Repair Centers Research Articles

A green closed loop supply chain design using queuing system for reducing environmental impact and energy consumption

Abstract Due to increased environmental impacts and their important role in human life, reduction of impacts made by human has attracted more attention, recently. Green supply chains are among the most effective issues related to environmental impacts and increased number of studies in this area verifies this opinion. Transportation fleets transfer products between supply chain's centers and are one of the important factors which increase environmental impacts. Transportation fleets which transfer products between supply chain's centers are one of the important factors which increase environmental impacts while transferring products between centers and waiting in loading queue. Decreasing environmental impacts which are created by transportation fleets, from this point of view, is not investigated comprehensively in forward and reverse logistic supply chains. In order to deal with this gap, in this article a green supply chain with forward and reverse logistic consideration is designed and queuing system is used to optimize the transportation and waiting time of transportation fleets' network. This optimization model will lead to the reduction in environmental impacts. Our network consists of supplier, production system, distribution center, repair center, recycling center, disposal center, and collection center. Returned products from customers are collected in the collection center and transferred to other centers based on their type. Transportation fleets in the network are assumed to be customers of loading system in each center where each of these loading systems has a multi-server queuing system with finite sources. It is assumed that a sufficient number of servers are available in unloading centers, therefore, no queue will exist there. The proposed model will reduce the created environmental impacts and energy consumption of transportation fleets by determining loading, unloading and production rates, which affect waiting and transportation time. A numerical example is discussed for the NLP model in small size and solved with the exact methods. In addition, a meta-heuristics approach is employed to solve the large size of problem. Finally, the sensitivity analysis is performed to investigate the effects of change in parameters on model's decision variables and objective function.

Large Incisional Hernias Increase in Size

BackgroundPatients with an incisional hernia often wait a significant period of time from the first referral to hernia surgery because of waiting lists, watchful waiting, or the need for preoperative optimization. It is unknown if hernia dimensions or patient-reported symptoms increase during this period. The aim of the study was to examine if incisional hernias increase in size during the time from initial assessment to surgical repair. Materials and methodsA prospective controlled trial was performed on patients referred to a regional hernia center for repair of an incisional hernia with a transverse fascial defect of >7 cm. All patients underwent computed tomography scans and answered the Hernia-Related Quality of Life Score questionnaire and International Physical Activity Questionnaire at first assessment and again 30 ± 2 wk later or immediately before hernia repair. Changes in fascial defect sizes and hernia sac volume were assessed along with the patient-reported outcomes. ResultsA total of 35 patients were included. The median fascial defect area increased from 117.3 cm2 (interquartile range 46.5-181.2) to 150.4 cm2 (62.5-199.0), P < 0.001, and the median hernia sac volume increased from 5.11 L (2.28-8.09) to 6.25 L (3.03-10.38), P < 0.001. There were no significant changes in the patient-reported outcomes. ConclusionsIncisional hernias expand during the period from the first assessment to actual hernia repair.

Evaluating service quality in automobile maintenance and repair industry

PurposeThe purpose of this paper is to analyse service quality in the automobile maintenance and repair industry. A conceptual structural model is developed to investigate the impact of service quality, perceived service fairness and convenience on customer service satisfaction. The impact of service satisfaction and brand trust on word of mouth (WOM) is also explored, and the study assesses the mediating effect of customer service satisfaction on the relationship between service quality and WOM.Design/methodology/approachData from a questionnaire-based survey of 259 users of automobile maintenance and repair centres were analysed using covariance-based structural equation modelling.FindingsThe findings indicate that service quality dimensions (reliability, responsiveness and empathy), perceived service fairness and convenience are positively associated with customer service satisfaction, and that service satisfaction and trust positively influence WOM. The findings support the mediating effect of service satisfaction on the relationship between reliability and responsiveness and WOM.Research limitations/implicationsThe study’s main limitation is the cross-sectional design, which limits the generalisability of the findings.Practical implicationsTo ensure customer satisfaction and generate trust and WOM, automobile maintenance and repair service centres should improve reliability, responsiveness and empathy, as well as perceived service fairness and convenience.Originality/valueThe study demonstrates that the reliability and responsiveness dimensions of service quality are the most significant predictors of customer service satisfaction in the automobile maintenance and repair industry.

