Search results for: approach to patient
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16592

Search results for: approach to patient

13202 Hermeneutical Attitudes to Islamic Art

Authors: Mohammad Hasan Kakizadeh

Abstract:

It is a matter of philosophical hermeneutics according to specifications, we can hand to his hermeneutic, hermeneutical approaches can be analyzed with Islamic art, Islamic art hermeneutical approaches can be of two types: one is to "Islamic Art" Art is considered the analogies and metaphors and mysteries using Nmvdgarha and tried to express spiritual or religious ideology that demonstrates the truth of Islam, and other efforts is that "art" is basically a way inconsistent with the interpretation that or "sharia," Islamic law, not be considered a way to recognize and praise God, his creation, and therefore, the "art" is a tool for reform or knowledge to Nfs.az these two efforts, the first modern effort to try and of course preceded by the second. However, the first attempt is sometimes forgotten that the early centuries AD, with respect to the nature of hermeneutic thinkers for the arts could not resist the assaults of "art" in general, or specifically some legitimacy to the "art" of business and Knnd.dyn art at the stage of its history, which distinguishes them from each other are united with each other so easily possible. However, with the rise of the monotheistic religions and leave the Pagan religions, religion, and art renewed bond becomes a difficult problem. Much of the efforts of Muslim scholars have focused on the legitimacy back to the art. These attempts without a hermeneutic approach to the "art" does not correlate with success. The findings and conclusion in this study is that the hermeneutic approach to Islamic art, whether or Mshrvsazanh Mnakavanh what Bazsazanh or deconstructive, can not ignore the fact that Islamic art has been shaped by Mabdaltbyhay.

Keywords: art, Islamic art, hermeneutics, art, religion

Procedia PDF Downloads 369
13201 Model Based Simulation Approach to a 14-Dof Car Model Using Matlab/Simulink

Authors: Ishit Sheth, Chandrasekhar Jinendran, Chinmaya Ranjan Sahu

Abstract:

A fourteen degree of freedom (DOF) ride and handling control mathematical model is developed for a car using generalized boltzmann hamel equation which will create a basis for design of ride and handling controller. Mathematical model developed yield equations of motion for non-holonomic constrained systems in quasi-coordinates. The governing differential equation developed integrates ride and handling control of car. Model-based systems engineering approach is implemented for simulation using matlab/simulink, vehicle’s response in different DOF is examined and later validated using commercial software (ADAMS). This manuscript involves detailed derivation of full car vehicle model which provides response in longitudinal, lateral and yaw motion to demonstrate the advantages of the developed model over the existing dynamic model. The dynamic behaviour of the developed ride and handling model is simulated for different road conditions.

Keywords: Full Vehicle Model, MBSE, Non Holonomic Constraints, Boltzmann Hamel Equation

Procedia PDF Downloads 230
13200 Automatic Classification of the Stand-to-Sit Phase in the TUG Test Using Machine Learning

Authors: Yasmine Abu Adla, Racha Soubra, Milana Kasab, Mohamad O. Diab, Aly Chkeir

Abstract:

Over the past several years, researchers have shown a great interest in assessing the mobility of elderly people to measure their functional status. Usually, such an assessment is done by conducting tests that require the subject to walk a certain distance, turn around, and finally sit back down. Consequently, this study aims to provide an at home monitoring system to assess the patient’s status continuously. Thus, we proposed a technique to automatically detect when a subject sits down while walking at home. In this study, we utilized a Doppler radar system to capture the motion of the subjects. More than 20 features were extracted from the radar signals, out of which 11 were chosen based on their intraclass correlation coefficient (ICC > 0.75). Accordingly, the sequential floating forward selection wrapper was applied to further narrow down the final feature vector. Finally, 5 features were introduced to the linear discriminant analysis classifier, and an accuracy of 93.75% was achieved as well as a precision and recall of 95% and 90%, respectively.

Keywords: Doppler radar system, stand-to-sit phase, TUG test, machine learning, classification

Procedia PDF Downloads 161
13199 Impact of Maternal Nationality on Caesarean Section Rate Variation in a High-income Country

Authors: Saheed Shittu, Lolwa Alansari, Fahed Nattouf, Tawa Olukade, Naji Abdallah, Tamara Alshdafat, Sarra Amdouni

Abstract:

Cesarean sections (CS), a highly regarded surgical intervention for improving fetal-maternal outcomes and serving as an integral part of emergency obstetric services, are not without complications. Although CS has many advantages, it poses significant risks to both mother and child and increases healthcare expenditures in the long run. The escalating global prevalence of CS, coupled with variations in rates among immigrant populations, has prompted an inquiry into the correlation between CS rates and the nationalities of women undergoing deliveries at Al-Wakra Hospital (AWH), Qatar's second-largest public maternity hospital. This inquiry is motivated by the notable CS rate of 36%, deemed high in comparison to the 34% recorded across other Hamad Medical Corporation (HMC) maternity divisions This is Qatar's first comprehensive investigation of Caesarean section rates and nationalities. A retrospective cross-sectional study was conducted, and data for all births delivered in 2019 were retrieved from the hospital's electronic medical records. The CS rate, the crude rate, and adjusted risks of Caesarean delivery for mothers from each nationality were determined. The common indications for CS were analysed based on nationality. The association between nationality and Caesarean rates was examined using binomial logistic regression analysis considering Qatari women as a standard reference group. The correlation between the CS rate in the country of nationality and the observed CS rate in Qatar was also examined using Pearson's correlation. This study included 4,816 births from 69 different nationalities. CS was performed in 1767 women, equating to 36.5%. The nationalities with the highest CS rates were Egyptian (49.6%), Lebanese (45.5%), Filipino and Indian (both 42.2%). Qatari women recorded a CS rate of 33.4%. The major indication for elective CS was previous multiple CS (39.9%) and one prior CS, where the patient declined vaginal birth after the cesarean (VBAC) option (26.8%). A distinct pattern was noticed: elective CS was predominantly performed on Arab women, whereas emergency CS was common among women of Asian and Sub-Saharan African nationalities. Moreover, a significant correlation was found between the CS rates in Qatar and the women's countries of origin. Also, a high CS rate was linked to instances of previous CS. As a result of these insights, strategic interventions were successfully implemented at the facility to mitigate unwarranted CS, resulting in a notable reduction in CS rate from 36.5% in 2019 to 34% in 2022. This proves the efficacy of the meticulously researched approach. The focus has now shifted to reducing primary CS rates and facilitating well-informed decisions regarding childbirth methods.

Keywords: maternal nationality, caesarean section rate variation, migrants, high-income country

Procedia PDF Downloads 70
13198 A NoSQL Based Approach for Real-Time Managing of Robotics's Data

Authors: Gueidi Afef, Gharsellaoui Hamza, Ben Ahmed Samir

Abstract:

This paper deals with the secret of the continual progression data that new data management solutions have been emerged: The NoSQL databases. They crossed several areas like personalization, profile management, big data in real-time, content management, catalog, view of customers, mobile applications, internet of things, digital communication and fraud detection. Nowadays, these database management systems are increasing. These systems store data very well and with the trend of big data, a new challenge’s store demands new structures and methods for managing enterprise data. The new intelligent machine in the e-learning sector, thrives on more data, so smart machines can learn more and faster. The robotics are our use case to focus on our test. The implementation of NoSQL for Robotics wrestle all the data they acquire into usable form because with the ordinary type of robotics; we are facing very big limits to manage and find the exact information in real-time. Our original proposed approach was demonstrated by experimental studies and running example used as a use case.

Keywords: NoSQL databases, database management systems, robotics, big data

Procedia PDF Downloads 355
13197 Monitoring of Latent Tree Mortality after Forest Fires: A Biosensor Approach

Authors: Alessio Giovannelli, Claudia Cocozza, Enrico Marchi, Valerio Giorgio Muzzini, Eleftherios Touloupakis, Raffaella Margherita Zampieri

Abstract:

In Mediterranean countries, forest fires are recurrent events that need to be considered as a central component of regional and global forest management strategies and biodiversity restoration programmes. The response of tree function to fire damage can vary widely, also taking into account species, season, age of the tree, etc. Trees that survive fire may have different levels of physiological functionality, which may result in reduced growth or increased susceptibility to delayed mortality. An approach to assessing irreversible physiological injury in trees could help to inform management decisions at burned sites for biodiversity restoration, environmental safety and understanding of ecosystem functional adaptations. Physiological proxies for latent tree mortality, such as cambial cell death, reduced or absent starch and soluble sugar content in C sinks, and ethanol accumulation in the phloem, are considered proxies for cell death. However, their determination requires time-consuming laboratory protocols, making the approach unfeasible as a practical option in the field, but recent findings have shown that biosensors could be usefully applied to overcome these limitations. The study will focus on the development of amperometric biosensors capable of detecting a few target molecules in the phloem and xylem (such as ethanol and glucose) that have recently been identified as proxies for latent tree mortality. The results of a specific experiment on a stand of Pinus pinaster subjected to prescribed fire are reported.

