Search results for: differential outcomes
4769 LORA: A Learning Outcome Modelling Approach for Higher Education
Authors: Aqeel Zeid, Hasna Anees, Mohamed Adheeb, Mohamed Rifan, Kalpani Manathunga
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To achieve constructive alignment in a higher education program, a clear set of learning outcomes must be defined. Traditional learning outcome definition techniques such as Bloom’s taxonomy are not written to be utilized by the student. This might be disadvantageous for students in student-centric learning settings where the students are expected to formulate their own learning strategies. To solve the problem, we propose the learning outcome relation and aggregation (LORA) model. To achieve alignment, we developed learning outcome, assessment, and resource authoring tools which help teachers to tag learning outcomes during creation. A pilot study was conducted with an expert panel consisting of experienced professionals in the education domain to evaluate whether the LORA model and tools present an improvement over the traditional methods. The panel unanimously agreed that the model and tools are beneficial and effective. Moreover, it helped them model learning outcomes in a more student centric and descriptive way.Keywords: learning design, constructive alignment, Bloom’s taxonomy, learning outcome modelling
Procedia PDF Downloads 1874768 Conservative Treatment Versus Percutaneous Wire Fixation in treatment of Distal Radial Fracture in Elderly
Authors: Abdelfatah Elsenosy, Mahmoud Ebrahim
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Background: Distal radius fractures are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Aim and objectives: The aim of the study is to systematically review the literature for the management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes. Subjects and methods: Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched. Results: There was no statistical significance difference between CI and PKF groups’ frequency of complication in all of the selected studies. Based on the results, we recommend more analysis regarding every parameter of the radiographic and functional results and specific complications related to each fixation need to be accomplished, which requires more Randomized controlled trials (RCTs) with high quality. Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.Keywords: radius, fracture, surgical, RCTs, conservative, radiographic, outcomes, orthopedic
Procedia PDF Downloads 1464767 Analytical Solutions of Time Space Fractional, Advection-Dispersion and Whitham-Broer-Kaup Equations
Authors: Muhammad Danish Khan, Imran Naeem, Mudassar Imran
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In this article, we study time-space Fractional Advection-Dispersion (FADE) equation and time-space Fractional Whitham-Broer-Kaup (FWBK) equation that have a significant role in hydrology. We introduce suitable transformations to convert fractional order derivatives to integer order derivatives and as a result these equations transform into Partial Differential Equations (PDEs). Then the Lie symmetries and corresponding optimal systems of the resulting PDEs are derived. The symmetry reductions and exact independent solutions based on optimal system are investigated which constitute the exact solutions of original fractional differential equations.Keywords: modified Riemann-Liouville fractional derivative, lie-symmetries, optimal system, invariant solutions
Procedia PDF Downloads 4314766 Pregnancy and Birth Outcomes of Single versus Multiple Embryo Transfer in Gestational Surrogacy Arrangements: A Systematic Review
Authors: Jutharat Attawet, Alex Y. Wang, Cindy M. Farquhar, Elizabeth A. Sullivan
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Background: Adverse maternal and perinatal outcomes of multiple pregnancies resulting from multiple embryo transfers (ET) has become significant concerns. This is particularly relevant for gestational carriers since they usually do not have infertility issues. Single embryo transfer (SET) therefore has been encouraged to assist reproductive technology (ART) practice in order to reduce multiple pregnancies. Objectives: This systematic review aims to investigate the pregnancy and birth outcomes of SET and multiple ET in surrogacy arrangements. Search methods: This study is a systematic review. Electronic databases were searched from CINAHL, Medline, Embase, Scopus and ProQuest for studies from 1980 to 2017. Cross-references and national ART reports were also manual searchings. Articles without restriction of English language and study types were accessed. Carrier cycles involving in SET and multiple ET were identified in database searching. The main outcome measures including clinical pregnancy, live delivery and multiple deliveries per gestational carrier cycle were compared between SET and multiple ET. Mantel-Haenzel risk ratios (RRs) with 95% confidence intervals (CIs), using the numbers of outcome events in SET and multiple ET of each study were calculated suing RevMan5.3. Outcomes: The search returned 97 articles of which 5 met the inclusion criteria. Approximately 50% of carrier cycles were transferred a single embryo and 50% were transferred more than one embryo. The clinical pregnancy rate (CPR) was 39% for SET and 53% for multiple ET, which was not significantly different with RR = 0.83 (95% CI: 0.67-1.03). The live delivery rate was 33% for SET and 57% for multiple ET