Search results for: medication therapy management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11203

Search results for: medication therapy management

8173 Risk Measurement and Management Strategies in Poultry Farm Enterprises in Imo State, Nigeria

Authors: Donatus Otuiheoma Ohajianya, Augusta Onyekachi Unamba

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This study analyzed risk among poultry farm enterprises in Imo State of Nigeria. Specifically, it examined sources of risks, the major risks associated with poultry farm enterprise, and the risk-reducing strategies among the poultry farm enterprises in the study area. Primary data collected in 2015 with validated questionnaire from 120 proportionately and randomly selected poultry farm enterprises were used for the study. The data were analyzed with descriptive statistics and W-Statistic that was validated with Pearson Criterion (X2). The results showed that major risk sources affecting poultry farm enterprises were production, marketing, financial and political in that order. The results found a W-Statistic value of 0.789, which was verified by Pearson Criterion to obtain X2-Calculated value of 4.65 which is lower that X2-Critical value of 11.07 at 5% significant level. The risk-reducing strategies were found to be diversification, savings, co-operative marketing, borrowing, and insurance. It was recommended that government and donor agencies should make policies aimed at encouraging poultry farm enterprises adopt the highlighted risk-reducing strategies in risk management to improve their productivity and farm income.

Keywords: risk, measurement, management, poultry farm, Imo State

Procedia PDF Downloads 288
8172 Natural Language Processing for the Classification of Social Media Posts in Post-Disaster Management

Authors: Ezgi Şendil

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Information extracted from social media has received great attention since it has become an effective alternative for collecting people’s opinions and emotions based on specific experiences in a faster and easier way. The paper aims to put data in a meaningful way to analyze users’ posts and get a result in terms of the experiences and opinions of the users during and after natural disasters. The posts collected from Reddit are classified into nine different categories, including injured/dead people, infrastructure and utility damage, missing/found people, donation needs/offers, caution/advice, and emotional support, identified by using labelled Twitter data and four different machine learning (ML) classifiers.

Keywords: disaster, NLP, postdisaster management, sentiment analysis

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8171 Stress Hyperglycaemia and Glycaemic Control Post Cardiac Surgery: Relaxed Targets May Be Acceptable

Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass

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8170 Design and Implementation of Machine Learning Model for Short-Term Energy Forecasting in Smart Home Management System

Authors: R. Ramesh, K. K. Shivaraman

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The main aim of this paper is to handle the energy requirement in an efficient manner by merging the advanced digital communication and control technologies for smart grid applications. In order to reduce user home load during peak load hours, utility applies several incentives such as real-time pricing, time of use, demand response for residential customer through smart meter. However, this method provides inconvenience in the sense that user needs to respond manually to prices that vary in real time. To overcome these inconvenience, this paper proposes a convolutional neural network (CNN) with k-means clustering machine learning model which have ability to forecast energy requirement in short term, i.e., hour of the day or day of the week. By integrating our proposed technique with home energy management based on Bluetooth low energy provides predicted value to user for scheduling appliance in advanced. This paper describes detail about CNN configuration and k-means clustering algorithm for short-term energy forecasting.

Keywords: convolutional neural network, fuzzy logic, k-means clustering approach, smart home energy management

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8169 Impact of Marketing towards Behavior Intention

Authors: Sathyamangalam Rangasamy Guru Prasath

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Due to the increasing homogeneity in product offerings, the attendant services provided are emerging as a key differentiator in the mind of the consumers. Services marketing are a sub field of marketing which covers the marketing of both goods and services. Service marketing differs from product marketing due to the face that services are intangible and typically require personal interaction with the customer. Relationships are a key factor when it comes to the marketing of services. The role of interpersonal relationships distinguishes service and product marketing in strategic vision and organizational considerations. This paper explores some of the trends in service marketing as they relate to strategic vision, operational and organizational changes, and marketing tactics. The presence of the customer in the service facility means that capacity management becomes an important driver of the firm’s profitability service marketing is a process from the organization’s point of view, but an experience from the customer’s perspective. The quality of the experience is a function of the careful design of customer service processes, adoption of standardized procedures, rigorous management of service quality, high standards of training and automation. Services marketing helps to ensure that these processes are designed from the customer’s perspective. Services marketing includes customer loyalty, managing relationships, complaint handling, improving service quality and productivity of service operations, and how to become a service leader in your industry.

Keywords: customer perspective, product marketing, service marketing, rigorous management

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8168 Influential Factors of Employees’ Work Motivation: Case Study of Siam Thai Co., Ltd

Authors: Pitsanu Poonpetpun, Witthaya Mekhum, Warangkana Kongsil

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This research was an attempt to study work motivation of employees in Siam Thai Co., Ltd. The study took place in Rayong with 59 employees as participants. The research tool was questionnaires which consisted of sets of questions about company’s policy, management, executives and good relationship within the firm. The questionnaires style was rating scale with 5 score bands. The questionnaires were analyzed by percentage, frequency, mean and standard deviation. From the study, the result showed that policy and management were in moderate scale, executive and managers were in moderate scale and relationship within the firm were in high scale.

