Search results for: direct and indirect strategies
4328 Endoscopic Treatment of Patients with Large Bile Duct Stones
Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev
Abstract:
Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP
Procedia PDF Downloads 864327 Maturity Model for Agro-Industrial Logistics
Authors: Erika Tatiana Ruiz, Wilson Adarme Jaimes
Abstract:
This abstract presents the methodology for improving the logistics processes of agricultural production units belonging to the coffee, cocoa, and fruit sectors, starting from the fundamental concepts and detailing each of the phases to carry out the diagnosis, which will be the basis for the formulation of its action plan and implementation of the maturity model. As a result of this work, the maturity model is formulated to improve logistics processes. This model seeks to: generate a progressive model that is useful for all productive units belonging to these sectors at the national level, regardless of their initial conditions, focus on the improvement of logistics processes as a strategy that contributes to improving the competitiveness of the agricultural sector in Colombia and spread the implementation of good logistics practices in postharvest in all departments of the country through autonomous tools. This model has been built through a series of steps that allow the evaluation and improvement of the logistics dimensions or indicators. The potential improvements for each dimension provide the foundation on which to advance to the next level. Within the maturity model, a methodology is indicated for the design and execution of strategies to improve its logistics processes, taking into account the current state of each production unit.Keywords: agroindustrial, characterization, logistics, maturity model, processes
Procedia PDF Downloads 1414326 Assess and Improve Building Energy Efficiency– a Case Study on the Office of Research and Graduate Studies at Qatar University
Authors: Mohamed Youssef
Abstract:
The proliferation of energy consumption in the built environment has made energy efficiency and savings strategies a priority objective for energy policies in most countries. Qatar is a clear example, where it has initiated several programs and institutions to mitigate the overuse of electricity consumption and control the energy load of the building by following global standards and spreading awareness campaigns. A Case study on the Office of Research and Graduate Studies at Qatar University has been investigated in this paper. The paper studied the rating load of existing buildings before and after retrofitting by using Carrier’s Hourly Analysis Program (HAP). The performance of the building has increased especially after using the LED light system instead of fluorescent light with a low payback period. GINAN paint and green roof have shown a considerable contribution to the reduction of electrical load in the building. In comparison, the double HR window had the least effect on the reduction of electricity consumption.Keywords: energy conservation in Qatar, HAP, LED light, GINAN paint, green roof, double HR window
Procedia PDF Downloads 1774325 Linkages between Climate Change, Agricultural Productivity, Food Security and Economic Growth
Authors: Jihène Khalifa
Abstract:
This study analyzed the relationships between Tunisia’s economic growth, food security, agricultural productivity, and climate change using the ARDL model for the period from 1990 to 2022. The ARDL model reveals a positive correlation between economic growth and lagged agricultural productivity. Additionally, the vector autoregressive (VAR) model highlights the beneficial impact of lagged agricultural productivity on economic growth and the negative effect of rainfall on economic growth. Granger causality analysis identifies unidirectional relationships from economic growth to agricultural productivity, crop production, food security, and temperature variations, as well as from temperature variations to crop production. Furthermore, a bidirectional causality is established between crop production and food security. The study underscores the impact of climate change on crop production and suggests the need for adaptive strategies to mitigate these climate effects.Keywords: economic growth, climate change, agriculture, ARDL, Granger causality, VAR
Procedia PDF Downloads 384324 A Study of Relational Factors Associated with Online Celebrity Business and Consumer Purchase Intention
Authors: Sixing Chen, Shuai Yang
Abstract:
Online celebrity business, also known as Internet celebrity business (or Wanghong business in Chinese), is an emerging relational C2C business model, and an alternative to traditional C2C transactional business models. There are already millions of these consumers, and this number is growing. In this model, consumer purchase decisions are driven by recommendations and endorsements in videos posted online by celebrities. The purpose of this paper is to determine the relational constructs within consumer relationships in the Internet celebrity business model and to investigate relationships between the constructs and consumer purchase intention. A questionnaire-based study was conducted with consumers who had an awareness of, or prior purchase experience with online celebrities. The results of exploratory factor analysis (EFA) and multiple regression analysis revealed three valid relational constructs: product experience sharing, lifestyle association, and real-time interaction. This study indicated that these constructs had the direct effect on consumer preference and purchase intention. The findings of this study provide insight into a business model in which online shopping is driven by celebrities. They suggest that online celebrities should pay more attention to product experience sharing, life style association and real-time interaction for managing their product promotions. These are the most salient factors with respect to the relational constructs identified in this study.Keywords: customer relationship, customer to customer, Internet celebrity, online celebrity, online marketing, purchase intention
