Study the Effect of Substitution Filler on performance of Asphalt Mixture

The major distresses in asphalt pavements are rutting, fatigue, and adhesion loss (moisture susceptibility). In this research study, two substitution fillers (Cement and Lime) were used with two different aggregate quarries (based on minerals composition) to evaluate the relatively most beneficial combination of both fillers as well as an aggregate quarry to enhance the performance life of asphalt pavements, especially in under-developed countries. Four basic tests, (Asphalt Pavement Analyzer, Four Points Bending Beam, Dynamic Modulus, and Rolling Bottle Test) that used for the most desired properties of any asphalt pavement, were utilized to access the performance properties of modified asphalt mixture. Based on all laboratory test results this research study concludes that replacement of aggregate filler with hydrated lime and cement has a beneficial effect on asphalt mix performance and to save investment by using raw material. Substitution filler improves the high-temperature rut performance and intermediate temperature fatigue performance of asphaltic concrete mixture up to 25% to that of the conventional mixture. At the same time, substitution filler has more beneficial to improve 70% adhesion properties to that of the conventional mixture

Smart Card-based Access Control System using Isolated Many-to-Many Authentication Scheme for Electric Vehicle Charging Stations

In recent years, the Internet of Things (IoT) trend has been adopted very quickly. The rapid growth of IoT has increased the need for physical access control systems (ACS) for IoT devices, especially for IoT devices containing confidential data or other potential security risks. This research focused on many-to-many ACS, a type of ACS in which many resource-owners and resource-users are involved in the same system. This type of system is advantageous in that the user can conveniently access resources from different resource-owners using the same system. However, such a system may create a situation where parties involved in the system have their data leaked because of the large number of parties involved in the system. Therefore, ‘isolation’ of the parties involved is needed. This research simulated the use of smart cards to access electric vehicle (EV) charging stations that implement an isolated many-to-many authentication scheme. Two ESP8266 MCUs, one RC522 RFID reader, and an LED represented an EV charging station. Each institute used a Raspberry Pi Zero W as the web and database server. This research also used VPN and HTTPS protocols to isolate each institute’s assets. Every component of the system was successfully implemented and tested functionally

Randomized controlled trial of standard versus double dose cotrimoxazole for childhood pneumonia in Pakistan

Objective: Increasing concern over bacterial resistance to cotrimoxazole, which is recommended by WHO as a first-line drug for treating non-severe pneumonia, led to the suggestion that this might not be optimal therapy. However, changing to alternative antimicrobial agents, such as amoxicillin, is costly. We compared the clinical efficacy of twice-daily cotrimoxazole in standard versus double dosage for treating non-severe pneumonia in children.Methods: A randomized controlled multicentre trial was implemented in seven hospital outpatient departments and two community health programmes. A total of 1143 children aged 2-59 months with non-severe pneumonia were randomly allocated to receive 4 mg trimethoprim plus 20 mg sulfamethoxazole/kg of body weight or 8 mg trimethoprim plus 40 mg sulfamethoxazole/kg of body weight orally twice-daily for 5 days Treatment failure occurred when a child required a change of therapy, died or was lost to follow-up. Children required a change of therapy if their condition worsened (they developed chest indrawing or danger signs) or if at 48 hours after enrollment, their clinical condition was the same (defined as having a respiratory rate that was 5 breaths/minute higher or lower than at the time of enrollment).Findings: The results of 1134 children were analysed: 578 were assigned to the standard dose of cotrimoxazole and 556 to the double dose. Treatment failed in 112 children (19.4%) in the standard group and 118 (21.2%) in the double-dose group (relative risk 1.10; 95% confidence interval = 0.87-1.37). Using multivariate analysis we found that treatment was more likely to fail in children who were not given the medicine correctly (P = 0.001), in those younger than 12 months (P = 0.004), those who had used antibiotics previously (P = 0.002), those whose respiratory rate was \u3e or =20 breaths/minute above the age-specific cut-off point (P = 0.006), and those from urban areas (P = 0.042).Conclusion: Both standard and double strength cotrimoxazole were equally effective in treating non-severe pneumonia. Close follow-up of patients is essential to prevent worsening of disease. Definitions of clinical failure need to be more specific. Surveillance in both rural and urban areas is essential in the development of treatment policies that are based on clinical outcomes

Smart Card-based Access Control System using Isolated Many-to-Many Authentication Scheme for Electric Vehicle Charging Stations