Keywords: motivation, job, performance, employees

Procedia PDF Downloads 249
8167 Solar Energy Management: A Case Study of Bhubaneswar City

Authors: Rachita Lal

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Solar energy is a clean energy source. Because it is readily available in India and has many potential decentralized uses, urban local authorities may use it in various ways to manage the energy needs in the territory under their control. Apart from these and other services for which people pay a substantial number of money, urban local councils play a crucial role in administering essential services like water supply, street lighting, and health care. ULBs may contribute considerably to the transition to solar energy, both for their benefit and simultaneously for several additional direct and indirect advantages at multiple levels. The research primarily focuses on using clean energy management to reduce urban areas' reliance on traditional (electricity) energy. A technique for estimating the rooftop solar power potential using GIS (Geographical Information System) is described. Given that the combustion of fossil fuels produces 75% of India's power, meeting the country's energy needs through renewable energy sources is a step toward sustainable development and combating climate change. The study will further help in categorization, phasing, and understanding the demand and supply and thus calculating the cumulative benefits. The main objectives are to study the consumption of conventional energy in the study area and to identify the potential areas where solar photovoltaic intervention can be installed.

Keywords: solar energy, GIS, clean energy management, sustainable development

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8166 Applied Spatial Mapping and Monitoring of Illegal Landfills for Deprived Urban Areas in Romania

Authors: Șercăianu Mihai, Aldea Mihaela, Iacoboaea Cristina, Luca Oana, Nenciu Ioana

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The rise and mitigation of unauthorized illegal waste dumps are a significant global issue within waste management ecosystems, impacting disadvantaged communities. Globally, including in Romania, many individuals live in houses without legal recognition, lacking ownership or construction permits, in areas known as "informal settlements." An increasing number of regions and cities in Romania are struggling to manage their illegal waste dumps, especially in the context of increasing poverty and lack of regulation related to informal settlements. One such informal settlement is located at the end of Bistra Street in Câlnic, within the Reșița Municipality of Caras Severin County. The article presents a case study that focuses on employing remote sensing techniques and spatial data to monitor and map illegal waste practices, with subsequent integration into a geographic information system tailored for the Reșița community. In addition, the paper outlines the steps involved in devising strategies aimed at enhancing waste management practices in disadvantaged areas, aligning with the shift toward a circular economy. Results presented in the paper contain a spatial mapping and visualization methodology calibrated with in situ data collection applicable for identifying illegal landfills. The emergence and neutralization of illegal dumps pose a challenge in the field of waste management. These approaches, which prove effective where conventional solutions have failed, need to be replicated and adopted more wisely.

Keywords: informal settlements, GIS, waste dumps, waste management, monitoring

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8165 Elements of a Culture of Quality in the Implementation of Quality Assurance Systems of Countries in the European Higher Education Area

Authors: Laura Mion

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The implementation of quality management systems in higher education in different countries is determined by national regulatory choices and supranational indications (such as the European Standard Guidelines for Quality Assurance). The effective functioning and transformative capacity of these quality management systems largely depend on the organizational context in which they are applied and, more specifically, on the culture of quality developed in single universities or in single countries. The University's concept of quality culture integrates the structural dimension of QA (quality management manuals, process definitions, tools) with the value dimension of an organization (principles, skills, and attitudes). Within the EHEA (European Higher Education Area), countries such as Portugal, the Netherlands, the UK, and Norway demonstrate a greater integration of QA principles in the various organizational levels and areas of competence of university institutions or have greater experience in implementation or scientific and political debate on the matter. Therefore, the study, through an integrative literature review, of the quality management systems of these countries is aimed at determining a framework of the culture of quality, helpful in defining the elements which, both in structural-organizational terms and in terms of values and skills and attitudes, have proved to be factors of success in the effective implementation of quality assurance systems in universities and in the countries considered in the research. In order for a QA system to effectively aim for continuous improvement in a complex and dynamic context such as the university one, it must embrace a holistic vision of quality from an integrative perspective, focusing on the objective of transforming the reality being evaluated.

Keywords: higher education, quality assurance, quality culture, Portugal, Norway, Netherlands, United Kingdom

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8164 The Implications in the Use of English as the Medium of Instruction in Business Management Courses at Vavuniya Campus

Authors: Jeyaseelan Gnanaseelan, Subajana Jeyaseelan

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The paper avails, in a systemic form, some of the results of the investigation into nature, functions, problems, and implications in the use of English as the medium of Instruction (EMI) in the Business Management courses at Vavuniya Campus of the University of Jaffna, located in the conflict-affected northern part of Sri Lanka. It is a case study of the responses of the students and the teachers from Tamil and Sinhala language communities of the Faculty of Business Studies. This paper analyzes the perceptions on the use of the medium, the EMI background, resources available and accessible, language abilities of the teachers and learners, learning style and pedagogy, the EMI methodology, the socio-economic and socio-political contexts typical of a non-native English learning context. The analysis is quantitative and qualitative. It finds out the functional perspective of the EMI in Sri Lanka and suggests practical strategies of contextualization and acculturation in the EMI organization and positions. The paper assesses the learner and teacher capacity in the use of English. The ethnic conflict and linguistic politics in Sri Lanka have contributed multiple factors to the current use of English as the medium. It has conflicted with its domestic realities and the globalization trends of the world at large which determines efficiency and effectiveness.

