Search results for: match outcome forecasting

Authors: R. Premasiri, W. A. H. A. Abeygunasekara, S. M. Hewavidana, T. Jananthan, R. M. S. Madawala, K. Vaheeshan

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Forecasting the potential for disastrous events such as landslides has become one of the major necessities in the current world. Most of all, the landslides occurred in Sri Lanka are found to be triggered mostly by intense rainfall events. The study area is the landslide near Gerandiella waterfall which is located by the 41st kilometer post on Nuwara Eliya-Gampala main road in Kotmale Division in Sri Lanka. The landslide endangers the entire Kotmale town beneath the slope. Geographic Information System (GIS) platform is very much useful when it comes to the need of emulating the real-world processes. The models are used in a wide array of applications ranging from simple evaluations to the levels of forecast future events. This project investigates the possibility of developing a dynamic model to map the spatial distribution of the slope stability. The model incorporates several theoretical models including the infinite slope model, Green Ampt infiltration model and Perched ground water flow model. A series of rainfall values can be fed to the model as the main input to simulate the dynamics of slope stability. Hydrological model developed using GIS is used to quantify the perched water table height, which is one of the most critical parameters affecting the slope stability. Infinite slope stability model is used to quantify the degree of slope stability in terms of factor of safety. DEM was built with the use of digitized contour data. Stratigraphy was modeled in Surfer using borehole data and resistivity images. Data available from rainfall gauges and piezometers were used in calibrating the model. During the calibration, the parameters were adjusted until a good fit between the simulated ground water levels and the piezometer readings was obtained. This model equipped with the predicted rainfall values can be used to forecast of the slope dynamics of the area of interest. Therefore it can be investigated the slope stability of rainfall induced landslides by adjusting temporal dimensions.

Keywords: factor of safety, geographic information system, hydrological model, slope stability

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Authors: Sandra Young

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The biodiversity literature is vast and heterogeneous. In today’s data age, numbers of data integration and standardisation initiatives aim to facilitate simultaneous access to all the literature across biodiversity domains for research and forecasting purposes. Ontologies are being used increasingly to organise this information, but the rationalisation intrinsic to ontologies can hit obstacles when faced with the intrinsic fluidity and inconsistency found in the domains comprising biodiversity. Essentially the problem is a conceptual one: biological taxonomies are formed on the basis of specific, physical specimens yet nomenclatural rules are used to provide labels to describe these physical objects. These labels are ambiguous representations of the physical specimen. An example of this is with the genus Melpomene, the scientific nomenclatural representation of a genus of ferns, but also for a genus of spiders. The physical specimens for each of these are vastly different, but they have been assigned the same nomenclatural reference. While there is much research into the conceptual stability of the taxonomic concept versus the nomenclature used, to the best of our knowledge as yet no research has looked empirically at the literature to see the conceptual plurality or singularity of the use of these species’ names, the linguistic representation of a physical entity. Language itself uses words as symbols to represent real world concepts, whether physical entities or otherwise, and as such lexicography has a well-founded history in the conceptual mapping of words in context for dictionary making. This makes it an ideal candidate to explore this problem. The lexicographic approach uses corpus-based analysis to look at word use in context, with a specific focus on collocated word frequencies (the frequencies of words used in specific grammatical and collocational contexts). It allows for inconsistencies and contradictions in the source data and in fact includes these in the word characterisation so that 100% of the available evidence is counted. Corpus analysis is indeed suggested as one of the ways to identify concepts for ontology building, because of its ability to look empirically at data and show patterns in language usage, which can indicate conceptual ideas which go beyond words themselves. In this sense it could potentially be used to identify if the hierarchical structures present within the empirical body of literature match those which have been identified in ontologies created to represent them. The first stages of this research have revealed a hierarchical structure that becomes apparent in the biodiversity literature when annotating scientific species’ names, common names and more general names as classes, which will be the focus of this paper. The next step in the research is focusing on a larger corpus in which specific words can be analysed and then compared with existing ontological structures looking at the same material, to evaluate the methods by means of an alternative perspective. This research aims to provide evidence as to the validity of the current methods in knowledge representation for biological entities, and also shed light on the way that scientific nomenclature is used within the literature.