Procedia PDF Downloads 3204323 A Dynamic Approach for Evaluating the Climate Change Risks on Building Performance
Authors: X. Lu, T. Lu, S. Javadi
Abstract:
A simple dynamic approach is presented for analyzing thermal and moisture dynamics of buildings, which is of particular relevance to understanding climate change impacts on buildings, including assessment of risks and applications of resilience strategies. With the goal to demonstrate the proposed modeling methodology, to verify the model, and to show that wooden materials provide a mechanism that can facilitate the reduction of moisture risks and be more resilient to global warming, a wooden church equipped with high precision measurement systems was taken as a test building for full-scale time-series measurements. Sensitivity analyses indicate a high degree of accuracy in the model prediction regarding the indoor environment. The model is then applied to a future projection of climate indoors aiming to identify significant environmental factors, the changing temperature and humidity, and effective response to the climate change impacts. The paper suggests that wooden building materials offer an effective and resilient response to anticipated future climate changes.Keywords: dynamic model, forecast, climate change impact, wooden structure, buildings
Procedia PDF Downloads 1574322 Empowering Rangatahi: Amplifying Youth Voices on Smartphone and Social Media Use in Aotearoa New Zealand
Authors: Melissa L Gould
Abstract:
The uptick in social media users during the COVID-19 lockdowns has accelerated concerns about cellphone addiction, cyberbullying, and exposure to harmful content, particularly mis- and disinformation and extremist content. The validity of these concerns is synthesized for media technologists to expose the strategies behind social media and search platform technology and explain why they restrict their children from using it. Banning cell phones in schools, increasing age limits on social media accounts, and putting warning labels on social media are some of the solutions proposed to protect young people from smartphones and social media. Largely missing from these conversations are the voices of young people (rangatahi). Instead, their lived experiences are being told and managed by adults. This presentation will outline my research that amplified the voices and lived experiences of young people by positioning them as experts. Using The Social Dilemma as a discussion prompt, the focus groups of rangatahi in Aotearoa, New Zealand, provide a space for young people to articulate their own lived experiences and respond to the dominant narratives on their generation's use of smartphones and social media.Keywords: social media, smart phones, young people, social dilemma
Procedia PDF Downloads 384321 Achievable Average Secrecy Rates over Bank of Parallel Independent Fading Channels with Friendly Jamming
Authors: Munnujahan Ara
Abstract:
In this paper, we investigate the effect of friendly jamming power allocation strategies on the achievable average secrecy rate over a bank of parallel fading wiretap channels. We investigate the achievable average secrecy rate in parallel fading wiretap channels subject to Rayleigh and Rician fading. The achievable average secrecy rate, due to the presence of a line-of-sight component in the jammer channel is also evaluated. Moreover, we study the detrimental effect of correlation across the parallel sub-channels, and evaluate the corresponding decrease in the achievable average secrecy rate for the various fading configurations. We also investigate the tradeoff between the transmission power and the jamming power for a fixed total power budget. Our results, which are applicable to current orthogonal frequency division multiplexing (OFDM) communications systems, shed further light on the achievable average secrecy rates over a bank of parallel fading channels in the presence of friendly jammers.Keywords: fading parallel channels, wire-tap channel, OFDM, secrecy capacity, power allocation
Procedia PDF Downloads 5144320 Water Supply and Utility Management to Address Urban Sanitation Issues
Authors: Akshaya P., Priyanjali Prabhkaran
Abstract:
The paper examines the formulation of strategies to develop a comprehensive model of city level water utility management to addressing urban sanitation issues. The water is prime life sustaining natural resources and nature’s gifts to all living beings on the earth multiple urban sanitation issues are addressed in the supply of water in a city. Many of these urban sanitation issues are linked to population expansion and economic inequity. Increased usage of water and the development caused water scarcity. The lack of water supply results increases the chance of unhygienic situations in the cities. In this study, the urban sanitation issues are identified with respect to water supply and utility management. The study compared based on their best practices and initiatives. From this, best practices and initiatives identify suitable sustainable measures to address water supply issues in the city level. The paper concludes with the listed provision that should be considered suitable measures for water supply and utility management in city level to address the urban sanitation issues.Keywords: water, benchmarking water supply, water supply networks, water supply management
