A Knowledge-based Decision Support System for RP&M Process Selection

Due to the large variety of RP&M material/machines and the. strengths/weaknesses associated with different RP&M processes, the decision·to select a suitableRP&M system becomes increasingly difficult. This paper presents a knowledge-based approach for the selection ofsuitable RP&M material/machine to meet specific. requirements ofRP&Mapplications. The system receives input data on the CAD modelandthe user's specifications,andgenerates outputs that provide the most appropriate combination ofRP&Mmaterial/machine.·Optimal orientations, together with estimated manufacturing time and cost, are considered and given in the final outcome to help the user make the choice.Mechanical Engineerin

Enough is ENOUGH: 24 Hours/Day is Enough

Today many people are crying for more time. Many pastors are also. The contents of this writing endeavor to address the issue of time starvation among overworked pastors. My conviction is that the God-given 24 hours a day is enough. God will never ask from us what we cannot give. Often we are victims of our own aspirations. The discussions and solutions provided in this writing fit into the shared values of pastoral ministry: a) our faithfulness to our ministerial call; b) our dedication to the Lord; and c) our love for His church and His people. Based upon these shared core values of ministry, the first section presents the problem of the issue at stake, i.e., the reasons for time starvation as well as a challenge for change to live long and serve well. The second section deals with the core of ministry, our understanding and philosophy of what time and ministry are. The third section makes practical suggestions as to how to best utilize our limited time resources. With some modifications, the specific suggestions can be adapted to any busy worker. In order to get the most out of this writing it will be advisable to reflect on the following questions respectively for the three different sections. Are you tired of the pettiness that characterizes so much of church life? 1 Do you often have to be all things to all men? 2 Do you arise each morning torn between a desire to save the world and a desire to savor the world? 3 Are you at the brink of taking no more pounding? Are you willing and ready for the challenge of change? If your answers to these five questions are all positive, Section One is where you should begin. Do you value time as a precious daily gift? Do you love the church more than the Lord of the church? Do you love the missions assigned more than the Lord of commission? What are your priorities in practice? Do you realize that God cares for our complete well-being, and the balance of our ministry and life? Discussions on these questions are found in Section Two. Do you know that time bandits are always trying to steal our time and energy? Are you able to recognize and seize your time bandits? Do you know that a meaningful life is not a matter of speed or efficiency?4 Do you realize that you can actually redeem time so as to enjoy more of life and ministry? Section Three provides some basic and practical tips as to how to redeem time as well as how to eliminate or minimize your time wasters. A chapter is also devoted to the discussions of different time planners. You may take the highlights of this writing and weave them into substantial actions that will bring significant changes --- to tum brokenness into blessings, and to turn possible burnout into ever-growing burn-on for the Lord

Supplementary data for “Comparisons of Staphylococcus aureus infection and other outcomes between users of angiotensin-converting-enzyme inhibitors and angiotensin II receptor blockers: lessons for COVID-19 from a nationwide cohort study”

Additional information regarding study design, baseline cohort characteristics, and results of sensitivity analyses

Socioeconomic determinants of multimorbidity: a population-based household survey of Hong Kong Chinese

<b>Introduction</b> Multimorbidity has been well researched in terms of consequences and healthcare implications. Nevertheless, its risk factors and determinants, especially in the Asian context, remain understudied. We tested the hypothesis of a negative relationship between socioeconomic status and multimorbidity, with contextually different patterns from those observed in the West.<p></p> <b>Methods</b> We conducted our study in the general Hong Kong (HK) population. Data on current health conditions, health behaviours, socio-demographic and socioeconomic characteristics was obtained from HK Government’s Thematic Household Survey. 25,780 individuals aged 15 or above were sampled. Binary logistic and negative binomial regression analyses were conducted to identify risk factors for presence of multimorbidity and number of chronic conditions, respectively. Sub-analysis of possible mediation effect through financial burden borne by private housing residents on multimorbidity was also conducted.<p></p> <b>Results</b> Unadjusted and adjusted models showed that being female, being 25 years or above, having an education level of primary schooling or below, having less than HK$15,000 monthly household income, being jobless or retired, and being past daily smoker were significant risk factors for the presence of multimorbidity and increased number of chronic diseases. Living in private housing was significantly associated with higher chance of multimorbidity and increased number of chronic diseases only after adjustments.<p></p> <b>Conclusions</b>Less advantaged people tend to have higher risks of multimorbidity and utilize healthcare from the public sector with poorer primary healthcare experience. Moreover, middle-class people who are not eligible for government subsidized public housing may be of higher risk of multimorbidity due to psychosocial stress from paying for the severely unaffordable private housing