Keywords: ontology, biodiversity, lexicography, knowledge representation, corpus linguistics

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Authors: Patrik Johansson, Selina Mardh

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The present study proposes a usability test method, Atmosphere, to assess the fitness of components and interaction patterns of design systems. The method covers the user’s perception of the components of the system, the efficiency of the logic of the interaction patterns, perceived ease of use as well as the user’s understanding of the intended outcome of interactions. These aspects are assessed by combining measures of first impression, visual affordance and expectancy. The method was applied to a design system developed for the design of an electronic health record system. The study was conducted involving 15 healthcare personnel. It could be concluded that the Atmosphere method provides tangible data that enable human-computer interaction practitioners to analyze and categorize components and patterns based on perceived usability, success rate of identifying interactive components and success rate of understanding components and interaction patterns intended outcome.

Keywords: atomic design, atmosphere methodology, design system, expectancy testing, first impression testing, usability testing, visual affordance testing

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Authors: Meenal Badki

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We address the issue of active feature determination, where the objective is to determine the set of examples on which additional data (such as lab tests) needs to be gathered, given a large number of examples with some features (such as demographics) and some examples with all the features (such as the complete Electronic Health Record). We note that certain features may be more costly, unique, or laborious to gather. Our proposal is a general active learning approach that is independent of classifiers and similarity metrics. It allows us to identify examples that differ from the full data set and obtain all the features for the examples that match. Our comprehensive evaluation shows the efficacy of this approach, which is driven by four authentic clinical tasks.

Keywords: feature determination, classification, active learning, sample-efficiency

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Authors: Anu S. Krishna

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The paper tries to analyse the UN involvement/intervention in the case of intra-state armed conflict of El Salvador and Nepal comparatively. The peace mission in El Salvador is considered to be the most successful missions of UN ever since it started involving in the peace-building activities. Meanwhile, in the armed conflict of South Asian country, Nepal, the result seemed to be disappointing in comparison with its counterpart. The study on this paper takes three variables as the success or failure of international mediation, i.e., a) signing of the peace agreement, b) disarmament/demobilization and c) constitutional mechanism. A significant amount of scholarship looks at the case of ONUSAL (United Nations Mission in El Salvador). Meanwhile, the armed conflict of Nepal and the role of UNMIN (United Nations Mediation in Nepal) are under researched so far. The paper thus tries to throw light on these cross-regional contexts that share certain similarities and dissimilarities in the nature of conflict. In addition, the international third-party involvement and their way of approaching both the cases differ, which again affected the mediation outcome. The paper tries to argue that, since the approach of the UN led international mediation in theses peace missions were contextual and varied from case to case, thus, finally affected the mediation outcome too.

Keywords: Nepal, UNMIN, El Salvador, ONUSAL, international mediation, armed conflict

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Authors: Jiun-Horng Tsai, Shi-Jie, Nieh

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Fine particulate matter (PM₂.₅) has become an important issue all over the world over the last decade. Annual mean PM₂.₅ concentration has been over the ambient air quality standard of PM₂.₅ (annual average concentration as 15μg/m³) which adapted by Taiwan Environmental Protection Administration (TEPA). TEPA, therefore, has developed a number of air pollution control measures to improve the ambient concentration by reducing the emissions of primary fine particulate matter and the precursors of secondary PM₂.₅. This study investigated the potential improvement of ambient PM₂.₅ concentration by the TEPA program and the other scenario for further emission reduction on various sources. Four scenarios had been evaluated in this study, including a basic case and three reduction scenarios (A to C). The ambient PM₂.₅ concentration was evaluated by Community Multi-scale Air Quality modelling system (CMAQ) ver. 4.7.1 along with the Weather Research and Forecasting Model (WRF) ver. 3.4.1. The grid resolutions in the modelling work are 81 km × 81 km for domain 1 (covers East Asia), 27 km × 27 km for domain 2 (covers Southeast China and Taiwan), and 9 km × 9 km for domain 3 (covers Taiwan). The result of PM₂.₅ concentration simulation in different regions of Taiwan shows that the annual average concentration of basic case is 24.9 μg/m³, and are 22.6, 18.8, and 11.3 μg/m³, respectively, for scenarios A to C. The annual average concentration of PM₂.₅ would be reduced by 9-55 % for those control scenarios. The result of scenario C (the emissions of precursors reduce to allowance levels) could improve effectively the airborne PM₂.₅ concentration to attain the air quality standard. According to the results of unit precursor reduction contribution, the allowance emissions of PM₂.₅, SOₓ, and NOₓ are 16.8, 39, and 62 thousand tons per year, respectively. In the Kao-Ping air basin, the priority for reducing precursor emissions is PM₂.₅ > NOₓ > SOₓ, whereas the priority for reducing precursor emissions is PM₂.₅ > SOₓ > NOₓ in others area. The result indicates that the target pollutants that need to be reduced in different air basin are different, and the control measures need to be adapted to local conditions.