Procedia PDF Downloads 1134319 Predictability of Supply Chain in Indian Automobile Division
Authors: Dharamvir Mangal
Abstract:
Supply chain management has increasingly become an inevitable challenge to most companies to continuously survive and prosper in the global chain-based competitive environment. The current challenges of the Indian automotive world, their implications on supply chain are summarized and analyzed in this paper. In this competitive era of ‘LPG’ i.e. Liberalization, Privatization and Globalization, modern marketing systems, introduction of products with short life cycles, and the discriminating expectations of customers have enforced business enterprises to invest in and focus attention on their Supply Chains (SCs) in order to meet out the level of customer’s satisfaction and to survive in the competitive market. In fact, many of trends in the auto industry are reinforcing the need to redefine supply chain strategies layouts, and operations etc. Many manufacturing operations are designed to maximize throughput and lower costs with modest considerations for the crash on inventory levels and distribution capabilities. To improve profitability and efficiency, automotive players are seeking ways to achieve operational excellence, reduce operating cost and enhance customer service through efficient supply chain management.Keywords: automotive industry, supply chain, challenges, market potential
Procedia PDF Downloads 3344318 Identifying Dynamic Structural Parameters of Soil-Structure System Based on Data Recorded during Strong Earthquakes
Authors: Vahidreza Mahmoudabadi, Omid Bahar, Mohammad Kazem Jafari
Abstract:
In many applied engineering problems, structural analysis is usually conducted by assuming a rigid bed, while imposing the effect of structure bed flexibility can affect significantly on the structure response. This article focuses on investigation and evaluation of the effects arising from considering a soil-structure system in evaluation of dynamic characteristics of a steel structure with respect to elastic and inelastic behaviors. The recorded structure acceleration during Taiwan’s strong Chi-Chi earthquake on different floors of the structure was our evaluation criteria. The respective structure is an eight-story steel bending frame structure designed using a displacement-based direct method assuring weak beam - strong column function. The results indicated that different identification methods i.e. reverse Fourier transform or transfer functions, is capable to determine some of the dynamic parameters of the structure precisely, rather than evaluating all of them at once (mode frequencies, mode shapes, structure damping, structure rigidity, etc.). Response evaluation based on the input and output data elucidated that the structure first mode is not significantly affected, even considering the soil-structure interaction effect, but the upper modes have been changed. Also, it was found that the response transfer function of the different stories, in which plastic hinges have occurred in the structure components, provides similar results.Keywords: bending steel frame structure, dynamic characteristics, displacement-based design, soil-structure system, system identification
Procedia PDF Downloads 5064317 The Nurse Practitioner’s Role Functions in Multi-Specialist Team When Caring for a Metastatic Colon Cancer Patient with Acute Intestinal Obstruction
Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen
Abstract:
Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team
Procedia PDF Downloads 1194316 Survey on Fiber Optic Deployment for Telecommunications Operators in Ghana: Coverage Gap, Recommendations and Research Directions
Authors: Francis Padi, Solomon Nunoo, John Kojo Annan
Abstract:
The paper "Survey on Fiber Optic Deployment for Telecommunications Operators in Ghana: Coverage Gap, Recommendations and Research Directions" presents a comprehensive survey on the deployment of fiber optic networks for telecommunications operators in Ghana. It addresses the challenges encountered by operators using microwave transmission systems for backhauling traffic and emphasizes the advantages of deploying fiber optic networks. The study delves into the coverage gap, provides recommendations, and outlines research directions to enhance the telecommunications infrastructure in Ghana. Additionally, it evaluates next-generation optical access technologies and architectures tailored to operators' needs. The paper also investigates current technological solutions and regulatory, technical, and economical dimensions related to sharing mobile telecommunication networks in emerging countries. Overall, this paper offers valuable insights into fiber optic network deployment for telecommunications operators in Ghana and suggests strategies to meet the increasing demand for data and mobile applications.Keywords: survey on fiber optic deployment, coverage gap, recommendations, research directions
Procedia PDF Downloads 314315 Upcycling of Inorganic Waste: Lessons Learned and Outlook for the Future
Authors: Miroslava Hujová, Patricia Rabello Monich, Jozef Kraxner, Dusan Galusek, Enrico Bernardo
Abstract:
Inorganic waste upcycling offers a solution how to avoid landfilling and how to save raw materials at the same time. However, its practical implementations in Slovakia and elsewhere in Europe, are rather limited despite the potential smaller countries like Slovakia have their advantage in closely-knitted inorganic materials industry. One part of discussion should include an overview of wastes that can be possibly used for upcycling, i.e. fly ashes, red mud, glass cullets, vitrified bottom ashes etc. These wastes can be processed by a variety of strategies, the one of our choice, alkali activation, opens the possibility for the formation of novel materials at almost negligible energetic expense. In the research, these materials are characterized by comprehensive means (X-Ray Fluorescece, Diffraction methods, Thermal Analysis, Scanning Electron Microscopy, Mechanical tests and Chemical stability), which time and time again demonstrate their competitive properties against traditional materials available at the market. It is just a question for discussion why these materials do not receive more significant attention from industry and there is pressing interest for the solution of standing situation.Keywords: upcycling, inorganic wastes, glass ceramics, alkali-activation
Procedia PDF Downloads 1424314 Self-denigration in Doctoral Defense Sessions: Scale Development and Validation
Authors: Alireza Jalilifar, Nadia Mayahi
Abstract:
The dissertation defense as a complicated conflict-prone context entails the adoption of elegant interactional strategies, one of which is self-denigration. This study aimed to develop and validate a self-denigration model that fits the context of doctoral defense sessions in applied linguistics. Two focus group discussions provided the basis for developing this conceptual model, which assumed 10 functions for self-denigration, namely good manners, modesty, affability, altruism, assertiveness, diffidence, coercive self-deprecation, evasion, diplomacy, and flamboyance. These functions were used to design a 40-item questionnaire on the attitudes of applied linguists concerning self-denigration in defense sessions. The confirmatory factor analysis of the questionnaire indicated the predictive ability of the measurement model. The findings of this study suggest that self-denigration in doctoral defense sessions is the social representation of the participants’ values, ideas and practices adopted as a negotiation strategy and a conflict management policy for the purpose of establishing harmony and maintaining resilience. This study has implications for doctoral students and academics and illuminates further research on self-denigration in other contexts.Keywords: academic discourse, politeness, self-denigration, grounded theory, dissertation defense
Procedia PDF Downloads 1414313 Health Equity in Hard-to-Reach Rural Communities in Abia State, Nigeria: An Asset-Based Community Development Intervention to Influence Community Norms and Address the Social Determinants of Health in Hard-to-Reach Rural Communities
Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos
Abstract:
Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment
Procedia PDF Downloads 994312 Start-Up Education at German Universities: A Website Based Research and Concept Development for Start-Ups with Focus on Venture Capital and Internationalization
Authors: Julia Braun, Sinikka Treuger, Magdalena Mißler-Behr
Abstract:
The support of start-ups at German universities is an elementary part of the efforts of the universities. Targeted support for innovative and technology-oriented start-ups is an important prerequisite for successful founding. The present study provides in a first research information on whether German universities have concepts and strategies for promoting the internationalization of start-ups, with a focus on various international markets, and whether they have the ability to successfully raise venture capital. The question is clarified as to how many universities in Germany have programs or concepts for the promotion of start-ups and whether they have already established an internationalization concept for the start-ups. Furthermore, it is shown whether the concepts found focus on the acquisition of venture capital. For this research, a website-based search of the concepts at German universities is carried out and evaluated. In a second study, an online survey at a selected German university is used to evaluate whether there is a general interest in such a concept. After that, a possible concept is derived. The aim of the research is to show the current status of German universities and to give an elaborated example of an education concept for a university which can be adapted by other universities.Keywords: education concept, german universities, internatinalization, start-ups, venture capital
Procedia PDF Downloads 1284311 Creativity in Educational Realities: Theoretical Considerations
Authors: Cristina Costa-Lobo, Ana Campina, José Menezes
Abstract:
Creativity implies originality, but originality does not imply the existence of creativity. Today, one of the challenges of the educational context is the development of educated, autonomous, prudent and competent citizens with a critical attitude, a well-founded questioning and a creative search for innovative alternatives and solutions. These supposedly cognitive capacities impose emotional analysis and decision making, and emotion is also considered as a creative act. Authors emphasize the importance of family and school in the creative manifestation of children and young people, and these agents can stimulate or impede creative expression. Thus, children entering the school system are faced with a barrier that blocks the externalization of this competence. This work deals with the implementation of specific strategies and promoters of an educational environment suitable for the development of creativity. The construct of creativity is discussed in a transdisciplinary perspective, and the importance of the construct is enhanced in psychoeducational practices, in challenging and multifaceted environments. It is assumed that the stimulation and early experience of creative thinking in an educational context are conditions that promote the development of problem-solving skills and future challenges.Keywords: creativity, education, psychology, pedagogy
