Internal Processes Research Articles

The Contactful Quad: An Effective Tool for Working With Trauma

The purpose of this paper is to explore the potential and development of the drama triangle, the winner’s triangle, and the trauma quadrangle in trauma work and to offer a tool to help identify the roles/patterns replayed when caught in drama. This fosters moving into a more active (winner’s) space and retaining a more integrated position. The authors draw on trauma-informed practices and transactional analysis (TA). They propose that the bystander position in response to trauma can be both an internal and external process. As a tool for working with developmental trauma, the authors offer the contactful quad, which through empowerment and witness aims to support the process of decontamination and deconfusion, to aid the healing process, and to support integration of the unresolved somatic experience of trauma responses. Using clinical vignettes, the authors demonstrate the power of the Actively Courageous position of the contactful quad as an antidote to the Bystander position.

Artificial Intelligence Hybrid Survival Assessment System for Robot-Assisted Proctectomy: A Retrospective Cohort Study.

Robotic-assisted proctectomy (RAP) has emerged as the predominant surgical approach for patients with rectal cancer in recent years; although good postoperative patient recovery with accurate prediction is a guarantee of adaptive surveillance management, there is still a lack of easy-to-use prognostic tools and risk scores designed specifically for those patients undergoing RAP. This study used the electronic health records of 506 RAP participants, including a National Specialist Center for da Vinci Robotic Colorectal Surgery (NSCVRCS) meta cohort, and an independent external validation Sun Yat-sen Memorial Hospital cohort. In the NSCVRCS meta cohort, patients were divided into a discovery cohort (70%, n = 268), where the best-fit model was applied to model our prediction system, RAP-AIscore. Subsequently, an internal validation process for RAP-AIscore was conducted using a replication cohort (30%, n = 116). The study designed and implemented a large-scale artificial intelligence (AI) hybrid framework to identify the best strategy for building a survival assessment system, the RAP-AIscore, from 132 potential modeling scenarios through a combination of iterative cross-validation, Monte Carlo cross-validation, and bootstrap resampling. The 10 variables most relevant to clinical interpretability were identified on the basis of the AI hybrid optimal model values, which helps provide reliable prognostic survival guidance for new patients. The consistent evaluation of discrimination, calibration, generalization, and prognostic value across cohorts reaffirmed the accuracy and robust extrapolation capability of this system. The 10 feature variables most associated with clinical interpretability on the basis of Shapley values were identified, facilitating reliable prognostic survival guidance for new patients. This study introduces a promising and informative tool, the RAP-AIscore, which can be explained through nomograms for interpreting clinical outcomes. It facilitates postoperative risk stratification management and enhances clinical management of prognosis for RAP patients.

Accounting for effects of growth rate when measuring ecological stability in response to pulse perturbations.

Ecological stability is a vital component of natural ecosystems that can inform effective conservation and ecosystem management. Furthermore, there is increasing interest in making comparisons of stability values across sites, systems and taxonomic groups, often using comparative synthetic approaches, such as meta-analysis. However, these synthetic approaches often compare/contrast systems where measures of stability mean very different things to the taxa involved. Here, we present results from theoretical models and empirical data to illustrate how differences in growth rates among taxa influence four widely used metrics of ecological stability of species abundances responding to pulse perturbations: resilience, recovery, resistance and temporal stability. We refer to these classic growth-rate-dependent metrics as 'realised' stability. We show that realised resilience and realised temporal stability vary as a function of organisms' growth rates; realised recovery depends on the relation between growth rate and sampling duration; and realised resistance depends on the relation between growth rate and sampling interval. To account for these influences, we introduce metrics intended to be more independent of growth rates, which we refer to as 'intrinsic' stability. Intrinsic stability can be used to summarise the overall effects of a disturbance, separately from internal recovery processes - thereby allowing more general comparisons of disturbances across organisms and contexts. We argue that joint consideration of both realised and intrinsic stability is important for future comparative studies.