Keywords: enzymes, glucose, ethanol, prescribed fires

Procedia PDF Downloads 18
13196 3D Guidance of Unmanned Aerial Vehicles Using Sliding Mode Approach

Authors: M. Zamurad Shah, M. Kemal Ozgoren, Raza Samar

Abstract:

This paper presents a 3D guidance scheme for Unmanned Aerial Vehicles (UAVs). The proposed guidance scheme is based on the sliding mode approach using nonlinear sliding manifolds. Generalized 3D kinematic equations are considered here during the design process to cater for the coupling between longitudinal and lateral motions. Sliding mode based guidance scheme is then derived for the multiple-input multiple-output (MIMO) system using the proposed nonlinear manifolds. Instead of traditional sliding surfaces, nonlinear sliding surfaces are proposed here for performance and stability in all flight conditions. In the reaching phase control inputs, the bang-bang terms with signum functions are accompanied with proportional terms in order to reduce the chattering amplitudes. The Proposed 3D guidance scheme is implemented on a 6-degrees-of-freedom (6-dof) simulation of a UAV and simulation results are presented here for different 3D trajectories with and without disturbances.

Keywords: unmanned aerial vehicles, sliding mode control, 3D guidance, nonlinear sliding manifolds

Procedia PDF Downloads 451
13195 An Experimental Approach to the Influence of Tipping Points and Scientific Uncertainties in the Success of International Fisheries Management

Authors: Jules Selles

Abstract:

The Atlantic and Mediterranean bluefin tuna fishery have been considered as the archetype of an overfished and mismanaged fishery. This crisis has demonstrated the role of public awareness and the importance of the interactions between science and management about scientific uncertainties. This work aims at investigating the policy making process associated with a regional fisheries management organization. We propose a contextualized computer-based experimental approach, in order to explore the effects of key factors on the cooperation process in a complex straddling stock management setting. Namely, we analyze the effects of the introduction of a socio-economic tipping point and the uncertainty surrounding the estimation of the resource level. Our approach is based on a Gordon-Schaefer bio-economic model which explicitly represents the decision making process. Each participant plays the role of a stakeholder of ICCAT and represents a coalition of fishing nations involved in the fishery and decide unilaterally a harvest policy for the coming year. The context of the experiment induces the incentives for exploitation and collaboration to achieve common sustainable harvest plans at the Atlantic bluefin tuna stock scale. Our rigorous framework allows testing how stakeholders who plan the exploitation of a fish stock (a common pool resource) respond to two kinds of effects: i) the inclusion of a drastic shift in the management constraints (beyond a socio-economic tipping point) and ii) an increasing uncertainty in the scientific estimation of the resource level.

Keywords: economic experiment, fisheries management, game theory, policy making, Atlantic Bluefin tuna

Procedia PDF Downloads 253
13194 The Current Ways of Thinking Mild Traumatic Brain Injury and Clinical Practice in a Trauma Hospital: A Pilot Study

Authors: P. Donnelly, G. Mitchell

Abstract:

Traumatic Brain Injury (TBI) is a major contributor to the global burden of disease; despite its ubiquity, there is significant variation in diagnosis, prognosis, and treatment between clinicians. This study aims to examine the spectrum of approaches that currently exist at a Level 1 Trauma Centre in Australasia by surveying Emergency Physicians and Neurosurgeons on those aspects of mTBI. A pilot survey of 17 clinicians (Neurosurgeons, Emergency Physicians, and others who manage patients with mTBI) at a Level 1 Trauma Centre in Brisbane, Australia, was conducted. The objective of this study was to examine the importance these clinicians place on various elements in their approach to the diagnosis, prognostication, and treatment of mTBI. The data were summarised, and the descriptive statistics reported. Loss of consciousness and post-traumatic amnesia were rated as the most important signs or symptoms in diagnosing mTBI (median importance of 8). MRI was the most important imaging modality in diagnosing mTBI (median importance of 7). ‘Number of the Previous TBIs’ and Intracranial Injury on Imaging’ were rated as the most important elements for prognostication (median importance of 9). Education and reassurance were rated as the most important modality for treating mTBI (median importance of 7). There was a statistically insignificant variation between the specialties as to the importance they place on each of these components. In this Australian tertiary trauma center, there appears to be variation in how clinicians approach mTBI. This study is underpowered to state whether this is between clinicians within a specialty or a trend between specialties. This variation is worthwhile in investigating as a step toward a unified approach to diagnosing, prognosticating, and treating this common pathology.

Keywords: mild traumatic brain injury, adult, clinician, survey

Procedia PDF Downloads 130
13193 Recursive Doubly Complementary Filter Design Using Particle Swarm Optimization

Authors: Ju-Hong Lee, Ding-Chen Chung

Abstract:

This paper deals with the optimal design of recursive doubly complementary (DC) digital filter design using a metaheuristic based optimization technique. Based on the theory of DC digital filters using two recursive digital all-pass filters (DAFs), the design problem is appropriately formulated to result in an objective function which is a weighted sum of the phase response errors of the designed DAFs. To deal with the stability of the recursive DC filters during the design process, we can either impose some necessary constraints on the phases of the recursive DAFs. Through a frequency sampling and a weighted least squares approach, the optimization problem of the objective function can be solved by utilizing a population based stochastic optimization approach. The resulting DC digital filters can possess satisfactory frequency response. Simulation results are presented for illustration and comparison.