which was not significantly different with RR = 0.78 (95% CI: 0.61-1.00). The multiple delivery rate per carrier was greater risks in the multiple ET carrier cycles (RR =0.4, 95% CI: 0.01-0.26). There were 104 sets of twins (including one set of twins selectively reduced from triplets to twins) and 1 set of triples in the multiple ET carrier cycle. In the SET carrier cycles, there were 2 sets of twins. Significance of the study: SET should be advocated among surrogate carriers to prevent multiple pregnancies and subsequent adverse outcomes for both carrier and baby. Surrogacy practice should be reviewed and surrogate carriers should be fully informed of the risk of adverse maternal and birth outcome of multiple pregnancies due to multiple embryo transfers.Keywords: assisted reproduction, birth outcomes, carrier, gestational surrogacy, multiple embryo transfer, multiple pregnancy, pregnancy outcomes, single embryo transfer, surrogate mother, systematic review
Procedia PDF Downloads 4044765 Location Privacy Preservation of Vehicle Data In Internet of Vehicles
Authors: Ying Ying Liu, Austin Cooke, Parimala Thulasiraman
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Internet of Things (IoT) has attracted a recent spark in research on Internet of Vehicles (IoV). In this paper, we focus on one research area in IoV: preserving location privacy of vehicle data. We discuss existing location privacy preserving techniques and provide a scheme for evaluating these techniques under IoV traffic condition. We propose a different strategy in applying Differential Privacy using k-d tree data structure to preserve location privacy and experiment on real world Gowalla data set. We show that our strategy produces differentially private data, good preservation of utility by achieving similar regression accuracy to the original dataset on an LSTM (Long Term Short Term Memory) neural network traffic predictor.Keywords: differential privacy, internet of things, internet of vehicles, location privacy, privacy preservation scheme
Procedia PDF Downloads 1804764 Analysis of a Differential System to Get Insights on the Potential Establishment of Microsporidia MB in the Mosquito Population for Malaria Control
Authors: Charlene N. T. Mfangnia, Henri E. Z. Tonnang, Berge Tsanou, Jeremy Herren
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Microsporidia MB is a recently discovered symbiont capable of blocking the transmission of Plasmodium from mosquitoes to humans. The symbiont can spread both horizontally and vertically among the mosquito population. This dual transmission gives the symbiont the ability to invade the mosquito population. The replacement of the mosquito population by the population of symbiont-infected mosquitoes then appears as a promising strategy for malaria control. In this context, the present study uses differential equations to model the transmission dynamics of Microsporidia MB in the population of female Anopheles mosquitoes. Long-term propagation scenarios of the symbiont, such as extinction, persistence or total infection, are obtained through the determination of the target and basic reproduction numbers, the equilibria, and the study of their stability. The stability is illustrated numerically, and the contribution of vertical and horizontal transmission in the spread of the symbiont is assessed. Data obtained from laboratory experiments are then used to explain the low prevalence observed in nature. The study also shows that the male death rate, the mating rate and the attractiveness of MB-positive mosquitoes are the factors that most influence the transmission of the symbiont. In addition, the introduction of temperature and the study of bifurcations show the significant influence of the environmental condition in the propagation of Microsporidia MB. This finding proves the necessity of taking into account environmental variables for the potential establishment of the symbiont in a new area.Keywords: differential equations, stability analysis, malaria, microsporidia MB, horizontal transmission, vertical transmission, numerical illustration
Procedia PDF Downloads 1134763 Teaching Children With Differential Learning Needs By Understanding Their Talents And Interests
Authors: Eunice Tan
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The purpose of this presentation is to look at an alternative to the approach and methodologies of working with special needs. The strength-based approach to education embodies a paradigm shift. It is a strategy to move away from a deficit-based methodology which inadvertently may lead to an extensive list of things that the child cannot do or is unable to do. Today, many parents of individuals with special needs are focused on the child’s deficits rather than on his or her strengths. Even when parents Recognise and identify their child’s strengths to be valuable and wish to develop their abilities, they face the challenge that there are insufficient programs committed to supporting the development and improvement of such abilities. What is a strength-based approach in education? A strength-based approach in education focuses on students' positive qualities and contributions to class instead of the skills and abilities they may not have. Many schools are focused on the child’s special educational needs rather than the whole child. Parents interviewed have said that they have to engage external tutors to help hone in on their child’s interests and strengths.Keywords: differential learning needs, special needs, instructional style, talents