Hydrodynamic Flexible Spindle (HydroFlex) Polishing of turbine blade internal cooling channels for oxide removal

Internal cooling channels are essential to turbine blades for high efficiency power generation. Effective removal of aluminum oxide build-up in turbine blade cooling channels is of critical importance to refurbishment and prolonged service life of turbine blades. Conventional internal polishing processes, including abrasive flow machining, chemical polishing, and electrical discharge machining cannot effectively remove the oxide layer within the internal cooling channels due to the complex geometry with high aspect ratio and diameter variation and the electric insulation of the oxide layer. In this case study, we investigated the application of a novel hydrodynamic flexible-spindle (HydroFlex) polishing process to remove the oxide layer within the internal cooling channels of an Inconel 738 turbine blade that was taken out of serve due to oxide build-up. For a 350 mm long cooling channel featured with an inner diameter transition from ϕ4 mm to ϕ2.5 mm, within 12 min, at the grinding wheel rotational speed of 50,000 rpm and 30,000 rpm, HydroFlex was able to completely remove the 14.31 µm thick oxide layer off from the wall of the turbine blade internal cooling channel, improve the channel circularity by 54.7 %, and decrease the channel surface roughness by up to 64.3 %. The results demonstrated the effectiveness of HydroFlex in polishing complex internal cooling channels of turbine blades for oxide removal and potential blade service life extension.

Cu-stabilized 7-filament MgB2 wires by an internal Mg diffusion process

Compared with the Powder-In-Tube (PIT) method, MgB2 wires fabricated through the Internal Mg Diffusion (IMD) method demonstrate superior superconducting properties. However, magnesium’s hexagonal close-packed (HCP) crystal structure presents challenges in introducing Cu stabilizers into wires, thereby constraining the thermal stability of MgB2 wires. In this investigation, we improved the fabrication process to produce four distinct hundred-meter-scale Cu-stabilized 7-filament MgB2 wires. Experimental results indicate that the composite wires’ maximum Cu/SC Ratio reaches 2.45. Introducing Cu stabilizers enables the wire to achieve a tensile strength of 393 MPa at room temperature. Furthermore, the critical current density Jc of the wire can reach 2.3 × 105 A/cm2 at 4.2 K and 4 T. Our research provides a reliable reference for further preparation of high-stability MgB2 wires.

Internal damage evolution of C/SiC composites in air at 1650 °C studied by in-situ synchrotron X-ray imaging

Carbon fibre reinforced silicon carbide (C/SiC) ceramic matrix composites have attracted considerable attention due to their exceptional properties and extensive potential applications as high-temperature structural materials. However, due to their complex structure and manufacturing defects, C/SiC composites exhibit intricate mechanical behaviour under thermal-mechanical-oxidative coupling environments. To date, systematic studies on the internal damage evolution and failure mechanisms of C/SiC composites under high-temperature oxidative environments are lacking. In this study, a combination of synchrotron X-ray micro-computed tomography (SR-μCT) and in-situ experiments under thermal-mechanical-oxidative coupling environments at room temperature and 1650 °C in air was used to characterize the internal microstructures and damage evolution processes of C/SiC composites at different loading levels. Additionally, the 3D strain fields during in-situ loading were quantitatively analysed using the Digital Volume Correlation (DVC) method. The findings underscore the substantial impact of oxidative damage on the mechanical response of C/SiC composites, particularly concerning tensile properties and fracture modes. At room temperature, severe delamination, fibre bundle pull-out and interfacial debonding occurred internally. Whereas, under high-temperature atmospheric conditions, severe fibre oxidation reactions occurred at the specimen edges, resulting in rapid porosity escalation. Crack initiation from surface defects followed by rapid inward propagation is observed. Moreover, while the strain distribution remains relatively uniform until fracture, a pronounced concentration of strain is evident near the fracture zones at room temperature, with an even greater concentration observed at 1650 °C. Notably, the region of concentrated strain within the 3D deformation field corresponds closely to the final fracture location, as revealed by quantitative DVC analysis.