Keywords: airborne PM₂.₅, community multi-scale air quality modelling system, control measures, weather research and forecasting model

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Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: Anuja Askhedkar, G. H. Agrawal, Madhu Gudgunti

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Direct Charge Transfer Switched Capacitor (DCT-SC) DAC is the internal DAC used in Delta-Sigma (∆∑) DAC which works on Over-Sampling concept. The Switched Capacitor DAC mainly suffers from mismatch among capacitors. Mismatch among capacitors in DAC, causes non linearity between output and input. Dynamic Element Matching (DEM) technique is used to match the capacitors. According to element selection logic there are many types. In this paper, Data Weighted Averaging (DWA) technique is used for mismatch shaping. In this paper, the 4 bit DCT-SC-DAC with DWA-DEM technique is implemented using WINSPICE simulation software in 180nm CMOS technology. DNL for DAC with DWA is ±0.03 LSB and INL is ± 0.02LSB.

Keywords: ∑-Δ DAC, DCT-SC-DAC, mismatch shaping, DWA, DEM

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Authors: Yichao Liu, Peter Fransson, Julian Heidecke, Jonas Wallin, Joacim Rockloev

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Dengue, a mosquito-borne viral disease, poses a significant public health challenge in endemic tropical or subtropical countries, including Sri Lanka. To reveal insights into the complexity of the dynamics of this disease and study the drivers, a comprehensive model capable of both robust forecasting and insightful inference of drivers while capturing the co-circulating of several virus strains is essential. However, existing studies mostly focus on only one aspect at a time and do not integrate and carry insights across the siloed approach. While mechanistic models are developed to capture immunity dynamics, they are often oversimplified and lack integration of all the diverse drivers of disease transmission. On the other hand, purely data-driven methods lack constraints imposed by immuno-epidemiological processes, making them prone to overfitting and inference bias. This research presents a hybrid model that combines machine learning techniques with mechanistic modelling to overcome the limitations of existing approaches. Leveraging eight years of newly reported dengue case data, along with socioeconomic factors, such as human mobility, weekly climate data from 2011 to 2018, genetic data detecting the introduction and presence of new strains, and estimates of seropositivity for different districts in Sri Lanka, we derive a data-driven vector (SEI) to human (SEIR) model across 16 regions in Sri Lanka at the weekly time scale. By conducting ablation studies, the lag effects allowing delays up to 12 weeks of time-varying climate factors were determined. The model demonstrates superior predictive performance over a pure machine learning approach when considering lead times of 5 and 10 weeks on data withheld from model fitting. It further reveals several interesting interpretable findings of drivers while adjusting for the dynamics and influences of immunity and introduction of a new strain. The study uncovers strong influences of socioeconomic variables: population density, mobility, household income and rural vs. urban population. The study reveals substantial sensitivity to the diurnal temperature range and precipitation, while mean temperature and humidity appear less important in the study location. Additionally, the model indicated sensitivity to vegetation index, both max and average. Predictions on testing data reveal high model accuracy. Overall, this study advances the knowledge of dengue transmission in Sri Lanka and demonstrates the importance of incorporating hybrid modelling techniques to use biologically informed model structures with flexible data-driven estimates of model parameters. The findings show the potential to both inference of drivers in situations of complex disease dynamics and robust forecasting models.

Keywords: compartmental model, climate, dengue, machine learning, social-economic

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Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan

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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.

Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program

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Authors: Jeonghwan Jeon, Mintak Han, Youngjun Kim