Procedia PDF Downloads 2494310 Pattern Discovery from Student Feedback: Identifying Factors to Improve Student Emotions in Learning
Authors: Angelina A. Tzacheva, Jaishree Ranganathan
Abstract:
Interest in (STEM) Science Technology Engineering Mathematics education especially Computer Science education has seen a drastic increase across the country. This fuels effort towards recruiting and admitting a diverse population of students. Thus the changing conditions in terms of the student population, diversity and the expected teaching and learning outcomes give the platform for use of Innovative Teaching models and technologies. It is necessary that these methods adapted should also concentrate on raising quality of such innovations and have positive impact on student learning. Light-Weight Team is an Active Learning Pedagogy, which is considered to be low-stake activity and has very little or no direct impact on student grades. Emotion plays a major role in student’s motivation to learning. In this work we use the student feedback data with emotion classification using surveys at a public research institution in the United States. We use Actionable Pattern Discovery method for this purpose. Actionable patterns are patterns that provide suggestions in the form of rules to help the user achieve better outcomes. The proposed method provides meaningful insight in terms of changes that can be incorporated in the Light-Weight team activities, resources utilized in the course. The results suggest how to enhance student emotions to a more positive state, in particular focuses on the emotions ‘Trust’ and ‘Joy’.Keywords: actionable pattern discovery, education, emotion, data mining
Procedia PDF Downloads 1004309 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care
Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky
Abstract:
Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive
Procedia PDF Downloads 1434308 Feedback Matrix Approach for Relativistic Runaway Electron Avalanches Dynamics in Complex Electric Field Structures
Authors: Egor Stadnichuk
Abstract:
Relativistic runaway electron avalanches (RREA) are a widely accepted source of thunderstorm gamma-radiation. In regions with huge electric field strength, RREA can multiply via relativistic feedback. The relativistic feedback is caused both by positron production and by runaway electron bremsstrahlung gamma-rays reversal. In complex multilayer thunderstorm electric field structures, an additional reactor feedback mechanism appears due to gamma-ray exchange between separate strong electric field regions with different electric field directions. The study of this reactor mechanism in conjunction with the relativistic feedback with Monte Carlo simulations or by direct solution of the kinetic Boltzmann equation requires a significant amount of computational time. In this work, a theoretical approach to study feedback mechanisms in RREA physics is developed. It is based on the matrix of feedback operators construction. With the feedback matrix, the problem of the dynamics of avalanches in complex electric structures is reduced to the problem of finding eigenvectors and eigenvalues. A method of matrix elements calculation is proposed. The proposed concept was used to study the dynamics of RREAs in multilayer thunderclouds.Keywords: terrestrial Gamma-ray flashes, thunderstorm ground enhancement, relativistic runaway electron avalanches, gamma-rays, high-energy atmospheric physics, TGF, TGE, thunderstorm, relativistic feedback, reactor feedback, reactor model
Procedia PDF Downloads 1774307 A Versatile Algorithm to Propose Optimized Solutions to the Dengue Disease Problem
Authors: Fernando L. P. Santos, Luiz G. Lyra, Helenice O. Florentino, Daniela R. Cantane
Abstract:
Dengue is a febrile infectious disease caused by a virus of the family Flaviridae. It is transmitted by the bite of mosquitoes, usually of the genus Aedes aegypti. It occurs in tropical and subtropical areas of the world. This disease has been a major public health problem worldwide, especially in tropical countries such as Brazil, and its incidence has increased in recent years. Dengue is a subject of intense research. Efficient forms of mosquito control must be considered. In this work, the mono-objective optimal control problem was solved for analysing the dengue disease problem. Chemical and biological controls were considered in the mathematical aspect. This model describes the dynamics of mosquitoes in water and winged phases. We applied the genetic algorithms (GA) to obtain optimal strategies for the control of dengue. Numerical simulations have been performed to verify the versatility and the applicability of this algorithm. On the basis of the present results we may recommend the GA to solve optimal control problem with a large region of feasibility.Keywords: genetic algorithm, dengue, Aedes aegypti, biological control, chemical control
Procedia PDF Downloads 3534306 Sustainability and Promotion of Inland Waterway Transportation Projects in Colombia: Case of the Magdalena River
