Dispute avoidance procedure: observing the influence of legal culture towards a workable legal system

It is pertinent to specifically conduct research on the viability of introducing dispute avoidance procedure (DAP) for construction industry due to the lack of research in this area, as most of the current research covers various issues within dispute resolution procedure and management field. The objective of this study is to examine the future of DAP in the Malaysian construction industry by looking into the perceptions of the construction industry players. Data were collected through interview of selected respondents and analyses to reveal patterns to help formulate a viable DAP mechanism. NVivo software has been used to manage and organise complete interview transcripts and facilitate data analysis process for this study. This study reveals that the existing DAP mechanisms are not viable for the Malaysian construction industry at present, mainly due to the issue of costing. Thus, a modified version of DAP was formulated to promote a viable mechanism. This study suggests that the structural elements of a viable DAP mechanism could be in the form of an 'involvement of top management' from both contracting parties (without the involvement of any third parties) who are decision makers or persons with financial authority, and the process is through 'discussion and negotiation'. In essence, this study captures the legal culture and trade usage of the industry which assisted the formulation of a viable DAP mechanism

Local search heuristics for elective surgery scheduling considering patient urgency

This paper study a surgery scheduling and surgeon assignment problem in operating rooms focusing on elective patients with different urgency. A long waiting time can increase the patient’s urgency and lead to health complication. Our aim is to maximize the sum of the urgency values assigned to each surgery. An integer linear programming model is referred to solve the problem. As the model consume a high computational time to solve for a large-scale instance, we developed a local search algorithm based on a simple heuristic to deal with the problem. To test the efficiency of our proposed heuristics, we compare the solutions of integer linear programming model with the heuristics. The results show that solutions obtained by the local search algorithm are good quality and has significantly reduce the computational time even when considering more surgeries in the waiting list

Multicenter Phase 2 Trial of Sirolimus for Tuberous Sclerosis: Kidney Angiomyolipomas and Other Tumors Regress and VEGF- D Levels Decrease

Tuberous sclerosis (TSC) related tumors are characterized by constitutively activated mTOR signaling due to mutations in TSC1 or TSC2.We completed a phase 2 multicenter trial to evaluate the efficacy and tolerability of the mTOR inhibitor, sirolimus, for the treatment of kidney angiomyolipomas.36 adults with TSC or TSC/LAM were enrolled and started on daily sirolimus. The overall response rate was 44.4% (95% confidence intervals [CI] 28 to 61); 16/36 had a partial response. The remainder had stable disease (47.2%, 17/36), or were unevaluable (8.3%, 3/36). The mean decrease in kidney tumor size (sum of the longest diameters [sum LD]) was 29.9% (95% CI, 22 to 37; n = 28 at week 52). Drug related grade 1-2 toxicities that occurred with a frequency of >20% included: stomatitis, hypertriglyceridemia, hypercholesterolemia, bone marrow suppression (anemia, mild neutropenia, leucopenia), proteinuria, and joint pain. There were three drug related grade 3 events: lymphopenia, headache, weight gain. Kidney angiomyolipomas regrew when sirolimus was discontinued but responses tended to persist if treatment was continued after week 52. We observed regression of brain tumors (SEGAs) in 7/11 cases (26% mean decrease in diameter), regression of liver angiomyolipomas in 4/5 cases (32.1% mean decrease in longest diameter), subjective improvement in facial angiofibromas in 57%, and stable lung function in women with TSC/LAM (n = 15). A correlative biomarker study showed that serum VEGF-D levels are elevated at baseline, decrease with sirolimus treatment, and correlate with kidney angiomyolipoma size (Spearman correlation coefficient 0.54, p = 0.001, at baseline).Sirolimus treatment for 52 weeks induced regression of kidney angiomyolipomas, SEGAs, and liver angiomyolipomas. Serum VEGF-D may be a useful biomarker for monitoring kidney angiomyolipoma size. Future studies are needed to determine benefits and risks of longer duration treatment in adults and children with TSC.Clinicaltrials.gov NCT00126672

Comparing O’Brien test using mean, median, symmetric and asymmetric trimmed mean

The assumption of homogeneity of variances can be tested with O’Brien procedure since it is compatible with standard analysis of variance (ANOVA). The test is very sensitive to non-normality which lead to find the alternative technique by replacing the original test with the robust measure of location. This study will investigate the behaviour of O’Brien test on robustness by using the usual variances on mean, median, symmetric trimmed and asymmetric trimmed mean under normal distribution and skewed normal distributions. The results show that O’Brien test is robust when data is distributed at normal and skewed normal under certain simulation study condition

Solving overbooking appointment scheduling problem under patient no show condition using heuristics procedure and genetic algorithm