Keywords: medium of instruction, English, business management, teaching and learning

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8163 Capacity Building and Training of Health Personals for Disaster Preparedness in North East India

Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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8162 A Customize Battery Management Approach for Satellite

Authors: Muhammad Affan, Muhammad Ilyas Raza, Muhammad Harris Hashmi

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This work is attributed to the battery management unit design of student Satellites under Pakistan National Student Satellite Program (PNSSP). The aim has been to design a customized, low-cost, efficient, reliable and less-complex battery management scheme for the Satellite. Nowadays, Lithium Ion (Li-ion) batteries have become the de-facto standard for remote applications, especially for satellites. Li-ion cells are selected for secondary storage. The design also addresses Li-ion safety requirements by monitoring, balancing and protecting cells for safe and prolonged operation. Accurate voltage measurement of individual cells was the main challenge because all the actions triggered were based on the digital voltage measurement. For this purpose, a resistive-divider network is used to maintain simplicity and cost-effectiveness. To cater the problem of insufficient i/o pins on microcontroller, fast multiplexers and de-multiplexers were used. The discrepancy inherited in the given design is the dissipation of heat due to the dissipative resistors. However, it is still considered to be the optimum adoption, considering the simple and cost-effective nature of the passive balancing technique. Furthermore, it is a completely unique solution, customized to meet specific requirements. However, there is still an option for a more advanced and expensive design.

Keywords: satellite, battery module, passive balancing, dissipative

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8161 Parent’s Preferences about Technology-Based Therapy for Children and Young People on the Autism Spectrum – a UK Survey

Authors: Athanasia Kouroupa, Karen Irvine, Sivana Mengoni, Shivani Sharma

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Exploring parents’ preferences towards technology-based interventions for children on the autism spectrum can inform future research and support technology design. The study aimed to provide a comprehensive description of parents’ knowledge and preferences about innovative technology to support children on the autism spectrum. Survey data were collected from parents (n = 267) internationally. The survey included information about the use of conventional (e.g., smartphone, iPod, tablets) and non-conventional (e.g., virtual reality, robot) technologies. Parents appeared to prefer conventional technologies such as tablets and dislike non-conventional ones. They highlighted the positive contribution technology brought to the children’s lives during the pandemic. A few parents were equally concerned that the compulsory introduction of technology during the pandemic was associated with elongated time on devices. The data suggested that technology-based interventions are not widely known, need to be financially approachable and achieve a high standard of design to engage users.

Keywords: autism, intervention, preferences, technology

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8160 The Robot Physician's (Rp - 7) Management and Care in Unstable ICU Oncology Patients

Authors: Alisher Agzamov, Hanan Al Harbi

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BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists. We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 220 +/- 80 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 150 +/- 55 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for patients with AML (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 20 % compared with the prerobot era, and there was an ICU cost savings of KD2.5 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, rp - 7 in icu management, cost and icu occupancy

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8159 iPSC-derived MSC Mediated Immunosuppression during Mouse Airway Transplantation

Authors: Mohammad Afzal Khan, Fatimah Alanazi, Hala Abdalrahman Ahmed, Talal Shamma, Kilian Kelly, Mohammed A. Hammad, Abdullah O. Alawad, Abdullah Mohammed Assiri, Dieter Clemens Broering

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Lung transplantation is a life-saving surgical replacement of diseased lungs in patients with end-stage respiratory malfunctions. Despite the remarkable short-term recovery, long-term lung survival continues to face several significant challenges, including chronic rejection and severe toxic side-effects due to global immunosuppression. Stem cell-based immunotherapy has been recognized as a crucial immunoregulatory regimen in various preclinical and clinical studies. Despite initial therapeutic outcomes, conventional stem cells face key limitations. The Cymerus™ manufacturing facilitates the production of a virtually limitless supply of consistent human induced pluripotent stem cell (iPSC)-derived mesenchymal stem cells, which could play a key role in selective immunosuppression and graft repair during rejection. Here, we demonstrated the impact of iPSC-derived human MSCs on the development of immune-tolerance and long-term graft survival in mouse orthotopic airway allografts. BALB/c→C57BL/6 allografts were reconstituted with iPSC-derived MSCs (2 million/transplant/ at d0), and allografts were examined for regulatory T cells (Tregs), oxygenation, microvascular blood flow, airway epithelium and collagen deposition during rejection. We demonstrated that iPSC-derived MSC treatment leads to significant increase in tissue expression of hTSG-6 protein, followed by an upregulation of mouse Tregs and IL-5, IL-10, IL-15 cytokines, which augments graft microvascular blood flow and oxygenation, and thereby maintained a healthy airway epithelium and prevented the subepithelial deposition of collagen at d90 post-transplantation. Collectively, these data confirmed that iPSC-derived MSC-mediated immunosuppression has potential to establish immune-tolerance and rescue allograft from sustained hypoxic/ischemic phase and subsequently limits long-term airway epithelial injury and collagen progression, which therapeutically warrant a study of Cymerus iPSC-derived MSCs as a potential management option for immunosuppression in transplant recipients.

