Search results for: hospital service

Authors: Yang Ye, Hongfei Qiu, Yaqi Li

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The planning and construction of traditional cities are oriented by cars, which leads to the problems of insufficient urban public space, fragmentation, and low utilization efficiency. With the development of driverless technology, the urban structure will change from the traditional single-core grid structure to the multi-core model. In terms of traffic organization, with the release of land for traffic facilities, public space will become more continuous and integrated with traffic space. In the context of driverless technology, urban public reconstruction is characterized by modularization and high efficiency, and its planning and layout features accord with points (service facilities), lines (smart lines), surfaces (activity centers). The public space of driverless urban roads will provide diversified urban public facilities and services. The intensive urban layout makes the commercial public space realize the functions of central activities and style display, respectively, in the interior (building atrium) and the exterior (building periphery). In addition to recreation function, urban green space can also utilize underground parking space to realize efficient dispatching of shared cars. The roads inside the residential community will be integrated into the urban landscape, providing conditions for the community public activity space with changing time sequence and improving the efficiency of space utilization. The intervention of driverless technology will change the thinking of traditional urban construction and turn it into a human-oriented one. As a result, urban public space will be richer, more connected, more efficient, and the urban space justice will be optimized. By summarizing the frontier research, this paper discusses the impact of unmanned driving on cities, especially urban public space, which is beneficial for landscape architects to cope with the future development and changes of the industry and provides a reference for the related research and practice.

Keywords: driverless, urban public space, construction strategy, urban design

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Authors: Guillaume Richard, Sarra Zaied

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Marine waste quantities increase more and more, 5 million tons of plastic waste enter the ocean every year. Their spatiotemporal distribution is never homogeneous and depends mainly on the hydrodynamic characteristics of the environment, as well as the size and location of the waste. As part of optimizing collect of marine plastic wastes, it is important to measure and monitor their evolution over time. In this context, diverse studies have been dedicated to describing waste behavior in order to identify its accumulation in ocean areas. None of the existing tools which track objects at sea had the objective of tracking down a slick of waste. Moreover, the applications related to marine waste are in the minority compared to rescue applications or oil slicks tracking applications. These approaches are able to accurately simulate an object's behavior over time but not during the collection mission of a waste sheet. This paper presents numerical modeling of a boat’s wake impact on the floating marine waste behavior during a collection mission. The aim is to predict the trajectory of a marine waste slick to optimize its collection using meteorological data of ocean currents, wind, and possibly waves. We have made the choice to use Ocean Parcels which is a Python library suitable for trajectoring particles in the ocean. The modeling results showed the important role of advection and diffusion processes in the spatiotemporal distribution of floating plastic litter. The performance of the proposed method was evaluated on real data collected from the Copernicus Marine Environment Monitoring Service (CMEMS). The results of the evaluation in Cape of Good Hope (South Africa) prove that the proposed approach can effectively predict the position and velocity of marine litter during collection, which allowed for optimizing time and more than $90\%$ of the amount of collected waste.

Keywords: marine litter, advection-diffusion equation, sea current, numerical model

Procedia PDF Downloads 86

Authors: Shane-Anthony Smith

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Teachers across grade levels and content areas face a myriad of challenges in the classroom. From inconsistent attendance to disruptive behaviors, these challenges can have a dire impact on the educational space, untimely leading to a loss of instructional time and student disenfranchisement from learning. While these challenges are not new to the educational landscape, the post-COVID classroom has, in many instances, been more severely impacted by behaviors that are not conducive to learning. Despite the mounting challenges, the role of the teacher remains unchanged - that is, to create and maintain a safe environment that is conducive to learning and promotes successful learning outcomes. Accomplishing this feat is no easy task. Yet, there are steps teachers can - indeed, must - take to better set themselves and their students up for success. The key to achieving this success is effective classroom transitions. This paper presents a four-step approach for teachers to engage in successful classroom transitions to promote meaningful student engagement and active positive learning outcomes. The transition strategy I will explore is called PREP (Pause, Reset, Establish Expectations, and Proceed). I developed this strategy in my work as a Residency Director for my university’s teacher residency program. In this role, I am tasked with coaching emerging teachers and their in-service teaching mentors in the field, as well as providing mentorship to special education resident teachers pursuing teaching degrees in the program. As a teacher educator, being in Middle and High school classrooms provides an intricate and critical understanding of the challenges, opportunities, and possibilities in the classroom. For this paper, I will explore how teachers can optimize the opportunities PREP provides to keep students engaged and, thus, improve student achievement. I will describe the approach, explain its use, and provide case-study examples of its classroom application.

Keywords: classroom management, teaching strategies, student engagement, classroom transition

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Authors: Claudia Schier, Arvid Biallas, Bernd Friedrich

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The demand for Li-ion-batteries owing to their benefits, such as; fast charging time, high energy density, low weight, large temperature range, and a long service life performance is increasing compared to other battery systems. These characteristics are substantial not only for battery-operated portable devices but also in the growing field of electromobility where high-performance energy storage systems in the form of batteries are highly requested. Due to the sharp rising production, there is a tremendous interest to recycle spent Li-Ion batteries in a closed-loop manner owed to the high content of valuable metals such as cobalt, manganese, and lithium as well as regarding the increasing demand for those scarce applied metals. Currently, there are just a few industrial processes using hydrometallurgical methods to recover valuable metals from Li-ion-battery waste. In this study, the extraction of valuable metals from spent Li-ion-batteries is investigated by pretreated and subsequently leached battery wastes using different precipitation methods in a comparative manner. For the extraction of lithium, cobalt, and other valuable metals, pelletized battery wastes with an initial Li content of 2.24 wt. % and cobalt of 22 wt. % is used. Hydrochloric acid with 4 mol/L is applied with 1:50 solid to liquid (s/l) ratio to generate pregnant leach solution for subsequent precipitation steps. In order to obtain pure precipitates, two different pathways (pathway 1 and pathway 2) are investigated, which differ from each other with regard to the precipitation steps carried out. While lithium carbonate recovery is the final process step in pathway 1, pathway 2 requires a preliminary removal of lithium from the process. The aim is to evaluate both processes in terms of purity and yield of the products obtained. ICP-OES is used to determine the chemical content of leach liquor as well as of the solid residue.