Procedia PDF Downloads 1974762 Molecular Dynamics Simulation for Vibration Analysis at Nanocomposite Plates
Authors: Babak Safaei, A. M. Fattahi
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Polymer/carbon nanotube nanocomposites have a wide range of promising applications Due to their enhanced properties. In this work, free vibration analysis of single-walled carbon nanotube-reinforced composite plates is conducted in which carbon nanotubes are embedded in an amorphous polyethylene. The rule of mixture based on various types of plate model namely classical plate theory (CLPT), first-order shear deformation theory (FSDT), and higher-order shear deformation theory (HSDT) was employed to obtain fundamental frequencies of the nanocomposite plates. Generalized differential quadrature (GDQ) method was used to discretize the governing differential equations along with the simply supported and clamped boundary conditions. The material properties of the nanocomposite plates were evaluated using molecular dynamic (MD) simulation corresponding to both short-(10,10) SWCNT and long-(10,10) SWCNT composites. Then the results obtained directly from MD simulations were fitted with those calculated by the rule of mixture to extract appropriate values of carbon nanotube efficiency parameters accounting for the scale-dependent material properties. The selected numerical results are presented to address the influences of nanotube volume fraction and edge supports on the value of fundamental frequency of carbon nanotube-reinforced composite plates corresponding to both long- and short-nanotube composites.Keywords: nanocomposites, molecular dynamics simulation, free vibration, generalized, differential quadrature (GDQ) method
Procedia PDF Downloads 3294761 Ensuring Compliancy in Traditional Tibetan Medicine Treatment Through Patient Education
Authors: Nashalla Gwyn Nyinda
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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes
Procedia PDF Downloads 694760 The Moderating Effect of Organizational Commitment in the Relationship between Emotional Intelligence and Work Outcomes
Authors: Ali Muhammad
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The purpose of this study is to determine the moderating of effect of organizational commitment in the relationship between emotional intelligence and work outcomes. The study presents a new model to explain the mechanism through which emotional intelligence influences work outcomes. The model includes emotional intelligence as an independent variable, organizational commitment as a moderating variable, and work performance, job involvement, job satisfaction, organizational citizenship behavior, and intention to leave as dependent variables. A sample of 208 employees working in eight Kuwaiti business organizations (from industrial, banking, service, and financial sectors) were surveyed, and data was analyzed using structural equation modeling. Results indicate that emotional intelligence is positively associated with organizational commitment and that the positive effect of emotional intelligence on job involvement and organizational citizenship behavior is moderated by organizational commitment. The results of the current study are discussed and are compared to the results of previous studies in this area. Finally, the directions for future research are suggested.Keywords: emotional intelligence, organizational commitment, job involvement, job satisfaction, organizational citizenship behavior, intention to leave
Procedia PDF Downloads 3194759 Effect of Joule Heating on Chemically Reacting Micropolar Fluid Flow over Truncated Cone with Convective Boundary Condition Using Spectral Quasilinearization Method
Authors: Pradeepa Teegala, Ramreddy Chetteti
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This work emphasizes the effects of heat generation/absorption and Joule heating on chemically reacting micropolar fluid flow over a truncated cone with convective boundary condition. For this complex fluid flow problem, the similarity solution does not exist and hence using non-similarity transformations, the governing fluid flow equations along with related boundary conditions are transformed into a set of non-dimensional partial differential equations. Several authors have applied the spectral quasi-linearization method to solve the ordinary differential equations, but here the resulting nonlinear partial differential equations are solved for non-similarity solution by using a recently developed method called the spectral quasi-linearization method (SQLM). Comparison with previously published work on special cases of the problem is performed and found to be in excellent agreement. The influence of pertinent parameters namely Biot number, Joule heating, heat generation/absorption, chemical reaction, micropolar and magnetic field on physical quantities of the flow are displayed through graphs and the salient features are explored in detail. Further, the results are analyzed by comparing with two special cases, namely, vertical plate and full cone wherever possible.Keywords: chemical reaction, convective boundary condition, joule heating, micropolar fluid, spectral quasilinearization method
Procedia PDF Downloads 3464758 Using the Clinical Decision Support Platform, Dem DX, to Assess the ‘Urgent Community Care Team’s Notes Regarding Clinical Assessment, Management, and Healthcare Outcomes
