Search results for: match outcome forecasting
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2956

Search results for: match outcome forecasting

2566 Outcome at the Extreme of Viability: A Single-Centre Experience

Authors: Antonia Harold-Barry, Eugene Dempsey

Abstract:

Background: The objective is to examine the survival and outcome of infants born under 26 weeks gestation in an Irish tertiary maternity hospital from 2007-2016 and to describe the survival and neurodevelopmental outcomes of these extremely preterm infants. Method: The population is 132 infants born at 23, 24, and 25 weeks in Cork University Maternity Hospital from 2007 to 2016. Ethical approval was granted by the Cork Clinical Research Ethics Committee. Patient details were obtained from the Vermont Oxford and Badger Networks. Survival rates and Bayley scores were calculated to assess neurodevelopmental outcomes. Statistical analysis with SPSS included frequencies, distributions, and comparisons between data from 2007-2011 and 2012-2016. Results: Overall survival rate was 63%. Of the surviving babies, 61% had Bayley scores calculated. Survival stood at 39% for delivery at 23 weeks, 50% at 24 weeks, and 83% at 25 weeks. The 2012 to 2016 cohort has shown further increases in survival, with 50% of babies at 23 weeks, 58% at 24 weeks, and 89% at 25 weeks. Corresponding figures for 2007-2011 are 20%, 39%, and 75%. Gestational age and incidence of periventricular leukomalacia were statistically significant, with a p-value of 0.022. Gestational age and delivery room deaths had a p-value of 0.025, as did gestational age and birth weight. A comparison of the two cohorts (2007-2011 and 2012-2016) with the administration of antenatal steroids showed a statistically significant p-value of 0.044. Conclusion: There is less morbidity and mortality in infants born at 25 than at 23 or 24 weeks. Survival of extremely premature infants has increased significantly over the past ten years. Survival rates with normal neurodevelopmental outcomes are comparable with international standards and reflect positive changes in attitude and practices in neonatal intensive care. This study will inform parents about the potential outcomes of extreme prematurity and policy regarding the management of extreme prematurity.

Keywords: extreme of viability, neurodevelopmental outcome, periventricular leukomalacia, prematurity

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2565 VaR Estimation Using the Informational Content of Futures Traded Volume

Authors: Amel Oueslati, Olfa Benouda

Abstract:

New Value at Risk (VaR) estimation is proposed and investigated. The well-known two stages Garch-EVT approach uses conditional volatility to generate one step ahead forecasts of VaR. With daily data for twelve stocks that decompose the Dow Jones Industrial Average (DJIA) index, this paper incorporates the volume in the first stage volatility estimation. Afterwards, the forecasting ability of this conditional volatility concerning the VaR estimation is compared to that of a basic volatility model without considering any trading component. The results are significant and bring out the importance of the trading volume in the VaR measure.

Keywords: Garch-EVT, value at risk, volume, volatility

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2564 Effect of Open-Ended Laboratory toward Learners Performance in Environmental Engineering Course: Case Study of Civil Engineering at Universiti Malaysia Sabah

Authors: N. Bolong, J. Makinda, I. Saad

Abstract:

Laboratory activities have produced benefits in student learning. With current drives of new technology resources and evolving era of education methods, renewal status of learning and teaching in laboratory methods are in progress, for both learners and the educators. To enhance learning outcomes in laboratory works particularly in engineering practices and testing, learning via hands-on by instruction may not sufficient. This paper describes and compares techniques and implementation of traditional (expository) with open-ended laboratory (problem-based) for two consecutive cohorts studying environmental laboratory course in civil engineering program. The transition of traditional to problem-based findings and effect were investigated in terms of course assessment student feedback survey, course outcome learning measurement and student performance grades. It was proved that students have demonstrated better performance in their grades and 12% increase in the course outcome (CO) in problem-based open-ended laboratory style than traditional method; although in perception, students has responded less favorable in their feedback.