Keywords: doubly complementary, digital all-pass filter, weighted least squares algorithm, particle swarm optimization

Procedia PDF Downloads 688
13192 Numerical Solutions of an Option Pricing Rainfall Derivatives Model

Authors: Clarinda Vitorino Nhangumbe, Ercília Sousa

Abstract:

Weather derivatives are financial products used to cover non catastrophic weather events with a weather index as the underlying asset. The rainfall weather derivative pricing model is modeled based in the assumption that the rainfall dynamics follows Ornstein-Uhlenbeck process, and the partial differential equation approach is used to derive the convection-diffusion two dimensional time dependent partial differential equation, where the spatial variables are the rainfall index and rainfall depth. To compute the approximation solutions of the partial differential equation, the appropriate boundary conditions are suggested, and an explicit numerical method is proposed in order to deal efficiently with the different choices of the coefficients involved in the equation. Being an explicit numerical method, it will be conditionally stable, then the stability region of the numerical method and the order of convergence are discussed. The model is tested for real precipitation data.

Keywords: finite differences method, ornstein-uhlenbeck process, partial differential equations approach, rainfall derivatives

Procedia PDF Downloads 107
13191 A Framework for Successful TQM Implementation and Its Effect on the Organizational Sustainability Development

Authors: Redha Elhuni, M. Munir Ahmad

Abstract:

The main purpose of this research is to construct a generic model for successful implementation of Total Quality Management (TQM) in oil sector, and to find out the effects of this model on the organizational sustainability development (OSD) performance of Libyan oil and gas companies using the structured equation modeling (SEM) approach. The research approach covers both quantitative and qualitative methods. A questionnaire was developed in order to identify the quality factors that are seen by Libyan oil and gas companies to be critical to the success of TQM implementation. Hypotheses were developed to evaluate the impact of TQM implementation on O SD. Data analysis reveals that there is a significant positive effect of the TQM implementation on OSD. 24 quality factors are found to be critical and absolutely essential for successful TQM implementation. The results generated a structure of the TQMSD implementation framework based on the four major road map constructs (Top management commitment, employee involvement and participation, customer-driven processes, and continuous improvement culture).

Keywords: total quality management, critical success factors, oil and gas, organizational sustainability development (SD), Libya

Procedia PDF Downloads 273
13190 Immiscible Polymer Blends with Controlled Nanoparticle Location for Excellent Microwave Absorption: A Compartmentalized Approach

Authors: Sourav Biswas, Goutam Prasanna Kar, Suryasarathi Bose

Abstract:

In order to obtain better materials, control in the precise location of nanoparticles is indispensable. It was shown here that ordered arrangement of nanoparticles, possessing different characteristics (electrical/magnetic dipoles), in the blend structure can result in excellent microwave absorption. This is manifested from a high reflection loss of ca. -67 dB for the best blend structure designed here. To attenuate electromagnetic radiations, the key parameters i.e. high electrical conductivity and large dielectric/magnetic loss are targeted here using a conducting inclusion [multiwall carbon nanotubes, MWNTs]; ferroelectric nanostructured material with associated relaxations in the GHz frequency [barium titanate, BT]; and a loss ferromagnetic nanoparticles [nickel ferrite, NF]. In this study, bi-continuous structures were designed using 50/50 (by wt) blends of polycarbonate (PC) and polyvinylidene fluoride (PVDF). The MWNTs was modified using an electron acceptor molecule; a derivative of perylenediimide, which facilitates π-π stacking with the nanotubes and stimulates efficient charge transport in the blends. The nanoscopic materials have specific affinity towards the PVDF phase. Hence, by introducing surface-active groups, ordered arrangement can be tailored. To accomplish this, both BT and NF was first hydroxylated followed by introducing amine-terminal groups on the surface. The latter facilitated in nucleophilic substitution reaction with PC and resulted in their precise location. In this study, we have shown for the first time that by compartmentalized approach, superior EM attenuation can be achieved. For instance, when the nanoparticles were localized exclusively in the PVDF phase or in both the phases, the minimum reflection loss was ca. -18 dB (for MWNT/BT mixture) and -29 dB (for MWNT/NF mixture), and the shielding was primarily through reflection. Interestingly, by adopting the compartmentalized approach where in, the lossy materials were in the PC phase and the conducting inclusion (MWNT) in PVDF, an outstanding reflection loss of ca. -57 dB (for BT and MWNT combination) and -67 dB (for NF and MWNT combination) was noted and the shielding was primarily through absorption. Thus, the approach demonstrates that nanoscopic structuring in the blends can be achieved under macroscopic processing conditions and this strategy can further be explored to design microwave absorbers.