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Due to the rapid development of information and communication technology (ICT), a substantial transformation is currently happening in the society. As the range of intelligent technologies and services is continuously expanding, ‘things’ are becoming capable of communicating one another and even with people. However, such “Internet of Things” has the technical weakness so that a great amount of such information transferred in real-time may be widely exposed to the threat of security. User’s personal data are a typical example which is faced with a serious security threat. The threats of security will be diversified and arose more frequently because next generation of unfamiliar technology develops. Moreover, as the society is becoming increasingly complex, security vulnerability will be increased as well. In the existing literature, a considerable number of private and public reports that forecast future society have been published as a precedent step of the selection of future technology and the establishment of strategies for competitiveness. Although there are previous studies that forecast security technology, they have focused only on technical issues and overlooked the interrelationships between security technology and social factors are. Therefore, investigations of security threats in the future and security technology that is able to protect people from various threats are required. In response, this study aims to derive potential security threats associated with the development of technology and to explore the security technology that can protect against them. To do this, first of all, private and public reports that forecast future and online documents from technology-related communities are collected. By analyzing the data, future issues are extracted and categorized in terms of STEEP (Society, Technology, Economy, Environment, and Politics), as well as security. Second, the components of potential security threats are developed based on classified future issues. Then, points that the security threats may occur –for example, mobile payment system based on a finger scan technology– are identified. Lastly, alternatives that prevent potential security threats are proposed by matching security threats with points and investigating related security technologies from patent data. Proposed approach can identify the ICT-related latent security menaces and provide the guidelines in the ‘problem – alternative’ form by linking the threat point with security technologies.

Keywords: future society, information and communication technology, security technology, technology forecasting

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Authors: Timothy Kayode Samson, Adedoyin Isola Lawal

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The past five years have shown a sharp increase in public interest in the crypto market, with its market capitalization growing from $100 billion in June 2017 to $2158.42 billion on April 5, 2022. Despite the outrageous nature of the volatility of cryptocurrencies, the use of skewed error innovation distributions in modelling the volatility behaviour of these digital currencies has not been given much research attention. Hence, this study models the volatility of 5 largest cryptocurrencies by market capitalization (Bitcoin, Ethereum, Tether, Binance coin, and USD Coin) using four variants of GARCH models (GJR-GARCH, sGARCH, EGARCH, and APARCH) estimated using three skewed error innovation distributions (skewed normal, skewed student- t and skewed generalized error innovation distributions). Daily closing prices of these currencies were obtained from Yahoo Finance website. Finding reveals that the Binance coin reported higher mean returns compared to other digital currencies, while the skewness indicates that the Binance coin, Tether, and USD coin increased more than they decreased in values within the period of study. For both Bitcoin and Ethereum, negative skewness was obtained, meaning that within the period of study, the returns of these currencies decreased more than they increased in value. Returns from these cryptocurrencies were found to be stationary but not normality distributed with evidence of the ARCH effect. The skewness parameters in all best forecasting models were all significant (p<.05), justifying of use of skewed error innovation distributions with a fatter tail than normal, Student-t, and generalized error innovation distributions. For Binance coin, EGARCH-sstd outperformed other volatility models, while for Bitcoin, Ethereum, Tether, and USD coin, the best forecasting models were EGARCH-sstd, APARCH-sstd, EGARCH-sged, and GJR-GARCH-sstd, respectively. This suggests the superiority of skewed Student t- distribution and skewed generalized error distribution over the skewed normal distribution.

Keywords: skewed generalized error distribution, skewed normal distribution, skewed student t- distribution, APARCH, EGARCH, sGARCH, GJR-GARCH

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Authors: Joni Agung Sudarmanto

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The concept of design has historically been elusive and characterized by its fluidity, leading to divergent viewpoints on its fundamental nature. Guy Julier views design as inherent in material culture, while Sanders sees it as a collective endeavor focusing on the outcome. Design's dualistic nature, procedural and outcome-oriented, spans various domains, including objects, individuals, and the environment. This comprehensive view of design challenges the notion that design practice is distinct from research, highlighting their shared exploratory nature. The article explores methodological techniques in design research and the three prevalent approaches: "into design," "through design," and "for design." The contradictory meanings of design arise from its etymology and its duality as both process and result, leading to its integrative nature across objects, humans, and the environment. The parallels between design and research activities, underscoring their exploratory and knowledge-generating nature, are situated within creative research, challenging the perception of design practice as separate from research endeavors. The "into design" approach encourages interdisciplinary collaboration, enriching design research with diverse perspectives. The "through design" approach bridges theory and practice, producing more practical outcomes. The "for design" approach supports specific design solutions, providing designers with valuable guidance.