Repairing one’s mood for the benefit of others: Agreeableness helps motivate low self-esteem people to feel better

The chronic experience and expression of negativity is associated with poorer personal and relationship outcomes. Unfortunately, compared to people with high self-esteem, those with low self-esteem (LSEs) are less motivated to repair their negative moods. The current research examined mood repair in a novel way: in a close relationship context, when mood repair centers on benefitting others. We hypothesized that LSEs are more motivated than usual to repair negative moods when doing so benefits close others and when high in agreeableness (a trait involving prosocial motivation). We found support for our hypothesis with self-report (Studies 1 and 2) and behavioral measures (Study 2) of mood repair motivation, through an experimental manipulation of relationship context (Study 1), when participants expected to communicate with their romantic partners (Study 2), and for both sad (Study 1) and angry (Study 2) moods. Agreeable LSEs were more motivated to repair their negative moods than were disagreeable LSEs.

A grounded theory of regaining normalcy and reintegration of women with obstetric fistula in Kenya

BackgroundObstetric fistula is a reproductive health problem causing immense suffering to 1% of women in Kenya that is formed as sequelae of prolonged obstructed labour. It is a chronic illness that disrupts women lives, causing stigma and isolation. Fistula illness often introduces a crisis in women’s life begetting feelings of shame and serious disruption to their social, psychological, physical and economic lives, in addition to dealing with moral and hygiene challenges. Currently, women undergo free of charge surgery at vesicovaginal fistula (VVF) camps held in national referral hospitals and dedicated fistula centres generating a significant pool of women who have undergone surgery and are ready to regain normal lives.ObjectiveThe purpose of this study was to explore experiences of women immersing back into communities and their return to normalcy after surgery in three VVF repair centres in Kenya. We set out to answer the question: what strategies improve obstetric fistula patients’ reintegration process?MethodsWe used grounded theory methodology to capture the reintegration and regaining normalcy experiences of women after surgery. Narrative interviews were held with 60 women during community follow-up visits in their homes after 6–19 months postoperatively. Grounded theory processes of theoretical sampling, repeated measurement; constant comparative coding in three stage open, axial and selective coding; memoing, reflexivity and positionality were applied. Emergent themes helped generate a grounded theory of reintegration and regaining normalcy for fistula patients.ResultsTo regain normal healthy lives, women respond to fistula illness by seeking surgery.. After surgery, four possible outcomes of the reintegration process present; reintegration fully or partially back into their previous communities, not reintegrated or newly integrating away from previous social and family settings. The reintegration statuses point to the diversity outcomes of care for fistula patients and the necessity of tailoring treatment programs to cater for individual patient needs.ConclusionThe emerging substantive theory on the process of reintegration and regaining normalcy for fistula patients is presented. The study findings have implications for fistula care, training and policy regarding women’s health, suggesting a model of care that encompasses physical, social, economic and psychological aspects of care after surgery and discharge.

Live cell monitoring of double strand breaks in S. cerevisiae.

We have used two different live-cell fluorescent protein markers to monitor the formation and localization of double-strand breaks (DSBs) in budding yeast. Using GFP derivatives of the Rad51 recombination protein or the Ddc2 checkpoint protein, we find that cells with three site-specific DSBs, on different chromosomes, usually display 2 or 3 foci that may coalesce and dissociate. This motion is independent of Rad52 and microtubules. Rad51-GFP, by itself, is unable to repair DSBs by homologous recombination in mitotic cells, but is able to form foci and allow repair when heterozygous with a wild type Rad51 protein. The kinetics of formation and disappearance of a Rad51-GFP focus parallels the completion of site-specific DSB repair. However, Rad51-GFP is proficient during meiosis when homozygous, similar to rad51 “site II” mutants that can bind single-stranded DNA but not complete strand exchange. Rad52-RFP and Rad51-GFP co-localize to the same DSB, but a significant minority of foci have Rad51-GFP without visible Rad52-RFP. We conclude that co-localization of foci in cells with 3 DSBs does not represent formation of a homologous recombination “repair center,” as the same distribution of Ddc2-GFP foci was found in the absence of the Rad52 protein.