Authors: David Julian Bernal Melgarejo
Abstract:
Inland Waterway Transportation (IWT) is playing an important role in national transport systems, water transportation is considered to be safe, energy efficient and environmentally friendly mode of transport, considering all the benefits of IWT the Colombian government is planning to restore the Magdalena’s River navigability, embrace waterway transportation in Colombia could strength competitiveness while reduce most of the transport externalities. However, the current situation of the Magdalena deplorable, the most important river of Colombia has been abandoned for decades and the solution is beyond of a single administrative entity. This paper analyzes the outcomes of the Navigation And Inland Waterway Action and Development in Europe (NAIADES) program as a prospective to develop a sustainable program in Colombia. In order to guarantee the long-term future, and the adaptability of the program a research based on individual interviews with stakeholders and policy experts were carried out, findings support the idea of lack of integration within governmental institution, develop marketing strategies and human resources.Keywords: inland waterway transportation, logistics, sustainability, multimodal transport systems, water transportation
Procedia PDF Downloads 4804305 Summer STEM Camp for Elementary Students: A Conduit to Pre-Service Teacher Training to Learn How to Include a Makerspace for an Inclusive Classroom
Authors: Jennifer Gallup, Beverly Ray, Esther Ntuli
Abstract:
Many students such as students from linguistically or culturally diverse backgrounds and those with a disability remain chronically underrepresented in higher level science and mathematics disciplines as well as many hands-on-lab-based activities due to the need for remedial reading and mathematics instruction. Makerspace labs can be a conduit for supporting inclusive learning for these students through hands-on active learning strategies that support equitable access to STEM disciplines. Makerspace is a physical space where individuals gather to create, invent, innovate, and learn while using hands-on materials such as 2D and 3D printers, software programs, electronics, and other tools and supplies. Makerspaces are emerging across many P-12 settings; however, many teachers enter the field not prepared to harness the power inherent in a makerspace, especially for those with disabilities and differing needs. This paper offers suggestions on teaching pre-service teachers and practicing teachers how to incorporate a makerspace into their professional practice through guided instruction and hands-on practice. Recommendations for interested stakeholders are included as well.Keywords: STEM learning, technology, autism, students with disabilities, makerspace
Procedia PDF Downloads 984304 Characteristics of Female Offenders: Using Childhood Victimization Model for Treatment
Authors: Jane E. Hill
Abstract:
Sexual, physical, or emotional abuses are behaviors used by one person in a relationship or within a family unit to control the other person. Physical abuse can consist of, but not limited to hitting, pushing, and shoving. Sexual abuse is unwanted or forced sexual activity on a person without their consent. Abusive behaviors include intimidation, manipulation, humiliation, isolation, frightening, terrorizing, coercing, threatening, blaming, hurting, injuring, or wounding another individual. Although emotional, psychological and financial abuses are not criminal behaviors, they are forms of abuse and can leave emotional scars on their victim. The purpose of this literature review research was to examine characteristics of female offenders, past abuse, and pathways to offending. The question that guided this research: does past abuse influence recidivism? The theoretical foundation used was relational theory by Jean Baker Miller. One common feature of female offenders is abuse (sexual, physical, or verbal). Abuse can cause mental illnesses and substance abuse. The abuse does not directly affect the women's recidivism. However, results indicated the psychological and maladaptive behaviors as a result of the abuse did contribute to indirect pathways to continue offending. The female offenders’ symptoms of ongoing depression, anxiety, and engaging in substance abuse (self medicating) did lead to the women's incarceration. Using the childhood victimization model as the treatment approach for women's mental illness and substance abuse disorders that were a result from history of child abuse have shown success. With that in mind, if issues surrounding early victimization are not addressed, then the women offenders may not recover from their mental illness or addiction and are at a higher risk of reoffending. However, if the women are not emotionally ready to engage in the treatment process, then it should not be forced onto them because it may cause harm (targeting prior traumatic experiences). Social capital is family support and sources that assist in helping the individual with education, employment opportunities that can lead to success. Human capital refers to internal knowledge, skills, and capacities that help the individual act in new and appropriate ways. The lack of human and social capital is common among female offenders, which leads to extreme poverty and economic marginalization, more often in frequent numbers than men. In addition, the changes in welfare reform have exacerbated women’s difficulties in gaining adequate-paying jobs to support themselves and their children that have contributed to female offenders reoffending. With that in mind, one way to lower the risk factor of female offenders from reoffending is to provide them with educational and vocational training, enhance their self-efficacy, and teach them appropriate coping skills and life skills. Furthermore, it is important to strengthen family bonds and support. Having a supportive family relationship was a statistically significant protective factor for women offenders.Keywords: characteristics, childhood victimization model, female offenders, treatment
