Search results for: semantic clinical classification
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6140

Search results for: semantic clinical classification

2840 Effects of Local Ground Conditions on Site Response Analysis Results in Hungary

Authors: Orsolya Kegyes-Brassai, Zsolt Szilvágyi, Ákos Wolf, Richard P. Ray

Abstract:

Local ground conditions have a substantial influence on the seismic response of structures. Their inclusion in seismic hazard assessment and structural design can be realized at different levels of sophistication. However, response results based on more advanced calculation methods e.g. nonlinear or equivalent linear site analysis tend to show significant discrepancies when compared to simpler approaches. This project's main objective was to compare results from several 1-D response programs to Eurocode 8 design spectra. Data from in-situ site investigations were used for assessing local ground conditions at several locations in Hungary. After discussion of the in-situ measurements and calculation methods used, a comprehensive evaluation of all major contributing factors for site response is given. While the Eurocode spectra should account for local ground conditions based on soil classification, there is a wide variation in peak ground acceleration determined from 1-D analyses versus Eurocode. Results show that current Eurocode 8 design spectra may not be conservative enough to account for local ground conditions typical for Hungary.

Keywords: 1-D site response analysis, multichannel analysis of surface waves (MASW), seismic CPT, seismic hazard assessment

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2839 Predicting Provider Service Time in Outpatient Clinics Using Artificial Intelligence-Based Models

Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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2838 Comparison of Rumen Microbial Analysis Pipelines Based on 16s rRNA Gene Sequencing

Authors: Xiaoxing Ye

Abstract:

To investigate complex rumen microbial communities, 16S ribosomal RNA (rRNA) sequencing is widely used. Here, we evaluated the impact of bioinformatics pipelines on the observation of OTUs and taxonomic classification of 750 cattle rumen microbial samples by comparing three commonly used pipelines (LotuS, UPARSE, and QIIME) with Usearch. In LotuS-based analyses, 189 archaeal and 3894 bacterial OTUs were observed. The observed OTUs for the Usearch analysis were significantly larger than the LotuS results. We discovered 1495 OTUs for archaea and 92665 OTUs for bacteria using Usearch analysis. In addition, taxonomic assignments were made for the rumen microbial samples. All pipelines had consistent taxonomic annotations from the phylum to the genus level. A difference in relative abundance was calculated for all microbial levels, including Bacteroidetes (QIIME: 72.2%, Usearch: 74.09%), Firmicutes (QIIME: 18.3%, Usearch: 20.20%) for the bacterial phylum, Methanobacteriales (QIIME: 64.2%, Usearch: 45.7%) for the archaeal class, Methanobacteriaceae (QIIME: 35%, Usearch: 45.7%) and Methanomassiliicoccaceae (QIIME: 35%, Usearch: 31.13%) for archaeal family. However, the most prevalent archaeal class varied between these two annotation pipelines. The Thermoplasmata was the top class according to the QIIME annotation, whereas Methanobacteria was the top class according to Usearch.

Keywords: cattle rumen, rumen microbial, 16S rRNA gene sequencing, bioinformatics pipeline

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2837 Pattern of Stress Distribution in Different Ligature-Wire-Brackets Systems: A FE and Experimental Analysis

Authors: Afef Dridi, Salah Mezlini

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Since experimental devices cannot calculate stress and deformation of complex structures. The Finite Element Method FEM has been widely used in several fields of research. One of these fields is orthodontics. The advantage of using such a method is the use of an accurate and non invasive method that allows us to have a sufficient data about the physiological reactions can happening in soft tissues. Most of researches done in this field were interested in the study of stresses and deformations induced by orthodontic apparatus in soft tissues (alveolar tissues). Only few studies were interested in the distribution of stress and strain in the orthodontic brackets. These studies, although they tried to be as close as possible to real conditions, their models did not reproduce the clinical cases. For this reason, the model generated by our research is the closest one to reality. In this study, a numerical model was developed to explore the stress and strain distribution under the application of real conditions. A comparison between different material properties was also done.