Hybrid Aortic Arch Debranching and TEVAR Is Safe in a Private, Community Hospital

Hybrid open cervical vessel debranching and thoracic endovascular aortic repair (TEVAR) is a treatment option in the management of aortic arch or proximal descending thoracic aortic aneurysms. However, these patients are often referred to tertiary care academic centers for aneurysm repair. Our study looks to assess the safety and outcomes of open cervical debranching and TEVAR within a private, community hospital setting. A total of 12 patients underwent hybrid open cervical vessel debranch with staged TEVAR from 2015 to 2018 at Riverside Community Hospital (Riverside, California). Three patients underwent open sternotomy with innominate artery bypass; four patients underwent combined carotid-carotid bypass with left carotid-axillary bypass or left subclavian transposition; three patients solely underwent left carotid-axillary bypass or left subclavian transposition. In cases involving multiple cervical bypasses, two surgeons were present. TEVAR was performed in a staged fashion during the same hospitalization. There were no patient deaths, MI, or stroke within the 30-day postoperative period and at 1-year follow-up. One patient suffered a small subdural bleed after ascending aorta to innominate bypass involving redo sternotomy and hypothermic circulatory arrest. The mean aortic zone stented was zone 1. On follow-up imaging, all bypass grafts were patent, all aneurysms demonstrated thrombosis without endoleak. Average follow-up was 20months. Hybrid cervical debranching with staged TEVAR can be safely performed by experienced vascular surgeons in the community setting. Staged repair appears to confer better operative and patient outcomes.

Design of Various Shear Connectors for Repair of Corroded Steel Girders with Ultra-High Performance Concrete

Corrosion accounts for approximately 20% of the structurally deficient bridges in the United States, causing a massive backlog of rehabilitation projects. The current repair procedure for corroded bridge girders is expensive, slow to implement, and necessitates complete closure of the bridge. Through an extensive study supported by the Connecticut Department of Transportation, a novel repair method has been developed to rapidly restore the strength of corroded bridge girder ends with minimal traffic interruption. First, shear connectors in the form of headed studs are welded on the uncorroded web plate above the bearing. Next, formwork is placed and ultra-high-performance concrete (UHPC) is cast down to the bottom flange. This creates an alternate load path around the section loss. Based on the experimental results, it may be concluded that the implementation of the repair reduces the strains on the web plate and strengthens the bridge girder, allowing it to surpass its original capacity. However, the success of the repair centers around the performance of the shear connectors. In addition to headed studs, threaded bars and UHPC dowels in perforated web were evaluated experimentally as alternative shear-transfer mechanisms. This paper presents the repair design objectives and considerations for a realistic girder end utilizing different shear connectors to demonstrate the flexibility and versatility of the repair. The details of the designs are illustrated to facilitate the transition of the research findings to practice.

Understanding lifetimes and failure modes of defective washing machines and dishwashers

