Large amplitude acoustic excitation of swirling turbulent jets

A swirling jet with a swirl number of S = 0.12 is exited by plane acoustic waves at various Strouhal numbers (St = fD/U sub alpha). The maximum forcing amplitude of excitation was at 6.88 percent of the time-mean axial velocity at a Strouhal number of St = 0.39. The maximum time-mean tangential and axial velocities at the nozzle exit were 18 and 84 m/sec respectively. It was observed that the swirling jet was excitable by plane acoustic waves and the preferred Strouhal number based on the nozzle diameter and exit axial velocity of the jet was about 0.39. As a result of excitation at this frequency, the time-mean axial velocity decayed faster along the jet centerline, reaching about 89 percent of its unexcited value at x/D = 9. Also the half velocity radius and momentum thichness, at 7 nozzle diameters downstream, increased by 13.2 and 5.8 percent respectively, indicating more jet spread and enhanced mixing. To our knowledge, this is the first reported experimental data indicating any mixing enhancement of swirling jets by acoustic excitation

Effect of initial tangential velocity distribution on the mean evolution of a swirling turbulent free jet

An existing cold jet facility at NASA-Lewis was modified to produce swirling flows with controllable initial tangential velocity distribution. Distinctly different swirl velocity profiles were produced, and their effects on jet mixing characteristics were measured downstream of an 11.43 cm diameter convergent nozzle. It was experimentally shown that in the near field of a swirling turbulent jet, the mean velocity field strongly depends on the initial swirl profile. Two extreme tangential velocity distributions were produced. The two jets shared approximately the same initial mass flow rate of 5.9 kg/s, mass averaged axial Mach number and swirl number. Mean centerline velocity decay characteristics of the solid body rotation jet flow exhibited classical decay features of a swirling jet with S = 0.48 reported in the literature. It is concluded that the integrated swirl effect, reflected in the swirl number, is inadequate in describing the mean swirling jet behavior in the near field

Controlled excitation of a cold turbulent swirling free jet

Experimental results from acoustic excitation of a cold free turbulent jet with and without swirl are presented. A flow with a swirl number of 0.35 (i.e., moderate swirl) is excited internally by plane acoustic waves at a constant sound pressure level and at various frequencies. It is observed that the cold swirling jet is excitable by plane waves, and that the instability waves grow about 50 percent less in peak rms amplitude, and saturate further upstream compared to corresponding waves in a jet without swirl having the same axial mass flux. The preferred Strouhal number based on the mass-averaged axial velocity and nozzle exit diameter for both swirling and nonswirling flows is 0.4. So far no change in the mean velocity components of the swirling jet is observed as a result of excitation

The effect of Aluminum on the increasing risk of developing anemia among workers of tile production plants

Background and aims: The aluminum-containing compounds are used as glaze in tile and ceramic production plants. It means that the workers working in these plants are in direct exposure to aluminum-containing compounds. The aim of this study was to assess the potential damages caused by aluminum among tile plant workers. Methods: In this cross-sectional study, 60 workers whom were in direct exposure to glazing material were enrolled as case group and 112 workers whose jobs were different from the case group and who had no exposure to the chemical materials in tile plants were considered as control group. After taking fasting blood samples, it was performed cell count tests using an automated blood cell counter. Serum iron and liver function test were measured using auto analyzer. Serum aluminum measurement was done by graphite furnace atomic absorption spectrometry and ferritin was measured by ELISA. Results: The serum aluminum level was significantly higher in the case group (7.26±2.63) than the control group (5.48±1.75) (P<0.001), as well as the mean hemoglobin level was lower in the case group (14.28±0.88) than the control group (15.44±1.19) (P<0.011). However, the mean level of iron and ferritin as well as liver tests exhibited no significant difference between two groups (P>0.05). Conclusion: Occupational exposure to aluminum in tile production industries could increase the serum aluminum level but may decrease blood hemoglobin concentration, which is a predisposing factor for anemia possibly through intervening in blood iron and ferritin