Keywords: barium titanate, EMI shielding, MWNTs, nickel ferrite

Procedia PDF Downloads 447
13189 An Abductive Approach to Policy Analysis: Policy Analysis as Informed Guessing

Authors: Adrian W. Chew

Abstract:

This paper argues that education policy analysis tends to be steered towards empiricist oriented approaches, which place emphasis on objective and measurable data. However, this paper argues that empiricist oriented approaches are generally based on inductive and/or deductive reasoning, which are unable to generate new ideas/knowledge. This paper will outline the logical structure of induction, deduction, and abduction, and argues that only abduction provides possibilities for the creation of new ideas/knowledge. This paper proposes the neologism of ‘informed guessing’ as a reformulation of abduction, and also as an approach to education policy analysis. On one side, the signifier ‘informed’ encapsulates the idea that abductive policy analysis needs to be informed by descriptive conceptualization theory to be able to make relations and connections between, and within, observed phenomenon and unobservable general structures. On the other side, the signifier ‘guessing’ captures the cyclical and unsystematic process of abduction. This paper will end with a brief example of utilising ‘informed guessing’ for a policy analysis of school choice lotteries in the United States.

Keywords: abductive reasoning, empiricism, informed guessing, policy analysis

Procedia PDF Downloads 353
13188 Case Report: A Rare Case of Popliteal Artery Aneurysm Presenting with Foot Drop

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Popliteal artery aneurysms (PAAs) are the most common arterial aneurysm of the periphery. It is defined as focal dilation of the artery more than 50% of the normal vessel diameter which usually varies between 7 mm to 11 mm. The most common presentation for PAAs is claudication due to luminal stenosis secondary to mural thrombus or acute limb ischaemia due to occlusive thrombosis or distal thromboembolism. It is less common for patients to present with non-ischaemic symptoms secondary to mass effect and compression of adjacent structures, and of these, presentation with common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female patient presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA of 22 mm by 21mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option taken in our case.

Keywords: aneurysm, foot drop, peroneal nerve, popliteal

Procedia PDF Downloads 404
13187 Scale up of Isoniazid Preventive Therapy: A Quality Management Approach in Nairobi County, Kenya

Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

Abstract:

HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

Procedia PDF Downloads 99
13186 The Distribution of rs5219 Polymorphism in the Non-Diabetic Elderly Jordanian Subject

Authors: Foad Alzoughool

Abstract:

Conflicting studies on the association between the rs5219 polymorphism and type 2 diabetes, some studies have confirmed a strong relationship between this variant and type2 diabetes, on the other hand, many studies denied the existence of this association. This study aimed to provide evidence about whether the rs5219 polymorphism has or hasn't a role as a risk factor for diabetes and meta-analysis to investigate the role of the control age group in the association. Genotyping of the rs5219 polymorphism was performed in a cohort of 266 healthy elderly subjects with a mean age (60.2 ± 5.1) with no history of diabetes (HbA1c < 6%) using standard Sanger sequencing methods. Lys/Lys alleles were detected in 20 persons (7.5%), Lys/Glu alleles in 96 persons (36.1%), and Glu/Glu in 150 persons (56.4%). The genotype distribution was consistent with Hardy–Weinberg equilibrium (P =0.7). Meta-analysis notably indicates no association between rs5219 polymorphism and type 2 diabetes in all studies used the younger age of the control group compared to the patient's age. In conclusion, our study sheds light on the importance of age factor among the control group recruited in case-control studies.

Keywords: Type 2 diabetes, rs5219 polymorphism, E23K, KCNJ11 gene

Procedia PDF Downloads 159
13185 Digital Advance Care Planning and Directives: Early Observations of Adoption Statistics and Responses from an All-Digital Consumer-Driven Approach

Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

Abstract:

Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

Procedia PDF Downloads 327
13184 Analyses and Optimization of Physical and Mechanical Properties of Direct Recycled Aluminium Alloy (AA6061) Wastes by ANOVA Approach

Authors: Mohammed H. Rady, Mohd Sukri Mustapa, S Shamsudin, M. A. Lajis, A. Wagiman

Abstract:

The present study is aimed at investigating microhardness and density of aluminium alloy chips when subjected to various settings of preheating temperature and preheating time. Three values of preheating temperature were taken as 450 °C, 500 °C, and 550 °C. On the other hand, three values of preheating time were chosen (1, 2, 3) hours. The influences of the process parameters (preheating temperature and time) were analyzed using Design of Experiments (DOE) approach whereby full factorial design with center point analysis was adopted. The total runs were 11 and they comprise of two factors of full factorial design with 3 center points. The responses were microhardness and density. The results showed that the density and microhardness increased with decreasing the preheating temperature. The results also found that the preheating temperature is more important to be controlled rather than the preheating time in microhardness analysis while both the preheating temperature and preheating time are important in density analysis. It can be concluded that setting temperature at 450 °C for 1 hour resulted in the optimum responses.