The available literature on average lifetimes and failure modes of household appliances is mainly based on results of surveys conducted among end-users, but very little precise information can be found on specific failure modes and repair rates.The main objective of this study is to provide quantitative data about frequent failures and average service lifetimes of two household appliances, through the analysis of repair services performed by professional repair operators.We based our analysis on available datasets provided by a representative independent repair centre based in Europe, and we focused on the failures most frequently occurring and the potential repair or discard of the appliances. A database of about 11,000 diagnoses on defective washing machines and dishwashers was analysed, and frequent failure modes and repair rates were identified. The analysis was supported by a tailored visualisation of results.Concerning washing machines, recurring failures diagnosed by the repair operator regarded the electronics, shock absorbers and bearings, doors, carbon brushes and pumps. While the highest repair rates (repaired devices over total diagnosed devices with a specific failure mode) were observed for doors, carbon brushes and removal of foreign objects, the lowest rates were observed for bearings, drums and tubs, circulation pumps and electronics. Regarding dishwashers, recurring failures involved pumps, electronics, aquastop and valves, foreign objects and doors. The lowest repair rates, however, were again observed for circulation pumps and electronics. We also observed that the average service lifetime of an appliance not repaired by repair centre operators is 12.6 years for washing machines and 12 years for dishwashers.This work brings important knowledge on lifetimes and failure modes of defective washing machines and dishwashers, concerning in particular weak and critical components, but also age of appliances to be repaired. Based on the exercise on the two appliances, we discuss a possible classification scheme for repair services of household appliances, including both information retrieved by professional repair operators and information retrieved through interviews with end-users.

Fixotek: Implementing and Testing Urban Reuse and Repair Centers in Sweden

The Fixotek project is testing if dedicated community spaces in residential areas could help encourage residents to fix, lend, swap and recycle consumer products, thereby preventing waste generation and recovering resources locally. Four Fixoteks have been developed, in districts with different socioeconomic conditions in Gothenburg, offering regular open hours and events. The idea has been very well received by the community, with differences in how easily it has been taken up in some of the locations. Two of the Fixoteks engage local volunteers and have developed closer to local initiatives, while in the other two more efforts are needed to engage the local community. Non the less, the locations have allowed residents to reuse and repair beyond what was possible before. The project has been implemented with a multi-stakeholder consortium, which has given it a holistic approach to the implementation, but makes decision taking slow.

Drivers perceptions of road accidents: A Qualitative Study

Background: Road accidents is a particular public health problem that is endangering the lives of many people every year in the world. Iran is one the most dangerous countries in terms of road accidents. Human factors and driving performance are the most important causes of this car accidents. This qualitative study was conducted to determine perceptions of 12 drivers in Shiraz city about road accidents, hoping to lead to effective interventions to inform and reduce the incidence of them. Methods: 12 drivers aged 24–60 years from Shiraz participated in qualitative, semi-structured, interviews about their perceptions of road accidents. The social ecological model informed interview question development, and data were examined using thematic analysis. Then the early categories formed. All interviews were recorded, categorized and analyzed. Results: The results of the study in five main themes included the sense of responsibility for driving regulations, the causes of driving hazardous behaviors, participation in modifying these behaviors, the requirements for preventive performance and the best practices for modifying behavior were emerged. Participants also believed that with more education, incentive behaviors would be more effective than punishment, accountability to their lives, occupants and people. They all opposed the increase in fines and noted that the authorities should be more concerned with measures, such as foundation of highways, the construction of parking sites, the construction of equipped centers for repair of vehicles and rest for the prevention of road accidents. Conclusion: According to the results of this study, the best and most cost-effective method is to reduce the incidence of injuries and improve the performance of drivers by using participatory and cooperative behaviors and avoiding of violence in law cases. More studies are recommended in this regard.

Translating advances in organ-on-a-chip technology for supporting organs.

Organ-on-a-chip platforms have recently seen tremendous progress. They have found potential applications in the study of physiology and pathology of tissues, drug toxicity, and development of tissue models for replacement of animal studies. However, their potential role in organ transplantation has hardly been discussed, so far. Organ transplantation represents a major medical advancement of the twenty-first century, yet it suffers from limitation due to the shortage of organ supply. Very often, organs harvested from donor's body are deemed non-usable because of being damaged or "marginal". Recently, developments of bioartificial devices such as artificial placenta and renal assist-devices have shown that it is possible to develop novel bioartificial organ support systems that can support the healing of damaged or marginal organs prior to their transplantation. In the current article, we introduce a novel concept for building bioartificial organ assist devices and systems by integrating arrays of numerous organ-on-a-chip platforms. The new system can be used in organ repair centers as means for temporary organ support and functional enhancement. We have also briefly reviewed the relevant organ-on-a-chip platforms developed so far, and related literature to form a basis for developing our new concept, device and its application. The proposed system may help to increase the number of organs available for transplantation and improve transplantation outcomes. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2006-2018, 2019.