Modal dynamic analysis of a synchronizer mechanism: A numerical study

The present paper shows the modal dynamic behaviour of a single cone synchronizer mechanism. A 3D finite element model is proposed to calculate the natural frequency of the system. By using an efficient method, the natural frequencies of every single component as well as the full system are extracted under different boundary conditions. The natural frequencies of the system in neutral and engaged conditions are extracted and the effective modes are identified. The finite element model is extended to evaluate transient response of the synchronizer mechanism. The effect of different boundary conditions on the modal response is presented. The results show that changing the actuator position can have a significant effect on the dynamic responses of the system. This methodology can be implemented to examine the transient behaviour of other shifting mechanisms

Towards energy aware cloud computing application construction

The energy consumption of cloud computing continues to be an area of significant concern as data center growth continues to increase. This paper reports on an energy efficient interoperable cloud architecture realised as a cloud toolbox that focuses on reducing the energy consumption of cloud applications holistically across all deployment models. The architecture supports energy efficiency at service construction, deployment and operation. We discuss our practical experience during implementation of an architectural component, the Virtual Machine Image Constructor (VMIC), required to facilitate construction of energy aware cloud applications. We carry out a performance evaluation of the component on a cloud testbed. The results show the performance of Virtual Machine construction, primarily limited by available I/O, to be adequate for agile, energy aware software development. We conclude that the implementation of the VMIC is feasible, incurs minimal performance overhead comparatively to the time taken by other aspects of the cloud application construction life-cycle, and make recommendations on enhancing its performance

A Hybrid Fuzzy Multi-criteria Decision Making Model to Evaluate the Overall Performance of Public Emergency Departments: A Case Study