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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation
Procedia PDF Downloads 1644757 The Role of Institutions in Community Wildlife Conservation in Zimbabwe
Authors: Herbert Ntuli, Edwin Muchapondwa
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This study used a sample of 336 households and community level data from 30 communities around the Gonarezhou National Park in Zimbabwe to analyse the association between ability to self-organize or cooperation and institutions on one hand and the relationship between success of biodiversity outcomes and cooperation on the other hand. Using both the ordinary least squares and instrumental variables estimation with heteroskedasticity-based instruments, our results confirmed that sound institutions are indeed an important ingredient for cooperation in the respective communities and cooperation positively and significantly affects biodiversity outcomes. Group size, community level trust, the number of stakeholders and punishment were found to be important variables explaining cooperation. From a policy perspective, our results show that external enforcement of rules and regulations does not necessarily translate into sound ecological outcomes but better outcomes are attainable when punishment is rather endogenized by local communities. This seems to suggest that communities should rather be supported in such a way that robust institutions that are tailor made to suit the needs of local condition will emerge that will in turn facilitate good environmental husbandry. Cooperation, training, benefits, distance from the nearest urban canter, distance from the fence, social capital average age of household head, fence and information sharing were found to be very important variables explaining the success of biodiversity outcomes ceteris paribus. Government programmes should target capacity building in terms of institutional capacity and skills development in order to have a positive impact on biodiversity. Hence, the role of stakeholders (e.g., NGOs) in capacity building and government effort should complement each other to ensure that the necessary resources are mobilized and all communities receive the necessary training and resources.Keywords: institutions, self-organize, common pool resources, wildlife, conservation, Zimbabwe
Procedia PDF Downloads 2814756 Pricing European Continuous-Installment Options under Regime-Switching Models
Authors: Saghar Heidari
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In this paper, we study the valuation problem of European continuous-installment options under Markov-modulated models with a partial differential equation approach. Due to the opportunity for continuing or stopping to pay installments, the valuation problem under regime-switching models can be formulated as coupled partial differential equations (CPDE) with free boundary features. To value the installment options, we express the truncated CPDE as a linear complementarity problem (LCP), then a finite element method is proposed to solve the resulted variational inequality. Under some appropriate assumptions, we establish the stability of the method and illustrate some numerical results to examine the rate of convergence and accuracy of the proposed method for the pricing problem under the regime-switching model.Keywords: continuous-installment option, European option, regime-switching model, finite element method
Procedia PDF Downloads 1374755 Noninvasive Neurally Adjusted Ventilation versus Nasal Continuous or Intermittent Positive Airway Pressure for Preterm Infants: A Systematic Review and Meta-Analysis
Authors: Mohammed S. Bhader, Abdullah A. Ghaddaf, Anas Alamoudi, Amal Abualola, Renad Kalantan, Noura Alkhulaifi, Ibrahim Halawani, Mohammed Alhindi
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Background: Noninvasive neurally adjusted ventilatory assist (NAVA) is a relatively new mode of noninvasive ventilation with promising clinical and patient-ventilator outcomes for preterm infants. The aim of this systematic review was to compare NAVA to nasal continuous or positive airway pressure (NCPAP) or intermittent positive airway pressure (NIPP) for preterm infants. Methods: We searched the online databases Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared NAVA to NCPAP or NIPP for preterm infants < 37 weeks gestational age. We sought to evaluate the following outcomes: noninvasive intubation failure rate, desaturation rate, the fraction of inspired oxygen (FiO2), and length of stay in the neonatal intensive care unit (NICU). We used the mean difference (MD) to represent continuous outcomes, while the odds ratio (OR) was used to represent dichotomous outcomes. Results: A total of 11 RCTs that enrolled 429 preterm infants were deemed eligible. NAVA showed similar clinical outcomes to NCPAP or NIPP with respect to noninvasive intubation failure (RR for NAVA versus NCPAP: 0.82, 95% confidence interval (CI): 0.49 to 1.37), desaturation rate (RR for NAVA versus NCPAP: 0.69, 95%CI: 0.36 to 1.29; RR for NAVA versus NIPP: 0.58, 95%CI: 0.08 to 4.25), FiO2 (MD for NAVA versus NCPAP: –0.01, 95%CI: –0.04 to 0.02; MD for NAVA versus NIPP: –7.16, 95%CI: –22.63 to 8.31), and length of stay in the NICU (MD for NAVA versus NCPAP: 1.34, 95%CI: –4.17 to 6.85). Conclusion: NAVA showed similar clinical and ventilator-related outcomes compared to the usual care noninvasive respiratory support measures NCPAP or NIPP for preterm infants.Keywords: preterm infants, noninvasive neurally adjusted ventilatory assist, NIV-NAVA, non-invasive ventilation, nasal continuous or positive airway pressure, NCPAP, intermittent positive airway pressure ventilation, NIPP, respiratory distress syndrome, RDS