Keywords: AA6061, density, DOE, hot extrusion, microhardness

Procedia PDF Downloads 349
13183 Analysis of Fault Tolerance on Grid Computing in Real Time Approach

Authors: Parampal Kaur, Deepak Aggarwal

Abstract:

In the computational Grid, fault tolerance is an imperative issue to be considered during job scheduling. Due to the widespread use of resources, systems are highly prone to errors and failures. Hence, fault tolerance plays a key role in the grid to avoid the problem of unreliability. Scheduling the task to the appropriate resource is a vital requirement in computational Grid. The fittest resource scheduling algorithm searches for the appropriate resource based on the job requirements, in contrary to the general scheduling algorithms where jobs are scheduled to the resources with best performance factor. The proposed method is to improve the fault tolerance of the fittest resource scheduling algorithm by scheduling the job in coordination with job replication when the resource has low reliability. Based on the reliability index of the resource, the resource is identified as critical. The tasks are scheduled based on the criticality of the resources. Results show that the execution time of the tasks is comparatively reduced with the proposed algorithm using real-time approach rather than a simulator.

Keywords: computational grid, fault tolerance, task replication, job scheduling

Procedia PDF Downloads 436
13182 Decision Support System for Hospital Selection in Emergency Medical Services: A Discrete Event Simulation Approach

Authors: D. Tedesco, G. Feletti, P. Trucco

Abstract:

The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

Procedia PDF Downloads 91
13181 Software User Experience Enhancement through User-Centered Design and Co-design Approach

Authors: Shan Wang, Fahad Alhathal, Hari Subramanian

Abstract:

User-centered design skills play an important role in crafting a positive and intuitive user experience for software applications. Embracing a user-centric design approach involves understanding the needs, preferences, and behaviors of the end-users throughout the design process. This mindset not only enhances the usability of the software but also fosters a deeper connection between the digital product and its users. This paper encompasses a 6-month knowledge exchange collaboration project between an academic institution and an external industry in 2023 in the UK; it aims to improve the user experience of a digital platform utilized for a knowledge management tool, to understand users' preferences for features, identify sources of frustration, and pinpoint areas for enhancement. This research conducted one of the most effective methods to implement user-centered design through co-design workshops for testing user onboarding experiences that involve the active participation of users in the design process. More specifically, in January 2023, we organized eight co-design workshops with a diverse group of 11 individuals. Throughout these co-design workshops, we accumulated a total of 11 hours of qualitative data in both video and audio formats. Subsequently, we conducted an analysis of user journeys, identifying common issues and potential areas for improvement within three insights. This analysis was pivotal in guiding the knowledge management software in prioritizing feature enhancements and design improvements. Employing a user-centered design thinking process, we developed a series of graphic design solutions in collaboration with the software management tool company. These solutions were targeted at refining onboarding user experiences, workplace interfaces, and interactive design. Some of these design solutions were translated into tangible interfaces for the knowledge management tool. By actively involving users in the design process and valuing their input, developers can create products that are not only functional but also resonate with the end-users, ultimately leading to greater success in the competitive software landscape. In conclusion, this paper not only contributes insights into designing onboarding user experiences for software within a co-design approach but also presents key theories on leveraging the user-centered design process in software design to enhance overall user experiences.

Keywords: user experiences design, user centered design, co-design approach, knowledge management tool

Procedia PDF Downloads 9
13180 Money Laundering Risk Assessment in the Banking Institutions: An Experimental Approach

Authors: Yusarina Mat-Isa, Zuraidah Mohd-Sanusi, Mohd-Nizal Haniff, Paul A. Barnes

Abstract:

In view that money laundering has become eminent for banking institutions, it is an obligation for the banking institutions to adopt a risk-based approach as the integral component of the accepted policies on anti-money laundering. In doing so, those involved with the banking operations are the most critical group of personnel as these are the people who deal with the day-to-day operations of the banking institutions and are obligated to form a judgement on the level of impending risk. This requirement is extended to all relevant banking institutions staff, such as tellers and customer account representatives for them to identify suspicious customers and escalate it to the relevant authorities. Banking institutions staffs, however, face enormous challenges in identifying and distinguishing money launderers from other legitimate customers seeking genuine banking transactions. Banking institutions staffs are mostly educated and trained with the business objective in mind to serve the customers and are not trained to be “detectives with a detective’s power of observation”. Despite increasing awareness as well as trainings conducted for the banking institutions staff, their competency in assessing money laundering risk is still insufficient. Several gaps have prompted this study including the lack of behavioural perspectives in the assessment of money laundering risk in the banking institutions. Utilizing experimental approach, respondents are randomly assigned within a controlled setting with manipulated situations upon which judgement of the respondents is solicited based on various observations related to the situations. The study suggests that it is imperative that informed judgement is exercised in arriving at the decision to proceed with the banking services required by the customers. Judgement forms a basis of opinion for the banking institution staff to decide if the customers posed money laundering risk. Failure to exercise good judgement could results in losses and absorption of unnecessary risk into the banking institutions. Although the banking institutions are exposed with choices of automated solutions in assessing money laundering risk, the human factor in assessing the risk is indispensable. Individual staff in the banking institutions is the first line of defence who are responsible for screening the impending risk of any customer soliciting for banking services. At the end of the spectrum, the individual role involvement on the subject of money laundering risk assessment is not a substitute for automated solutions as human judgement is inimitable.

Keywords: banking institutions, experimental approach, money laundering, risk assessment

Procedia PDF Downloads 267
13179 Parameters Identification and Sensitivity Study for Abrasive WaterJet Milling Model

Authors: Didier Auroux, Vladimir Groza

Abstract:

This work is part of STEEP Marie-Curie ITN project, and it focuses on the identification of unknown parameters of the proposed generic Abrasive WaterJet Milling (AWJM) PDE model, that appears as an ill-posed inverse problem. The necessity of studying this problem comes from the industrial milling applications where the possibility to predict and model the final surface with high accuracy is one of the primary tasks in the absence of any knowledge of the model parameters that should be used. In this framework, we propose the identification of model parameters by minimizing a cost function, measuring the difference between experimental and numerical solutions. The adjoint approach based on corresponding Lagrangian gives the opportunity to find out the unknowns of the AWJM model and their optimal values that could be used to reproduce the required trench profile. Due to the complexity of the nonlinear problem and a large number of model parameters, we use an automatic differentiation software tool (TAPENADE) for the adjoint computations. By adding noise to the artificial data, we show that in fact the parameter identification problem is highly unstable and strictly depends on input measurements. Regularization terms could be effectively used to deal with the presence of data noise and to improve the identification correctness. Based on this approach we present results in 2D and 3D of the identification of the model parameters and of the surface prediction both with self-generated data and measurements obtained from the real production. Considering different types of model and measurement errors allows us to obtain acceptable results for manufacturing and to expect the proper identification of unknowns. This approach also gives us the ability to distribute the research on more complex cases and consider different types of model and measurement errors as well as 3D time-dependent model with variations of the jet feed speed.

Keywords: Abrasive Waterjet Milling, inverse problem, model parameters identification, regularization

Procedia PDF Downloads 316
13178 Disaggregating and Forecasting the Total Energy Consumption of a Building: A Case Study of a High Cooling Demand Facility

Authors: Juliana Barcelos Cordeiro, Khashayar Mahani, Farbod Farzan, Mohsen A. Jafari

Abstract:

Energy disaggregation has been focused by many energy companies since energy efficiency can be achieved when the breakdown of energy consumption is known. Companies have been investing in technologies to come up with software and/or hardware solutions that can provide this type of information to the consumer. On the other hand, not all people can afford to have these technologies. Therefore, in this paper, we present a methodology for breaking down the aggregate consumption and identifying the highdemanding end-uses profiles. These energy profiles will be used to build the forecast model for optimal control purpose. A facility with high cooling load is used as an illustrative case study to demonstrate the results of proposed methodology. We apply a high level energy disaggregation through a pattern recognition approach in order to extract the consumption profile of its rooftop packaged units (RTUs) and present a forecast model for the energy consumption.  

Keywords: energy consumption forecasting, energy efficiency, load disaggregation, pattern recognition approach

Procedia PDF Downloads 278
13177 Using Heat-Mask in the Thermoforming Machine for Component Positioning in Thermoformed Electronics

Authors: Behnam Madadnia

Abstract:

For several years, 3D-shaped electronics have been rising, with many uses in home appliances, automotive, and manufacturing. One of the biggest challenges in the fabrication of 3D shape electronics, which are made by thermoforming, is repeatable and accurate component positioning, and typically there is no control over the final position of the component. This paper aims to address this issue and present a reliable approach for guiding the electronic components in the desired place during thermoforming. We have proposed a heat-control mask in the thermoforming machine to control the heating of the polymer, not allowing specific parts to be formable, which can assure the conductive traces' mechanical stability during thermoforming of the substrate. We have verified our approach's accuracy by applying our method on a real industrial semi-sphere mold for positioning 7 LEDs and one touch sensor. We measured the LEDs' position after thermoforming to prove the process's repeatability. The experiment results demonstrate that the proposed method is capable of positioning electronic components in thermoformed 3D electronics with high precision.