[EN] Performance evaluation is relevant for supporting managerial decisions related to the improvement of public emergency departments (EDs). As different criteria from ED context and several alternatives need to be considered, selecting a suitable Multicriteria Decision-Making (MCDM) approach has become a crucial step for ED performance evaluation. Although some methodologies have been proposed to address this challenge, a more complete approach is still lacking. This paper bridges this gap by integrating three potent MCDM methods. First, the Fuzzy Analytic Hierarchy Process (FAHP) is used to determine the criteria and sub-criteria weights under uncertainty, followed by the interdependence evaluation via fuzzy Decision-Making Trial and Evaluation Laboratory(FDEMATEL). The fuzzy logic is merged with AHP and DEMATEL to illustrate vague judgments. Finally, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) is used for ranking EDs. This approach is validated in a real 3-ED cluster. The results revealed the critical role of Infrastructure (21.5%) in ED performance and the interactive nature of Patient safety (C+R =12.771). Furthermore, this paper evidences the weaknesses to be tackled for upgrading the performance of each ED.Ortiz-Barrios, M.; Alfaro Saiz, JJ. (2020). A Hybrid Fuzzy Multi-criteria Decision Making Model to Evaluate the Overall Performance of Public Emergency Departments: A Case Study. International Journal of Information Technology & Decision Making. 19(6):1485-1548. https://doi.org/10.1142/S0219622020500364S14851548196Lord, K., Parwani, V., Ulrich, A., Finn, E. B., Rothenberg, C., Emerson, B., … Venkatesh, A. K. (2018). Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service. The American Journal of Emergency Medicine, 36(7), 1246-1248. doi:10.1016/j.ajem.2018.03.043Sørup, C. M., Jacobsen, P., & Forberg, J. L. (2013). Evaluation of emergency department performance – a systematic review on recommended performance and quality-in-care measures. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 21(1). doi:10.1186/1757-7241-21-62Farokhi, S., & Roghanian, E. (2018). Determining quantitative targets for performance measures in the balanced scorecard method using response surface methodology. Management Decision, 56(9), 2006-2037. doi:10.1108/md-08-2017-0772Ortiz Barrios, M. A., & Felizzola Jiménez, H. (2016). Use of Six Sigma Methodology to Reduce Appointment Lead-Time in Obstetrics Outpatient Department. Journal of Medical Systems, 40(10). doi:10.1007/s10916-016-0577-3Sunder M., V., Ganesh, L. S., & Marathe, R. R. (2018). A morphological analysis of research literature on Lean Six Sigma for services. International Journal of Operations & Production Management, 38(1), 149-182. doi:10.1108/ijopm-05-2016-0273Bergeron, B. P. (2017). Performance Management in Healthcare. doi:10.4324/9781315102214Santos, S. P., Belton, V., Howick, S., & Pilkington, M. (2018). Measuring organisational performance using a mix of OR methods. Technological Forecasting and Social Change, 131, 18-30. doi:10.1016/j.techfore.2017.07.028Ho, W., & Ma, X. (2018). The state-of-the-art integrations and applications of the analytic hierarchy process. European Journal of Operational Research, 267(2), 399-414. doi:10.1016/j.ejor.2017.09.007Dargi, A., Anjomshoae, A., Galankashi, M. R., Memari, A., & Tap, M. B. M. (2014). Supplier Selection: A Fuzzy-ANP Approach. Procedia Computer Science, 31, 691-700. doi:10.1016/j.procs.2014.05.317Jing, M., Jie, Y., Shou-yi, L., & Lu, W. (2015). Application of fuzzy analytic hierarchy process in the risk assessment of dangerous small-sized reservoirs. International Journal of Machine Learning and Cybernetics, 9(1), 113-123. doi:10.1007/s13042-015-0363-4Samanlioglu, F., Taskaya, Y. E., Gulen, U. C., & Cokcan, O. (2018). A Fuzzy AHP–TOPSIS-Based Group Decision-Making Approach to IT Personnel Selection. International Journal of Fuzzy Systems, 20(5), 1576-1591. doi:10.1007/s40815-018-0474-7CHEN, M.