Procedia PDF Downloads 1094754 Evaluation of Prestressed Reinforced Concrete Slab Punching Shear Using Finite Element Method
Authors: Zhi Zhang, Liling Cao, Seyedbabak Momenzadeh, Lisa Davey
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Reinforced concrete (RC) flat slab-column systems are commonly used in residential or office buildings, as the flat slab provides efficient clearance resulting in more stories at a given height than regular reinforced concrete beam-slab system. Punching shear of slab-column joints is a critical component of two-way reinforced concrete flat slab design. The unbalanced moment at the joint is transferred via slab moment and shear forces. ACI 318 provides an equation to evaluate the punching shear under the design load. It is important to note that the design code considers gravity and environmental load when considering the design load combinations, while it does not consider the effect from differential foundation settlement, which may be a governing load condition for the slab design. This paper describes how prestressed reinforced concrete slab punching shear is evaluated based on ACI 318 provisions and finite element analysis. A prestressed reinforced concrete slab under differential settlements is studied using the finite element modeling methodology. The punching shear check equation is explained. The methodology to extract data for punching shear check from the finite element model is described and correlated with the corresponding code provisions. The study indicates that the finite element analysis results should be carefully reviewed and processed in order to perform accurate punching shear evaluation. Conclusions are made based on the case studies to help engineers understand the punching shear behavior in prestressed and non-prestressed reinforced concrete slabs.Keywords: differential settlement, finite element model, prestressed reinforced concrete slab, punching shear
Procedia PDF Downloads 1304753 Ankle Arthroscopy: Indications, Patterns of Admissions, Surgical Outcomes, and Associated Complications Among Saudi Patients at King Abdul-Aziz Medical City in Riyadh
Authors: Mohammad Abdullah Almalki
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Background: Despite the frequent usage of ankle arthroscopy, there is limited medical literature regarding its indications, patterns of admissions, surgical outcomes, and associated complicated at Saudi Arabia. Hence, this study would highlight the surgical outcomes of such surgical approach that will assist orthopedic surgeons to detect which surgical procedure needs to be done as well as to help them regarding their diagnostic workups. Methods: At the Orthopedic Division of King Abdul‑Aziz Medical City in Riyadh and through a cross‑sectional design and convenient sampling techniques, the present study had recruited 20 subjects who fulfill the inclusion and exclusion criteria between 2016 and 2018. Data collection was carried out by a questionnaire designed and revised by an expert panel of health professionals. Results: Twenty patients were reviewed (11M and 9F) with an average age of 40.1 ± 12.2. Only 30% of the patients (5M, 1F) have no comorbidity, but 70% of patients (7M, 8F) were having at least one comorbidity. The most common indications were osteochondritis dissecans (n = 7, 35%), ankle fracture without dislocation (n = 4, 20%), and tibiotalar impingement (n = 3, 15%). Patients recorded pain in all cases (100%). The top four symptoms after pain were instability (30%, n = 6), muscle weakness (15%, n = 3) swelling (15%, n = 3), and stiffness (5%, n = 1). Two‑third of cases reached to their full healthy status and toe‑touch weight‑bearing was seen in two patients (10%). Conclusion: Ankle arthroscopy improved the rehabilitation rates in our tertiary care center. In addition, the surgical outcomes are favorable in our hospital since it has a very short length of stay, unexpended surgery, and fewest physiotherapy sessions.Keywords: ankle, arthroscopy, indications, patterns
Procedia PDF Downloads 874752 Single Stage “Fix and Flap” Orthoplastic Approach to Severe Open Tibial Fractures: A Systematic Review of the Outcomes
Authors: Taylor Harris
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Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review
Procedia PDF Downloads 864751 Improving Load Frequency Control of Multi-Area Power System by Considering Uncertainty by Using Optimized Type 2 Fuzzy Pid Controller with the Harmony Search Algorithm
Authors: Mehrdad Mahmudizad, Roya Ahmadi Ahangar
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This paper presents the method of designing the type 2 fuzzy PID controllers in order to solve the problem of Load Frequency Control (LFC). The Harmony Search (HS) algorithm is used to regulate the measurement factors and the effect of uncertainty of membership functions of Interval Type 2 Fuzzy Proportional Integral Differential (IT2FPID) controllers in order to reduce the frequency deviation resulted from the load oscillations. The simulation results implicitly show that the performance of the proposed IT2FPID LFC in terms of error, settling time and resistance against different load oscillations is more appropriate and preferred than PID and Type 1 Fuzzy Proportional Integral Differential (T1FPID) controllers.Keywords: load frequency control, fuzzy-pid controller, type 2 fuzzy system, harmony search algorithm