In recent years, the Internet of Things (IoT) trend has been adopted very quickly. The rapid growth of IoT has increased the need for physical access control systems (ACS) for IoT devices, especially for IoT devices containing confidential data or other potential security risks. This research focused on many-to-many ACS, a type of ACS in which many resource-owners and resource-users are involved in the same system. This type of system is advantageous in that the user can conveniently access resources from different resource-owners using the same system. However, such a system may create a situation where parties involved in the system have their data leaked because of the large number of parties involved in the system. Therefore, ‘isolation’ of the parties involved is needed. This research simulated the use of smart cards to access electric vehicle (EV) charging stations that implement an isolated many-to-many authentication scheme. Two ESP8266 MCUs, one RC522 RFID reader, and an LED represented an EV charging station. Each institute used a Raspberry Pi Zero W as the web and database server. This research also used VPN and HTTPS protocols to isolate each institute’s assets. Every component of the system was successfully implemented and tested functionally

Impact of IoT on Manufacturing Industry 4.0: A New Triangular Systematic Review

The Internet of Things (IoT) has realised the fourth industrial revolution concept; however, its applications in the manufacturing industry are relatively sparse and primarily investigated without contextual peculiarities. Our research undertakes an intricate critical review to investigate significant aspects of IoT applications in the manufacturing Industry 4.0 perspective to address this gap. We adopt a systematic literature review approach by Denyer and Tranfield (2009) to carry out critical analyses that help develop future research domains based on empirical studies. We describe key knowledge gaps in the existing literature and empirical studies by exploring the main contribution categories and finding six critical differences between traditional and manufacturing Industry 4.0 and 10 enablers and 11 challenges of IoT applications. Finally, an agenda for future research is proposed with 11 research domains to focus on the recognised gaps

A simple clinical coding strategy to improve recording of child maltreatment concerns: an audit study

Background Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE) but there is evidence of substantial under-recording.Aim To determine whether a simple coding strategy improved recording of maltreatment-related concerns in electronic primary care records.Design and Setting Clinical audit of rates of maltreatment-related coding before January 2010–December 2011 and after January–December 2012 implementation of a simple coding strategy in 11 English family practices. The strategy included encouraging general practitioners to use, always and as a minimum, the Read code ‘Child is cause for concern’. A total of 25,106 children aged 0–18 years were registered with these practices. We also undertook a qualitative service evaluation to investigate barriers to recording.Method Outcomes were recording of 1) any maltreatment-related codes, 2) child protection proceedings and 3) child was a cause for concern.Results We found increased recording of any maltreatment-related code (rate ratio 1.4; 95% CI 1.1–1.6), child protection procedures (RR 1.4; 95% CI 1.1–1.6) and cause for concern (RR 2.5; 95% CI 1.8–3.4) after implementation of the coding strategy. Clinicians cited the simplicity of the coding strategy as the most important factor assisting implementation.Conclusion This simple coding strategy improved clinician’s recording of maltreatment-related concerns in a small sample of practices with some ‘buy-in’. Further research should investigate how recording can best support the doctor–patient relationshipHow this fits in Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE), but there is evidence of substantial underrecording. We describe a simple clinical coding strategy that helped general practitioners to improve recording of maltreatment-related concerns. These improvements could improve case finding of children at risk and information sharing

The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol

Background: Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care. Objective: To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care. Method: Two reviewers independently searched 11 international databases during the period 1999–2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion .A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis

Structural Analysis and material selection for biocompatible cantilever beam in soft robotic nanomanipulator

This paper investigates the selection of appropriate materials for cantilever beams in surgical robotic nanomanipulators. Cantilever beams play a crucial role in soft robotic surgery. Biocompatible materials, which have minimal adverse effects on biological systems, are commonly used for these beams. Using SOLIDWORKS software simulation, the study assesses the flexibility of cantilever beams made from different biocompatible materials. The analysis involves varying the applied force (0.001 µN to 0.004 µN), beam length (80 µm, 120 µm, and 160 µm), and beam thickness (0.4 µm, 0.6 µm, and 0.8 µm). Four materials—Alumina, Poly-Ether-Ether-Ketone (PEEK), Polyurethane (PUR), and Ti-6Al-4V—are evaluated. Simulation results highlight Polyurethane (PUR) as a suitable material for cantilever beams in nanomanipulators due to its favorable properties. These findings provide valuable insights for the design and advancement of efficient and reliable robotic nanomanipulators, advancing the field of soft robotic surgery

Quality improvement of prescribing safety: a pilot study in primary care using UK electronic health records.