Keywords: visco-hyperelasticity, FEM, orthodontic treatment, inverse method

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2836 Repeated Suicidal Attempts in Foster Teenagers: Breaking the Cycle Using a Stepped Care Approach

Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

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2835 Causes of Variation Orders in the Egyptian Construction Industry: Time and Cost Impacts

Authors: A. Samer Ezeldin, Jwanda M. El Sarag

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Variation orders are of great importance in any construction project. Variation orders are defined as any change in the scope of works of a project that can be an addition omission, or even modification. This paper investigates the variation orders that occur during construction projects in Egypt. The literature review represents a comparison of causes of variation orders among Egypt, Tanzania, Nigeria, Malaysia and the United Kingdom. A classification of occurrence of variation orders due to owner related factors, consultant related factors and other factors are signified in the literature review. These classified events that lead to variation orders were introduced in a survey with 19 events to observe their frequency of occurrence, and their time and cost impacts. The survey data was obtained from 87 participants that included clients, consultants, and contractors and a database of 42 scenarios was created. A model is then developed to help assist project managers in predicting the frequency of variations and account for a budget for any additional costs and minimize any delays that can take place. Two experts with more than 25 years of experience were given the model to verify that the model was working effectively. The model was then validated on a residential compound that was completed in July 2016 to prove that the model actually produces acceptable results.

Keywords: construction, cost impact, Egypt, time impact, variation orders

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2834 Genetic Variation among the Wild and Hatchery Raised Populations of Labeo rohita Revealed by RAPD Markers

Authors: Fayyaz Rasool, Shakeela Parveen

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The studies on genetic diversity of Labeo rohita by using molecular markers were carried out to investigate the genetic structure by RAPAD marker and the levels of polymorphism and similarity amongst the different groups of five populations of wild and farmed types. The samples were collected from different five locations as representatives of wild and hatchery raised populations. RAPAD data for Jaccard’s coefficient by following the un-weighted Pair Group Method with Arithmetic Mean (UPGMA) for Hierarchical Clustering of the similar groups on the basis of similarity amongst the genotypes and the dendrogram generated divided the randomly selected individuals of the five populations into three classes/clusters. The variance decomposition for the optimal classification values remained as 52.11% for within class variation, while 47.89% for the between class differences. The Principal Component Analysis (PCA) for grouping of the different genotypes from the different environmental conditions was done by Spearman Varimax rotation method for bi-plot generation of the co-occurrence of the same genotypes with similar genetic properties and specificity of different primers indicated clearly that the increase in the number of factors or components was correlated with the decrease in eigenvalues. The Kaiser Criterion based upon the eigenvalues greater than one, first two main factors accounted for 58.177% of cumulative variability.

Keywords: variation, clustering, PCA, wild, hatchery, RAPAD, Labeo rohita

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2833 Seismic Hazard Prediction Using Seismic Bumps: Artificial Neural Network Technique

Authors: Belkacem Selma, Boumediene Selma, Tourkia Guerzou, Abbes Labdelli

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Natural disasters have occurred and will continue to cause human and material damage. Therefore, the idea of "preventing" natural disasters will never be possible. However, their prediction is possible with the advancement of technology. Even if natural disasters are effectively inevitable, their consequences may be partly controlled. The rapid growth and progress of artificial intelligence (AI) had a major impact on the prediction of natural disasters and risk assessment which are necessary for effective disaster reduction. The Earthquakes prediction to prevent the loss of human lives and even property damage is an important factor; that is why it is crucial to develop techniques for predicting this natural disaster. This present study aims to analyze the ability of artificial neural networks (ANNs) to predict earthquakes that occur in a given area. The used data describe the problem of high energy (higher than 10^4J) seismic bumps forecasting in a coal mine using two long walls as an example. For this purpose, seismic bumps data obtained from mines has been analyzed. The results obtained show that the ANN with high accuracy was able to predict earthquake parameters; the classification accuracy through neural networks is more than 94%, and that the models developed are efficient and robust and depend only weakly on the initial database.

Keywords: earthquake prediction, ANN, seismic bumps

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2832 Identification System for Grading Banana in Food Processing Industry

Authors: Ebenezer O. Olaniyi, Oyebade K. Oyedotun, Khashman Adnan

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In the food industry high quality production is required within a limited time to meet up with the demand in the society. In this research work, we have developed a model which can be used to replace the human operator due to their low output in production and slow in making decisions as a result of an individual differences in deciding the defective and healthy banana. This model can perform the vision attributes of human operators in deciding if the banana is defective or healthy for food production based. This research work is divided into two phase, the first phase is the image processing where several image processing techniques such as colour conversion, edge detection, thresholding and morphological operation were employed to extract features for training and testing the network in the second phase. These features extracted in the first phase were used in the second phase; the classification system phase where the multilayer perceptron using backpropagation neural network was employed to train the network. After the network has learned and converges, the network was tested with feedforward neural network to determine the performance of the network. From this experiment, a recognition rate of 97% was obtained and the time taken for this experiment was limited which makes the system accurate for use in the food industry.