Keywords: stem cell therapy, immunotolerance, regulatory T cells, hypoxia and ischemia, microvasculature

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8158 Common Sense Leadership in the Example of Turkish Political Leader Devlet Bahçeli

Authors: B. Gültekin, T. Gültekin

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Peace diplomacy is the most important international tool to maintain peace all over the World. This study consists of three parts. In the first part, the leadership of Devlet Bahçeli, leader of the Nationalist Movement Party, will be introduced as a tool of peace communication and peace management. Also, in this part, peace communication will be explained by the peace leadership traits of Devlet Bahçeli, who is one of the efficient political leaders representing the concepts of compromise and agreement on different sides of politics. In the second part of study, it is aimed to analyze Devlet Bahçeli’s leadership within the frame of peace communication and the final part of this study is about creating an original public communication model for public diplomacy based on Devlet Bahçeli as an example. As a result, the main purpose of this study is to develop an original peace communication model including peace modules, peace management projects, original dialogue procedures and protocols exhibited in the policies of Devlet Bahçeli. The political leadership represented by Devlet Bahçeli inspires political leaders to provide peace communication. In this study, principles and policies of peace leadership of Devlet Bahçeli will be explained as an original model on a peace communication platform.

Keywords: public diplomacy, dialogue management, peace leadership, peace diplomacy

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8157 Portable Glove Controlled Video Game for Hand Rehabilitation

Authors: Vinesh Janarthanan, Mohammad H. Rahman

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There are numerous neurological conditions that may result in a loss of motor function. Such conditions may include cerebral palsy, Parkinson’s disease, stroke or multiple sclerosis. Due to impaired motor function, specifically in the hand and arm, living independently becomes tremendously more difficult. Rehabilitation programs are the main method to treat these kinds of disabled individuals. However, these programs require longtime commitment from the clinicians/therapists, demand person to person caring, and typically the treatment duration is usually very long. Aside from the treatment received from the therapist, the continuation of neuroplasticity at home is essential to maximizing development and restoring the biological function. To contribute in this area, we have researched and developed a portable and comfortable hand glove for fine motor skills rehabilitation. The glove provides interactive home-based therapy to engage the patient with simple games. The key to this treatment is the repetition of moving the hand and being capable of positioning the hand in various ways.

Keywords: home based, wearable sensors, glove, rehabilitation, motor function, video games

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8156 Nursing Students' Experience of Using Electronic Health Record System in Clinical Placements

Authors: Nurten Tasdemir, Busra Baloglu, Zeynep Cingoz, Can Demirel, Zeki Gezer, Barıs Efe

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Student nurses are increasingly exposed to technology in the workplace after graduation with the growing numbers of electric health records (EHRs), handheld computers, barcode scanner medication dispensing systems, and automatic capture of patient data such as vital signs. Internationally, electronic health records (EHRs) systems are being implemented and evaluated. Students will inevitably encounter EHRs in the clinical learning environment and their professional practice. Nursing students must develop competency in the use of EHR. Aim: The study aimed to examine nursing students’ experiences of learning to use electronic health records (EHR) in clinical placements. Method: This study adopted a descriptive approach. The study population consisted of second and third-year nursing students at the Zonguldak School of Health in the West Black Sea Region of Turkey; the study was conducted during the 2015–2016 academic year. The sample consisted of 315 (74.1% of 425 students) nursing students who volunteered to participate. The students, who were involved in clinical practice, were invited to participate in the study Data were collected by a questionnaire designed by the researchers based on the relevant literature. Data were analyzed descriptively using the Statistical Package for Social Sciences (SPSS) for Windows version 16.0. The data are presented as means, standard deviations, and percentages. Approval for the study was obtained from the Ethical Committee of the University (Reg. Number: 29/03/2016/112) and the director of Nursing Department. Findings: A total of 315 students enrolled in this study, for a response rate of 74.1%. The mean age of the sample was 22.24 ± 1.37 (min: 19, max: 32) years, and most participants (79.7%) were female. Most of the nursing students (82.3%) stated that they use information technologies in clinical practice. Nearly half of the students (42.5%) reported that they have not accessed to EHR system. In addition, 61.6% of the students reported that insufficient computers available in clinical placement. Of the students, 84.7% reported that they prefer to have patient information from EHR system, and 63.8% of them found more effective to preparation for the clinical reporting. Conclusion: This survey indicated that nursing students experience to learn about EHR systems in clinical placements. For more effective learning environment nursing education should prepare nursing students for EHR systems in their educational life.