Keywords: engineering education, open-ended laboratory, environmental engineering lab

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2563 Technological Affordances of a Mobile Fitness Application- A Role of Escapism and Social Outcome Expectation

Authors: Inje Cho

Abstract:

The leading health risks threatening the world today are associated with a modern lifestyle characterized by sedentary behavior, stress, anxiety, and an obesogenic food environment. To counter this alarming trend, the Centers for Disease Control and Prevention have proffered Physical Activity guidelines to bolster physical engagement. Concurrently, the burgeon of smartphones and mobile applications has witnessed a proliferation of fitness applications aimed at invigorating exercise adherence and real-time activity monitoring. Grounded in the Uses and gratification theory, this study delves into the technological affordances of mobile fitness applications, discerning the mediating influences of escapism and social outcome expectations on attitudes and exercise intention. The theory explains how individuals employ distinct communication mediums to satiate their exigencies and desires. Technological affordances manifest as attributes of emerging technologies that galvanize personal engagement in physical activities. Several features of mobile fitness applications include affordances for goal setting, virtual rewards, peer support, and exercise information. Escapism, denoting the inclination to disengage from normal routines, has emerged as a salient motivator for the consumption of new media. This study postulates that individual’s perceptions technological affordances within mobile fitness applications, can affect escapism and social outcome expectations, potentially influencing attitude, and behavior formation. Thus, the integrated model has been developed to empirically examine the interrelationships between technological affordances, escapism, social outcome expectations, and exercise intention. Structural Equation Modelling serves as the methodological tool, and a cohort of 400 Fitbit users shall be enlisted from the Prolific, data collection platform. A sequence of multivariate data analyses will scrutinize both the measurement and hypothesized structural models. By delving into the effects of mobile fitness applications, this study contributes to the growing of new media studies in sport management. Moreover, the novel integration of the uses and gratification theory, technological affordances, via the prism of escapism, illustrates the dynamics that underlies mobile fitness user’s attitudes and behavioral intentions. Therefore, the findings from this study contribute to theoretical understanding and provide pragmatic insights to developers and practitioners in optimizing the impact of mobile fitness applications.

Keywords: technological affordances, uses and gratification, mobile fitness apps, escapism, physical activity

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2562 The Use and Safety of Leave from an Acute Inpatient Psychiatry Unit: A Retrospective Review of Pass Outcomes Over Four Years Abstract

Authors: Vasilis C. Hristidis, Ricardo Caceda, Ji Soo Kim, Brian Bronson, Emily A. Hill

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Objective: Leave passes to provide authorized leave for hospitalized patients from a psychiatric inpatient unit. Though providing day passes was once a relatively common practice, there is relatively little data describing their safety and efficacy. Methods: This descriptive study examines the use of leave passes in an adult inpatient unit at a university hospital between 2017 and 2021, with attention to reasons for granting the day pass, duration, and outcome of the pass. Results: During the study period, ten patients with primary psychotic or mood disorders received 12 passes for either housing coordination, COVID-19 vaccination, or major family events. There were no fatalities or elopements. One patient experienced severe agitation and engaged in non-suicidal self-injurious behavior. A second patient showed mild, redirectable psychomotor agitation upon return to the unit. The remaining 10 passes were uneventful. Conclusions: Our findings support the view that patients with diverse diagnoses can safely be provided leave from an inpatient setting with adequate planning and support, yielding a low incidence of adverse events.

Keywords: passes, inpatient, psychiatry, inpatient leave, outcome

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2561 The Role of Social Media in the Success or Failure of a Revolution: A Comparative Case Study of 2008/2018 Revolutions in Armenia

Authors: Nane Giloyan

Abstract:

The rapid development of social networks in the 21st century increases the interests towards the role and impact of social media on the success or failure of a revolution. Even though studies are investigating the role of social media on the outcome of a revolution, still, the conclusions on this matter are ambiguous so far. Hence, this research aims to investigate the role of social media in the success or failure of a revolution and make a contribution to the literature gap. The study aims to examine the research question whether the use of social media explains the success or failure of revolutions in 2008 and 2018 in Armenia. The research question is investigated through content analysis of two cases; failed revolution in 2008 and the successful revolution in 2018 in Armenia. The secondary data analysis was based on information devoted to two revolutions using local and major international news articles, journal and critical articles, in Armenian, Russian and English, also videos, posts and live streams of the revolutionary leaders. There can be many factors explaining the success or failure of a revolution. However, the investigation of the factors and their role to explain the outcome of a revolution other than the use of social media is beyond the scope of this research study. The study holds other variables constant and concludes that in the cases of 2008 and 2018 revolutions in Armenia the mobilization of society through social media explains the differences in the outcomes (failed or successful). The comparative case study of the revolutions in 2008 and 2018 in Armenia emphasizes the important role and impact of the use of social media on the success or failure of a revolution. The results highlight that the use of the Internet, particularly social media and live streams, by the opposition was the essential difference between two revolutions. Social media platforms, live streams, and communication apps that were absent in the revolutionary situation in 2008 were fundamental to the Armenian Velvet Revolution in 2018. The changes in the situation in favor of the opposition, so the outcome of the protests, were mainly based on the Internet-based mobilization of the society. It is also important to take into consideration that the country experienced a great increase in penetration rates over the decade. The percentage of access to the Internet drastically increased between 2008 and 2018. This fact may help to have a clearer understanding of the use of the Internet and social media by the opposition and the reliance on social media by society. According to the results of the continent analysis, the use of social media to direct the protests and to mobilize the society, have a vital role and positive impact on the outcome of a revolution. Thus the study concludes that it is the use of social media to initiate, organize, and direct the protests that explain the success or failure of two Armenian revolutions.