Procedia PDF Downloads 2784750 Nano Liquid Thin Film Flow over an Unsteady Stretching Sheet
Authors: Prashant G. Metri
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A numerical model is developed to study nano liquid film flow over an unsteady stretching sheet in the presence of hydromagnetic have been investigated. Similarity transformations are used to convert unsteady boundary layer equations to a system of non-linear ordinary differential equations. The resulting non-linear ordinary differential equations are solved numerically using Runge-Kutta-Fehlberg and Newton-Raphson schemes. A relationship between film thickness β and the unsteadiness parameter S is found, the effect of unsteadiness parameter S, and the hydromagnetic parameter S, on the velocity and temperature distributions are presented. The present analysis shows that the combined effect of magnetic field and viscous dissipation has a significant influence in controlling the dynamics of the considered problem. Comparison with known results for certain particular cases is in excellent agreement.Keywords: boundary layer flow, nanoliquid, thin film, unsteady stretching sheet
Procedia PDF Downloads 2574749 A Numerical Solution Based on Operational Matrix of Differentiation of Shifted Second Kind Chebyshev Wavelets for a Stefan Problem
Authors: Rajeev, N. K. Raigar
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In this study, one dimensional phase change problem (a Stefan problem) is considered and a numerical solution of this problem is discussed. First, we use similarity transformation to convert the governing equations into ordinary differential equations with its boundary conditions. The solutions of ordinary differential equation with the associated boundary conditions and interface condition (Stefan condition) are obtained by using a numerical approach based on operational matrix of differentiation of shifted second kind Chebyshev wavelets. The obtained results are compared with existing exact solution which is sufficiently accurate.Keywords: operational matrix of differentiation, similarity transformation, shifted second kind chebyshev wavelets, stefan problem
Procedia PDF Downloads 4034748 Comprehensive Lifespan Support for Quality of Life
Authors: Joann Douziech
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Individuals with intellectual and developmental disabilities (IDD) possess characteristics that present both challenges and gifts. Individuals with IDD require and are worthy of intentional, strategic, and specialized support throughout their lifespan to ensure optimum quality-of-life outcomes. The current global advocacy movement advancing the rights of individuals with IDD emphasizes a high degree of choice over life decisions. For some individuals, this degree of choice results in a variety of negative health and well-being outcomes. Improving the quality of life outcomes requires the combination of a commitment to the rights of the individual with a responsibility to provide support and choice commensurate with individual capacity. A belief that individuals with IDD are capable of learning and they are worthy of being taught provides the foundation for a holistic model of support throughout their lifespan. This model is based on three pillars of engineering the environment, promoting skill development and maintenance, and staff support. In an ever-changing world, supporting quality of life requires attention to moments, phases, and changes in stages throughout the lifespan. Balancing these complexities with strategic, responsive, and dynamic interventions enhances the quality of life of individuals with ID throughout their lifespan.Keywords: achieving optimum quality of life, comprehensive support, lifespan approach, philosophy and pedagogy
Procedia PDF Downloads 674747 Analysis of Conditional Effects of Forms of Upward versus Downward Counterfactual Reasoning on Gambling Cognition and Decision of Nigerians
Authors: Larry O. Awo, George N. Duru
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There are growing public and mental health concerns over the availability of gambling platforms and shops in Nigeria and the high level of youth involvement in gambling. Early theorizing maintained that gambling involvement was driven by a quest for resource gains. However, evidence shows that the economic model of gambling tends to explain the involvement of the gambling business owners (sport lottery operators: SLOs) as most gamblers lose more than they win. This loss, according to the law of effect, ought to discourage decisions to gamble. However, the quest to recover losses has often initiated prolonged gambling sessions. Therefore, the need to investigate mental contemplations (such as counterfactual reasoning (upward versus downward) of what “would, should, or could” have been, and feeling of the illusion of control; IOC) over gambling outcomes as risk or protective factors in gambling decisions became pertinent. The present study sought to understand the differential contributions and conditional effects of upward versus downward counterfactual reasoning as pathways through which the association between IOC and gambling decisions of Nigerian youths (N = 120, mean age = 18.05, SD = 3.81) could