Keywords: dualistic nature of design, integrative perspectives, methodological approaches, design research

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Authors: Pinel Sebastien, Bourrin François, De Madron Du Rieu Xavier, Ludwig Wolfgang, Arnau Pedro

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Heavy precipitation constitutes a major meteorological threat in the western Mediterranean. Research has investigated the relationship between the states of the Mediterranean Sea and the atmosphere with the precipitation for short temporal windows. However, at a larger temporal scale, the precursor signals of heavy rainfall in the sea and atmosphere have drawn little attention. Moreover, despite ongoing improvements in numerical weather prediction, the medium-term forecasting of rainfall events remains a difficult task. Here, we aim to investigate the influence of early-spring environmental parameters on the following autumnal heavy precipitations. Hence, we develop a machine learning model to predict extreme autumnal rainfall with a 6-month lead time over the Spanish Catalan coastal area, based on i) the sea pattern (main current-LPC and Sea Surface Temperature-SST) at the mesoscale scale, ii) 4 European weather teleconnection patterns (NAO, WeMo, SCAND, MO) at synoptic scale, and iii) the hydrological regime of the main local river (Rhône River). The accuracy of the developed model classifier is evaluated via statistical analysis based on classification accuracy, logarithmic and confusion matrix by comparing with rainfall estimates from rain gauges and satellite observations (CHIRPS-2.0). Sensitivity tests are carried out by changing the model configuration, such as sea SST, sea LPC, river regime, and synoptic atmosphere configuration. The sensitivity analysis suggests a negligible influence from the hydrological regime, unlike SST, LPC, and specific teleconnection weather patterns. At last, this study illustrates how public datasets can be integrated into a machine learning model for heavy rainfall prediction and can interest local policies for management purposes.

Keywords: extreme hazards, sensitivity analysis, heavy rainfall, machine learning, sea-atmosphere modeling, precipitation forecasting

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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Authors: Fae Princess Bermudez

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Background: One of the least significant leads on a 12-lead electrocardiogram is the augmented right lead (aVR), as it is not as specific compared to the other leads. In this case series, the value of lead aVR, which is more often than not ignored, is highlighted. Three cases of aVR ST segment elevation on 12-lead electrocardiogram are described, with the end outcome of demise of all three patients. The importance of immediate revascularization is described to improve prognosis in this group of patients. Objectives: This case series aims to primarily present under-reported cases of isolated aVR ST-segrment elevation myocardial infarction (STEMI), their course and outcome. More specific aims are to identify the criteria in determination of isolated aVR STEMI, know its clinical significance, and determine appropriate management for patients with this ECG finding. Method: A short review of previous studies, case reports, articles and guidelines from 2011-2016 was done. The author reviewed available literature, sorted out those that proved to be significant for the presented cases, and described them in conjunction with the aforementioned cases. Findings: Based on the limited information on these rare or under-reported cases, it was found that isolated aVR STEMI had a poorer prognosis that led to significant mortality and morbidity of patients. The significance of aVR ST-elevation was that of an occlusion of the left coronary artery or a severe three-vessel disease in the presence of an Acute Coronary Syndrome. Guidelines from American Heart Association/American College of Cardiology Foundation in 2013 already recognized ST-elevation of lead aVR in isolation as a STEMI; hence, recommended that patients with this particular ECG finding should undergo reperfusion strategies to improve prognosis. Conclusion: The indispensability of isolated aVR ST-segment elevation on ECG should alert physicians, especially Emergency physicians, to the high probability of Acute Coronary Syndrome with a very poor prognosis. If this group of patients is not promptly managed, demise may ensue, with cardiogenic shock as the most probable cause. With this electrocardiogram finding, physicians must be quick to make clinical decisions to increase chances of survival of this group of patients.

Keywords: AVR ST-elevation, diffuse ST-segment depression, left coronary artery infarction, myocardial infarction

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Authors: Kate Duggan

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Introduction: Functional Communication Training (FCT) is an approach which aims to reduce behaviours of concern by teaching more effective ways to communicate. It requires identification of the function of the behaviour of concern, through gathering information from key stakeholders and completing observations of the individual’s behaviour including antecedents to, and consequences of the behaviour. Appropriate communicative alternatives are then identified and taught to the individual using systematic instruction techniques. Behaviours of concern demonstrated by individuals with autism spectrum conditions (ASC) frequently have a communication function. When contributing to positive behavior support plans, speech and language therapists and other professionals working with individuals with ASC need to identify alternative communicative behaviours which are equally reinforcing as the existing behaviours of concern. Successful implementation of FCT is dependent on an effective ‘response match’. The new way of communicating must be equally as effective as the behaviour previously used and require the same amount or less effort from the individual. It must also be understood by the communication partners the individual encounters and be appropriate to their communicative contexts. Method: Four case studies within a non-maintained special school environment were described and analysed. A response match framework was used to identify the effectiveness of functional communication training delivered by the student’s speech and language therapist, teacher and learning support assistants. The success of systematic instruction techniques used to develop new communicative behaviours was evaluated using the CODES framework. Findings: Functional communication training can be used as part of a positive behaviour support approach for students within this setting. All case studies reviewed demonstrated ‘response success’, in that the desired response was gained from the new communicative behaviour. Barriers to the successful embedding of new communicative behaviours were encountered. In some instances, the new communicative behaviour could not be consistently understood across all communication partners which reduced ‘response recognisability’. There was also evidence of increased physical or cognitive difficulty in employing the new communicative behaviour which reduced the ‘response effectivity’. Successful use of ‘thinning schedules of reinforcement’, taught students to tolerate a delay to reinforcement once the new communication behaviour was learned.