Aortic valve repair in adult congenital heart disease.

Aortic valve repair in adult congenital heart disease (ACHD) went through a major development during the last two decades to become an increasingly established treatment option in experienced heart valve repair centers. This mini-review addresses valve-sparing treatment strategies in the two most common clinical entities of patients with adult congenital aortic valve disease, namely those presenting with bicuspid (BAV) and unicuspid (UAV) aortic valve disease. Both diseases are integral components of the continuum of congenital aortic valve diseases and represent one of the most common reasons of cardiovascular morbidity in young and otherwise healthy adult patients. The review will highlight the most important advantages of aortic valve sparing procedures as compared to the conventional valve replacement strategy. New treatment aspects will be reviewed including minimally-invasive surgical approaches for aortic valve repair as well as modern protocols of enhanced perioperative recovery which will potentially improve the perioperative recovery and quality of life of the patients undergoing valve-sparing surgical procedures in the future.

Experience of using Community Radio for Fistula Communication in Bangladesh

Aims: To share the experience of using community radio networks for female genital fistula communication in Bangladesh.&#x0D; Methods: We selected 11 community radio stations from remote areas in Bangladesh. Four hours orientation training was provided to manager and fistula focal person per radio station. We provided pre-recorded education and advocacy materials for fistula prevention and communication. Station staffs were provided with a manual for fistula communication.&#x0D; Results: 32 key staff members of community radios were trained. At least 33 episodes were broad casted focusing on prevention of early marriage, care of obstructed labor, treatment and rehabilitation of fistula. Information about fistula prevention, case identification, repair center and rehabilitation were provided to an estimated number 660,000 people living in hard to reach places through community radio stations. They incorporated fistula messages song, dramas and talk shows on fistula throughout the year.&#x0D; Conclusions: Community radio is a low cost, effective media for fistula communication in hard to reach areas. It is capable of linking a range of stakeholders and can be a strong force for facilitation of social movement for fistula free communities.

Surgical success of patients presenting for repair of VVF - Data from fistula repair centre, Ayub Teaching Hospital, Abbottabad, Pakistan (2016-18)

Abstract: Obstetrical fistula is a devastating condition which socially impairs the life of patients in reproductive years. These females are usually socially isolated. Mostly patients don't have awareness regarding management of their problem due to poverty and ignorance.&#x0D; Fistula centre was estabished in Gynae department of Ayub Teaching Hospital, Abbottabad three years ago in collaboration with Pakistan National Forum on Women's Health ( PNFWH). In this presentation details of patients treated in fistula centre will be discussed.

Assessment of the impact of non-state actors in the support for obstetric fistula care: Matters arising

Aims: To review the impact of support of non-state actors on communal OF repair effort in fistula repair Centre.&#x0D; Methods: We reviewed the support given for OF repairs at Adeoyo Maternity Hospital, Ibadan from 2013 to 2018. The type of support was either Partial or Full support; involved support from various organizations such as Extended Hands, GWIN, Faith Hookes Foundation, Engenderhealth/USAID. Partial support was provided by above-listed organizations between 2013- 2016. However, sustained Full support was provided by Fistula carePlus/Engenderhealth/USAID between 2017 and 2018.&#x0D; Results: Partial support involved supply of equipment, health education, radio jingles, fistula repairs; while Full support included supply of medical consumable, mobilization of fistula clients/client mobilization using social workers, feeding of clients for minimum of 2 weeks, provision of power backup, mobilization and remuneration of OF surgeons and manpower, in addition to those listed above. One hundred, eighty-seven women benefitted from support. Fistula types ranging from obstetric, iatrogenic and traumatic fistula were repaired using both pooled effort and routine repair models. During partial support, 70(37.4%) women were repaired compared to 117 (62.6%) when sustained full support was provided. All women freely accepted participation in the supported repair program.&#x0D; Conclusions: There is a compelling improvement in patronage, access to care and opportunity to develop the skills of enthusiast among the health-workers; and thus a need for more commitment in our quest to eliminate obstetric fistula.

