot hand was very rigid in its motion, and prone to damages when dealing with hard surfaces or when subjected to external environmental forces. The robot hand could damage fragile objects during grasping tasks if a position control alone is used. Therefore, this study proposes application of force control to the robot hand to improve its current grasping capabilities. Impedance control that considers the dynamic of the robot to produce the softness like human hand was implemented in this study. The dynamical behaviour of the robot hand strongly depends on the impedance parameters known as virtual mass, damping and stiffness. Therefore, the optimal values of impedance parameters need to be investigated to develop a position-based impedance control for the robot finger. Hence, the objective of this study is to determine the optimal value of impedance parameters to impose desired dynamics to the robot system. A constant force weighing 100 g was used by implementing varying impedance parameters to the tip-end’s position. Three experiments were conducted: first to decide the order of parameters to be adjusted, then to determine the optimal value of impedance parameters, and finally to test the optimal values with random force applied to the robot finger. The determined optimal values are: stiffness=1000, damping=10 and mass=1. Thus, the combined parameters have proven that the modified position is capable of responding according to the exerted contact force.
Food waste is a mixture of organic residues that affect fermentation process. Thus, appropriate parameters should be optimised to ensure high biomethane production. In this research, response surface methodology (RSM) was utilised for building models, evaluating the significance of several independent factors (pH, temperature, substrate concentration and inocula size) and determining optimum conditions for desirable responses (biomethane yield). The RSM and contour plots set the optimum working factors in order to accomplish the desired biomethane yield. Results suggest that biomethane yield can be increased when pH and temperature are increased. Thus, the main effects of parameters are pH and temperature.
NiTi is well known for its shape memory effect and super elasticity (SE), and is widely used in medical, dentistry and aerospace applications. For shape memory, NiTi has the ability to undergo deformation at certain temperature then recover to its original shape while SE occurs at narrow temperature range just above its transformation temperature. It shows that this material remembers its original shape and is elastic under stress. The application of nitinol as partial replacement in reinforced concrete beam for seismic resistant structures is popular due to it re-centring capability and distinctive properties. Using Shape Memory Alloy (SMA) in structures has its downsides. Hence, hybrid reinforced concrete beam with SMA was introduced to improve the structure’s ductility and energy dissipation. Hence, this research is aimed at distinguishing microstructure and mechanical properties of SMA and steel rebar. Not much is known about how SMA behaves when subjected to compression. Therefore, X-Ray Diffraction (XRD) was used to analyse if any secondary phase exists and Differential Scanning Calorimetry (DSC) test was used to analyse the phase transformation. The results showed hybrid NiTi-steel rebar can address some deficiencies of NiTi and in terms of costs. On the other hand, combining them will result in super elastic recovery, displacement ductility and strength capacity for seismic resistant design.
Displacement ventilation (DV) has been found to be effective in cooling large indoor spaces, but its effectiveness in providing thermal comfort in tropical buildings requires more detailed analysis to be made. This study examines the thermal environment in a lecture hall cooled via DV using FloEFD, a computational fluid dynamics (CFD) software. A calibrated CFD simulation model was developed to replicate the actual atmospheric conditions of the DV-cooled lecture hall. Results indicate that some parts of the hall received more cooling and air movement than required which would result in local thermal discomfort, especially at the front seating areas. The CFD results were consistent with those of earlier studies which validated the simulation model. The findings can be used to determine the locations which are more prone to steep thermal gradients in addition to reducing thermal discomfort, which include suitable arrangements of occupants in the lecture hall when it is not fully occupied and resetting the diffusers’ supply air temperature.
The present study examines the interaction between concrete and steel plate, particularly on the load bearing capacity of concrete blocks under confinement effects. 12 concrete blocks with the dimensions of 200 mm × 200 mm in cross section and 200 mm high were tested up to failure under compression load through 10 mm thickness of steel bearing plate. A series of experimental testing were performed to determine the maximum load bearing capacity in different sizes of steel plate and to identify the possible failure modes. The experimental data obtained from the experimental investigations were compared with pre-existing experimental data obtained from literature and mathematical formulation in various international standards. Experimental results indicate that the use of larger bearing plate gave higher value of load bearing capacity compared with small bearing plate due to larger contact area, thus, resulting in better effect of confinement. It was found that the concrete blocks fail in the shape of inverse pyramid when the steel plate is placed on top of it. Besides, other failures are vertical cracks and splitting cracks which appeared at the outer edge of contact area.
Pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) has been recognised as an effective technique to analyse car paint. This study was conducted to assess the combination of Py-GC-MS and chemometric techniques to classify car paint primer, the inner layer of car paint system. Fifty car paint primer samples from various manufacturers were analysed using Py-GC-MS, and data set of identified pyrolysis products was subjected to principal component analysis (PCA) and discriminant analysis (DA). The PCA rendered 16 principal components with 86.33% of the total variance. The DA was useful to classify the car paint primer samples according to their types (1k and 2k primer) with 100% correct classification in the test set for all three modes (standard, stepwise forward and stepwise backward). Three compounds, indolizine, 1,3-benzenedicarbonitrile and p-terphenyl, were the most significant compounds in discriminating the car paint primer samples.
MeSH terms: Indolizines; Gas Chromatography-Mass Spectrometry; Paint; Terphenyl Compounds; Discriminant Analysis; Principal Component Analysis
In an earlier study, a three-fingered robot hand was developed for assembly work. Proportional Integral Derivative (PID) control was used to control the position of a DC micromotor measured by an encoder. However, PID control alone could not cater the nonlinearities due to friction of gears and varying loads applied to the finger. Therefore, in order to develop an intelligent control algorithm in future, the effects of varying PID gains need to be investigated to distinguish the optimal value that could produce the best transient response performance. This paper discusses the effect of varying PID gains on position transient response of the joint motor of robot hand through real-time experiments. Several ranges of KP, KI and KD were identified based on the required transient response parameters such as percentage overshoot (%OS), settling time (TS) of within 2%, steady state error (SSE) and rise time (TR). The gains are tuned across the range by a fixed interval with the tuning order starting from KP, KI and KD. It can be observed that the suitable ranges of PID are 0.3 to 0.5 for KP, 1.15 to 1.45 for KI and 0.10 to 0.14 for KD. Meanwhile, the optimum value of 0.4, 1.45 and 0.10 for KP, KI and KD respectively is found to produce 0 of % OS, 5.09 sec of TS and 2.48 sec of TR. Hence, the gains can be applied to the development of an improved position control using intelligent method for the robot hand in future works.
This study examines the effect of a low glycaemic index (LGI) intervention to improve dietary intake among women with Gestational Diabetes Mellitus (GDM). Women with GDM were randomised to receive either a low GI intervention (LGI; n = 20) or standard nutrition therapy (SNT; n = 20) for a 4-week period. Food Frequency Questionnaire (FFQ) and Three-Day Diet Record assessed the dietary intake and food choices. Dietary intake and food choices of the participants were comparable at baseline. At the end of the study, energy, protein, fat and carbohydrate were reduced in both groups (p < 0.05). In the LGI group, fibre and calcium intake was higher compared with SNT group. More participants in
the LGI group consumed rice from the low GI varieties, the whole grain breads and the low GI biscuits (p<0.05) compared with participants in the SNT group. The diet GI reduced significantly in the LGI group (50 ± 9 units) compared with the SNT group (57 ± 6) (p < 0.05). Findings showed low GI dietary intervention improved the dietary intake of women with GDM.
Keywords: Carbohydrate, dietary intake, Gestational Diabetes Mellitus, low glycaemic index
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
This study describes the adaptations of diatoms, Cylindrotheca fusiformis and other marine diatoms, in a new formulated enriched medium Tris-phosphate seawater (TP-SW). The medium was designed to maintain long-term cultures of wide-range marine diatoms in laboratory that produces high biomass of cultures. The diatoms were adapted and cultivated in the medium for 15 days and the number of cells was recorded daily. It was found that the number of cells declined after two weeks indicating death phase of the cells. This indicates that the TP-SW medium has supported the growth of diatoms during the period and can be used to cultivate diatoms in vitro. Studies on the TP-SW medium must be done to obtain optimal medium that can provide not only a conducive environment for the survival of diatoms but also high biomass production.