The existence of an efficient appointment schedule is important in the healthcare system since it can minimize patient waiting time, resource idle time, and resource overtime and, hence, optimize the utilization and productivity of healthcare organization. In this research, the overbooking technique is implemented to compensate for patient no-show behavior. The aims of this research are to identify the maximum number of patients that can be assigned to a time slot by examining the effects of multiple assignment and to construct a near-optimal overbooking appointment schedule. Heuristics procedure and genetic algorithm are used in this research. From the results obtained, the number of patients that can be assigned to a time slot is found to be at most three. This information can reduce the conflict which may occur when the patients arrive simultaneously. The results also show that the genetic algorithm has a better performance than the heuristics procedure in solving this problem

Simulated annealing approach for outpatient scheduling in a haemodialysis unit

National Renal Registry Malaysia has reported that the dialysis treatment demand among chronic kidney and end-stage kidney disease patients rises yearly. However, available haemodialysis (HD) units have limited facilities to meet the current and increasing demand. This leads to congestion, long waiting times, and an increase in the duration of treatment (DOT) among HD patients during their treatment sessions. Two essential factors in providing optimal treatment plans are outpatient scheduling and nurse assignment. Therefore, the objectives of this study are to minimise patients’ total DOT, including the waiting time for pre-dialysis and post-dialysis sessions, which also includes determining the amount of patient flow in an HD unit. Regarding the first objective, we include simulated annealing (SA) into our simple heuristics (SH) in the patient scheduling optimisation model. Here, the initial solution obtained from the method can be improved. The backtracking heuristic (BH) is then applied to the nurse assignment problem, where at least two nurses are needed for each dialysis patient. The results show that the solutions obtained for outpatient scheduling by SA are efficient and have significantly reduced the computational time compared with the SH, even when considering more patients on the waiting list. As for total DOT, we obtain the optimum value compared to the average DOT values for both 3-hour and 4-hour sessions. Besides, a discrete-event simulation (DES) experiment of patient flow in an HD unit was performed by gradual variations in patient arrival rates, λ, to avoid congestion in the system. DES has the potential to accommodate emergency patients that seek HD treatment without causing much disruption to the system

Double solutions and stability analysis of slip flow past a stretching/shrinking sheet in a carbon nanotube

A stagnation point flow past a stretching/shrinking surface in carbon nanotubes (CNTs) with slip effects is investigated in this paper. Applying transformations of similarity, the governing partial differential equations are modified to the nonlinear ordinary differential equations. Afterward, they are numerically solved in Matlab by the bvp4c solver. The single-wall CNTs and multi-wall CNTs are used, including water as a base fluid. The effects of the flow parameters are investigated, shown in the form of graphs, and physically evaluated for the dimensionless velocity, temperature, skin friction, and Nusselt numbers. According to our findings, the unique solution exists for stretching sheets, whereas non-unique solutions are obtainable for shrinking sheets. The stability analysis is utilized to discover which solution is stable

Developing the Value Management Maturity Model (VM3©)

Value management (VM) practices have been expanded and became a well-received technique globally. Organisations are now progressing towards a better implementation of VM and should be assessing their strengths and weaknesses in order to move forward competitively. There is a need to benchmark the existing VM practices to reflect their maturing levels which is currently not available. This paper outlines the concept of Value Management Maturity Model (VM3') as a structured plan of maturity and performance growth for businesses. It proposes five levels of maturity and each level has its own criteria or attributes to be achieved before progressing to a higher level. The framework for VM3' has been developed based on the review of literatures related to VM and maturity models (MM). Data is collected through questionnaire surveys to organisations that have implemented VM methodology. Additionally, semi-structured interviews were conducted to select individuals involved in implementing VM. The questions were developed to achieve the research objectives; investigating the current implementation of VM and, exploring the organisation's MM knowledge and practices. However, this research was limited to VM implementation in the Malaysian government's projects and programmes. VM3' introduces a new paradigm in VM as it provides a rating method for capabilities or performance. It is advocated that this VM3' framework is still being refined in the advance stage in order to provide a comprehensive and well accepted method to provide ratings for organisations' maturity

Exact analytical solution for MHD flow and heat transfer of Jeffrey fluid over a stretching sheet with viscous dissipation

The magnetohydrodynamic (MHD) flow and heat transfer of Jeffrey fluid over a stretching sheet with the presence of viscous dissipation is studied analytically. The governing partial differential equations are transformed to non-linear ordinary differential equations with the facilitation of sophisticated similarity variables, which are then being solved analytically by using exact analytical method. The effects of the physical parameters on the velocity and temperature distributions are presented through graphs, discussed and compared with the previous work of the same problem that has been solved numerically to verify the present analytical method being used. The skin friction coefficient and the local Nusselt number are also computed and analyzed