Keywords: banana, food processing, identification system, neural network

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2831 Study on Optimization Design of Pressure Hull for Underwater Vehicle

Authors: Qasim Idrees, Gao Liangtian, Liu Bo, Miao Yiran

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In order to improve the efficiency and accuracy of the pressure hull structure, optimization of underwater vehicle based on response surface methodology, a method for optimizing the design of pressure hull structure was studied. To determine the pressure shell of five dimensions as a design variable, the application of thin shell theory and the Chinese Classification Society (CCS) specification was carried on the preliminary design. In order to optimize variables of the feasible region, different methods were studied and implemented such as Opt LHD method (to determine the design test sample points in the feasible domain space), parametric ABAQUS solution for each sample point response, and the two-order polynomial response for the surface model of the limit load of structures. Based on the ultimate load of the structure and the quality of the shell, the two-generation genetic algorithm was used to solve the response surface, and the Pareto optimal solution set was obtained. The final optimization result was 41.68% higher than that of the initial design, and the shell quality was reduced by about 27.26%. The parametric method can ensure the accuracy of the test and improve the efficiency of optimization.

Keywords: parameterization, response surface, structure optimization, pressure hull

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2830 Using Satellite Images Datasets for Road Intersection Detection in Route Planning

Authors: Fatma El-Zahraa El-Taher, Ayman Taha, Jane Courtney, Susan Mckeever

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Understanding road networks plays an important role in navigation applications such as self-driving vehicles and route planning for individual journeys. Intersections of roads are essential components of road networks. Understanding the features of an intersection, from a simple T-junction to larger multi-road junctions, is critical to decisions such as crossing roads or selecting the safest routes. The identification and profiling of intersections from satellite images is a challenging task. While deep learning approaches offer the state-of-the-art in image classification and detection, the availability of training datasets is a bottleneck in this approach. In this paper, a labelled satellite image dataset for the intersection recognition problem is presented. It consists of 14,692 satellite images of Washington DC, USA. To support other users of the dataset, an automated download and labelling script is provided for dataset replication. The challenges of construction and fine-grained feature labelling of a satellite image dataset is examined, including the issue of how to address features that are spread across multiple images. Finally, the accuracy of the detection of intersections in satellite images is evaluated.

Keywords: satellite images, remote sensing images, data acquisition, autonomous vehicles

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2829 Cost Based Analysis of Risk Stratification Tool for Prediction and Management of High Risk Choledocholithiasis Patients

Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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2828 Translation and Validation of the Thai Version of the Japanese Sleep Questionnaire for Preschoolers

Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

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2827 Encryption and Decryption of Nucleic Acid Using Deoxyribonucleic Acid Algorithm

Authors: Iftikhar A. Tayubi, Aabdulrahman Alsubhi, Abdullah Althrwi

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The deoxyribonucleic acid text provides a single source of high-quality Cryptography about Deoxyribonucleic acid sequence for structural biologists. We will provide an intuitive, well-organized and user-friendly web interface that allows users to encrypt and decrypt Deoxy Ribonucleic Acid sequence text. It includes complex, securing by using Algorithm to encrypt and decrypt Deoxy Ribonucleic Acid sequence. The utility of this Deoxy Ribonucleic Acid Sequence Text is that, it can provide a user-friendly interface for users to Encrypt and Decrypt store the information about Deoxy Ribonucleic Acid sequence. These interfaces created in this project will satisfy the demands of the scientific community by providing fully encrypt of Deoxy Ribonucleic Acid sequence during this website. We have adopted a methodology by using C# and Active Server Page.NET for programming which is smart and secure. Deoxy Ribonucleic Acid sequence text is a wonderful piece of equipment for encrypting large quantities of data, efficiently. The users can thus navigate from one encoding and store orange text, depending on the field for user’s interest. Algorithm classification allows a user to Protect the deoxy ribonucleic acid sequence from change, whether an alteration or error occurred during the Deoxy Ribonucleic Acid sequence data transfer. It will check the integrity of the Deoxy Ribonucleic Acid sequence data during the access.

Keywords: algorithm, ASP.NET, DNA, encrypt, decrypt

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2826 Firesetting in a Male Prison; An Investigation into the Personality Differences in Firesetters and Non-firesetters

Authors: Elinor Bull, Faye Horsley

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Abstract Objective: The current study investigated if there was a difference in personality factors in prisoners who had a recorded history of firesetting and who had no recorded history of firesetting. Participants: Participants were 64 male prisoners in a Category B male prison. Participants who had set a fire were identified through the prisons data base, and prisoners who had not set a fire were selected at random. Method: The study used the International Personality Item Pool-50 to measure personality factors, and prisoners who had set a fire were identified through a range of sources accessible to the prison. Analytical evaluation was done by the Multivariate Kruskal Wallis and Mann-Whitney tests. Findings: There was a significant difference between the the firesetting and non-firesetting group in the scores of the personality factor of Contentiousness. Contentiousness was significantly lower in the firesetting sample compared to the non-firesetting sample. Conclusions: Implications for clinical practice and future research are discussed.