Keywords: social media, revolution, Armenia, success, failure

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2560 Deep Learning Framework for Predicting Bus Travel Times with Multiple Bus Routes: A Single-Step Multi-Station Forecasting Approach

Authors: Muhammad Ahnaf Zahin, Yaw Adu-Gyamfi

Abstract:

Bus transit is a crucial component of transportation networks, especially in urban areas. Any intelligent transportation system must have accurate real-time information on bus travel times since it minimizes waiting times for passengers at different stations along a route, improves service reliability, and significantly optimizes travel patterns. Bus agencies must enhance the quality of their information service to serve their passengers better and draw in more travelers since people waiting at bus stops are frequently anxious about when the bus will arrive at their starting point and when it will reach their destination. For solving this issue, different models have been developed for predicting bus travel times recently, but most of them are focused on smaller road networks due to their relatively subpar performance in high-density urban areas on a vast network. This paper develops a deep learning-based architecture using a single-step multi-station forecasting approach to predict average bus travel times for numerous routes, stops, and trips on a large-scale network using heterogeneous bus transit data collected from the GTFS database. Over one week, data was gathered from multiple bus routes in Saint Louis, Missouri. In this study, Gated Recurrent Unit (GRU) neural network was followed to predict the mean vehicle travel times for different hours of the day for multiple stations along multiple routes. Historical time steps and prediction horizon were set up to 5 and 1, respectively, which means that five hours of historical average travel time data were used to predict average travel time for the following hour. The spatial and temporal information and the historical average travel times were captured from the dataset for model input parameters. As adjacency matrices for the spatial input parameters, the station distances and sequence numbers were used, and the time of day (hour) was considered for the temporal inputs. Other inputs, including volatility information such as standard deviation and variance of journey durations, were also included in the model to make it more robust. The model's performance was evaluated based on a metric called mean absolute percentage error (MAPE). The observed prediction errors for various routes, trips, and stations remained consistent throughout the day. The results showed that the developed model could predict travel times more accurately during peak traffic hours, having a MAPE of around 14%, and performed less accurately during the latter part of the day. In the context of a complicated transportation network in high-density urban areas, the model showed its applicability for real-time travel time prediction of public transportation and ensured the high quality of the predictions generated by the model.

Keywords: gated recurrent unit, mean absolute percentage error, single-step forecasting, travel time prediction.

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2559 Dynamic Model for Forecasting Rainfall Induced Landslides

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

Abstract:

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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2558 Mycophenolate Versus Methotrexate in Non-Infectious Ocular Inflammatory Disease: A Systematic Review and Meta-Analysis

Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi

Abstract:

Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.

Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis

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2557 A Lexicographic Approach to Obstacles Identified in the Ontological Representation of the Tree of Life

Authors: Sandra Young

Abstract:

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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2556 Understanding the Classification of Rain Microstructure and Estimation of Z-R Relationship using a Micro Rain Radar in Tropical Region

Authors: Tomiwa, Akinyemi Clement

Abstract:

Tropical regions experience diverse and complex precipitation patterns, posing significant challenges for accurate rainfall estimation and forecasting. This study addresses the problem of effectively classifying tropical rain types and refining the Z-R (Reflectivity-Rain Rate) relationship to enhance rainfall estimation accuracy. Through a combination of remote sensing, meteorological analysis, and machine learning, the research aims to develop an advanced classification framework capable of distinguishing between different types of tropical rain based on their unique characteristics. This involves utilizing high-resolution satellite imagery, radar data, and atmospheric parameters to categorize precipitation events into distinct classes, providing a comprehensive understanding of tropical rain systems. Additionally, the study seeks to improve the Z-R relationship, a crucial aspect of rainfall estimation. One year of rainfall data was analyzed using a Micro Rain Radar (MRR) located at The Federal University of Technology Akure, Nigeria, measuring rainfall parameters from ground level to a height of 4.8 km with a vertical resolution of 0.16 km. Rain rates were classified into low (stratiform) and high (convective) based on various microstructural attributes such as rain rates, liquid water content, Drop Size Distribution (DSD), average fall speed of the drops, and radar reflectivity. By integrating diverse datasets and employing advanced statistical techniques, the study aims to enhance the precision of Z-R models, offering a more reliable means of estimating rainfall rates from radar reflectivity data. This refined Z-R relationship holds significant potential for improving our understanding of tropical rain systems and enhancing forecasting accuracy in regions prone to heavy precipitation.

Keywords: remote sensing, precipitation, drop size distribution, micro rain radar

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2555 Active Features Determination: A Unified Framework

Authors: Meenal Badki

Abstract:

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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2554 A Comparative Assessment of Daylighting Metrics Assessing the Daylighting Performance of Three Shading Devices under Four Different Orientations

Authors: Mohamed Boubekri, Jaewook Lee

Abstract:

The assessment of the daylighting performance of a design solution is a complex task due to the changing nature of daylight. A few quantitative metrics are available to designers to assess such a performance, among them are the mean hourly illuminance (MHI), the daylight factor (DF), the daylight autonomy (DA) and the useful daylight illuminance (UDI). Each of these metrics has criteria and limitations that affect the outcome of the evaluation. When to use one metric instead of another depends largely on the design goals to be achieved. Using Design Iterate Validate Adapt (DIVA) daylighting simulation program we set out to examine the performance behavior of these four metrics with the changing dimensions of three shading devices: a horizontal overhang, a horizontal louver system, and a vertical louver system, and compare their performance behavior as the orientation of the window changes. The context is a classroom of a prototypical elementary school in South Korea. Our results indicate that not all four metrics behave similarly as we vary the size of each shading device and as orientations changes. The UDI is the metric that leads to outcome most different than the other three metrics. Our conclusion is that not all daylighting metrics lead to the same conclusions and that it is important to use the metric that corresponds to the specific goals and objectives of the daylighting solution.

Keywords: daylight factor, hourly daylight illuminance, daylight autonomy, useful daylight illuminance

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2553 Prognostic Value in Meningioma Patients’: A Clinical-Histopathological Study

Authors: Ilham Akbar Rahman, Aflah Dhea Bariz Yasta, Iin Fadhilah Utami Tamasse, Devina Juanita

Abstract:

Meningioma is adult brain tumors originating from the meninges covering the brain and spinal cord. The females have approximately twice higher 2:1 than male in the incidence of meningioma. This study aimed to analyze the histopathological grading and clinical aspect in predicting the prognosis of meningioma patients. An observational study with cross sectional design was used on 53 meningioma patients treated at Dr. Wahidin Sudirohusodo hospital in 2016. The data then were analyzed using SPSS 20.0. Of 53 patients, mostly 41 (77,4%) were female and 12 (22,6%) were male. The distribution of histopathology patients showed the meningothelial meningioma of 18 (43,9%) as the most type found. Fibroplastic meningioma were 8 (19,5%), while atypical meningioma and psammomatous meningioma were 6 (14,6%) each. The rest were malignant meningioma and angiomatous meningioma which found in respectively 2 (4,9%) and 1 (2,4%). Our result found significant finding that mostly male were fibroblastic meningioma (50%), however meningothelial meningioma were found in the majority of female (54,8%) and also seizure comprised only in higher grade meningioma. On the outcome of meningioma patient treated operatively, histopathological grade remained insignificant (p > 0,05). This study can be used as prognostic value of meningioma patients based on gender, histopathological grade, and clinical manifestation. Overall, the outcome of the meningioma’s patients is good and promising as long as it is well managed.