Keywords: augmentative and alternative communication, autism spectrum conditions, behaviours of concern, functional communication training

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Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

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The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: clique, clan, electronic health records, physician collaboration

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Authors: Priya Kedia, Kiranmoy Das

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There is a rich literature on variable selection in regression setting. However, most of these methods assume normality for the response variable under consideration for implementing the methodology and establishing the statistical properties of the estimates. In many real applications, the distribution for the response variable may be non-Gaussian, and one might be interested in finding the best subset of covariates at some predetermined quantile level. We develop dynamic Bayesian approach for variable selection in quantile regression framework. We use a zero-inflated mixture prior for the regression coefficients, and consider the asymmetric Laplace distribution for the response variable for modeling different quantiles of its distribution. An efficient Gibbs sampler is developed for our computation. Our proposed approach is assessed through extensive simulation studies, and real application of the proposed approach is also illustrated. We consider the data from health and retirement study conducted by the University of Michigan, and select the important predictors when the outcome of interest is out-of-pocket medical cost, which is considered as an important measure for financial risk. Our analysis finds important predictors at different quantiles of the outcome, and thus enhance our understanding on the effects of different predictors on the out-of-pocket medical cost.

Keywords: variable selection, quantile regression, Gibbs sampler, asymmetric Laplace distribution

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Authors: M. De Filippo, J. S. Kuang

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In construction industry, reinforced concrete (RC) slabs represent fundamental elements of buildings and bridges. Different methods are available for analysing the structural behaviour of slabs. In the early ages of last century, the yield-line method has been proposed to attempt to solve such problem. Simple geometry problems could easily be solved by using traditional hand analyses which include plasticity theories. Nowadays, advanced finite element (FE) analyses have mainly found their way into applications of many engineering fields due to the wide range of geometries to which they can be applied. In such cases, the application of an elastic or a plastic constitutive model would completely change the approach of the analysis itself. Elastic methods are popular due to their easy applicability to automated computations. However, elastic analyses are limited since they do not consider any aspect of the material behaviour beyond its yield limit, which turns to be an essential aspect of RC structural performance. Furthermore, their applicability to non-linear analysis for modeling plastic behaviour gives very reliable results. Per contra, this type of analysis is computationally quite expensive, i.e. not well suited for solving daily engineering problems. In the past years, many researchers have worked on filling this gap between easy-to-implement elastic methods and computationally complex plastic analyses. This paper aims at proposing a numerical procedure, through which a pseudo-lower bound solution, not violating the yield criterion, is achieved. The advantages of moment distribution are taken into account, hence the increase in strength provided by plastic behaviour is considered. The lower bound solution is improved by detecting over-yielded moments, which are used to artificially rule the moment distribution among the rest of the non-yielded elements. The proposed technique obeys Nielsen’s yield criterion. The outcome of this analysis provides a simple, yet accurate, and non-time-consuming tool of predicting the lower-bound solution of the collapse load of RC slabs. By using this method, structural engineers can find the fracture patterns and ultimate load bearing capacity. The collapse triggering mechanism is found by detecting yield-lines. An application to the simple case of a square clamped slab is shown, and a good match was found with the exact values of collapse load.

Keywords: computational mechanics, lower bound method, reinforced concrete slabs, yield-line

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Authors: Muna Mohamed Omer Mirghani

Abstract:

This paper responds to one of the key national development strategies and a typical challenge in the Gash Basin as well as in different parts of Sudan, namely managing water scarcity in view of climate change impacts in minor water systems sustaining over 50% of the Sudan population. While now focusing on the Gash river basin, the ultimate aim is to replicate the same approach in similar water systems in central and west Sudan. The key objective of the paper is the identification of outcome-based water governance interventions in Gash Basin, guided by the global Sustainable Development Goal six (SDG 6 on water and sanitation) and the Sudan water resource policy framework. The paper concluded that improved water resources management of the Gash Basin is a prerequisite for ensuring desired policy outcomes of groundwater use and flood risk management purposes. Analysis of various water governance dimensions in the Gash indicated that the operationalization of a Basin-level institutional reform is critically focused on informed actors and adapted practices through knowledge and technologies along with the technical data and capacity needed to make that. Adapting the devolved Institutional structure at state level is recommended to strengthen the Gash basin regulatory function and improve compliance of groundwater users.