Keywords: firesetting, personality, arson, prison, prisoners

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2825 Expanding Behavioral Crisis Care: Expansion of Psychiatric and Addiction-Care Services through a 23/7 Behavioral Crisis Center

Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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2824 Women Bodies and Images in Funerary Landscapes of the Late Antique Oecumene: An Analysis of Women Representation Between Idealized Pagan Antecedents and Concrete Female Power Within Christian Communities

Authors: Camilla Marraccini

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The sarcophagus of Adelphia represents an iconographic unicum compared to female representations on sarcophagi. From the time of its discovery in 1872 until recent studies , the figurative program of the sarcophagus' lid has been the subject of extensive debate. Critics have been divided between those who have interpreted the scene as the life of Mary , those who have interpreted it as a depiction of Adelphia , those who saw it as a traditional representation of Moses and Christ , and those who read a particular philosophical doctrine depicting Sophia dei . Indeed, next to the female orans, Maries on the throne and female servants of Christ, the distinctiveness of the sarcophagus becomes evident and a unique scene stands out on the lid: a procession of nine women culminating with a frontal woman on the throne. Using an iconographic analysis that questions 1.the traces of the typologies of christian women found in sarcophagi and 2.the pagan models used by the artisans of Christianity, this paper aims to investigate an interpretation of the scene based on the discoveries of meaning and semantic shifts that can be understood once the model used for this iconography is found, whilst conducting a comparative analysis that underlines the importance of understanding the reasons behind this commission. Searching for the commissioner's will needs to be an interdisciplinary quest: from iconographical analysis to epigraphical and archaeological data. Considering, that several recent studies have emphasized the important female presence in the catacomb of St.Giovanni (perhaps a burial dedicated exclusively to female monastic cults?) , where the sarcophagus was found, the local development of the cult of St. Lucia, and the fact that Adelfia is referred to as clarissima femina in her inscription, the present paper will try to make a transition between art and social context. Thus, this paper aims to understand whether this iconography can be an ulterior source, next to the epigraphical ones, to reconstruct the concrete role of Adelfia in local women's communities. In summary, by tracing different forms of continuity between pagan and christian practices, this paper aims to understand what the relationship between actual hierarchical power, funerary self-representations and the inherited semantics of images could tell us about the life and death of late antique Christian women.

Keywords: early Christian art, female bodies, iconography, female communities, sarcophagi

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2823 Strengthening Strategy across Languages: A Cognitive and Grammatical Universal Phenomenon

Authors: Behnam Jay

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In this study, the phenomenon called “Strengthening” in human language refers to the strategic use of multiple linguistic elements to intensify specific grammatical or semantic functions. This study explores cross-linguistic evidence demonstrating how strengthening appears in various grammatical structures. In French and Spanish, double negatives are used not to cancel each other out but to intensify the negation, challenging the conventional understanding that double negatives result in an affirmation. For example, in French, il ne sait pas (He dosn't know.) uses both “ne” and “pas” to strengthen the negation. Similarly, in Spanish, No vio a nadie. (He didn't see anyone.) uses “no” and “nadie” to achieve a stronger negative meaning. In Japanese, double honorifics, often perceived as erroneous, are reinterpreted as intentional efforts to amplify politeness, as seen in forms like ossharareru (to say, (honorific)). Typically, an honorific morpheme appears only once in a predicate, but native speakers often use double forms to reinforce politeness. In Turkish, the word eğer (indicating a condition) is sometimes used together with the conditional suffix -se(sa) within the same sentence to strengthen the conditional meaning, as in Eğer yağmur yağarsa, o gelmez. (If it rains, he won't come). Furthermore, the combination of question words with rising intonation in various languages serves to enhance interrogative force. These instances suggest that strengthening is a cross-linguistic strategy that may reflect a broader cognitive mechanism in language processing. This paper investigates these cases in detail, providing insights into why languages may adopt such strategies. No corpus was used for collecting examples from different languages. Instead, the examples were gathered from languages the author encountered during their research, focusing on specific grammatical and morphological phenomena relevant to the concept of strengthening. Due to the complexity of employing a comparative method across multiple languages, this approach was chosen to illustrate common patterns of strengthening based on available data. It is acknowledged that different languages may have different strengthening strategies in various linguistic domains. While the primary focus is on grammar and morphology, it is recognized that the strengthening phenomenon may also appear in phonology. Future research should aim to include a broader range of languages and utilize more comprehensive comparative methods where feasible to enhance methodological rigor and explore this phenomenon more thoroughly.