Integrated Decision Support System for Selection of RP Processes

This paper describes an ‘Integrated Decision Support System for the Selection of RP Processes (IDSSSRP)’. The basic methodology proposed in the IDSSSRP is a Sigma approach towards benchmarking of the Rapid Prototyping (RP) processes. It characterizes a RP process by using benchmarking and the sigma approach to assess its capability compared to its potential. Although the six-sigma approach has basically been a management concept and the success of its implementation has been on process time reduction and quality improvement, this paper adopts the use of six-sigma tools and benchmarking in the characterization of RP processes. Apart from geometrical benchmarks, other benchmarks include mechanical benchmarks and process benchmarks. Benchmarking individual RP processes facilitates standardization and reduces variability in the prototypes produced by the processes. Following standardizations of geometrical, mechanical and process benchmarks, a saturated database can then become very useful in providing decision support to the end user on a particular process as well as a source of information for benchmarking new RP machines. A case study of the benchmarking process developed on the Direct Metal Laser Sintering-Selective Laser Sintering (DMLS-SLS) RP process is presented using the proposed approach. This paper also outlines the working and implementation of a web-based decision support system based on the IDSSSRP.Mechanical Engineerin

The association of types of training and practice settings with doctors’ empathy and patient enablement among patients with chronic illness in Hong Kong

Background: The increase in non-communicable disease (NCD) is becoming a global health problem and there is an increasing need for primary care doctors to look after these patients although whether family doctors are adequately trained and prepared is unknown. Objective: This study aimed to determine if doctors with family medicine (FM) training are associated with enhanced empathy in consultation and enablement for patients with chronic illness as compared to doctors with internal medicine training or without any postgraduate training in different clinic settings. Methods: This was a cross-sectional questionnaire survey using the validated Chinese version of the Consultation and Relational Empathy (CARE) Measure as well as Patient Enablement Instrument (PEI) for evaluation of quality and outcome of care. 14 doctors from hospital specialist clinics (7 with family medicine training, and 7 with internal medicine training) and 13 doctors from primary care clinics (7 with family medicine training, and 6 without specialist training) were recruited. In total, they consulted 823 patients with chronic illness. The CARE Measure and PEI scores were compared amongst doctors in these clinics with different training background: family medicine training, internal medicine training and those without specialist training. Generalized estimation equation (GEE) was used to account for cluster effects of patients nested with doctors. <b>Results</b> Within similar clinic settings, FM trained doctors had higher CARE score than doctors with no FM training. In hospital clinics, the difference of the mean CARE score for doctors who had family medicine training (39.2, SD = 7.04) and internal medicine training (35.5, SD = 8.92) was statistically significant after adjusting for consultation time and gender of the patient. In the community care clinics, the mean CARE score for doctors with family medicine training and those without specialist training were 32.1 (SD = 7.95) and 29.2 (SD = 7.43) respectively, but the difference was not found to be significant. For PEI, patients receiving care from doctors in the hospital clinics scored significantly higher than those in the community clinics, but there was no significant difference in PEI between patients receiving care from doctors with different training backgrounds within similar clinic setting. Conclusion: Family medicine training was associated with higher patient perceived empathy for chronic illness patients in the hospital clinics. Patient enablement appeared to be associated with clinic settings but not doctors’ training background. Training in family medicine and a clinic environment that enables more patient doctor time might help in enhancing doctors’ empathy and enablement for chronic illness patients

Suicidal thoughts among university students: The role of mattering, state self-esteem and depression level

The protective role of mattering on suicide ideation among university students was examined. Our study is grounded in the Interpersonal-Psychological Theory of Suicide, which led to a hypothesis that between depression levels and state self-esteem has significant serial multiple mediating effects on the relationship between mattering and suicide ideation. University students from various nationality who study in Indonesia and Malaysia (n=509) responded to General Mattering Scale, State Self-Esteem Scale, Beck’s Depression Inventory, and Suicide Ideation Attributes Scale, as well as demographic details including their gender, spirituality, education, birth order and nationality. The result of Bootstrap analyses with 95% confident interval from 5000 samples suggested that the serial mediation partially occurred to the link between mattering and suicide ideation