Procedia PDF Downloads 1154303 Discriminant Shooting-Related Statistics between Winners and Losers 2023 FIBA U19 Basketball World Cup
Authors: Navid Ebrahmi Madiseh, Sina Esfandiarpour-Broujeni, Rahil Razeghi
Abstract:
Introduction: Quantitative analysis of game-related statistical parameters is widely used to evaluate basketball performance at both individual and team levels. Non-free throw shooting plays a crucial role as the primary scoring method, holding significant importance in the game's technical aspect. It has been explored the predictive value of game-related statistics in relation to various contextual and situational variables. Many similarities and differences also have been found between different age groups and levels of competition. For instance, in the World Basketball Championships after the 2010 rule change, 2-point field goals distinguished winners from losers in women's games but not in men's games, and the impact of successful 3-point field goals on women's games was minimal. The study aimed to identify and compare discriminant shooting-related statistics between winning and losing teams in men’s and women’s FIBA-U19-Basketball-World-Cup-2023 tournaments. Method: Data from 112 observations (2 per game) of 16 teams (for each gender) in the FIBA-U19-Basketball-World-Cup-2023 were selected as samples. The data were obtained from the official FIBA website using Python. Specific information was extracted, organized into a DataFrame, and consisted of twelve variables, including shooting percentages, attempts, and scoring ratio for 3-pointers, mid-range shots, paint shots, and free throws. Made% = scoring type successful attempts/scoring type total attempts¬ (1)Free-throw-pts% (free throw score ratio) = (free throw score/total score) ×100 (2)Mid-pts% (mid-range score ratio) = (mid-range score/total score) ×100 (3) Paint-pts% (paint score ratio) = (Paint score/total score) ×100 (4) 3p_pts% (three-point score ratio) = (three-point score/total score) ×100 (5) Independent t-tests were used to examine significant differences in shooting-related statistical parameters between winning and losing teams for both genders. Statistical significance was p < 0.05. All statistical analyses were completed with SPSS, Version 18. Results: The results showed that 3p-made%, mid-pts%, paint-made%, paint-pts%, mid-attempts, and paint-attempts were significantly different between winners and losers in men (t=-3.465, P<0.05; t=3.681, P<0.05; t=-5.884, P<0.05; t=-3.007, P<0.05; t=2.549, p<0.05; t=-3.921, P<0.05). For women, significant differences between winners and losers were found for 3p-made%, 3p-pts%, paint-made%, and paint-attempt (t=-6.429, P<0.05; t=-1.993, P<0.05; t=-1.993, P<0.05; t=-4.115, P<0.05; t=02.451, P<0.05). Discussion: The research aimed to compare shooting-related statistics between winners and losers in men's and women's teams at the FIBA-U19-Basketball-World-Cup-2023. Results indicated that men's winners excelled in 3p-made%, paint-made%, paint-pts%, paint-attempts, and mid-attempt, consistent with previous studies. This study found that losers in men’s teams had higher mid-pts% than winners, which was inconsistent with previous findings. It has been indicated that winners tend to prioritize statistically efficient shots while forcing the opponent to take mid-range shots. In women's games, significant differences in 3p-made%, 3p-pts%, paint-made%, and paint-attempts were observed, indicating that winners relied on riskier outside scoring strategies. Overall, winners exhibited higher accuracy in paint and 3P shooting than losers, but they also relied more on outside offensive strategies. Additionally, winners acquired a higher ratio of their points from 3P shots, which demonstrates their confidence in their skills and willingness to take risks at this competitive level.Keywords: gender, losers, shoot-statistic, U19, winners
Procedia PDF Downloads 1024302 Optimizing Telehealth Internet of Things Integration: A Sustainable Approach through Fog and Cloud Computing Platforms for Energy Efficiency
Authors: Yunyong Guo, Sudhakar Ganti, Bryan Guo
Abstract:
The swift proliferation of telehealth Internet of Things (IoT) devices has sparked concerns regarding energy consumption and the need for streamlined data processing. This paper presents an energy-efficient model that integrates telehealth IoT devices into a platform based on fog and cloud computing. This integrated system provides a sustainable and robust solution to address the challenges. Our model strategically utilizes fog computing as a localized data processing layer and leverages cloud computing for resource-intensive tasks, resulting in a significant reduction in overall energy consumption. The incorporation of adaptive energy-saving strategies further enhances the efficiency of our approach. Simulation analysis validates the effectiveness of our model in improving energy efficiency for telehealth IoT systems, particularly when integrated with localized fog nodes and both private and public cloud infrastructures. Subsequent research endeavors will concentrate on refining the energy-saving model, exploring additional functional enhancements, and assessing its broader applicability across various healthcare and industry sectors.Keywords: energy-efficient, fog computing, IoT, telehealth