Keywords: strengthening, cross-linguistic analysis, syntax, semantics, cognitive mechanism

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2822 An Application for Risk of Crime Prediction Using Machine Learning

Authors: Luis Fonseca, Filipe Cabral Pinto, Susana Sargento

Abstract:

The increase of the world population, especially in large urban centers, has resulted in new challenges particularly with the control and optimization of public safety. Thus, in the present work, a solution is proposed for the prediction of criminal occurrences in a city based on historical data of incidents and demographic information. The entire research and implementation will be presented start with the data collection from its original source, the treatment and transformations applied to them, choice and the evaluation and implementation of the Machine Learning model up to the application layer. Classification models will be implemented to predict criminal risk for a given time interval and location. Machine Learning algorithms such as Random Forest, Neural Networks, K-Nearest Neighbors and Logistic Regression will be used to predict occurrences, and their performance will be compared according to the data processing and transformation used. The results show that the use of Machine Learning techniques helps to anticipate criminal occurrences, which contributed to the reinforcement of public security. Finally, the models were implemented on a platform that will provide an API to enable other entities to make requests for predictions in real-time. An application will also be presented where it is possible to show criminal predictions visually.

Keywords: crime prediction, machine learning, public safety, smart city

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2821 Strategic Interventions to Address Health Workforce and Current Disease Trends, Nakuru, Kenya

Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

Abstract:

Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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2820 Offline Signature Verification Using Minutiae and Curvature Orientation

Authors: Khaled Nagaty, Heba Nagaty, Gerard McKee

Abstract:

A signature is a behavioral biometric that is used for authenticating users in most financial and legal transactions. Signatures can be easily forged by skilled forgers. Therefore, it is essential to verify whether a signature is genuine or forged. The aim of any signature verification algorithm is to accommodate the differences between signatures of the same person and increase the ability to discriminate between signatures of different persons. This work presented in this paper proposes an automatic signature verification system to indicate whether a signature is genuine or not. The system comprises four phases: (1) The pre-processing phase in which image scaling, binarization, image rotation, dilation, thinning, and connecting ridge breaks are applied. (2) The feature extraction phase in which global and local features are extracted. The local features are minutiae points, curvature orientation, and curve plateau. The global features are signature area, signature aspect ratio, and Hu moments. (3) The post-processing phase, in which false minutiae are removed. (4) The classification phase in which features are enhanced before feeding it into the classifier. k-nearest neighbors and support vector machines are used. The classifier was trained on a benchmark dataset to compare the performance of the proposed offline signature verification system against the state-of-the-art. The accuracy of the proposed system is 92.3%.

Keywords: signature, ridge breaks, minutiae, orientation

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2819 Differentiated Thyroid Cancer Presenting with Solitary Bony Metastases to the Frontal Bone of the Skull

Authors: Christy M. Moen, Richard B. Townsley

Abstract:

Introduction: Metastasis to the frontal bone in thyroid cancer is extremely rare. A literature review found only six cases of thyroid cancer that metastasised to the frontal bone, with two of those involving further bone sites. Case Report: The patient was originally referred to the Oral and Maxillofacial Surgery team with an isolated mass on her forehead. Biopsies were performed, which showed this was likely a metastatic deposit from thyroid cancer. CT-PET scan showed this was an isolated lesion. The patient had a total thyroidectomy, and the forehead lesion was managed with radiotherapy. On interval scanning, the patient’s bony lesion had increased in size and had new lung nodules, which likely represented further metastasis. Conclusion: Isolated bony metastases to the frontal bone are rare. An important clinical principle to remember is that a bony metastasis from an unknown primary is more likely than primary bone cancer.