-F., TZENG, G.-H., & TANG, T.-I. (2005). FUZZY MCDM APPROACH FOR EVALUATION OF EXPATRIATE ASSIGNMENTS. International Journal of Information Technology & Decision Making, 04(02), 277-296. doi:10.1142/s0219622005001520Gul, M., Celik, E., Gumus, A. T., & Guneri, A. F. (2016). Emergency department performance evaluation by an integrated simulation and interval type-2 fuzzy MCDM-based scenario analysis. European J. of Industrial Engineering, 10(2), 196. doi:10.1504/ejie.2016.075846Jovčić, Průša, Dobrodolac, & Švadlenka. (2019). A Proposal for a Decision-Making Tool in Third-Party Logistics (3PL) Provider Selection Based on Multi-Criteria Analysis and the Fuzzy Approach. Sustainability, 11(15), 4236. doi:10.3390/su11154236Saaty, T. L., & Vargas, L. G. (2012). Models, Methods, Concepts & Applications of the Analytic Hierarchy Process. International Series in Operations Research & Management Science. doi:10.1007/978-1-4614-3597-6Vargas, L. G. (2016). Voting with Intensity of Preferences. International Journal of Information Technology & Decision Making, 15(04), 839-859. doi:10.1142/s0219622016400058Lee, K.-C., Tsai, W.-H., Yang, C.-H., & Lin, Y.-Z. (2018). An MCDM approach for selecting green aviation fleet program management strategies under multi-resource limitations. Journal of Air Transport Management, 68, 76-85. doi:10.1016/j.jairtraman.2017.06.011Labib, A., & Read, M. (2015). A hybrid model for learning from failures: The Hurricane Katrina disaster. Expert Systems with Applications, 42(21), 7869-7881. doi:10.1016/j.eswa.2015.06.020Hosseini, S., & Khaled, A. A. (2016). A hybrid ensemble and AHP approach for resilient supplier selection. Journal of Intelligent Manufacturing, 30(1), 207-228. doi:10.1007/s10845-016-1241-yZavadskas, E. K., Govindan, K., Antucheviciene, J., & Turskis, Z. (2016). Hybrid multiple criteria decision-making methods: a review of applications for sustainability issues. Economic Research-Ekonomska Istraživanja, 29(1), 857-887. doi:10.1080/1331677x.2016.1237302Lolli, F., Balugani, E., Ishizaka, A., Gamberini, R., Butturi, M. A., Marinello, S., & Rimini, B. (2019). On the elicitation of criteria weights in PROMETHEE-based ranking methods for a mobile application. Expert Systems with Applications, 120, 217-227. doi:10.1016/j.eswa.2018.11.030De Almeida Filho, A. T., Clemente, T. R. N., Morais, D. C., & de Almeida, A. T. (2018). Preference modeling experiments with surrogate weighting procedures for the PROMETHEE method. European Journal of Operational Research, 264(2), 453-461. doi:10.1016/j.ejor.2017.08.006Sun, G., Guan, X., Yi, X., & Zhou, Z. (2018). An innovative TOPSIS approach based on hesitant fuzzy correlation coefficient and its applications. Applied Soft Computing, 68, 249-267. doi:10.1016/j.asoc.2018.04.004Frazão, T. D. C., Camilo, D. G. G., Cabral, E. L. S., & Souza, R. P. (2018). Multicriteria decision analysis (MCDA) in health care: a systematic review of the main characteristics and methodological steps. BMC Medical Informatics and Decision Making, 18(1). doi:10.1186/s12911-018-0663-1Ortiz-Barrios, M. A., Herrera-Fontalvo, Z., Rúa-Muñoz, J., Ojeda-Gutiérrez, S., De Felice, F., & Petrillo, A. (2018). An integrated approach to evaluate the risk of adverse events in hospital sector. Management Decision, 56(10), 2187-2224. doi:10.1108/md-09-2017-0917Al Salem, A. A., & Awasthi, A. (2018). Investigating rank reversal in reciprocal fuzzy preference relation based on additive consistency: Causes and solutions. Computers & Industrial Engineering, 115, 573-581. doi:10.1016/j.cie.2017.11.027Aires, R. F. de F., & Ferreira, L. (2019). A new approach to avoid rank reversal cases in the TOPSIS method. Computers & Industrial Engineering, 