Rapid Prototyping of 3D Scaffolds for Tissue Engineering Using a Four-Axis Multiple-Dispenser Robotic System

A desktop rapid prototyping (RP) system has been developed to fabricate scaffolds for tissue engineering (TE) applications. The system is a computer-controlled four-axis machine with a multiple-dispenser head. This paper presents the scaffold fabrication process to build free-form scaffolds from relevant features extracted from given CT-scan images for TE applications. This involves obtaining the required geometric data for the scaffold in the form of a solid model from CT-scan images. The extracted scaffold model is then sliced into consecutive two-dimensional (2D) layers to generate appropriately formatted data for the desktop RP system to fabricate the scaffolds. The basic material processing involves the sequential dispensing of two or more materials to form a strand. The four-axis system enables strands to be laid in a different direction at each layer to form suitable interlacing 3D free-form scaffold structures. The multipledispenser head also allows the introduction of living cells and additional materials during the scaffold building. The building of the scaffolds with the desktop RP system is described based on the sequential dispensing of chitosan dissolved in acetic acid and sodium hydroxide solution. Neutralization of the acetic acid by the sodium hydroxide results in a precipitate to form a gellike chitosan strand.Mechanical Engineerin

Sustainable development goals, universal health coverage and equity in health systems: the Orang Asli commons approach

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-0420Universal health coverage is a key health target in the Sustainable Development Goals (SDGs) that has the means to link equitable social and economic development. As a concept firmly based on equity, it is widely accepted at international and national levels as important for populations to attain ‘health for all’ especially for marginalised groups. However, implementing universal coverage has been fraught with challenges and the increasing privatisation of health care provision adds to the challenge because it is being implemented in a health system that rests on a property regime that promotes inequality. This paper asks the question, ‘What does an equitable health system look like?’ rather than the usual ‘How do you make the existing health system more equitable?’ Using an ethnographic approach, the authors explored via interviews, focus group discussions and participant observation a health system that uses the commons approach such as which exists with indigenous peoples and found features that helped make the system intrinsically equitable. Based on these features, the paper proposes an alternative basis to organise universal health coverage that will better ensure equity in health systems and ultimately contribute to meeting the SDGs.https://doi.org/10.1017/gheg.2016.81pubpu

Global incidence and mortality for prostate cancer: analysis of temporal patterns and trends in 36 countries

Background: Prostate cancer (PCa) is a leading cause of mortality and morbidity globally, but its specific geographic patterns and temporal trends are under-researched. Objective: To test the hypotheses that PCa incidence is higher and PCa mortality is lower in countries with higher socioeconomic development, and that temporal trends for PCa incidence have increased while mortality has decreased over time. Design, setting, and participants: Data on age-standardized incidence and mortality rates in 2012 were retrieved from the GLOBOCAN database. Temporal patterns were assessed for 36 countries using data obtained from Cancer incidence in five continents volumes I–X and the World Health Organization mortality database. Correlations between incidence or mortality rates and socioeconomic indicators (human development index [HDI] and gross domestic product [GDP]) were evaluated. Outcome measurements and statistical analysis: The average annual percent change in PCa incidence and mortality in the most recent 10 yr according to join-point regression. Results and limitations: Reported PCa incidence rates varied more than 25-fold worldwide in 2012, with the highest incidence rates observed in Micronesia/Polynesia, the USA, and European countries. Mortality rates paralleled the incidence rates except for Africa, where PCa mortality rates were the highest. Countries with higher HDI (r = 0.58) and per capita GDP (r = 0.62) reported greater incidence rates. According to the most recent 10-yr temporal data available, most countries experienced increases in incidence, with sharp rises in incidence rates in Asia and Northern and Western Europe. A substantial reduction in mortality rates was reported in most countries, except in some Asian countries and Eastern Europe, where mortality increased. Data in regional registries could be underestimated. Conclusions: PCa incidence has increased while PCa mortality has decreased in most countries. The reported incidence was higher in countries with higher socioeconomic development. Patient summary: The incidence of prostate cancer has shown high variations geographically and over time, with smaller variations in mortality