The objective of this study is to elucidate sorption mechanism of ammonia-N by Spent Mushroom Substrate Biochar (SMSB), produced from pyrolysis process of Spent Mushroom Substrate (SMS) at 550°C for two hours. Surface functional group, ash contents, and elemental compositions were analysed using Boehm titration, furnace and Inductively Coupled Plasma-Optical Emission Spectroscopy (ICPOES) respectively. Sorption parameters (i.e., sorbent dosage, input ammonia-N concentration, and contact time) were optimised, and the sorption data were analysed using kinetic models (i.e., pseudo-first-order and pseudo-second-order), and isotherm models (i.e., Langmuir, Freundlich, and Dubinin-Radushkevich (D-R)). The surface of SMSB consists of carboxylic (0.3 mmol/g), phenolic (0.5 mmol/g), and basic functional groups (0.2 mmol/g). Sorption of ammonia-N was best described by the pseudo-second-order kinetic model and the Dubinin-Radushkevich (D-R) isotherm model. The D-R sorption capacity for SMSB was 12.6 mg/g, and correlates well with the amount of acid functional groups (i.e., carboxylic and phenolic groups) in SMSB (i.e., 14.4 mg/g). The low Freundlich constant (n = 0.754), and low D-R mean free energy per mol of the adsorbate (E = 4.4 kJ/mol) indicates a physical sorption process, and ammonia-N binds with acid functional groups through weak forces. The result shows great potential of SMSB for removing ammonia-N in wastewater.
Agarwood or gaharu, due to its unique scent and quality is considered one of the most expensive wood in the world. This paper uses solvent trap, Gas Chromatography-Flame Ionization Detector (GC-FID) and Gas Chromatography-Mass Spectrometry (GC-MS) to establish agarwood quality, and is part of ongoing research. The result showed that monoterpenes hydrocarbon, sesquiterpenes hydrocarbon and oxygenated sesquiterpene contribute to agarwood smoke. Among many compounds extracted, 2-hydrdoxy-benzaldehyde, β-selinene and guaia-1(10),11-dien-15,2-olide were found dominant in monoterpenes hydrocarbon, sesquiterpenes hydrocarbon and oxygenated sesquiterpenes respectively. This finding pointed to the utility of solvent trap in extracting chemical compounds of agarwood smoke. This study is also useful for further research on establishing the grade of agarwood.
We describe a rare presentation of pontine infarction in a lady who was on dual antiplatelet therapy.
Her presentation includes one and a half syndrome, left facial nerve palsy and contralateral hemiataxia.
Magnetic resonance imaging (MRI) of the brain revealed acute infarction of the dorsal pons. A diagnosis
of “nine” syndrome secondary to lacunar stroke was made. She continued dual antiplatelet therapy
and her symptoms resolved completely over three months.
Placenta previa is a condition when the placental tissue extends over the internal cervical os. It is associated with
maternal and fetal morbidity and mortality. With intrauterine death, the mode of delivery will be more difficult to
decide. Here, we report a case of 30 years old G3P2 with placenta previa major diagnosed with intrauterine death at
29 weeks gestation who was managed conservatively and delivered vaginally with minimal complication. A good
patient selection and thorough counseling, patient with placenta previa major and intrauterine death still can be safely
delivered vaginally.
Myomectomy is rarely performed in pregnancy due to risk of miscarriage or pregnancy loss, bleeding and possible
hysterectomy. Myomectomy is mainly reserved for unavoidable indications such as rapidly growing fibroid or severe
pain with possiblity of red degeneration for which medical treatment failed. However, good outcome had been
reported in selective second trimester myomectomies.
Scleral buckle placement is a well-established technique for the treatment of primary rhegmatogenous retinal
detachment. Complications associated with scleral buckle are uncommon and its presentations can be vary. We
report a case of recurrent orbital cellulitis with anterior segment ischemia following a forgotten episode of previous
scleral buckling surgery, presenting with blurring of vision, redness and swelling of the lids. The presence of scleral
buckle was detected by detailed examination and confirmed by orbital imaging. Orbital infection and rubeosis iridis
were successfully treated with scleral buckle removal, intravenous antibiotics and intracameral ranibizumab.
However, the retinal detachment recurred and the visual acuity deteriorated to light perception. There was no further
intervention as the family declined in view of her old age. In cases of recurrent orbital infection, detailed clinical
examination is important to look for evidence of ocular prostheses as a source of infection. Orbital imaging is an
adjunct for making the diagnosis especially in cases where history is unreliable. Anterior segment ischemia due to
scleral buckle responds well to buckle removal with ranibizumab injection.