Keywords: electronic health record, clinical placement, nursing student, nursing education

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8155 Ovarian Stimulation and Oocyte Cryopreservation for Fertility Preservation in Adolescent Females at the Royal Children’s Hospital: A Case Series

Authors: Kira Merigan

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BACKGROUND- Fertility preservation (FP) measures are increasingly recognised as an important consideration for children and adolescents planned to undergo potentially damaging gonadotoxic therapy. Worldwide, there are very few documented cases of FP in young females by way of ovarian stimulation and oocyte cryopreservation.AIM – To report a case series of mature oocyte cryopreservation in 5post-pubertal adolescents aged 14-17 years old, with varied medical conditions requiring gonadotoxic treatment. SETTING-These cases took place via a multidisciplinary team approach at The Royal Children’s Hospital, a large tertiary centre in Melbourne, Australia. INTERVENTION– Ovarian stimulation and oocyte collection was performed as detailed in each case. RESULTS –Across the 5 patients, 3-28 oocytes were retrieved. We report pre-treatment workup, complications, and delays to treatment. CONCLUSION- Oocyte cryopreservation may be a safe alternative to ovarian tissue cryopreservation (OTC) in the adolescent population

Keywords: fertility preservation, adolescent, ovarian stimulation, oocyte cryopreservation

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8154 The Optimization of TICSI in the Convergence Mechanism of Urban Water Management

Authors: M. Macchiaroli, L. Dolores, V. Pellecchia

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With the recent Resolution n. 580/2019/R/idr, the Italian Regulatory Authority for Energy, Networks, and Environment (ARERA) for the Urban Water Management has introduced, for water managements characterized by persistent critical issues regarding the planning and organization of the service and the implementation of the necessary interventions for the improvement of infrastructures and management quality, a new mechanism for determining tariffs: the regulatory scheme of Convergence. The aim of this regulatory scheme is the overcoming of the Water Service Divided in order to improve the stability of the local institutional structures, technical quality, contractual quality, as well as in order to guarantee transparency elements for Users of the Service. Convergence scheme presupposes the identification of the cost items to be considered in the tariff in parametric terms, distinguishing three possible cases according to the type of historical data available to the Manager. The study, in particular, focuses on operations that have neither data on tariff revenues nor data on operating costs. In this case, the Manager's Constraint on Revenues (VRG) is estimated on the basis of a reference benchmark and becomes the starting point for defining the structure of the tariff classes, in compliance with the TICSI provisions (Integrated Text for tariff classes, ARERA's Resolution n. 665/2017/R/idr). The proposed model implements the recent studies on optimization models for the definition of tariff classes in compliance with the constraints dictated by TICSI in the application of the Convergence mechanism, proposing itself as a support tool for the Managers and the local water regulatory Authority in the decision-making process.

Keywords: decision-making process, economic evaluation of projects, optimizing tools, urban water management, water tariff

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8153 Magnetic Carriers of Organic Selenium (IV) Compounds: Physicochemical Properties and Possible Applications in Anticancer Therapy

Authors: E. Mosiniewicz-Szablewska, P. Suchocki, P. C. Morais

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Despite the significant progress in cancer treatment, there is a need to search for new therapeutic methods in order to minimize side effects. Chemotherapy, the main current method of treating cancer, is non-selective and has a number of limitations. Toxicity to healthy cells is undoubtedly the biggest problem limiting the use of many anticancer drugs. The problem of how to kill cancer without harming a patient can be solved by using organic selenium (IV) compounds. Organic selenium (IV) compounds are a new class of materials showing a strong anticancer activity. They are first organic compounds containing selenium at the +4 oxidation level and therefore they eliminate the multidrug-resistance for all tumor cell lines tested so far. These materials are capable of selectively killing cancer cells without damaging the healthy ones. They are obtained by the incorporation of selenous acid (H2SeO3) into molecules of fatty acids of sunflower oil and therefore, they are inexpensive to manufacture. Attaching these compounds to magnetic carriers enables their precise delivery directly to the tumor area and the simultaneous application of the magnetic hyperthermia, thus creating a huge opportunity to effectively get rid of the tumor without any side effects. Polylactic-co-glicolic acid (PLGA) nanocapsules loaded with maghemite (-Fe2O3) nanoparticles and organic selenium (IV) compounds are successfully prepared by nanoprecipitation method. In vitro antitumor activity of the nanocapsules were evidenced using murine melanoma (B16-F10), oral squamos carcinoma (OSCC) and murine (4T1) and human (MCF-7) breast lines. Further exposure of these cells to an alternating magnetic field increased the antitumor effect of nanocapsules. Moreover, the nanocapsules presented antitumor effect while not affecting normal cells. Magnetic properties of the nanocapsules were investigated by means of dc magnetization, ac susceptibility and electron spin resonance (ESR) measurements. The nanocapsules presented a typical superparamagnetic behavior around room temperature manifested itself by the split between zero field-cooled/field-cooled (ZFC/FC) magnetization curves and the absence of hysteresis on the field-dependent magnetization curve above the blocking temperature. Moreover, the blocking temperature decreased with increasing applied magnetic field. The superparamagnetic character of the nanocapsules was also confirmed by the occurrence of a maximum in temperature dependences of both real ′(T) and imaginary ′′ (T) components of the ac magnetic susceptibility, which shifted towards higher temperatures with increasing frequency. Additionally, upon decreasing the temperature the ESR signal shifted to lower fields and gradually broadened following closely the predictions for the ESR of superparamagnetoc nanoparticles. The observed superparamagnetic properties of nanocapsules enable their simple manipulation by means of magnetic field gradient, after introduction into the blood stream, which is a necessary condition for their use as magnetic drug carriers. The observed anticancer and superparamgnetic properties show that the magnetic nanocapsules loaded with organic selenium (IV) compounds should be considered as an effective material system for magnetic drug delivery and magnetohyperthermia inductor in antitumor therapy.