Free‐space quantum key distribution transmitter system using WDM filter for channel integration

AbstractIn this study, we report a transmitter system for free‐space quantum key distribution (QKD) using the BB84 protocol, which does not require an internal alignment process, by using a wavelength‐division multiplexing (WDM) filter and polarization‐encoding module. With a custom‐made WDM filter, the signals required for QKD can be integrated by simply connecting fibers, thus avoiding the laborious internal alignment required for free‐space QKD systems using conventional bulk‐optic setups. The WDM filter is designed to multiplex the single‐mode signals from 785‐nm quantum and 1550‐nm synchronization channels for spatial‐mode matching while maintaining the polarization relations. The measured insertion loss and isolation are 1.8 dB and 32.6 dB for 785 nm and 0.7 dB and 28.3 dB for 1550 nm, respectively. We also evaluate the QKD performance of the proposed system. The sifted key rate and quantum bit error rate are 1.6 Mbps and 0.62%, respectively, at an operating speed of 100 MHz, rendering our system comparable to conventional systems using bulk‐optic devices for channel integration.

Assessing performance of water supply operation of water companies in China: A union dynamic multi-activity network data envelopment analysis

Urban growth and the increasing urban water demand highlight the importance of performance analysis in the water supply industry. Both water supply companies (WSCs) and water supply and sewage companies (WSSCs) produce and deliver potable water for city dwellers. Water authorities use benchmarks to monitor the two types of companies’ operations. The internal operation process and heterogeneities of observations were not considered for relative performance evaluation by conventional DEA models. To overcome these limitations, this study proposes a union dynamic multi-activity network data envelopment analysis (DMANDEA) model to extend static network DEA to a more general case for dynamic efficiency assessment of the water supply operations of water companies. For the first time, the model allows for the decomposition of the water supply operation into water production (WP) and water consumption (WC) substages and performance comparisons for water companies by considering their heterogeneity simultaneously. Specifically, by using a non-radial directional distance function (DDF), the inefficiencies for substages and the entire system can be both assessed dynamically. This model is applied to a sample of 246 water companies in China in 2016–2018. The overall, period, and substages’ group efficiencies, meta efficiency, and technology gap ratio (TGR) for 179 WSCs and 67 WSSCs are all provided. The empirical results reveal that: (1) the average group efficiencies of WSCs and WSSCs are 0.4567 and 0.6611, respectively. The meta efficiencies of WSCs and WSSCs are 0.4523 and 0.4703, respectively. The TGR of WSCs (0.994) is greater than that of WSSCs (0.7067). (2) WSSCs perform better than WSCs do, which suggests that economies of scope do exist in WSSCs. However, WSCs possess the best technology for water supply operations because of their high TGR. (3) The average meta efficiency for all the observed water companies (0.4572) is not optimistic, which correlates more with inefficiency in the WP stage. The causes stem from the natural monopoly, lack of competition, and relatively lower water tariffs. The Chinese water supply industry requires diversification of ownership and operation modes, and gradual increases in water tariffs. (4) Water companies in the eastern region outperform those in other regions. Regional cooperation, such as technology sharing, the transfer of managerial experience, and information exchange, needs to be emphasized.

Evaluation of Financial Performance with the Balanced Scorecard Approach in Retail Companies

This research assesses the financial performance of retail enterprises utilizing the Balanced Scorecard (BSC) methodology. The study used a quantitative methodology, gathering data from 75 retail firms via a Likert-scale questionnaire (1 to 5). The analysis use SPSS version 26, concentrating on four key Balanced Scorecard perspectives: financial, customer, internal business processes, and learning and growth. The findings indicate substantial positive relationships across the customer, internal processes, and learning and growth perspectives with financial success, with the customer viewpoint serving as the most robust predictor. The results indicate that retail firms can improve financial performance by prioritizing customer satisfaction, operational efficiency, and ongoing innovation. These insights offer significant recommendations for retail managers seeking to synchronize strategic objectives with operational performance.