132, 84-97. doi:10.1016/j.cie.2019.04.023Emrouznejad, A., & Yang, G. (2018). A survey and analysis of the first 40 years of scholarly literature in DEA: 1978–2016. Socio-Economic Planning Sciences, 61, 4-8. doi:10.1016/j.seps.2017.01.008Arya, A., & Yadav, S. P. (2017). Development of FDEA Models to Measure the Performance Efficiencies of DMUs. International Journal of Fuzzy Systems, 20(1), 163-173. doi:10.1007/s40815-017-0325-yMufazzal, S., & Muzakkir, S. M. (2018). A new multi-criterion decision making (MCDM) method based on proximity indexed value for minimizing rank reversals. Computers & Industrial Engineering, 119, 427-438. doi:10.1016/j.cie.2018.03.045Kaliszewski, I., & Podkopaev, D. (2016). Simple additive weighting—A metamodel for multiple criteria decision analysis methods. Expert Systems with Applications, 54, 155-161. doi:10.1016/j.eswa.2016.01.042Mousavi-Nasab, S. H., & Sotoudeh-Anvari, A. (2018). A new multi-criteria decision making approach for sustainable material selection problem: A critical study on rank reversal problem. Journal of Cleaner Production, 182, 466-484. doi:10.1016/j.jclepro.2018.02.062Chen, Z., Ming, X., Zhang, X., Yin, D., & Sun, Z. (2019). A rough-fuzzy DEMATEL-ANP method for evaluating sustainable value requirement of product service system. Journal of Cleaner Production, 228, 485-508. doi:10.1016/j.jclepro.2019.04.145Jumaah, F. M., Zadain, A. A., Zaidan, B. B., Hamzah, A. K., & Bahbibi, R. (2018). Decision-making solution based multi-measurement design parameter for optimization of GPS receiver tracking channels in static and dynamic real-time positioning multipath environment. Measurement, 118, 83-95. doi:10.1016/j.measurement.2018.01.011Singh, A., & Prasher, A. (2017). Measuring healthcare service quality from patients’ perspective: using Fuzzy AHP application. Total Quality Management & Business Excellence, 30(3-4), 284-300. doi:10.1080/14783363.2017.1302794Otay, İ., Oztaysi, B., Cevik Onar, S., & Kahraman, C. (2017). Multi-expert performance evaluation of healthcare institutions using an integrated intuitionistic fuzzy AHP&DEA methodology. Knowledge-Based Systems, 133, 90-106. doi:10.1016/j.knosys.2017.06.028Awasthi, A., Govindan, K., & Gold, S. (2018). Multi-tier sustainable global supplier selection using a fuzzy AHP-VIKOR based approach. International Journal of Production Economics, 195, 106-117. doi:10.1016/j.ijpe.2017.10.013Gul, M., Guneri, A. F., & Nasirli, S. M. (2018). A fuzzy-based model for risk assessment of routes in oil transportation. International Journal of Environmental Science and Technology, 16(8), 4671-4686. doi:10.1007/s13762-018-2078-zKazancoglu, Y., Kazancoglu, I., & Sagnak, M. (2018). Fuzzy DEMATEL-based green supply chain management performance. Industrial Management & Data Systems, 118(2), 412-431. doi:10.1108/imds-03-2017-0121Abdullah, L., & Zulkifli, N. (2015). Integration of fuzzy AHP and interval type-2 fuzzy DEMATEL: An application to human resource management. Expert Systems with Applications, 42(9), 4397-4409. doi:10.1016/j.eswa.2015.01.021Ashtiani, M., & Azgomi, M. A. (2016). A hesitant fuzzy model of computational trust considering hesitancy, vagueness and uncertainty. Applied Soft Computing, 42, 18-37. doi:10.1016/j.asoc.2016.01.023Zyoud, S. H., & Fuchs-Hanusch, D. (2017). A bibliometric-based survey on AHP and TOPSIS techniques. Expert Systems with Applications, 78, 158-181. doi:10.1016/j.eswa.2017.02.016Scholz, S., Ngoli, B., & Flessa, S. (2015). Rapid assessment of infrastructure of primary health care facilities – a relevant instrument for health care systems management. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0838-8Ivlev, I., Vacek, J., & Kneppo, P. (2015). Multi-criteria decision analysis for supporting the selection of medical devices under uncertainty. European Journal of Operational Research, 247(1), 216-228. doi:10.1016/j.ejor.2015.05.075Kovacs, E., Strobl, R., Phillips, A., Stephan, A.