Keywords: cancer treatment, magnetic drug delivery system, nanomaterials, nanotechnology

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8152 Incorporating Priority Round-Robin Scheduler to Sustain Indefinite Blocking Issue and Prioritized Processes in Operating System

Authors: Heng Chia Ying, Charmaine Tan Chai Nie, Burra Venkata Durga Kumar

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Process scheduling is the method of process management that determines which process the CPU will proceed with for the next task and how long it takes. Some issues were found in process management, particularly for Priority Scheduling (PS) and Round Robin Scheduling (RR). The proposed recommendations made for IPRRS are to combine the strengths of both into a combining algorithm while they draw on others to compensate for each weakness. A significant improvement on the combining technique of scheduler, Incorporating Priority Round-Robin Scheduler (IPRRS) address an algorithm for both high and low priority task to sustain the indefinite blocking issue faced in the priority scheduling algorithm and minimize the average turnaround time (ATT) and average waiting time (AWT) in RR scheduling algorithm. This paper will delve into the simple rules introduced by IPRRS and enhancements that both PS and RR bring to the execution of processes in the operating system. Furthermore, it incorporates the best aspects of each algorithm to build the optimum algorithm for a certain case in terms of prioritized processes, ATT, and AWT.

Keywords: round Robin scheduling, priority scheduling, indefinite blocking, process management, sustain, turnaround time

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8151 Lean Environmental Management Integration System (LEMIS) Framework Development

Authors: A. P. Puvanasvaran, Suresh A. L. Vasu, N. Norazlin

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The Lean Environmental Management Integration System (LEMIS) framework development is integration between lean core element and ISO 14001. The curiosity on the relationship between continuous improvement and sustainability of lean implementation has influenced this study toward LEMIS. Characteristic of ISO 14001 standard clauses and core elements of lean principles are explored from past studies and literature reviews. Survey was carried out on ISO 14001 certified companies to examine continual improvement by implementing the ISO 14001 standard. The study found that there is a significant and positive relationship between Lean Principles: value, value stream, flow, pull and perfection with the ISO 14001 requirements. LEMIS is significant to support the continuous improvement and sustainability. The integration system can be implemented to any manufacturing company. It gives awareness on the importance on why organizations need to sustain its Environmental management system. At the meanwhile, the lean principle can be adapted in order to streamline daily activities of the company. Throughout the study, it had proven that there is no sacrifice or trade-off between lean principles with ISO 14001 requirements. The framework developed in the study can be further simplified in the future, especially the method of crossing each sub requirements of ISO 14001 standard with the core elements of Lean principles in this study.

Keywords: LEMIS, ISO 14001, integration, framework

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8150 Imposing Speed Constraints on Arrival Flights: Case Study for Changi Airport

Authors: S. Aneeka, S.M. Phyoe, R. Guo, Z.W. Zhong

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Arrival flights tend to spend long waiting times at holding stacks if the arrival airport is congested. However, the waiting time spent in the air in the vicinity of the arrival airport may be reduced if the delays are distributed to the cruising phase of the arrival flights by means of speed control. Here, a case study was conducted for the flights arriving at Changi Airport. The flights that were assigned holdings were simulated to fly at a reduced speed during the cruising phase. As the study involves a single airport and is limited to imposing speed constraints to arrivals within 200 NM from its location, the simulation setup in this study could be considered as an application of the Extended Arrival Management (E-AMAN) technique, which is proven to result in considerable fuel savings and more efficient management of delays. The objective of this experiment was to quantify the benefits of imposing cruise speed constraints to arrivals at Changi Airport and to assess the effects on controllers’ workload. The simulation results indicated considerable fuel savings, reduced aircraft emissions and reduced controller workload.