Performance Analysis Measured by Key Performance

Humans are the main asset in an organization, so human resources (HR) must be managed and utilized in a balanced and humane manner. A private hospital is a health institution owned by a non-profit and private company whose operational activities are financed through payments for medical services by the patients themselves. Siloam Hospital Bali is located at Jl. Sunset Road No. 818, Kuta, Kec. Kuta, Badung Regency, Bali with a total of 73 employees as respondents. This research aims to determine performance analysis as measured by key performance (financial and profitability, customer satisfaction, internal processes, learning and growth and company performance). The research data is secondary data obtained from Siloam Hospitals Bali. Testing the research hypothesis used SPSS (Statistical Product and Service Solution) analysis techniques. The research results show that financial and profitability (X1), customer satisfaction (X2), internal processes (X3), learning and growth both partially and simultaneously have a positive and significant influence on company performance (Y). It is hoped that in future research other variables that influence company performance can be examined.

Relationship between Sensory Processing Sensitivity and Personality Traits

Reactions to stimuli vary from person to person. The same stimulus has different effects depending on the perception of different people and the physical and mental states they are in. Considering this difference, situations can be seen in which a person perceives a specific stimulus or group of stimuli as negative and disturbing for themselves. In particular, people with high levels of sensory processing sensitivity feel the negative effects of stimuli more intensely both in terms of their internal processes (hunger, pain, sadness, stress, etc.) and the situation of the physical environment (loud noise, bright light, pungent odor, etc.) which they are in. On the other hand, the existence of situations where sensory processing sensitivity has a positive effect is also noticeable. In this context, the relationship between sensory processing sensitivity and personality traits is examined. The concept of personality is explained in different ways by many different theorists in the international literature. In order to avoid confusion that may arise in the definition and understanding of personality traits, in this review study, personality traits are examined on the basis of the Five Factor Personality Theory. Within the framework of the personality definition of the Five Factor Personality Theory, The relationship between five basic personality traits and sensory processing sensitivity is examined by also considering the subdimensions of each five personality traits.

Optimizing the order picking and delivery process to the final recipient

The aim of this study is to analyse and evaluate the order picking process and the transport of products to customers, taking into account the specific characteristics and potential of small and medium-sized industrial enterprises. Scientific standards and selected indicators for measuring the efficiency and quality of transport and order picking processes were used to achieve the intended objectives. The research was conducted in a small, family-owned manufacturing and trading company specialising in the production and sale of wrought iron finishing elements and fences. The analysis covered both internal and external transport processes. It was shown that the order picking process in the studied company is largely based on manual procedures, which, despite high precision, generates time-consuming activities related to the movement of warehouse employees. External transport efficiency indicators showed high efficiency and appropriate use of transport resources. The high quality of deliveries, as measured by on-time and reliability indicators, confirms customer satisfaction. The study was conducted in one company, which is a limitation. Future studies should include more companies from the same sector. Proposed improvements need to be verified sometime after implementation and solutions resulting from data analysis can help SMEs in similar industries to improve their logistics processes. The work brings a new approach to the analysis of order picking and transport processes in the context of SMEs, providing practical solutions and indicating areas for further research. It is aimed at logistics managers, researchers and practitioners interested in optimising logistics processes in the industrial sector.

Beyond the “Cool” Intelligence: Abilities to Master Internal Personality Processes

Beyond the “Cool” Intelligence: Abilities to Master Internal Personality Processes

Internal validation of the Tampa Robotic Difficulty Scoring System: real-time assessment of the novel robotic scoring system in predicting clinical outcomes after hepatectomy.

