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Limaye, Dnyanesh ; Fortwengel, Gerhard ; Shankar Pitani, Ravi ; Sathe, Sushama ; Chivate, Sanika ; Jagadale, Prabhas ; Saeed, Farah ; Alam, Syed Mahboob ; Rodilla, Vicent ; Mounib, Chaimae ; Santiesteban Jr., Edel
Background: Patient satisfaction is considered as an indicator of the healthcare quality. Information on patient satisfaction based on medical expertise of the physician, interpersonal skills, physician-patient interaction time, perception and needs of the patient allow policymakers to identify areas for improvement. Primary care services and healthcare structure differ between the countries. The present study was done to determine and analyze the determinants associated with patient satisfaction in India, Pakistan, Spain and USA.
Methods: This descriptive study was performed in January to August 2019 among students from Mumbai University, India, Dow University of Health Sciences, Karachi, Pakistan, University CEU Cardenal Herrera, Valencia, Spain, Texas State University, Texas, USA. On the basis of the eligibility criterion (those who gave a written informed consent and were registered students of respective university) 890 (India: 369, Pakistan: 128, Spain: 195, USA: 99) students were selected for the present study.
Results: India had almost similar male (49%) to female (51%) ratio of participants. For other 3 countries (PK, ES, US), female participant percentage was nearly 20% or even more as compared to male participants. Overall participant’s satisfaction score about medial expertise of the doctor were highest in India (71%) and were lowest in Spain (43%). Overall satisfaction score about time spent with doctor were highest for India (64%) and were lowest for Spain (41%). Overall satisfaction score about communication with doctor were highest for US (60%) and were lowest for PK (53%). Overall satisfaction score for medical care given by the doctor was lowest in PK (43%) and was highest in US (64%). Overall satisfaction about doctor, highest number of US (83%) and lowest number of PK (32%) participants were satisfied about medical interaction with doctors.
Conclusions: These multi-country findings can provide information for health policy making in India, Pakistan, Spain and USA. Although the average satisfaction per country, except Pakistan is more than 60%, the results suggest that there is ample room for improvement.
Background: The globalization of clinical research should also benefit the population in developing markets. In this context, the approval of tested medicines and the associated expansion of medical care beyond clinical studies would be desirable as a possible long-term benefit.
Objectives: This study was designed to compare the development of the number of clinical trials with the number of marketing authorizations of medicines on the African continent. To contrast these 2 parameters, the data were analyzed using the model of an ecological study.
Methods: To reflect the broad spectrum of African developing countries with diverse levels of development, the data collection was based on 2 geographically selected sample countries each from Central, North, East, West, and Southern Africa. Based on the ClinicalTrials.gov registry, the first step was to collect trends data on the development of the clinical trials in the 10 selected countries of the country list of the African Region published by the World Health Organization for the period 2015 to 2018. Subsequently, data on the current number of marketing authorizations of medicines in the selected sample countries were identified using the online registries of the national authorities. The data were utilized in comparative analyses.
Results: Eight out of 10 model countries showed an increase in the number of clinical trials, with the exceptions of Cameroon and Libya, which showed an overall decline in research activity over the entire time. In direct comparison with drug registrations, the numbers indicate a similar development. The only exception here is Nigeria, a country with a solid performance in clinical research and yet a decrease in medicine registrations since 2015.
Conclusions: The expected increase in the development of clinical research as result of the globalization trend can basically be observed in most of the model countries. However, this increase does not guarantee an improvement in the number of medicine registrations. Although this is evident in some of the selected model countries, it cannot be projected to the entire African region. This may be linked to the diverse development of the individual countries due to the different political situations and the varying degrees of clinical research infrastructure.
Parametric study of piezoresistive structures in continuous fiber reinforced additive manufacturing
(2024)
Heitkamp, Tim ; Goutier, Marijn ; Hilbig, Karl ; Girnth, Simon ; Waldt, Nils ; Klawitter, Günter ; Vietor, Thomas
Recent advancements in fiber reinforced additive manufacturing leverage the piezoresistivity of continuous carbon fibers. This effect enables the fabrication of structural components with inherent piezoresistive properties suitable for load measurement or structural monitoring. These are achieved without necessitating additional manufacturing or assembly procedures. However, there remain unexplored variables within the domain of continuous fiber-reinforced additive manufacturing. Crucially, the roles of fiber curvature radii and sensing fiber bundle counts have yet to be comprehensively addressed. Additionally, the compression-sensitive nature of printed carbon fiber-reinforced specimens remains a largely unexplored research area. To address these gaps, this study presents experimental analyses on tensile and three-point flexural specimens incorporating sensing carbon fiber strands. All specimens were fabricated with three distinct curvature radii. For the tensile specimens, the number of layers was also varied. Sensing fiber bundles were embedded on both tensile and compression sides of the flexural specimens. Mechanical testing revealed a linear-elastic behavior in the specimens. It was observed that carbon fibers supported the majority of the load, leading to brittle fractures. The resistance measurements showed a dependence on both the number of sensing layers and the radius of curvature, and exhibited a slight decreasing trend in the cyclic tests. Compared with the sensors subjected to tensile stress, the sensors embedded on the compression side showed a lower gauge factor.