Keywords: aircraft emissions, air traffic flow management, controller workload, fuel consumption

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8149 Sustainability of Telecom Operators Orange-CI, MTN-CI, and MOOV Africa in Cote D’Ivoire

Authors: Odile Amoncou, Djedje-Kossu Zahui

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The increased demand for digital communications during the COVID-19 pandemic has seen an unprecedented surge in new telecom infrastructure around the world. The expansion has been more remarkable in countries with developing telecom infrastructures. Particularly, the three telecom operators in Cote d’Ivoire, Orange CI, MTN CI, and MOOV Africa, have considerably scaled up their exploitation technologies and capacities in terms of towers, fiber optic installation, and customer service hubs. The trend will likely continue upward while expanding the carbon footprint of the Ivorian telecom operators. Therefore, the corporate social and environmental responsibilities of these telecommunication companies can no longer be overlooked. This paper assesses the sustainability of the three Ivorian telecommunication network operators by applying a combination of commonly used sustainability management indexes. These tools are streamlined and adapted to the relatively young and developing digital network of Cote D’Ivoire. We trust that this article will push the respective CEOs to make sustainability a top strategic priority and understand the substantial potential returns in terms of saving, new products, and new clients while improving their corporate image. In addition, good sustainability management can increase their stakeholders.

Keywords: sustainability of telecom operators, sustainability management index, carbon footprint, digital communications

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8148 Lessons from Patients Expired due to Severe Head Injuries Treated in Intensive Care Unit of Lady Reading Hospital Peshawar

Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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8147 Short-Term Operation Planning for Energy Management of Exhibition Hall

Authors: Yooncheol Lee, Jeongmin Kim, Kwang Ryel Ryu

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This paper deals with the establishment of a short-term operational plan for an air conditioner for efficient energy management of exhibition hall. The short-term operational plan is composed of a time series of operational schedules, which we have searched using genetic algorithms. Establishing operational schedule should be considered the future trends of the variables affecting the exhibition hall environment. To reflect continuously changing factors such as external temperature and occupant, short-term operational plans should be updated in real time. But it takes too much time to evaluate a short-term operational plan using EnergyPlus, a building emulation tool. For that reason, it is difficult to update the operational plan in real time. To evaluate the short-term operational plan, we designed prediction models based on machine learning with fast evaluation speed. This model, which was created by learning the past operational data, is accurate and fast. The collection of operational data and the verification of operational plans were made using EnergyPlus. Experimental results show that the proposed method can save energy compared to the reactive control method.

Keywords: exhibition hall, energy management, predictive model, simulation-based optimization

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8146 Proposition of an Integrative Model for Assessing the Effectiveness of the Performance Management System

Authors: Mariana L. de Araújo, Pedro P. M. Menezes

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Research on strategic human resource management (SHRM) has made progress in the last few decades, showing a relationship between policies and practices of human resource management (HRM) and improving organizational results. That's because demonstrating the effectiveness of any HRM or other organizational practice, which means the extent that this can operate as a tool to achieve organizational performance, is a complex and arduous task to execute. Even today, there isn't consensus about "effectiveness," and the tools to measure the effectiveness are disconnected and not convincing. It is not different from the performance management system (PMS) effectiveness. A disproportionate focus on specific criteria adopted and an accumulation of studies that don't relate to the others, which damages the development of the field. Therefore, it aimed to evaluate the effectiveness of the PMS through models, dimensions, criteria, and measures. The objective of this study is to propose a theoretical-integrative model for evaluating PMS based on the literature in the PMS field. So, the PRISMA protocol was applied to carry out a systematic review, resulting in 57 studies. After performing the content analysis, we identified six dimensions: learning, societal impact, reaction, financial results, operational results and transfer, and 22 categories. In this way, a theoretical-integrative model for assessing the effectiveness of PMS was proposed based on the findings of this study, in which it was possible to confirm that the effectiveness construct is somewhat complex when viewing that most of the reviewed studies considered multiple dimensions in their assessment. In addition, we identified that the most immediate and proximal results of PMS are the most adopted by the studies; conversely, the studies adopted less distal outcomes to assess the effectiveness of PMS. Another finding of this research is that the reviewed studies predominantly analyze from the individual or psychological perspective, even when it comes to criteria whose phenomena are at an organizational level. Therefore, this study converges with a trend recently identified when referring to a process of "psychologization" in which GP studies, in general, have demonstrated macro results of the GP system from an individual perspective. Therefore, given the identification of a methodological pattern, the predominant influence of individual and psychological aspects in studies on HRM in administration is highlighted, demonstrated by the reflection on the practically absolute way of measuring the effectiveness of PMS from perceptual and subjective measures. Therefore, based on the recognition of the patterns identified, the model proposed to promote studies on the subject more broadly and profoundly to broaden and deepen the perspective of the field of management's interests so that the evaluation of the effectiveness of PMS can promote inputs on the impact of the PMS system in organizational performance. Finally, the findings encourage reflections on assessing the effectiveness of PMS through the theoretical-integrative model developed so that the field can promote new theoretical and practical perspectives.

