RMS capacity utilisation: product family and supply chain

yesThe paper contributes to development of RMS through linkage with external stakeholders such as customers and suppliers of parts/raw materials to handle demand fluctuations that necessitate information sharing across the supply chain tiers. RMS is developed as an integrated supply chain hub for adjusting production capacity using a hybrid methodology of decision trees and Markov analysis. The proposed Markov Chain model contributes to evaluate and monitor system reconfigurations required due to changes of product families with consideration of the product life cycles. The simulation findings indicate that system productivity and financial performance in terms of the profit contribution of product-process allocation will vary over configuration stages. The capacity of an RMS with limited product families and/or limited model variants becomes gradually inoperative whilst approaching upcoming configuration stages due to the end of product life cycles. As a result, reconfiguration preparation is suggested quite before ending life cycle of an existing product in process, for switching from a product family to a new/another product family in the production range, subject to its present demand. The proposed model is illustrated through a simplified case study with given product families and transition probabilities

Softening Coefficient of Reinforced Concrete Elements Subjected to Three-Dimensional Loads

Reinforced concrete structures are prone to fail under the effect of complex threedimensional loading conditions. Accurate constitutive models for concrete under the effect of triaxial stresses are therefore necessary in order to predict the proper response. Strong interaction between in-plane and out of plane shear loads has been observed in experimental tests of concrete structures. This paper presents the derivation of concrete constitutive laws under the effect of triaxial stresses, in particular the softening coefficient, using the results of large-scale tests on representative concrete panels. The experimental program of 7 full-scale panel specimens is briefly described, and the results are then used to derive analytical expressions for the softening coefficient under the effect of bi-directional shear. Finally, existing membrane shear theories are modified to take into consideration the effect of applied out-of-plane shear. The response of the tested panels proved to be accurately predicted using the new theory

Behavior of Reinforced Concrete Membrane Elements Subjected to Bidirectional Shear Loads

The shear design and behavior of a typical membrane reinforced concrete (RC) element has been extensively studied in the past several decades. Such design requires knowledge of the constitutive behavior of RC elements subjected to a shear stress acting along its plane (in-plane shear). These constitutive models were accurately derived from experimental test data on representative RC panel elements. The true behavior of many large, complex structures, however, involves interaction between the in-plane and out-of-plane shear stresses acting on the RC element. To investigate this interaction, large-scale tests on representative concrete panels need to be conducted. The University of Houston is equipped with a unique universal panel testing machine that was used for this purpose. The panel tester enhanced the understanding of the in-plane shear behavior of RC elements. Recently, 10 additional hydraulic jacks were mounted in the out-of-plane direction of the universal panel tester to facilitate testing of concrete elements subjected to bidirectional and tridirectional shear stresses. The experimental program included designing, fabricating, instrumenting, and testing full-scale RC elements. The elements were subjected to different combinations of in-plane and out-of-plane shear loads. A strong interaction between in-plane shear strength and out-of-plane shear stresses was observed

Pattern of Bladder Cancer at University Teaching Hospital, Lusaka, Zambia in the era of HIV Epidemic

Background: Human Immunodeficiency Virus (HIV) is endemic to Zambia and is associated with changes in the patterns of both AIDS and non- AIDS defining cancers. Bladder cancer is one malignancy that has been noted toincrease in the era of HIV/ AIDS epidemic. This study sought to describe the pattern of cancer of the bladder at UTH in the era of HIV/AIDS epidemic in respect with the epidemiological characteristics, prevalence of HIV infection and the histological types of bladder cancer in patients with cancer of the bladder.Patients and Methods: A prospective cross sectional, hospital based study was performed at the University Teaching Hospital (UTH), Lusaka, Zambia, between November 2009 and November 2010. Patients with bladder cancer who presented to the hospital during this period were recruited and  parameters studied included patients demographics, HIV status and pathology of cancer. Data collected was analyzed using SPSS 17.Results: A total of 53 patients with median age of 57.49 years who had histological confirmed bladder cancer were recruited during this one year period. The male to female ratio was 1.3 to 1. Of the 53 patients, HIV infection was found in six patients (11.3 %). Squamous cell carcinoma was the most common histological type (60.4%) followed by Transitional cell carcinoma (30.2%) and adenocarcinoma was least common type (9.4%).Schistosoma infection was found in 14 patients all had SCC. The study found a statistically significant reduction in the mean age of bladder cancer in HIV infected patients.Conclusions: Squamous cell carcinoma is still the most common histological type of bladder cancer in Zambia and it's strongly associated with schistosomia infection. Haematuria remains to be the most common presenting symptom in bladder cancer patients

