Complications of Tube Thoracostomy- How Well Are We Training our junior Doctors?

Objective:   This study aims to explore the common causative factors of dysfunctional closed chest drainage unit, their relative frequency and to give recommendations for its prevention. Study Design: Retrospective study Place and Duration of study: Department of Thoracic surgery, Nishter Medical University, Multan, between February 2015 and January 2017 Method: 139 patients were included in whom tube thoracostomy had been performed but it had failed in draining the pleural collection. Detailed history and thorough physical examination were carried out, Chest x-ray and where necessary chest CT scan were done to evaluate placement of chest tube and to work out the causative factor of dysfunctional closed chest drainage unit. Results: Out of the 139 study cases, 36(25.9%) were females while 103(74.1%) were male patients. Mean age of our study cases was 37.2 ±14.5 years (minimum age was 12 while maximum age was 65 years). A wrong connection of CDU was the most common cause of dysfunctional closed CDU. It was found in 24 cases (17.3%).Where as inadequate prime fluid, loose connections, kinked tubes; over full bottles were the other common problems. Conclusion: Dysfunctional closed chest drainage unit is a common but serious clinical problem which results in significant rise in morbidity, prolonged hospital stay and economic burden. It can be prevented by adopting proper protocol of tube thoracostomy. Keywords: Dysfunctional chest drainage unit, Faulty chest tubes, Non-functioning tube thoracostomy, Failure of chest drainage system. Abbreviations: Chest drainage unit-CDU, tube thoracostomy-T

Effect of Casting Pressure on the Properties of 100% Recycled Aggregate Concrete Pavers

The construction and demolition (C&D) waste is required to be recycled for sustainable development and to save natural resources. In this study, the influence of casting pressure on the properties of pavers made using Recycled Aggregate Concrete (RAC) was investigated. RAC mix having 60% fine and 40% coarse recyled aggregates was prepared using 20% cement (by weight of total aggregates). The same mix was used in making concrete pavers of size 200 mm x 100 mm x 60 mm by employing Compression Casting Technique (CCT). For comparison purposes, pavers of same size were also prepared using Natural Aggregate Concete (NAC) under the same casting pressure. Pavers were tested to determine their density, initial rate of water absorption, porosity and efflorescence. The tests were performed after 28 days of casting. The results showed that above mentioned properties of RAC pavers are improved with the increase of casting pressure; by increasing the casting pressure from 5 to 30 MPa, density, initial rate of water absorption and prosity of RAC was improved up to 2.01%, 83.6% and 51.7%, respectively. The results further indicated that compared to NAC pavers, RAC pavers exhibit inferior properties. No efflorescence was observed in RAC and NAC pavers

Non-Destructive Testing of Fully Recycled Aggregate Concrete Bricks Prepared by Compression Casting Technique

This research study aims to investigate the quality and strength of fully recycled aggregate concrete (RAC) bricks made by using Compression Casting Technique (CCT). Standard size RAC bricks were manufactured using 70% recycled coarse and 30% recycled fine concrete aggregates with 15% cement content by weight of total aggregates. Three values of casting pressure (i.e., 25, 30 and 35 MPa) were studied. Recycled concrete aggregates (fine and coarse) required for this study were produced by crushing of tested concrete samples having compressive strength range of 3000 to 4000 psi. Both destructive and non-destructive testing were performed on RAC bricks. Among NDT, ultrasonic pulse velocity test was performed to assess the quality of RAC bricks and based on results, a correlation between compressive strength and UPV test values is proposed. In addition, Schmitt hammer test was also performed, and their values were compared with laboratory tested samples. Results have highlighted that Schmitt hammer and UPV test can be consider as convenient and reliable way to assess the strength and quality of RAC bricks in the field

Progressive unsupervised domain adaptation for ASR using ensemble models and multi-stage training

In Automatic Speech Recognition (ASR), teacher-student (T/S) training has shown to perform well for domain adaptation with small amount of training data. However, adaption without ground-truth labels is still challenging. A previous study has shown the effectiveness of using ensemble teacher models in T/S training for unsupervised domain adaptation (UDA) but its performance still lags behind compared to the model trained on in-domain data. This paper proposes a method to yield better UDA by training multi-stage students with ensemble teacher models. Initially, multiple teacher models are trained on labelled data from read and meeting domains. These teachers are used to train a student model on unlabelled out-of-domain telephone speech data. To improve the adaptation, subsequent student models are trained sequentially considering previously trained model as their teacher. Experiments are conducted with three teachers trained on AMI, WSJ and LibriSpeech and three stages of students on SwitchBoard data. Results shown on eval00 test set show significant WER improvement with multi-stage training with an absolute gain of 9.8%, 7.7% and 3.3% at each stage

Hypothesis and conceptual framework development of cross cultural training and perceived success of expatriates

Rising trends of globalization in economic, managerial and social arenas have resulted in interpersonal contacts across the cultures. Multinational companies are increasingly focusing on trainings of their employees for improvement of performance. This research is based on the practical idea and literature review about the success of employees who are deputed for overseas assignments.Various factors related to the success or failures of expatriates have been explored in this study and one of the important aspects "cross cultural training" has been focused to find its impact on success of expatriates. This study encompasses the definition of cross cultural training ranging to its importance and effects. Substantial investment pertaining to foreign subsidiaries fashions the management to expect for the high returns, on the other hand, failure of expatriates adds significantly in failure of companies in deed.Proper cross cultural training of employees help them to shun the cultural shock and difficulties in adjustment abroad. For completion of this research, a very comprehensive questionnaire was designed basing on theoretical framework and a case study of expatriates of National Database and Registration Authority (NADRA) of Pakistan was carried out. Study found that there are multi-faceted uses of cross cultural training and it is one of the major sources to reduce cultural shock and pre-mature return of the employees.The research is not only useful for NADRA and Government Sector of Pakistan rather through conceptual work it is universally constructive for developing a general idea about cross cultural training and its impact on success of expatriates. This research specifically covered all related areas of expatriates of studied organization and findings have been discussed in order to grasp the relevant sides of topic by controlling rest of variables for getting potentially reliable results