BACKGROUND: Quality improvement (QI) is a priority for general practice, and GPs are expected to participate in and provide evidence of QI activity. There is growing interest in harnessing the potential of electronic health records (EHR) to improve patient care by supporting practices to find cases that could benefit from a medicines review. AIM: To develop scalable and reproducible prescribing safety reports using patient-level EHR data. DESIGN AND SETTING: UK general practices that contribute de-identified patient data to the Clinical Practice Research Datalink (CPRD). METHOD: A scoping phase used stakeholder consultations to identify primary care QI needs and potential indicators. QI reports containing real data were sent to 12 pilot practices that used Vision GP software and had expressed interest. The scale-up phase involved automating production and distribution of reports to all contributing practices that used both Vision and EMIS software systems. Benchmarking reports with patient-level case review lists for two prescribing safety indicators were sent to 457 practices in December 2017 following the initial scale-up (Figure 2). RESULTS: Two indicators were selected from the Royal College of General Practitioners Patient Safety Toolkit following stakeholder consultations for the pilot phase involving 12 GP practices. Pilot phase interviews showed that reports were used to review individual patient care, implement wider QI actions in the practice, and for appraisal and revalidation. CONCLUSION: Electronic health record data can be used to provide standardised, reproducible reports that can be delivered at scale with minimal resource requirements. These can be used in a national QI initiative that impacts directly on patient care

A patient-centred intervention to improve the management of multimorbidity in general practice:the 3D RCT

Background: People with multimorbidity experience impaired quality of life, poor health and a burden from treatment. Their care is often disease-focused rather than patient-centred and tailored to their individual needs. Objective: To implement and evaluate a patient-centred intervention to improve the management of patients with multimorbidity in general practice. Design: Pragmatic, cluster randomised controlled trial with parallel process and economic evaluations. Practices were centrally randomised by a statistician blind to practice identifiers, using a computer-generated algorithm. Setting: Thirty-three general practices in three areas of England and Scotland. Participants: Practices had at least 4500 patients and two general practitioners (GPs) and used the EMIS (Egton Medical Information Systems) computer system. Patients were aged ≥ 18 years with three or more long-term conditions. Interventions: The 3D (Dimensions of health, Depression and Drugs) intervention was designed to offer patients continuity of care with a named GP, replacing separate reviews of each long-term condition with comprehensive reviews every 6 months. These focused on individualising care to address patients’ main problems, attention to quality of life, depression and polypharmacy and on disease control and agreeing treatment plans. Control practices provided usual care. Outcome measures: Primary outcome – health-related quality of life (assessed using the EuroQol-5 Dimensions, five-level version) after 15 months. Secondary outcomes – measures of illness burden, treatment burden and patient-centred care. We assessed cost-effectiveness from a NHS and a social care perspective. Results: Thirty-three practices (1546 patients) were randomised from May to December 2015 [16 practices (797 patients) to the 3D intervention, 17 practices (749 patients) to usual care]. All participants were included in the primary outcome analysis by imputing missing data. There was no evidence of difference between trial arms in health-related quality of life {adjusted difference in means 0.00 [95% confidence interval (CI) –0.02 to 0.02]; p = 0.93}, illness burden or treatment burden. However, patients reported significant benefits from the 3D intervention in all measures of patient-centred care. Qualitative data suggested that both patients and staff welcomed having more time, continuity of care and the patient-centred approach. The economic analysis found no meaningful differences between the intervention and usual care in either quality-adjusted life-years [(QALYs) adjusted mean QALY difference 0.007, 95% CI –0.009 to 0.023] or costs (adjusted mean difference £126, 95% CI –£739 to £991), with wide uncertainty around point estimates. The cost-effectiveness acceptability curve suggested that the intervention was unlikely to be either more or less cost-effective than usual care. Seventy-eight patients died (46 in the intervention arm and 32 in the usual-care arm), with no evidence of difference between trial arms; no deaths appeared to be associated with the intervention. Limitations: In this pragmatic trial, the implementation of the intervention was incomplete: 49% of patients received two 3D reviews over 15 months, whereas 75% received at least one review. Conclusions: The 3D approach reflected international consensus about how to improve care for multimorbidity. Although it achieved the aim of providing more patient-centred care, this was not associated with benefits in quality of life, illness burden or treatment burden. The intervention was no more or less cost-effective than usual care. Modifications to the 3D approach might improve its effectiveness. Evaluation is needed based on whole-system change over a longer period of time. Trial registration: Current Controlled Trials ISRCTN06180958. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 7, No. 5. See the NIHR Journals Library website for further project information