Women's Intention to Prevent Vesico Vaginal Fistula Recurrence in Two Repair Centres in Zambia

Objective: The study purpose was to determine the association between intention to prevent Vesico-Vaginal Fistula recurrence and knowledge of the risk factors of Vesico Vaginal Fistula recurrence, attitude towards Vesico Vaginal Fistula prevention and self esteem among women with Vesico-Vaginal Fistula in two repair centers in Zambia.Design: This was a descriptive cross sectional correlational study in which data were obtained through the structured interview schedule.Main Outcomes: Vesico vaginal fistula has been recognized as a preventable tragedy and a challenge in areas where access to health care with emergency obstetric care is poor. The situation is getting worse among women, and the key to ending fistula is to prevent it.Measures: The Ministry of Health need to introduce waiting homes in hospitals with emergency obstetric care so that repaired women with VVF can wait for delivery. The MOH needs to support community sensitization orpublic education on attitudes towards Vesico vaginal fistula prevention which will in turn improve intentions to prevent Vesico vaginal fistula  recurrence. Management at katete and Chilonga mission hospitalsshould ensure that counseling services are intensified to women with a repaired VVF so as to prevent recurrence. Antenatal clinics should be used as an opportunity for teaching Vesico Vaginal fistula since the study findingreview that 45% of the respondents did not know the risk factors of recurrence.Results: Majority of the respondents (97%) had positive intentions to prevent VesicoVaginal Fistula recurrence. More than half of the respondents (55%) knew the risk factors of VVF recurrence, 61% had positive attitudes towards Vesico Vaginal Fistula prevention and 52% had low level of self esteem. There was a significant positive relationship between intentionto prevent Vesico Vaginal Fistula recurrence and attitude towards Vesico Vaginal Fistula prevention and a significant negative relationship between intention to prevent Vesico Vaginal Fistula recurrence and self esteem. Knowledge of the risk factors of Vesico vaginal fistula recurrence was not significant. Using multiple regressions, attitude and self esteem were significant explaining 15% of the variance in intention to preventVVF recurrence.Conclusion: Vesico vaginal fistula is a very unpleasant experience for women. Corrective measures have been started by UNFPA but these need to be strengthened. There is need for innovation to consider other solutions that has not been tried before. This is important in order to prevent recurrence of Vesico vaginal fistula among repaired women in subsequent pregnancies

Pattern of Bladder Cancer at University Teaching Hospital, Lusaka, Zambia in the era of HIV Epidemic

Background: Human Immunodeficiency Virus (HIV) is endemic to Zambia and is associated with changes in the patterns of both AIDS and non- AIDS defining cancers. Bladder cancer is one malignancy that has been noted to increase in the era of HIV/ AIDS epidemic. This study sought to describe the pattern of cancer of the bladder at UTH in the era of HIV/AIDS epidemic in respect with the epidemiological characteristics, prevalence of HIV infection and the histological types of bladder cancer in patients with cancer of the bladder.Patients and Methods: A prospective cross sectional, hospital based study was performed at the University Teaching Hospital (UTH), Lusaka, Zambia, between November 2009 and November 2010. Patients with bladder cancer who presented to the hospital during this period were recruited and parameters studied included patients demographics, HIV status and pathology of cancer. Data collected was analyzed using SPSS 17.Results: A total of 53 patients with median age of 57.49 years who had histological confirmed bladder cancer were recruited during this one year period. The male to female ratio was 1.3 to 1. Of the 53 patients, HIV infection was found in six patients (11.3 %). Squamous cell carcinoma was the most common histological type (60.4%) followed by Transitional cell carcinoma (30.2%) and adenocarcinoma was least common type (9.4%). Schistosoma infection was found in 14 patients all had SCC. The study found a statistically significant reduction in the mean age of bladder cancer in HIV infected patients.Conclusions: Squamous cell carcinoma is still the most common histological type of bladder cancer in Zambia and it's strongly associated with schistosomia infection. Haematuria remains to be the most common presenting symptom in bladder cancer patients.