Keywords: water governance, Gash Basin, integrated groundwater management, Sudan

Procedia PDF Downloads 153

Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi

Abstract:

Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus

Procedia PDF Downloads 143

Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

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Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

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Authors: Reda Mankbadi

Abstract:

There are several technologically-important flow situations in which there is a need to control the outcome of the fluid flow. This could include flow separation, drag, noise, as well as particulate separations, to list only a few. One possible approach is the passive control, in which the design geometry is changed. An alternative approach is the Active Flow Control (AFC) technology in which an actuator is imbedded in the flow field to change the outcome. Examples of AFC are pulsed jets, synthetic jets, plasma actuators, heating and cooling, Etc. In this work will present an overview of the development of this field. Some examples will include: Airfoil Noise Suppression: LES is used to simulate the effect of the synthetic jet actuator on controlling the far field sound of a transitional airfoil. The results show considerable suppression of the noise if the synthetic jet is operated at frequencies. Mixing Enhancement and suppression: Results will be presented to show that imposing acoustic excitations at the nozzle exit can lead to enhancement or reduction of the jet plume mixing. In a vertical takeoff of Aircraft or in Space Launch, we will present results on the effects of water injection on reducing noise, and on protect the structure and pay load from fatigue damage. Other applications will include airfoil-gust interaction and propulsion systems optimizations.

Keywords: aerodynamics, simulations, aeroacoustics, active flow control (AFC), Large-Eddy Simulations (LES)

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Authors: Ali Bakari Mohammed

Abstract:

Transitioning is a continuous process of radical change in a society which involves co-evolution of institutional, technological, socio-cultural, and ecological developments at different scales and levels. Transition management model is a methodology that influences structural change of complex systems over a period (0-30 years) by experimenting and implementing new techniques. A transition management in the context of groundwater is a radical change from the current operate and control system to a next generation integrated and sustainable system that takes into account quality protection and sustained supply into the future. This study evaluates the transition management model in adopting it as a viable tool for the attainment of sustainable groundwater management. The outcome of the evaluation shows that there are three levels (strategic, tactical and operational) of operating the transition management model. At the strategic level, long-term goals for sustainable groundwater management are formulated, at the tactical level activities such as inter institutional networking, negotiation, planning and financing are carried out, and at the operational level, transition experiments and strategic niche management are carried out at the societal level. Overall, different actors and set of activities are required to partake at each management level. The outcome of this paper will provide basis for the implementation of the Sustainable Development Goal (SDG) 6 in Nigeria.

Keywords: transition management, groundwater, sustainable management, tool, Nigeria

Procedia PDF Downloads 244

Authors: Lourenco Camnahas, Eileen Willis, Greg Fisher, Jessie Gunson, Pascale Dettwiller, Charlene Thornton

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Stock-out of pharmaceuticals is a common issue at all level of health services in Timor-Leste, a small post-conflict country. This lead to the research questions: what are the current methods used to quantify pharmaceutical supplies; what factors contribute to the on-going pharmaceutical stock-out? The study examined factors that influence the pharmaceutical supply chain system. Methodology: Privett and Goncalvez dependency model has been adopted for the design of the qualitative interviews. The model examines pharmaceutical supply chain management at three management levels: management of individual pharmaceutical items, health facilities, and health systems. The interviews were conducted in order to collect information on inventory management, logistics management information system (LMIS) and the provision of pharmaceuticals. Andersen' behavioural model for healthcare utilization also informed the interview schedule, specifically factors linked to environment (healthcare system and external environment) and the population (enabling factors). Forty health professionals (bureaucrats, clinicians) and six senior officers from a United Nations Agency, a global multilateral agency and a local non-governmental organization were interviewed on their perceptions of factors (healthcare system/supply chain and wider environment) impacting on stock out. Additionally, policy documents for the entire healthcare system, along with population data were collected. Findings: An analysis using Pozzebon’s critical interpretation identified a range of difficulties within the system from poor coordination to failure to adhere to policy guidelines along with major difficulties with inventory management, quantification, forecasting, and budgetary constraints. Weak logistics management information system, lack of capacity in inventory management, monitoring and supervision are additional organizational factors that also contributed to the issue. There were various methods of quantification of pharmaceuticals applied in the government sector, and non-governmental organizations. Lack of reliable data is one of the major problems in the pharmaceutical provision. Global Fund has the best quantification methods fed by consumption data and malaria cases. There are other issues that worsen stock-out: political intervention, work ethic and basic infrastructure such as unreliable internet connectivity. Major issues impacting on pharmaceutical quantification have been identified. However, current data collection identified limitations within the Andersen model; specifically, a failure to take account of predictors in the healthcare system and the environment (culture/politics/social. The next step is to (a) compare models used by three non-governmental agencies with the government model; (b) to run the Andersen explanatory model for pharmaceutical expenditure for 2 to 5 drug items used by these three development partners in order to see how it correlates with the present model in terms of quantification and forecasting the needs; (c) to repeat objectives (a) and (b) using the government model; (d) to draw a conclusion about the strength.