Keywords: cancer, thyroid, head and neck, surgery

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2818 Stock Market Prediction Using Convolutional Neural Network That Learns from a Graph

Authors: Mo-Se Lee, Cheol-Hwi Ahn, Kee-Young Kwahk, Hyunchul Ahn

Abstract:

Over the past decade, deep learning has been in spotlight among various machine learning algorithms. In particular, CNN (Convolutional Neural Network), which is known as effective solution for recognizing and classifying images, has been popularly applied to classification and prediction problems in various fields. In this study, we try to apply CNN to stock market prediction, one of the most challenging tasks in the machine learning research. In specific, we propose to apply CNN as the binary classifier that predicts stock market direction (up or down) by using a graph as its input. That is, our proposal is to build a machine learning algorithm that mimics a person who looks at the graph and predicts whether the trend will go up or down. Our proposed model consists of four steps. In the first step, it divides the dataset into 5 days, 10 days, 15 days, and 20 days. And then, it creates graphs for each interval in step 2. In the next step, CNN classifiers are trained using the graphs generated in the previous step. In step 4, it optimizes the hyper parameters of the trained model by using the validation dataset. To validate our model, we will apply it to the prediction of KOSPI200 for 1,986 days in eight years (from 2009 to 2016). The experimental dataset will include 14 technical indicators such as CCI, Momentum, ROC and daily closing price of KOSPI200 of Korean stock market.

Keywords: convolutional neural network, deep learning, Korean stock market, stock market prediction

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2817 Single Cell Rna Sequencing Operating from Benchside to Bedside: An Interesting Entry into Translational Genomics

Authors: Leo Nnamdi Ozurumba-Dwight

Abstract:

Single-cell genomic analytical systems have proved to be a platform to isolate bulk cells into selected single cells for genomic, proteomic, and related metabolomic studies. This is enabling systematic investigations of the level of heterogeneity in a diverse and wide pool of cell populations. Single cell technologies, embracing techniques such as high parameter flow cytometry, single-cell sequencing, and high-resolution images are playing vital roles in these investigations on messenger ribonucleic acid (mRNA) molecules and related gene expressions in tracking the nature and course of disease conditions. This entails targeted molecular investigations on unit cells that help us understand cell behavoiur and expressions, which can be examined for their health implications on the health state of patients. One of the vital good sides of single-cell RNA sequencing (scRNA seq) is its probing capacity to detect deranged or abnormal cell populations present within homogenously perceived pooled cells, which would have evaded cursory screening on the pooled cell populations of biological samples obtained as part of diagnostic procedures. Despite conduction of just single-cell transcriptome analysis, scRNAseq now permits comparison of the transcriptome of the individual cells, which can be evaluated for gene expressional patterns that depict areas of heterogeneity with pharmaceutical drug discovery and clinical treatment applications. It is vital to strictly work through the tools of investigations from wet lab to bioinformatics and computational tooled analyses. In the precise steps for scRNAseq, it is critical to do thorough and effective isolation of viable single cells from the tissues of interest using dependable techniques (such as FACS) before proceeding to lysis, as this enhances the appropriate picking of quality mRNA molecules for subsequent sequencing (such as by the use of Polymerase Chain Reaction machine). Interestingly, scRNAseq can be deployed to analyze various types of biological samples such as embryos, nervous systems, tumour cells, stem cells, lymphocytes, and haematopoietic cells. In haematopoietic cells, it can be used to stratify acute myeloid leukemia patterns in patients, sorting them out into cohorts that enable re-modeling of treatment regimens based on stratified presentations. In immunotherapy, it can furnish specialist clinician-immunologist with tools to re-model treatment for each patient, an attribute of precision medicine. Finally, the good predictive attribute of scRNAseq can help reduce the cost of treatment for patients, thus attracting more patients who would have otherwise been discouraged from seeking quality clinical consultation help due to perceived high cost. This is a positive paradigm shift for patients’ attitudes primed towards seeking treatment.

Keywords: immunotherapy, transcriptome, re-modeling, mRNA, scRNA-seq

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2816 Evaluation of the Relations between Childhood Trauma and Dissociative Experiences, Self-Perception, and Early Maladaptive Schemes in Sexual Assault Convicts

Authors: Safak Akdemir

Abstract:

The main purpose of this research is to evaluate the relationships between childhood traumas and dissociative experiences, self-perceptions and early maladaptive schemas in male convicts convicted of sexual assault crimes in prison. In our study, male convicts in prison for the crime of sexual assault constitute the experimental group, and the participants matched with this experimental group in terms of education, age and gender constitute the control group. The experimental group of the research consists of 189 male individuals who are convicted in the Ministry of Justice, General Directorate of Prisons, Istanbul/Maltepe L Type Closed Prison. The control group of this study consists of 147 adult males matched with the experimental group in terms of age, gender and education parameters. A total of 336 adult male individuals are included in the sample of this study. 46% of the experimental group were convicted of only sexual assault, 54% of them were convicted of both sexual assault and murder, injury and drug crimes. Total of five data collection tools, namely the Personal Information Form created by S. A. & E. O., Childhood Trauma Questionnaire (CTQ), the Dissociative Experiences Scale (DES), the Rosenberg Self-Esteem Scale (RSES), and the Young Schema Questionnaire-Short Form (YSQ-SF3), were completed. DES cut-off score of 99 (52.39%) of 189 convicts in the experimental group and 12 (8.17%) of 147 people in the control group was found to be 30 and above, and this result indicates the presence of pathological dissociative experiences. 180 (95.23%) of the sexual assault convicts in the experimental group had at least one childhood trauma, 154 (81.48%) were emotional neglect, 140 (74.07%) were emotional abuse, 121 (64.02%) were physical neglect, 91 (4814%) physical abuse and 70 (37.03%) sexual abuse. 168 (88.88%) of the experimental group reported multiple type of trauma and 12 (6.34%) reported single type of trauma. While the childhood traumas, isolation, abandonment and emotional deprivation schema levels of the convicts with a DES cut-off score of 30 and above are higher than the convicts with a DES cut-off score of 30 and above, their self-esteem is lower than this group. Experimental group while childhood traumas, dissociative experiences and early maladaptive schemas are higher than the control group, their self-esteem levels are lower. Dissociative experiences, abandonment and emotional deprivation early maladaptive schemas are more common in convicts aged between 18-30 years compared to convicts aged 31 and over. In addition, dissociative experiences and early maladaptive schemas of male convicts who reported physical and sexual abuse were higher than those who did not report physical and sexual abuse, while their self-esteem was at a lower level. As a result, in terms of psychotraumatology and clinical forensic psychology, dissociative disorders developed under the influence of chronic childhood traumas, with clinical interviews and psychometric measurements to be made in terms of forensic psychiatry; it is of fundamental importance to evaluate it in terms of neurosis-psychosis distinction, disability retirement, custody, malpractice, criminal and legal capacity criteria.

Keywords: crime, sexual assault, criminology, rape crimes, dissocitative disorders, maladative schemas

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2815 Managing Psychogenic Non-Epileptic Seizure Disorder: The Benefits of Collaboration between Psychiatry and Neurology

Authors: Donald Kushon, Jyoti Pillai

Abstract:

Psychogenic Non-epileptic Seizure Disorder (PNES) is a challenging clinical problem for the neurologist. This study explores the benefits of on-site collaboration between psychiatry and neurology in the management of PNES. A 3 month period at a university hospital seizure clinic is described detailing specific management approaches taken as a result of this collaboration. This study describes four areas of interest: (1. After the video EEG results confirm the diagnosis of PNES, the presentation of the diagnosis of PNES to the patient. (2. The identification of co-morbid psychiatric illness (3. Treatment with specific psychotherapeutic interventions (including Cognitive Behavioral Therapy) and psychopharmacologic interventions (primarily SSRIs) and (4. Preliminary treatment outcomes.

Keywords: cognitive behavioral therapy (CBT), psychogenic non-epileptic seizure disorder (PNES), selective serotonin reuptake inhibitors (SSRIs), video electroencephalogram (VEEG)

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2814 A Comparative Analysis of Machine Learning Techniques for PM10 Forecasting in Vilnius

Authors: Mina Adel Shokry Fahim, Jūratė Sužiedelytė Visockienė

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With the growing concern over air pollution (AP), it is clear that this has gained more prominence than ever before. The level of consciousness has increased and a sense of knowledge now has to be forwarded as a duty by those enlightened enough to disseminate it to others. This realisation often comes after an understanding of how poor air quality indices (AQI) damage human health. The study focuses on assessing air pollution prediction models specifically for Lithuania, addressing a substantial need for empirical research within the region. Concentrating on Vilnius, it specifically examines particulate matter concentrations 10 micrometers or less in diameter (PM10). Utilizing Gaussian Process Regression (GPR) and Regression Tree Ensemble, and Regression Tree methodologies, predictive forecasting models are validated and tested using hourly data from January 2020 to December 2022. The study explores the classification of AP data into anthropogenic and natural sources, the impact of AP on human health, and its connection to cardiovascular diseases. The study revealed varying levels of accuracy among the models, with GPR achieving the highest accuracy, indicated by an RMSE of 4.14 in validation and 3.89 in testing.