Keywords: meningioma, prognostic value, histopathological grading, clinical manifestation

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2552 Effectiveness of Control Measures for Ambient Fine Particulate Matters Concentration Improvement in Taiwan

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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2551 Do Career Expectancy Beliefs Foster Stability as Well as Mobility in One's Career? A Conceptual Model

Authors: Bishakha Majumdar, Ranjeet Nambudiri

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Considerable dichotomy exists in research regarding the role of optimism and self-efficacy in work and career outcomes. Optimism and self-efficacy are related to performance, commitment and engagement, but also are implicated in seeing opportunities outside the firm and switching jobs. There is absence of research capturing these opposing strands of findings in the same model and providing a holistic understanding of how the expectancy beliefs operate in case of the working professional. We attempt to bridge this gap by proposing that career-decision self-efficacy and career outcome expectations affect intention to quit through the competitive mediation pathways of internal and external marketability. This model provides a holistic picture of the role of career expectancy beliefs on career outcomes, by considering perceived career opportunities both inside and outside one’s present organization. The understanding extends the application of career expectancy beliefs in the context of career decision-making by the employed individual. Further, it is valuable for reconsidering the effectiveness of hiring and retention techniques used by a firm, as selection, rewards and training programs need to be supplemented by interventions that specifically strengthen the stability pathway.

Keywords: career decision self-efficacy, career outcome expectations, marketability, intention to quit, job mobility

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2550 Implementation of 4-Bit Direct Charge Transfer Switched Capacitor DAC with Mismatch Shaping Technique

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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2549 Design Systems and the Need for a Usability Method: Assessing the Fitness of Components and Interaction Patterns in Design Systems Using Atmosphere Methodology

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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2548 A Data-Driven Compartmental Model for Dengue Forecasting and Covariate Inference

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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2547 Forecasting Future Society to Explore Promising Security Technologies

Authors: Jeonghwan Jeon, Mintak Han, Youngjun Kim

Abstract:

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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2546 The UN Mediation in the Armed Conflict of Nepal and El Salvador: A Cross-Regional Comparative Perspective Study

Authors: Anu S. Krishna

Abstract:

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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2545 Modelling Volatility of Cryptocurrencies: Evidence from GARCH Family of Models with Skewed Error Innovation Distributions

Authors: Timothy Kayode Samson, Adedoyin Isola Lawal

Abstract:

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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2544 Combining Multiscale Patterns of Weather and Sea States into a Machine Learning Classifier for Mid-Term Prediction of Extreme Rainfall in North-Western Mediterranean Sea

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

Abstract:

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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2543 Field Prognostic Factors on Discharge Prediction of Traumatic Brain Injuries

Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

Abstract:

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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2542 Evaluation of the Impact of Functional Communication Training on Behaviors of Concern for Students at a Non-Maintained Special School

Authors: Kate Duggan

Abstract:

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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2541 Randomized Controlled Trial of Group Cognitive Behavioral Therapy for Depressive Symptoms among Menopausal Chinese Women

Authors: Jing Ding

Abstract:

The present study will propose a Randomized Controlled Trial (RCT) that will assess the efficacy of group Cognitive Behavioral Therapy (CBT) in treating depressive symptoms among menopausal women in China. Considering the high prevalence of menopausal symptoms and depressive disorders among this population, the present study is intended to explore whether group CBT can provide relief for these psychological disturbances commonly linked with hot flashes and night sweats during menopause. Thus, participants will be recruited through gynecologic and psychological outpatient clinics in Beijing, China, and then randomly assigned to either the CBT intervention group or the waitlist control group. The primary outcome measures for major depression will include the PHQ-9, while for menopausal symptoms, the main outcome measure will be the KMI. Secondary measures will include the assessment of sleep quality, quality of life, and general well-being. The current study offers evidence-based intervention for non-pharmacological menopausal symptoms in women and underlines the benefits that group CBT can have, both at a mental health level and for physical symptoms during menopause. This study could set the stage for the wider clinical practice of CBT with this demographic.

Keywords: group CBT, depression, women's mental health, menopause

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2540 Outcome of Bowel Management Program in Patient with Spinal Cord Injury

Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan

Abstract:

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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2539 Exploring the Dualistic Nature of Design: Integrative Perspectives and Methodological Approaches in Design Research

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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2538 Developing Medical Leaders: A Realistic Evaluation Study for Improving Patient Safety and Maximising Medical Engagement

Authors: Lisa Fox, Jill Aylott

Abstract:

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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2537 A Case Series on Isolated Lead aVR ST-Segment Elevation Clinical Significance and Outcome

Authors: Fae Princess Bermudez

Abstract:

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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