Les formes graves de la grippe A(H1N1) 2009 chez la femme enceinte: expérience du centre hospitalier universitaire de Fès, Maroc et revue de la littérature

Introduction: Le but de cette étude est de décrire les caractéristiques épidémiologiques, cliniques, paracliniques ainsi que l’évolution des femmes enceintes ou en post partum atteintes de formes graves de Grippe A(H1N1) 2009. Méthodes: C’est une étude prospective observationnelle monocentrique, menée au sein de notre service de réanimation mère et enfant au centre hospitalier universitaire Hassan II à Fès, sur une période de 3 mois, allant de novembre 2009 à janvier 2010. Résultats: L’âge moyen était de 28 ans, dans 85% des cas la grossesse se situaient au troisième trimestre, le syndrome grippal était constant, la SpO2 initiale était en moyenne de 86%. A la radiographie thoracique, un syndrome alvéolaire bilatéral était toujours présent. L’infection virale était confirmée dans tous les cas par la polymerase chain reaction. Chez 3 patientes la PaO2/FiO2 était inférieure à 300. L’Oseltamivir était l’antiviral utilisé chez toutes les parturientes. Un syndrome de détresse respiratoire aigu a été développé chez 28% des parturientes, elles ont été ventilées artificiellement avec des niveaux de pressions expiratoires positives à 14 +/- 1 cmH2O. L’évolution était favorable dans 71% des cas, cependant, 2 décès ont été déplorés. Conclusion: Les résultats rejoignent les données de la littérature, à savoir, un risque accru pour la femme enceinte de développer une forme grave, une présentation clinique similaire au reste de la population, l’intérêt de la vaccination et d’un traitement antiviral précoce et le rôle de l’ECMO dans le traitement des hypoxémies réfractaires

Pemanfaatan Citra Landsat 8 Multitemporal Untuk Pemetaan Muatan Padatan Tersuspensi Pada Muara Sungai Serayu Jawa Tengah

Alih fungsi lahan pada kawasan Dieng, Kabupaten Wonosobo berdampak pada peningkatan jumlah muatan padatan tersuspensi (MPT) pada muara sungai. Penelitian ini bertujuan untuk: (1) mengkaji kemampuan saluran citra Landsat 8 OLI untuk pemetaan distribusi MPT pada muara Sungai Serayu melalui analisis regresi (2) memetakan variasi dan mengkaji pola distribusi MPT pada muara Sungai Serayu. Metode yang digunakan dalam mengestimasi MPT di muara sungai Serayu adalah analisis regresi liniear antara variabel saluran Landsat 8 OLI dan data MPT aktual. Variabel saluran Landsat 8 OLI yang sesuai untuk memetakan konsentrasi MPT adalah penisbahan antara saluran hijau dan saluran biru atau B3/B2 dengan kesalahan standar yang dihasilkan ± 4,59 mg/l untuk setiap nilai piksel yang diestimasi. Distribusi MPT 2013 sampai 2015 cenderung mengarah ke perairan tenggara muara Sungai Serayu akibat kondisi hidrodinamika seperti pasang surut, arus permukaan dan fenomena upwelling. Pola distribusi MPT cenderung fluktuatif namun terjadi penurunan konsentrasi dari tahun ketahun

Using platelet-to-lymphocyte ratio as a diagnostic marker in malignant ovarian tumors

Background: Ovarian malignancy, is the fifth global fatal disease for women, and the most common cause of death in Gynecological cancer. Objective was to evaluate any diagnostic role of Platelet-to-lymphocyte ratio in epithelial ovarian tumors.Methods: A prospective analysis, over 1 year; (October 2016 to October 2017). Setting: University hospital’s Gynaecological oncology centre. Subjects & Methodology: A total of 36 patients with epithelial ovarian tumors, not under any adjuvant therapy and negative for any other malignancy, or any blood diseases causing blood count changes. All subjects underwent preoperative assessment of CA125 and Platelet-to-lymphocyte ratio (PLR), followed by a staging laparotomy and the appropriate management according to the standard protocols. Postoperative histopathological confirmation of the disease type, stage and grade was done for all cases.Results: (77.8%) of the patients had early stage disease while (22.2%) had advanced stage. Neither mean platelet, lymphocytic counts, nor PLR express any significant difference between early and late stage disease. CA 125 levels, however changed significantly in advanced stages. PLR showed a statistically significant difference between the three stages of the disease (P=0.007).   There was a positive correlation between PLR and CA125 (r=0.184 and P=0.283).Conclusions: PLR rise significantly with tumor stages and correlates significantly with CA125. No significant change in PLR values with tumor type or grade. PLR might be a potential diagnostic / prognostic marker of ovarian epithelial cancer