As the robotic approach in hepatectomy gains prominence, the need to establish a robotic-specific difficulty scoring system (DSS) is evident. The Tampa Difficulty Score was conceived to bridge this gap, offering a novel and dedicated robotic DSS aimed at improving preoperative surgical planning and predicting potential clinical challenges in robotic hepatectomies. In this study, we internally validated the recently published Tampa DSS by applying the scoring system to our most recent cohort of patients. The Tampa Difficulty Score was applied to 170 recent patients who underwent robotic hepatectomy in our center. Patients were classified into: Group 1 (score 1-8, n = 23), Group 2 (score 9-24, n = 120), Group 3 (score 25-32, n = 20), and Group 4 (score 33-49, n = 7). Key variables for each of the groups were analyzed and compared. Statistical significance was accepted at p ≤ 0.05. Notable correlations were found between the Tampa Difficulty Score and key clinical parameters such as operative duration (p < 0.0001), estimated blood loss (p < 0.0001), and percentage of major resection (p = 0.00007), affirming the score's predictive capacity for operative technical complexity. The Tampa Difficulty Score also correlated with major complications (Clavien-Dindo ≥ III) (p < 0.0001), length of stay (p = 0.011), and 30-day readmission (p = 0.046) after robotic hepatectomy. The Tampa Difficulty Score, through the internal validation process, has confirmed its effectiveness in predicting intra- and postoperative outcomes in patients undergoing robotic hepatectomy. The predictive capacity of this system is useful in preoperative surgical planning and risk categorization. External validation is necessary to further explore the accuracy of this robotic DSS.

Understanding Children’s Learning of Part–Whole Relations Using Fingu

AbstractIn this article, we investigate the effects of the app Fingu on a child’s understanding of the part-whole concept. Using the Artifact Centric Activity Theory framework, we initially analyse the internalisation and externalisation processes that appear to occur during one child’s use of the app. Based on the learning from this process, we then use other aspects of the framework, in particular the subject-artifact-group triangle, to understand how Fingu might be used productively in mathematics education classrooms. Using a 13-min video of a child playing Fingu as our data source, we analyse how children might, as they learn about part-whole relationships, interact with the game. We also investigate how design principles in creating apps can impact on the experience of using the app in ways that may be unintended by their designers. This work has implications for app designers and for mathematics educators seeking to incorporate digital technologies into mathematics education.

Evaluating the impact of risk management and risk-based internal audit on fraud detection in local governments

One of the leading indicators for improving fraud detection capability is the evaluation of the implementation of risk management and risk-based internal audit and information technology systems. This study aims to evaluate how risk management and risk-based internal audits influence fraud detection capabilities in local government when integrated with information technology systems. SPSS 26 was utilized for data analysis. The paper uses a quantitative approach, collecting primary data with questionnaires distributed among 200 auditors and 70 supervisors across four districts in West Java. A purposive sampling approach based on self-selection was used. The findings show that the ability to detect fraud is significantly and positively influenced by the implementation of a risk-based internal audit (sig 0.000 &amp;amp;lt; 0.05) and risk management process (sig 0.000 &amp;amp;lt; 0.05). On the other hand, the risk management framework (sig 0.107 &amp;amp;gt; 0.05) has a negative and insignificant effect on improving fraud detection capability. In addition, the relationships between the risk management process (sig 0.006 &amp;amp;lt; 0.05) and fraud detection capability were found to be moderated by information technology systems. However, information technology systems are unable to moderate the relationship between risk-based internal audit (sig 0.563 &amp;amp;gt; 0.05) and risk management framework (sig 0.115 &amp;amp;gt; 0.05) on fraud detection capability. Therefore, risk management and risk-based internal audits are able to detect fraud, and information technology systems can strengthen the risk management process with the ability to detect fraud. AcknowledgmentThe authors would like to thank the University of North Sumatra, especially the Research Institute, for its support and the Ministry of Education and Research through the Directorate of Research, Technology, and Community Service program for providing intellectual assistance and funding for this project in the PMDSU grant (number: 91/UN5.4.10.S/PPM/KP-DRTPM/2024).

AB-INITIO CALCULATIONS FOR THE SEARCH FOR STABLE STRUCTURES FOR IRON-PHOSPHORUS AND NICKEL-PHOSPHORUS SYSTEMS

The study of the internal structure of our planet is one of the most relevant topics in fundamental research. In particular, the analysis of the phase ratios of iron compounds with light elements at high pressures is an important task for determining the composition and structure of the core of our planet. Due to the complexity of conducting experiments at such high pressures (in the Earth's core ~365 GPa), ab-initio calculations become a useful method for conducting such studies. With the advent of new algorithms for searching for crystal structures, such as USPEX, AIRS and CALYPSO, the number of studies and available data on compounds of iron-nickel-containing systems with light elements has increased significantly. These tools have significantly expanded our capabilities in studying the internal processes in planets, creating broader prospects for further research and understanding the evolution of planetary bodies. The integration of these advanced computational methods makes it possible to accurately predict stable and metastable phases of iron compounds under extreme conditions, providing invaluable data on the behavior of materials in the conditions of the Earth's core.