Single molecule tracking reveals spatio-temporal dynamics of bacterial DNA repair centres

Single-particle (molecule) tracking (SPT/SMT) is a powerful method to study dynamic processes in living bacterial cells at high spatial and temporal resolution. We have performed single-molecule imaging of early DNA double-strand break (DSB) repair events during homologous recombination in the model bacterium Bacillus subtilis. Our findings reveal that DNA repair centres arise at all sites on the chromosome and that RecN, RecO and RecJ perform fast, enzyme-like functions during detection and procession of DNA double strand breaks, respectively. Interestingly, RecN changes its diffusion behavior upon induction of DNA damage, from a largely diffusive to a DNA-scanning mode, which increases efficiency of finding all sites of DNA breaks within a frame of few seconds. RecJ continues being bound to replication forks, but also assembles at many sites on the nucleoid upon DNA damage induction. RecO shows a similar change in its mobility as RecN, and also remains bound to sites of damage for few hundred milliseconds. Like RecN, it enters the nucleoid in damaged cells. Our data show that presynaptic preparation of DSBs including loading of RecA onto ssDNA is highly rapid and dynamic, and occurs throughout the chromosome, and not only at replication forks or only at distinct sites where many breaks are processes in analogy to eukaryotic DNA repair centres.

Evaluating Constraints to Animal Traction Development and Sustainability in the Upper Noun Valley, North West Region Cameroon

The principal aim of this study was to find out the reasons for the low adoption of animal traction in the Upper Noun Valley community. The general views were; to find out the level of animal traction adoption, to see its level of profitability, to examine its importance on agricultural sustainability and the overall constraints and benefits involved in animal traction. Combinations of multi-stage random and purposive sampling procedures were applied to obtain the needed information from oxen-farmers and institutions. A cross sectional data was collected and analysed from random sample of 90 oxen farmers within the Upper Noun Valley Community. Data were collected and analysed using Statistical Package for Social Sciences (SPSS) and Microsoft Excel. The study revealed that small-scale farmers encountered several sustainability challenges from inappropriate implements, pasture difficulty, lack of training and repair centres, poor animal housing. Animal traction sustainability depends on its; affordability, flexibility, timeliness on farm and organic manure provision. In order to overcome the alarming food insecurity in Cameroon, both the government and stakeholders should regain consciousness on abandoned training centres, and minimum packages should be given to small-scale farmer as well as local blacksmiths and veterinary centres be provided at the Divisional level.

The needs of aircraft avionics’ radio line replaceable unit repair center at UniKL MIAT

For the local aircraft maintenance industry, radio line replaceable unit (LRU) has been essential in aircraft’s airworthiness but at the same time, costly for many Malaysian aviation companies. This study analyzes the survey conducted with 66 aviation industry personnel from 11 local aviation companies, which have had to spend a considerable amount of financial budget on their LRU maintenance every year. The conclusion from the survey data shows that most of them agreed on the need to establish an LRU Center in a local approved training organization such as Universiti Kuala Lumpur – Malaysian Institute of Aviation Technology (UniKL MIAT) because of several justifiable reasons such as significantly cheaper costs, more hands-on training and job opportunities, shorter delivery time, and possible research and development benefits.

Experienced Centers for Cleft Palate Repair Have Improved Outcomes

High volume centers (HVC) are commonly associated with increased resources and improved patient outcomes. An analysis of hospital volume and socioeconomic variables has not been reported for cleft palate repairs, widely performed yet difficult surgeries. The purpose of our study was to assess the efficacy and outcomes of high volume centers specifically for specific subtypes of cleft palate repair.