-J., Müller, M., Gensichen, J., & Grill, E. (2018). Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care. Journal of General Internal Medicine, 33(7), 1142-1154. doi:10.1007/s11606-018-4435-5Morley, C., Unwin, M., Peterson, G. M., Stankovich, J., & Kinsman, L. (2018). Emergency department crowding: A systematic review of causes, consequences and solutions. PLOS ONE, 13(8), e0203316. doi:10.1371/journal.pone.0203316Hermann, R. M., Long, E., & Trotta, R. L. (2019). Improving Patients’ Experiences Communicating With Nurses and Providers in the Emergency Department. Journal of Emergency Nursing, 45(5), 523-530. doi:10.1016/j.jen.2018.12.001Hawley, K. L., Mazer-Amirshahi, M., Zocchi, M. S., Fox, E. R., & Pines, J. M. (2015). Longitudinal Trends in U.S. Drug Shortages for Medications Used in Emergency Departments (2001-2014). Academic Emergency Medicine, 23(1), 63-69. doi:10.1111/acem.12838Stang, A. S., Crotts, J., Johnson, D. W., Hartling, L., & Guttmann, A. (2015). Crowding Measures Associated With the Quality of Emergency Department Care: A Systematic Review. Academic Emergency Medicine, 22(6), 643-656. doi:10.1111/acem.12682Chanamool, N., & Naenna, T. (2016). Fuzzy FMEA application to improve decision-making process in an emergency department. Applied Soft Computing, 43, 441-453. doi:10.1016/j.asoc.2016.01.007Farup, P. G. (2015). Are measurements of patient safety culture and adverse events valid and reliable? Results from a cross sectional study. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0852-xCarter, E. J., Pouch, S. M., & Larson, E. L. (2013). The Relationship Between Emergency Department Crowding and Patient Outcomes: A Systematic Review. Journal of Nursing Scholarship, 46(2), 106-115. doi:10.1111/jnu.12055Ebben, R. H. A., Siqeca, F., Madsen, U. R., Vloet, L. C. M., & van Achterberg, T. (2018). Effectiveness of implementation strategies for the improvement of guideline and protocol adherence in emergency care: a systematic review. BMJ Open, 8(11), e017572. doi:10.1136/bmjopen-2017-017572Innes, G. D., Sivilotti, M. L. A., Ovens, H., McLelland, K., Dukelow, A., Kwok, E., … Chochinov, A. (2018). Emergency overcrowding and access block: A smaller problem than we think. CJEM, 21(2), 177-185. doi:10.1017/cem.2018.446Di Somma, S., Paladino, L., Vaughan, L., Lalle, I., Magrini, L., & Magnanti, M. (2014). Overcrowding in emergency department: an international issue. Internal and Emergency Medicine, 10(2), 171-175. doi:10.1007/s11739-014-1154-8Uthman, O. A., Walker, C., Lahiri, S., Jenkinson, D., Adekanmbi, V., Robertson, W., & Clarke, A. (2018). General practitioners providing non-urgent care in emergency department: a natural experiment. BMJ Open, 8(5), e019736. doi:10.1136/bmjopen-2017-019736Razzak, J. A., Baqir, S. M., Khan, U. R., Heller, D., Bhatti, J., & Hyder, A. A. (2013). Emergency and trauma care in Pakistan: a cross-sectional study of healthcare levels. Emergency Medicine Journal, 32(3), 207-213. doi:10.1136/emermed-2013-202590Dart, R. C., Goldfrank, L. R., Erstad, B. L., Huang, D. T., Todd, K. H., Weitz, J., … Anderson, V. E. (2018). Expert Consensus Guidelines for Stocking of Antidotes in Hospitals That Provide Emergency Care. Annals of Emergency Medicine, 71(3), 314-325.e1. doi:10.1016/j.annemergmed.2017.05.021Mkoka, D. A., Goicolea, I., Kiwara, A., Mwangu, M., & Hurtig, A.-K. (2014). Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania. BMC Pregnancy and Childbirth, 14(1). doi:10.1186/1471-2393-14-108Beck, M. J., Okerblom, D., Kumar, A., Bandyopadhyay, S., & Scalzi, L. V. (2016). Lean intervention improves patient discharge times, improves emergency department throughput and reduces congestion. Hospital Practice, 44(5), 252-259. doi:10.1080/21548331.2016.1254559Morais Oliveira, M., Marti, C., Ramlawi, M., Sarasin, F. P., Grosgurin, O., Poletti, P.