Network convergence is an increasing trend in the automation domain. More and more plant owners strive for a unification of networks in their plants. This yields a seamless network structure, simplified supervision, and reduced training effort for the personnel, as only one unified network technology needs to be handled. Ethernet-APL is one piece of the puzzle for such a converged network, supporting various real time protocols like PROFINET, EtherNet, HART-IP as well as the middleware protocol OPC UA. This paper gives an overview on the impact of Ethernet-APL field devices to OT security and proposes how to ensure OT security for them.
OSGi in Cloud Environments
(2013)
Limaye, Dnyanesh ; Ziesenis, Patrick ; Limaye, Vaidehi ; Ahmad, Mansoor ; Saeed, Farah ; Alam, Mahboob ; Rizvi, Ramla ; Kapadi, Atul ; Sathe, Sushama ; Fortwengel, Gerhard
Background: Oral cancers (OC) are malignant lesions occurring in the oral cavity that include squamous cell carcinomas (SCC), salivary gland and odontogenic neoplasms. Even though it is the eighth most common malignancy globally but in Pakistan it is the second commonest type of cancer. Lack of awareness about ill-effects of preventable risk factors of oral cancer increases the burden of disease due to the associated high cost of treatment, permanent impairment and high mortality. Hence, awareness can be very helpful in prevention, control and early diagnosis of oral cancer.
Methods: A cross-sectional study was carried out among university students from Karachi, Pakistan during April to May 2018. Three hundred students were approached to participate in the study of which 277 agreed to participate. Pretested questionnaire was distributed and collected data was analysed using IBM SPSS version 23.
Results: There were 125 (45%) males and 152 (55%) females in the study and response rate was 94%. Sixty one percent (154/250) respondents correctly identified smoking, and tobacco chewing as possible causes of oral cancer. Almost one third (74%; 184/250) respondents correctly responded that oral cancer does not spread from person to person through touch or speaking. Sixty six percent (164/250) respondents believed that oral cancer is curable. Mean score of knowledge was higher in females (61%) than males (53%). Significantly higher number of females compared to male participants answered correctly to questions regarding cause of oral cancer, spread of disease and occurrence of oral cancer in AIDS patients.
Conclusions: Participants showed poor knowledge about oral cancer. Female participants showed better knowledge compared to male counterparts. Details about oral cancer should be incorporated in the university curriculum and periodic awareness programs should be organized for students.
Limaye, Dnyanesh ; Bhatkhande, Gauri ; Sabu, Shweta ; Jain, Aashvi ; Taskar, Poorva ; Gupta, Utkarsh ; Sydymanov, Arlan ; Limaye, Vaidehi ; Pitani, Ravi Shankar ; Sathe, Sushama ; Fortwengel, Gerhard ; Kanso, Zeinab
Background: Oral cancer is among the top three types of cancers in India. Severe alcoholism, use of tobacco in the form of cigarettes, smokeless tobacco, and betel nut chewing are the most common risk factors for oral cancer. Often individuals with pre cancer even notice the alterations, such as reduced mouth opening in oral submucous fibrosis (OSMF), but they are not aware about the causes and consequences of these changes. Awareness about causes and features of oral cancers can be very helpful in prevention, control and early diagnosis of oral cancer.
Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. Five hundred students were approached to participate in the study of which 400 agreed to participate. Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: There were 199 (49%) males and 201 (50%) females in the study and response rate was (80%). Respondents had good knowledge about oral cancer. Seventy four percent (268/362) respondents correctly identified smoking, and tobacco chewing as possible causes of oral cancer. Almost all (96%; 348/362) respondents correctly responded that oral cancer does not spread from person to person through touch or speaking. Seventy two percent (260/362) respondents believed that oral cancer is curable. Significantly higher number of male (98%) compared to female participants answered correctly to questions regarding spread of disease and occurrence of oral cancer in AIDS patients.
Conclusions: Participants showed good knowledge about oral cancer. Female participants showed lesser knowledge compared to male counterparts. Details about oral cancer should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.
The increasing variety of combinations of different building technology components offers a high potential for energy and cost savings in today's buildings. However, in most cases, this potential is not yet fully exploited due to the lack of intelligent supervisory control systems that are required to manage the complexity of the resulting overall systems. In this article, we present the implementation of a mixed-integer nonlinear model predictive control approach as a smart realtime building energy management system. The presented methodology is based on a forward-looking optimization of the overall energy costs. It takes into account energy demand forecasts and varying electricity market prices. We achieve real-time capability of the controller by applying a decomposition approach, which approximates the optimal solution of the underlying mixed-integer optimal control problem by convexification and rounding of the relaxed solution. The quality of the suboptimal solution is evaluated by comparison with the globally optimal solution obtained by the dynamic programming method. Based on a real-world scenario, we demonstrate that utilization of the real-time capable mixedinteger nonlinear model predictive control approach in a building control system leads to savings of 16% in the total operating costs and 13% in primary energy compared to the state-of-the-art control strategy without any loss of comfort for the residents.
This paper presents a novel approach for modelling the energy consumption of the coupled parallel moulding sand mixers of a foundry as an optimal control problem. The minimization of energy consumption is optimized by scheduling the mixing processes in a linear integer programming scheme. The sand flow through the foundry’s sand preparation is characterized by a physical model. This model considers the sand demand of the moulding machine as disturbance, the stored sand masses in the mixer hoppers and machine hoppers, respectively. The novel approach of handling dwell-times for dosing, mixing and transport processes using dead-time systems and constraint pushing allows the application of a linear model. The formulation of the optimal control problem aims at real-time application as model predictive control at the production plant. Initial application results indicate an improvement in energy consumption of approximately 8%.