Effect of Implementing the Balanced Scorecard on the Management Performance of PT YKK AP Indonesia

This study aims to determine the effect of a balanced scorecard on the management performance of PT. YKK AP Indonesia. This study used 40 employees of PT. YKK AP Indonesia, who met the criteria to be respondents. This study was conducted using the conventional sampling method on PT employees. YKK AP Indonesia and analyzed using multiple linear regression. The first stage tested the validity and reliability of questions for each variable. The second stage conducted a classical test, and the third stage conducted an F test, t-test, and determination coefficient test. The results of the t-test study showed that the variables of financial perspective, customer perspective, internal business process perspective, and growth and learning perspective had a partial effect on management performance. In the F test, all independent variables simultaneously affected the dependent variable. Meanwhile, the determination coefficient value shows that the independent variables of financial perspective, customer perspective, internal business process perspective, and growth and learning perspective contributed to the dependent variable, namely management performance, by 49%, while other factors outside the model influenced the remaining 51%.

BALANCED SCORECARD DESIGN AS A MODEL FOR MEASUREMENT OF PUSKESMAS PERFORMANCE IN EAST LOMBOK DISTRICT

The objective of this study is to develop a performance measuring model based on the balanced scorecard framework at the UPT Puskesmas Suela in East Lombok Regency, using the Analytic Hierarchy Process (AHP) technique. This research employed qualitative approaches. Data were gathered with a paired comparison questionnaire employing the Analytic Hierarchy Process (AHP) scale. The performance evaluation of community health centers is conducted using four reference standards, including the financial perspective, community perspective, internal business process perspective, and development and learning perspective. Utilizing this technique for data processing is beneficial in making judgments based on many factors. The research findings indicate that the primary criterion of utmost importance for community health centers is finance, with a weight of 0.465450. The subsequent prioritization criterion is society, assigned a weight of 0.214555. Additionally, both the internal business process criteria and development and learning criteria hold equal significance, each with a weight of 0.112321. Related indicates that Puskesmas as a public sector agency focuses on improving performance on financial perspectives.

Statistical analysis plan for the SOLUTIONS randomised controlled trial with internal pilot: Solution Focused Brief Therapy (SFBT) in 10–17 year olds presenting at police custody

BackgroundWithin England, children and young people entering police custody are referred to Liaison and Diversion (L&D) teams. These teams liaise with healthcare and other support services aiming to divert children and young people away from the criminal justice system. Although targeted psychological interventions are not typically offered to children and young people by L&D teams, evidence suggests that Solution Focused Brief Therapy (SFBT) leads to a reduction in internalising and externalising behaviour problems.MethodsA two-arm individually randomised controlled trial (RCT) with internal pilot and process evaluation will be conducted with approximately 448 children and young people aged 10–17 years presenting at police custody suites who are referred to the L&D team or recruited via online routes if they have previously presented at any police custody suite in England. The primary outcome is the Self-Report Delinquency Measure (SRDM) at 6 months post-randomisation. Analyses will be performed using intention-to-treat.ResultsThe statistical analysis plan (SAP) for the trial is described. The plan details of analyses to be undertaken which will be reported in the primary and any secondary publications. The plan was developed and published prior to locking our database and unblinding to treatment allocation.DiscussionThis RCT will evaluate the effectiveness of SFBT in reducing offending behaviours in CYP presenting at police custody suites including testing of moderating factors and sensitivity of the primary analyses.Trial registrationClinicalTrials.gov ISRCTN14195235. Registered on June 16, 2023.