-A., … Rutschmann, O. T. (2018). Impact of a patient-flow physician coordinator on waiting times and length of stay in an emergency department: A before-after cohort study. PLOS ONE, 13(12), e0209035. doi:10.1371/journal.pone.0209035Vermeulen, M. J., Stukel, T. A., Boozary, A. S., Guttmann, A., & Schull, M. J. (2016). The Effect of Pay for Performance in the Emergency Department on Patient Waiting Times and Quality of Care in Ontario, Canada: A Difference-in-Differences Analysis. Annals of Emergency Medicine, 67(4), 496-505.e7. doi:10.1016/j.annemergmed.2015.06.028Singh, S., Lin, Y.-L., Nattinger, A. B., Kuo, Y.-F., & Goodwin, J. S. (2015). Variation in readmission rates by emergency departments and emergency department providers caring for patients after discharge. Journal of Hospital Medicine, 10(11), 705-710. doi:10.1002/jhm.2407Källberg, A.-S., Göransson, K. E., Florin, J., Östergren, J., Brixey, J. J., & Ehrenberg, A. (2015). Contributing factors to errors in Swedish emergency departments. International Emergency Nursing, 23(2), 156-161. doi:10.1016/j.ienj.2014.10.002Riga, M., Vozikis, A., Pollalis, Y., & Souliotis, K. (2015). MERIS (Medical Error Reporting Information System) as an innovative patient safety intervention: A health policy perspective. Health Policy, 119(4), 539-548. doi:10.1016/j.healthpol.2014.12.006Norman, G. R., Monteiro, S. D., Sherbino, J., Ilgen, J. S., Schmidt, H. G., & Mamede, S. (2017). The Causes of Errors in Clinical Reasoning. Academic Medicine, 92(1), 23-30. doi:10.1097/acm.0000000000001421Lisbon, D., Allin, D., Cleek, C., Roop, L., Brimacombe, M., Downes, C., & Pingleton, S. K. (2014). Improved Knowledge, Attitudes, and Behaviors After Implementation of TeamSTEPPS Training in an Academic Emergency Department. American Journal of Medical Quality, 31(1), 86-90. doi:10.1177/1062860614545123Li, L., Georgiou, A., Vecellio, E., Eigenstetter, A., Toouli, G., Wilson, R., & Westbrook, J. I. (2015). The Effect of Laboratory Testing on Emergency Department Length of Stay: A Multihospital Longitudinal Study Applying a Cross‐classified Random‐effect Modeling Approach. Academic Emergency Medicine, 22(1), 38-46. doi:10.1111/acem.12565Telem, D. A., Yang, J., Altieri, M., Patterson, W., Peoples, B., Chen, H., … Pryor, A. D. (2016). Rates and Risk Factors for Unplanned Emergency Department Utilization and Hospital Readmission Following Bariatric Surgery. Annals of Surgery, 263(5), 956-960. doi:10.1097/sla.0000000000001536Rigobello, M. C. G., Carvalho, R. E. F. L. de, Guerreiro, J. M., Motta, A. P. G., Atila, E., & Gimenes, F. R. E. (2017). The perception of the patient safety climate by professionals of the emergency department. International Emergency Nursing, 33, 1-6. doi:10.1016/j.ienj.2017.03.003Farmer, B. (2016). Patient Safety in the Emergency Department. Emergency Medicine, 48(9), 396-404. doi:10.12788/emed.2016.0052Liu, H.-C., You, J.-X., Zhen, L., & Fan, X.-J. (2014). A novel hybrid multiple criteria decision making model for material selection with target-based criteria. Materials & Design, 60, 380-390. doi:10.1016/j.matdes.2014.03.071Kou, G., Ergu, D., & Shang, J. (2014). Enhancing data consistency in decision matrix: Adapting Hadamard model to mitigate judgment contradiction. European Journal of Operational Research, 236(1), 261-271. doi:10.1016/j.ejor.2013.11.035Keshavarz Ghorabaee, M., Amiri, M., Zavadskas, E. K., & Antucheviciene, J. (2017). Supplier evaluation and selection in fuzzy environments: a review of MADM approaches. Economic Research-Ekonomska Istraživanja, 30(1), 1073-1118. doi:10.1080/1331677x.2017.1314828Barrios, M. A. O., De Felice, F., Negrete, K. P., Romero, B. A., Arenas, A. Y., & Petrillo, A. (2016). An AHP-Topsis Integrated Model for Selecting the Most Appropriate Tomography Equipment. International Journal of Information Technology & Decision Making, 15(04), 861-885. doi:10.1142/s021962201640006xYeh, D.