be explained. The study adopted a randomized group design, and data were obtained by means of stimulus material (the Gambling Episode; GE) and self-report measures of IOC and Gambling Decision. One-way analysis of variance (ANOVA) result showed that participants in the upward counterfactual reasoning group (M = 22.08) differed from their colleagues in the downward counterfactual reasoning group (M = 17.33) on the decision to gamble, and this difference was significant [F(1,112) = 23, P < .01]. HAYES PROCESS macro moderation analysis results showed that 1) IOC and upward counterfactual reasoning were positively associated with the decision to gamble (B = 14.21, t = 6.10, p < .01 and B = 7.22, t = 2.07, p <.05, respectively), 2) downward counterfactual reasoning was negatively associated with the decision to gamble more to recover losses (B = 10.03, t = 3.21, p < .01), 3) upward counterfactual reasoning did not moderate the association between IOC and gambling decision (p > .05), and 4) downward counterfactual reasoning negatively moderated the association between IOC and gambling decision (B = 07, t = 2.18, p < .05) such that the association was strong at the low level of downward counterfactual, but wane at high levels of downward counterfactual reasoning. The implication of these findings is that IOC and upward counterfactual reasoning were risk factors and promoted gambling behavior, while downward counterfactual reasoning protects individuals from gambling activities. Thus, it is concluded that downward counterfactual reasoning strategies should be included in gambling therapy and treatment packages as it could diminish feelings of both IOC and negative feelings of missed positive outcomes and the urge to gamble.Keywords: counterfactual reasoning, gambling cognition, gambling decision, Nigeria, youths
Procedia PDF Downloads 904746 The Wage Differential between Migrant and Native Workers in Australia: Decomposition Approach
Authors: Sabrina Tabassum
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Using Census Data for Housing and Population of Australia 2001, 2006, 2011, and 2016, this paper shows the existence of wage differences between natives and immigrants in Australia. Addressing the heterogeneous nature of immigrants, this study group the immigrants in three broad categories- migrants from English speaking countries and migrants from India and China. Migrants from English speaking countries and India earn more than the natives per week, whereas migrants from China earn far less than the natives per week. Oaxaca decomposition suggests that major part of this differential is unexplained. Using the occupational segregation concept and Brown decomposition, this study indicates that migrants from India and China would have been earned more than the natives if they had the same occupation distribution as natives due to their individual characteristics. Within occupation, wage differences are more prominent than inter-occupation wage differences for immigrants from China and India.Keywords: Australia, labour, migration, wage
Procedia PDF Downloads 1264745 Public Policy and Sexuality Education for Youth with Disabilities: Impact on Sexual Behavior and Outcomes
Authors: Alexandra M. Kriofske Mainella
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This paper will examine the need for more aggressive public policies around bodily, reproductive and sexual health education for young people with disabilities in the United States. This paper will consider the policies around sexuality education for students in the United States and the recommendation for national standards around sexuality education. We will investigate the intersection of these policies and recommendations for students with disabilities and the Individuals with Disabilities Education Act (IDEA): what this means for students with disabilities’ access to comprehensive sexuality education and how it affects their behaviors and outcomes.Keywords: disability, sexuality, education, policy
Procedia PDF Downloads 4374744 Long-Term Otitis Media with Effusion and Related Hearing Loss and Its Impact on Developmental Outcomes
Authors: Aleema Rahman
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Introduction: This study aims to estimate the prevalence of long-term otitis media with effusion (OME) and hearing loss in a prospective longitudinal cohort studyand to study the relationship between the condition and educational and psychosocial outcomes. Methods: Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) will be undertaken. ALSPAC is a longitudinal birth cohort study carried out in the UK, which has collected detailed measures of hearing on ~7000 children from the age of seven. A descriptive analysis of the data will be undertaken to estimate the prevalence of OME and hearing loss (defined as having average hearing levels > 20dB and type B tympanogram) at 7, 9, 11, and 15 years as well as that of long-term OME and hearing loss. Logistic and linear regression analyses will be conducted to examine associations between long-term OME and hearing loss and educational outcomes (grades obtained from standardised national attainment tests) and psychosocial outcomes such as anxiety, social fears, and depression at ages 10-11 and 15-16 years. Results: Results will be presented in terms of the prevalence of OME and hearing loss in the population at each age. The prevalence of long-term OME and hearing loss, defined as having OME and hearing loss at two or