Keywords: 3D-shaped electronics, electronic components, thermoforming, component positioning

Procedia PDF Downloads 97
13176 A Hybrid Pareto-Based Swarm Optimization Algorithm for the Multi-Objective Flexible Job Shop Scheduling Problems

Authors: Aydin Teymourifar, Gurkan Ozturk

Abstract:

In this paper, a new hybrid particle swarm optimization algorithm is proposed for the multi-objective flexible job shop scheduling problem that is very important and hard combinatorial problem. The Pareto approach is used for solving the multi-objective problem. Several new local search heuristics are integrated into an algorithm based on the critical block concept to enhance the performance of the algorithm. The algorithm is compared with the recently published multi-objective algorithms based on benchmarks selected from the literature. Several metrics are used for quantifying performance and comparison of the achieved solutions. The algorithms are also compared based on the Weighting summation of objectives approach. The proposed algorithm can find the Pareto solutions more efficiently than the compared algorithms in less computational time.

Keywords: swarm-based optimization, local search, Pareto optimality, flexible job shop scheduling, multi-objective optimization

Procedia PDF Downloads 369
13175 The Outcome of Early Balance Exercises and Agility Training in Sports Rehabilitation for Patients Post Anterior Cruciate Ligament (ACL) Reconstruction

Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

Abstract:

Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

Procedia PDF Downloads 255
13174 A Formal Property Verification for Aspect-Oriented Programs in Software Development

Authors: Moustapha Bande, Hakima Ould-Slimane, Hanifa Boucheneb

Abstract:

Software development for complex systems requires efficient and automatic tools that can be used to verify the satisfiability of some critical properties such as security ones. With the emergence of Aspect-Oriented Programming (AOP), considerable work has been done in order to better modularize the separation of concerns in the software design and implementation. The goal is to prevent the cross-cutting concerns to be scattered across the multiple modules of the program and tangled with other modules. One of the key challenges in the aspect-oriented programs is to be sure that all the pieces put together at the weaving time ensure the satisfiability of the overall system requirements. Our paper focuses on this problem and proposes a formal property verification approach for a given property from the woven program. The approach is based on the control flow graph (CFG) of the woven program, and the use of a satisfiability modulo theories (SMT) solver to check whether each property (represented par one aspect) is satisfied or not once the weaving is done.

Keywords: aspect-oriented programming, control flow graph, property verification, satisfiability modulo theories

Procedia PDF Downloads 177
13173 The Differentiation of Performances among Immigrant Entrepreneurs: A Biographical Approach

Authors: Daniela Gnarini

Abstract:

This paper aims to contribute to the field of immigrants' entrepreneurial performance. The debate on immigrant entrepreneurship has been dominated by cultural explanations, which argue that immigrants’ entrepreneurial results are linked to groups’ characteristics. However, this approach does not consider important dimensions that influence entrepreneurial performances. Furthermore, cultural theories do not take into account the huge differences in performances also within the same ethnic group. For these reason, this study adopts a biographical approach, both at theoretical and at methodological level, which can allow to understand the main aspects that make the difference in immigrants' entrepreneurial performances, by exploring the narratives of immigrant entrepreneurs, who operate in the restaurant sector in two different Italian metropolitan areas: Milan and Rome. Through the qualitative method of biographical interviews, this study analyses four main dimensions and their combinations: a) individuals' entrepreneurial and migratory path: this aspect is particularly relevant to understand the biographical resources of immigrant entrepreneurs and their change and evolution during time; b) entrepreneurs' social capital, with a particular focus on their networks, through the adoption of a transnational perspective, that takes into account both the local level and the transnational connections. This study highlights that, though entrepreneurs’ connections are significant, especially as far as those with family members are concerned, often their entrepreneurial path assumes an individualised trajectory. c) Entrepreneurs' human capital, including both formal education and skills acquired through informal channels. The latter are particularly relevant since in the interviews and data collected the role of informal transmission emerges. d) Embeddedness within the social, political and economic context, to understand the main constraints and opportunities both at local and national level. The comparison between two different metropolitan areas within the same country helps to understand this dimension.

Keywords: biographies, immigrant entrepreneurs, life stories, performance

Procedia PDF Downloads 226