-Y., & Cheng, C.-H. (2016). Performance Management of Taiwan’s National Hospitals. International Journal of Information Technology & Decision Making, 15(01), 187-213. doi:10.1142/s0219622014500199Chen, T.-Y. (2014). An Interactive Signed Distance Approach for Multiple Criteria Group Decision-Making Based on Simple Additive Weighting Method with Incomplete Preference Information Defined by Interval Type-2 Fuzzy Sets. International Journal of Information Technology & Decision Making, 13(05), 979-1012. doi:10.1142/s0219622014500229Gou, X., Xu, Z., & Liao, H. (2019). Hesitant Fuzzy Linguistic Possibility Degree-Based Linear Assignment Method for Multiple Criteria Decision-Making. International Journal of Information Technology & Decision Making, 18(01), 35-63. doi:10.1142/s0219622017500377Saksrisathaporn, K., Bouras, A., Reeveerakul, N., & Charles, A. (2016). Application of a Decision Model by Using an Integration of AHP and TOPSIS Approaches within Humanitarian Operation Life Cycle. International Journal of Information Technology & Decision Making, 15(04), 887-918. doi:10.1142/s0219622015500261Hsiao, B., & Chen, L.-H. (2019). Performance Evaluation for Taiwanese Hospitals by Multi-Activity Network Data Envelopment Analysis. International Journal of Information Technology & Decision Making, 18(03), 1009-1043. doi:10.1142/s0219622018500165Saaty, T. L., & Ergu, D. (2015). When is a Decision-Making Method Trustworthy? Criteria for Evaluating Multi-Criteria Decision-Making Methods. International Journal of Information Technology & Decision Making, 14(06), 1171-1187. doi:10.1142/s021962201550025xChang, K.-H., Chang, Y.-C., & Lee, Y.-T. (2014). Integrating TOPSIS and DEMATEL Methods to Rank the Risk of Failure of FMEA. International Journal of Information Technology & Decision Making, 13(06), 1229-1257. doi:10.1142/s0219622014500758Yeh, T.-M., & Huang, Y.-L. (2014). Factors in determining wind farm location: Integrating GQM, fuzzy DEMATEL, and ANP. Renewable Energy, 66, 159-169. doi:10.1016/j.renene.2013.12.003Ortíz, M. A., Felizzola, H. A., & Isaza, S. N. (2015). A contrast between DEMATEL-ANP an

Scaffolds for cartilage regeneration: to use or not to use?

Joint cartilage has been a significant focus on the field of tissue engineering and regenerative medicine (TERM) since its inception in the 1980s. Represented by only one cell type, cartilage has been a simple tissue that is thought to be straightforward to deal with. After three decades, engineering cartilage has proven to be anything but easy. With the demographic shift in the distribution of world population towards ageing, it is expected that there is a growing need for more effective options for joint restoration and repair. Despite the increasing understanding of the factors governing cartilage development, there is still a lot to do to bridge the gap from bench to bedside. Dedicated methods to regenerate reliable articular cartilage that would be equivalent to the original tissue are still lacking. The use of cells, scaffolds and signalling factors has always been central to the TERM. However, without denying the importance of cells and signalling factors, the question posed in this chapter is whether the answer would come from the methods to use or not to use scaffold for cartilage TERM. This paper presents some efforts in TERM area and proposes a solution that will transpire from the ongoing attempts to understand certain aspects of cartilage development, degeneration and regeneration. While an ideal formulation for cartilage regeneration has yet to be resolved, it is felt that scaffold is still needed for cartilage TERM for years to come