more time points, will also be reported. Furthermore, any associations between long-term OME and hearing loss and the educational and psychosocial outcomes will be presented. Analyses will take into account demographic factors such as sex and social deprivation and relevant confounders, including socioeconomic status, ethnicity, and IQ. Discussion: Findings from this study will provide new epidemiological information on the prevalence of long-term OME and hearing loss. The research will provide new knowledge on the impact of OME for the small group of children who do not grow out of condition by age 7 but continue to have hearing loss and need clinical care through later childhood. The study could have clinical implications and may influence service delivery for this group of children.Keywords: educational attainment, hearing loss, otitis media with effusion, psychosocial development
Procedia PDF Downloads 1384743 Rayleigh Wave Propagation in an Orthotropic Medium under the Influence of Exponentially Varying Inhomogeneities
Authors: Sumit Kumar Vishwakarma
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The aim of the paper is to investigate the influence of inhomogeneity associated with the elastic constants and density of the orthotropic medium. The inhomogeneity is considered as exponential function of depth. The impact of gravity had been discussed. Using the concept of separation of variables, the system of a partial differential equation (equation of motion) has been converted into ordinary differential equation, which is coupled in nature. It further reduces to a biquadratic equation whose roots were found by using MATLAB. A suitable boundary condition is employed to derive the dispersion equation in a closed-form. Numerical simulations had been performed to show the influence of the inhomogeneity parameter. It was observed that as the numerical values of increases, the phase velocity of Rayleigh waves decreases at a particular wavenumber. Graphical illustrations were drawn to visualize the effect of the increasing and decreasing values of the inhomogeneity parameter. It can be concluded that it has a remarkable bearing on the phase velocity as well as damping velocity.Keywords: Rayleigh waves, orthotropic medium, gravity field, inhomogeneity
Procedia PDF Downloads 1274742 COVID-19 and Heart Failure Outcomes: Readmission Insights from the 2020 United States National Readmission Database
Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle
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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.Keywords: Covid-19, heart failure, national readmission database, readmission outcomes
Procedia PDF Downloads 794741 Competition and Cooperation of Prosumers in Cournot Games with Uncertainty
Authors: Yong-Heng Shi, Peng Hao, Bai-Chen Xie
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Solar prosumers are playing increasingly prominent roles in the power system. However, its uncertainty affects the outcomes and functions of the power market, especially in the asymmetric information environment. Therefore, an important issue is how to take effective measures to reduce the impact of uncertainty on market equilibrium. We propose a two-level stochastic differential game model to explore the Cournot decision problem of prosumers. In particular, we study the impact of punishment and cooperation mechanisms on the efficiency of the Cournot game in which prosumers face uncertainty. The results show that under the penalty mechanism of fixed and variable rates, producers and consumers tend to take conservative actions to hedge risks, and the variable rates mechanism is more reasonable. Compared with non-cooperative situations, prosumers can improve the efficiency of the game through cooperation, which we attribute to the superposition of market power and uncertainty reduction. In addition, the market environment of asymmetric information intensifies the role of uncertainty. It reduces social welfare but increases the income of prosumers. For regulators, promoting alliances is an effective measure to realize the integration, optimization, and stable grid connection of producers and consumers.Keywords: Cournot games, power market, uncertainty, prosumer cooperation
Procedia PDF Downloads 1074740 Performance of Bridge Approach Slabs in Bridge Construction: A Case Study
Authors: Aurora Cerri, Niko Pullojani
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Long-term differential settlement between the bridge structure and the bridge embankment typically results in an abrupt grade change, causing driver discomfort, impairing driver safety, and exerting a potentially excessive impact traffic loading on the abutment. This paper has analysed a case of study showing the effect of an approaching slab realized in a bridge constructed at Tirane-Elbasan Motorway. The layer thickness under the slab is modeled as homogenous, the slab is a reinforced concrete structure and over that the asphaltic layers take place. Analysis indicates that reinforced concrete approaching slab distributes the stresses quite uniformly into the road fill layers and settlements varies in a range less than 2.50 cm in the total slab length of 6.00 m with a maximum slope of 1/240. Results taken from analytical analysis are compared with topographic measurements done on field and they carry great similarities.Keywords: approach slab, bridge, road pavement, differential settlement
Procedia PDF Downloads 221