Procedia PDF Downloads 824301 The Characteristics of Transformation of Institutional Changes and Georgia
Authors: Nazira Kakulia
Abstract:
The analysis of transformation of institutional changes outlines two important characteristics. These are: the speed of the changes and their sequence. Successful transformation must be carried out in three different stages; On the first stage, macroeconomic stabilization must be achieved with the help of fiscal and monetary tools. Two-tier banking system should be established and the active functions of central bank should be replaced by the passive ones (reserve requirements and refinancing rate), together with the involvement growth of private sector. Fiscal policy by itself here means the creation of tax system which must replace previously existing direct state revenues; the share of subsidies in the state expenses must be reduced also. The second stage begins after reaching the macroeconomic stabilization at a time of change of formal institutes which must stimulate the private business. Corporate legislation creates a competitive environment at the market and the privatization of state companies takes place. Bankruptcy and contract law is created. he third stage is the most extended one, which means the formation of all state structures that is necessary for the further proper functioning of a market economy. These three stages about the cycle period of political and social transformation and the hierarchy of changes can also be grouped by the different methodology: on the first and the most short-term stage the transfer of power takes place. On the second stage institutions corresponding to new goal are created. The last phase of transformation is extended in time and it includes the infrastructural, socio-cultural and socio-structural changes. The main goal of this research is to explore and identify the features of such kind of models.Keywords: competitive environment, fiscal policy, macroeconomic stabilization, tax system
Procedia PDF Downloads 2674300 Laser Shock Peening of Additively Manufactured Nickel-Based Superalloys
Authors: Michael Munther, Keivan Davami
Abstract:
One significant roadblock for additively manufactured (AM) parts is the buildup of residual tensile stresses during the fabrication process. These residual stresses are formed due to the intense localized thermal gradients and high cooling rates that cause non-uniform material expansion/contraction and mismatched strain profiles during powder-bed fusion techniques, such as direct metal laser sintering (DMLS). The residual stresses adversely affect the fatigue life of the AM parts. Moreover, if the residual stresses become higher than the material’s yield strength, they will lead to acute geometric distortion. These are limiting the applications and acceptance of AM components for safety-critical applications. Herein, we discuss laser shock peening method as an advanced technique for the manipulation of the residual stresses in AM parts. An X-ray diffraction technique is used for the measurements of the residual stresses before and after the laser shock peening process. Also, the hardness of the structures is measured using a nanoindentation technique. Maps of nanohardness and modulus are obtained from the nanoindentation, and a correlation is made between the residual stresses and the mechanical properties. The results indicate that laser shock peening is able to induce compressive residual stresses in the structure that mitigate the tensile residual stresses and increase the hardness of AM IN718, a superalloy, almost 20%. No significant changes were observed in the modulus after laser shock peening. The results strongly suggest that laser shock peening can be used as an advanced post-processing technique to optimize the service lives of critical components for various applications.Keywords: additive manufacturing, Inconel 718, laser shock peening, residual stresses
Procedia PDF Downloads 1314299 Hierarchical Queue-Based Task Scheduling with CloudSim
Authors: Wanqing You, Kai Qian, Ying Qian
Abstract:
The concepts of Cloud Computing provide users with infrastructure, platform and software as service, which make those services more accessible for people via Internet. To better analysis the performance of Cloud Computing provisioning policies as well as resources allocation strategies, a toolkit named CloudSim proposed. With CloudSim, the Cloud Computing environment can be easily constructed by modelling and simulating cloud computing components, such as datacenter, host, and virtual machine. A good scheduling strategy is the key to achieve the load balancing among different machines as well as to improve the utilization of basic resources. Recently, the existing scheduling algorithms may work well in some presumptive cases in a single machine; however they are unable to make the best decision for the unforeseen future. In real world scenario, there would be numbers of tasks as well as several virtual machines working in parallel. Based on the concepts of multi-queue, this paper presents a new scheduling algorithm to schedule tasks with CloudSim by taking into account several parameters, the machines’ capacity, the priority of tasks and the history log.Keywords: hierarchical queue, load balancing, CloudSim, information technology
Procedia PDF Downloads 427