Keywords: inventory management, pharmaceutical forecasting and quantification, pharmaceutical stock-out, pharmaceutical supply chain management

Procedia PDF Downloads 202

Authors: R. R. Mankbadi

Abstract:

There are several technologically-important flow situations in which there is a need to control the outcome of the fluid flow. This could include flow separation, drag, noise, as well as particulate separations, to list only a few. One possible approach is the passive control, in which the design geometry is changed. An alternative approach is the Active Flow Control (AFC) technology in which an actuator is embedded in the flow field to change the outcome. Examples of AFC are pulsed jets, synthetic jets, plasma actuators, heating, and cooling, etc. In this work will present an overview of the development of this field. Some examples will include Airfoil Noise Suppression: Large-Eddy Simulations (LES) is used to simulate the effect of synthetic jet actuator on controlling the far field sound of a transitional airfoil. The results show considerable suppression of the noise if the synthetic jet is operated at frequencies. Mixing Enhancement and suppression: Results will be presented to show that imposing acoustic excitations at the nozzle exit can lead to enhancement or reduction of the jet plume mixing. In vertical takeoff of Aircrafts or in Space Launch, we will present results on the effects of water injection on reducing noise, and on protecting the structure and payload from fatigue damage. Other applications will include airfoil-gust interaction and propulsion systems optimizations.

Keywords: aeroacoustics, flow control, aerodynamics, large eddy simulations

Procedia PDF Downloads 265

Authors: Salwa Hagag Abdelaziz, Dorria Salem, Hoda Zaki, Suzan Atteya

Abstract:

Early detection of breast cancer saves many thousands of lives each year via application of mammography and genetic screening and many more lives could be saved if nurses are involved in breast care screening practices. So, the aim of the study was to identify nurse's role in early detection of breast cancer through mammography and genetic screening and its impact on patient's outcome. In order to achieve this aim, 400 women above 40 years, asymptomatic were recruited for mammography and genetic screening. In addition, 50 nurses and 6 technologists were involved in the study. A descriptive analytical design was used. Five tools were utilized: sociodemographic, mammographic examination and risk factors, women's before, during and after mammography, items relaying to technologists, and items related to nurses were also obtained. The study finding revealed that 3% of women detected for malignancy and 7.25% for fibroadenoma. Statistically, significant differences were found between mammography results and age, family history, genetic screening, exposure to smoke, and using contraceptive pills. Nurses have insufficient knowledge about screening tests. Based on these findings the present study recommended involvement of nurses in breast care which is very important to in force population about screening practices.

Keywords: mammography, early detection, genetic screening, breast cancer

Procedia PDF Downloads 543

Authors: Shaan Khosla, Jon Krohn

Abstract:

In a recruiting context, machine learning models are valuable for recommendations: to predict the best candidates for a vacancy, to match the best vacancies for a candidate, and compile a set of similar candidates for any given candidate. While useful to create these models, validating their accuracy in a recommendation context is difficult due to a sparsity of data. In this report, we use network graph data to generate useful representations for candidates and vacancies. We use candidates and vacancies as network nodes and designate a bi-directional link between them based on the candidate interviewing for the vacancy. After using node2vec, the embeddings are used to construct a validation dataset with a ranked order, which will help validate new recommender systems.

Keywords: AI, machine learning, NLP, recruiting

Procedia PDF Downloads 63