Keywords: performance management, strategic human resource management, effectiveness, organizational performance

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8145 Breast Cancer Therapy-Related Cardiac Dysfunction Identifying in Kazakhstan: Preliminary Findings of the Cohort Study

Authors: Saule Balmagambetova, Zhenisgul Tlegenova, Saule Madinova

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Cardiotoxicity associated with anticancer treatment, now defined as cancer therapy-related cardiac dysfunction (CTRCD), accompanies cancer patients and negatively impacts their survivorship. Currently, a cardio-oncological service is being created in Kazakhstan based on the provisions of the European Society of Cardio-oncology (ESC) Guidelines. In the frames of a pilot project, a cohort study on CTRCD conditions was initiated at the Aktobe Cancer center. One hundred twenty-eight newly diagnosed breast cancer patients started on doxorubicin and/or trastuzumab were recruited. Echocardiography with global longitudinal strain (GLS) assessment, biomarkers panel (cardiac troponin (cTnI), brain natriuretic peptide (BNP), myeloperoxidase (MPO), galectin-3 (Gal-3), D-dimers, C-reactive protein (CRP)), and other tests were performed at baseline and every three months. Patients were stratified by the cardiovascular risks according to the ESC recommendations and allocated into the risk groups during the pre-treatment visit. Of them, 10 (7.8%) patients were assigned to the high-risk group, 48 (37.5%) to the medium-risk group, and 70 (54.7%) to the low-risk group, respectively. High-risk patients have been receiving their cardioprotective treatment from the outset. Patients were also divided by treatment - in the anthracycline-based 83 (64.8%), in trastuzumab- only 13 (10.2%), and in the mixed anthracycline/trastuzumab group 32 individuals (25%), respectively. Mild symptomatic CTRCD was revealed and treated in 2 (1.6%) participants, and a mild asymptomatic variant in 26 (20.5%). Mild asymptomatic conditions are defined as left ventricular ejection fraction (LVEF) ≥50% and further relative reduction in GLS by >15% from baseline and/or a further rise in cardiac biomarkers. The listed biomarkers were assessed longitudinally in repeated-measures linear regression models during 12 months of observation. The associations between changes in biomarkers and CTRCD and between changes in biomarkers and LVEF were evaluated. Analysis by risk groups revealed statistically significant differences in baseline LVEF scores (p 0.001), BNP (p 0.0075), and Gal-3 (p 0.0073). Treatment groups found no statistically significant differences at baseline. After 12 months of follow-up, only LVEF values showed a statistically significant difference by risk groups (p 0.0011). When assessing the temporal changes in the studied parameters for all treatment groups, there were statistically significant changes from visit to visit for LVEF (p 0.003); GLS (p 0.0001); BNP (p<0.00001); MPO (p<0.0001); and Gal-3 (p<0.0001). No moderate or strong correlations were found between the biomarkers values and LVEF, between biomarkers and GLS. Between the biomarkers themselves, a moderate, close to strong correlation was established between cTnI and D-dimer (r 0.65, p<0.05). The dose-dependent effect of anthracyclines has been confirmed: the summary dose has a moderate negative impact on GLS values: -r 0.31 for all treatment groups (p<0.05). The present study found myeloperoxidase as a promising biomarker of cardiac dysfunction in the mixed anthracycline/trastuzumab treatment group. The hazard of CTRCD increased by 24% (HR 1.21; 95% CI 1.01;1.73) per doubling in baseline MPO value (p 0.041). Increases in BNP were also associated with CTRCD (HR per doubling, 1.22; 95% CI 1.12;1.69). No cases of chemotherapy discontinuation due to cardiotoxic complications have been recorded. Further observations are needed to gain insight into the ability of biomarkers to predict CTRCD onset.

Keywords: breast cancer, chemotherapy, cardiotoxicity, Kazakhstan

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8144 Green Supply Chain Network Optimization with Internet of Things

Authors: Sema Kayapinar, Ismail Karaoglan, Turan Paksoy, Hadi Gokcen

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Green Supply Chain Management is gaining growing interest among researchers and supply chain management. The concept of Green Supply Chain Management is to integrate environmental thinking into the Supply Chain Management. It is the systematic concept emphasis on environmental problems such as reduction of greenhouse gas emissions, energy efficiency, recycling end of life products, generation of solid and hazardous waste. This study is to present a green supply chain network model integrated Internet of Things applications. Internet of Things provides to get precise and accurate information of end-of-life product with sensors and systems devices. The forward direction consists of suppliers, plants, distributions centres and sales and collect centres while, the reverse flow includes the sales and collects centres, disassembled centre, recycling and disposal centre. The sales and collection centre sells the new products are transhipped from factory via distribution centre and also receive the end-of life product according their value level. We describe green logistics activities by presenting specific examples including “recycling of the returned products and “reduction of CO2 gas emissions”. The different transportation choices are illustrated between echelons according to their CO2 gas emissions. This problem is formulated as a mixed integer linear programming model to solve the green supply chain problems which are emerged from the environmental awareness and responsibilities. This model is solved by using Gams package program. Numerical examples are suggested to illustrate the efficiency of the proposed model.

Keywords: green supply chain optimization, internet of things, greenhouse gas emission, recycling

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