Keywords: air pollution, anthropogenic and natural sources, machine learning, Gaussian process regression, tree ensemble, forecasting models, particulate matter

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2813 Energy Management System and Interactive Functions of Smart Plug for Smart Home

Authors: Win Thandar Soe, Innocent Mpawenimana, Mathieu Di Fazio, Cécile Belleudy, Aung Ze Ya

Abstract:

Intelligent electronic equipment and automation network is the brain of high-tech energy management systems in critical role of smart homes dominance. Smart home is a technology integration for greater comfort, autonomy, reduced cost, and energy saving as well. These services can be provided to home owners for managing their home appliances locally or remotely and consequently allow them to automate intelligently and responsibly their consumption by individual or collective control systems. In this study, three smart plugs are described and one of them tested on typical household appliances. This article proposes to collect the data from the wireless technology and to extract some smart data for energy management system. This smart data is to quantify for three kinds of load: intermittent load, phantom load and continuous load. Phantom load is a waste power that is one of unnoticed power of each appliance while connected or disconnected to the main. Intermittent load and continuous load take in to consideration the power and using time of home appliances. By analysing the classification of loads, this smart data will be provided to reduce the communication of wireless sensor network for energy management system.

Keywords: energy management, load profile, smart plug, wireless sensor network

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2812 Feasibility and Acceptability of Mindfulness-Based Cognitive Therapy in People with Depression and Cardiovascular Disorders: A Feasibility Randomised Controlled Trial

Authors: Modi Alsubaie, Chris Dickens, Barnaby Dunn, Andy Gibson, Obioha Ukoumunned, Alison Evans, Rachael Vicary, Manish Gandhi, Willem Kuyken

Abstract:

Background: Depression co-occurs in 20% of people with cardiovascular disorders, can persist for years and predicts worse physical health outcomes. While psychosocial treatments have been shown to effectively treat acute depression in those with comorbid cardiovascular disorders, to date there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Therefore, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. Methods: A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of self-report measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, immediately after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. Results: 3400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1%) were interested in taking part, 59 (1.7%) were screened as being suitable, and 33 (<1%) were eventually randomised to the three groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disease (one to 25 years). Of 11 participants randomised to adapted MBCT seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 participants randomised completed all the assessment measures at all three-time points. With regards to the primary outcome (depression), five out of the seven people who completed the adapted MBCT and three out of five under MBSR showed significant clinical change, while in TAU no one showed any clinical change at the three-month follow-up. Conclusions: The adapted MBCT intervention was feasible and acceptable to participants. However, aspects of the trial design were not feasible. In particular, low recruitment rates were achieved, and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high meaning the adapted intervention was unlikely to be well tailored to all participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to more successfully recruit a target sample that optimally matches the adapted intervention.

Keywords: mindfulness-based cognitive therapy (MBCT), depression, cardiovascular disorders, feasibility, acceptability

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2811 A Modest Proposal for Deep-Sixing Propositions in the Philosophy of Language

Authors: Patrick Duffley

Abstract:

Hanks (2021) identifies three Frege-inspired commitments concerning propositions that are widely shared across the philosophy of language: (1) propositions are the primary, inherent bearers of representational properties and truth-conditions; (2) propositions are neutral representations possessing a ‘content’ that is devoid of ‘force; (3) propositions can be entertained or expressed without being asserted. Hanks then argues that the postulate of neutral content must be abandoned, and the primary bearers of truth-evaluable representation must be identified as the token acts of assertoric predication that people perform when they are thinking or speaking about the world. Propositions are ‘types of acts of predication, which derive their representational features from their tokens.’ Their role is that of ‘classificatory devices that we use for the purposes of identifying and individuating mental states and speech acts,’ so that ‘to say that Russell believes that Mont Blanc is over 4000 meters high is to classify Russell’s mental state under a certain type, and thereby distinguish that mental state from others that Russell might possess.’ It is argued in this paper that there is no need to classify an utterance of 'Russell believes that Mont Blanc is over 4000 meters high' as a token of some higher-order utterance-type in order to identify what Russell believes; the meanings of the words themselves and the syntactico-semantic relations between them are sufficient. In our view what Hanks has accomplished in effect is to build a convincing argument for dispensing with propositions completely in the philosophy of language. By divesting propositions of the role of being the primary bearers of representational properties and truth-conditions and fittingly transferring this role to the token acts of predication that people perform when they are thinking or speaking about the world, he has situated truth in its proper place and obviated any need for abstractions like propositions to explain how language can express things that are true. This leaves propositions with the extremely modest role of classifying mental states and speech acts for the purposes of identifying and individuating them. It is demonstrated here however that there is no need whatsoever to posit such abstract entities to explain how people identify and individuate such states/acts. We therefore make the modest proposal that the term ‘proposition’ be stricken from the vocabulary of philosophers of language.

Keywords: propositions, truth-conditions, predication, Frege, truth-bearers

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