Keywords: hydrochloric acid, hydrometallurgy, Li-ion-batteries, metal recovery

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Authors: Thiago Spilborghs Bueno Meyer, Plinio Thomaz Aquino Junior

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Through speech, which privileges the functional and interactive nature of the text, it is possible to ascertain the spatiotemporal circumstances, the conditions of production and reception of the discourse, the explicit purposes such as informing, explaining, convincing, etc. These conditions allow bringing the interaction between humans closer to the human-robot interaction, making it natural and sensitive to information. However, it is not enough to understand what is said; it is necessary to recognize emotions for the desired interaction. The validity of the use of neural networks for feature selection and emotion recognition was verified. For this purpose, it is proposed the use of neural networks and comparison of models, such as recurrent neural networks and deep neural networks, in order to carry out the classification of emotions through speech signals to verify the quality of recognition. It is expected to enable the implementation of robots in a domestic environment, such as the HERA robot from the RoboFEI@Home team, which focuses on autonomous service robots for the domestic environment. Tests were performed using only the Mel-Frequency Cepstral Coefficients, as well as tests with several characteristics of Delta-MFCC, spectral contrast, and the Mel spectrogram. To carry out the training, validation and testing of the neural networks, the eNTERFACE’05 database was used, which has 42 speakers from 14 different nationalities speaking the English language. The data from the chosen database are videos that, for use in neural networks, were converted into audios. It was found as a result, a classification of 51,969% of correct answers when using the deep neural network, when the use of the recurrent neural network was verified, with the classification with accuracy equal to 44.09%. The results are more accurate when only the Mel-Frequency Cepstral Coefficients are used for the classification, using the classifier with the deep neural network, and in only one case, it is possible to observe a greater accuracy by the recurrent neural network, which occurs in the use of various features and setting 73 for batch size and 100 training epochs.

Keywords: emotion recognition, speech, deep learning, human-robot interaction, neural networks

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Authors: Kristel Faye Tandog

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The State Owned Enterprise (SOE) or also called Public Enterprise (PE) has been playing a vital role in a country’s social and economic development. Following this idea, this study focused on the Factor Structures of Financial Performance of the Local Economic Enterprises (LEEs) namely: Food Court, Market, Slaughterhouse, and Terminal in Matalam, Cotabato. It aimed to determine the profile of the LEEs in terms of organizational structure, manner of creation, years in operation, source of initial operating requirements, annual operating budget, geographical location, and size or description of the facility. This study also included the different financial ratios of LEE that covered a five year period from Calendar Year 2009 to 2013. Primary data using survey questionnaire was administered to 468 respondents and secondary data were sourced out from the government archives and financial documents of the said LGU. There were 12 dominant factors identified namely: “management”, “enforcement of laws”, “strategic location”, “existence of non-formal competitors”, “proper maintenance”, “pricing”, “customer service”, “collection process”, “rentals and services”, “efficient use of resources”, “staffing”, and “timeliness and accuracy”. On the other hand, the financial performance of the LEE of Matalam, Cotabato using financial ratios needs reformatting. This denotes that refinement as to the following ratios: Cash Flow Indicator, Activity, Profitability and Growth is necessary. The cash flow indicator ratio showed difficulty in covering its debts in successive years. Likewise, the activity ratios showed that the LEE had not been effective in putting its investment at work. Moreover, profitability ratios revealed that it had operated in minimum capacity and had incurred net losses and thus, it had a weak profit performance. Furthermore, growth ratios showed that LEE had a declining growth trend particularly in net income.

Keywords: factor structures, financial performance, financial ratios, state owned enterprises

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Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

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Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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Authors: Carolina Payares-Asprino

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Dual-phase duplex stainless steel comprised of ferrite and austenite has shown high strength and corrosion resistance in many aggressive environments. Joining duplex alloys is challenging due to several embrittling precipitates and metallurgical changes during the welding process. The welding parameters strongly influence the quality of a weld joint. Therefore, it is necessary to quantify the weld bead’s integral properties as a function of welding parameters, especially when part of the weld bead is removed through a machining process due to aesthetic reasons or to couple the elements in the in-service structure. The present study uses the existing stress-strain model to predict the stress-strain curves for duplex stainless-steel welds under different welding conditions. Having mathematical expressions that predict the shape of the stress-strain curve is advantageous since it reduces the experimental work in obtaining the tensile test. In analysis and design, such stress-strain modeling simplifies the time of operations by being integrated into calculation tools, such as the finite element program codes. The elastic zone and the plastic zone of the curve can be defined by specific parameters, generating expressions that simulate the curve with great precision. There are empirical equations that describe the stress-strain curves. However, they only refer to the stress-strain curve for the stainless steel, but not when the material is under the welding process. It is a significant contribution to the applications of duplex stainless steel welds. For this study, a 3x3 matrix with a low, medium, and high level for each of the welding parameters were applied, giving a total of 27 weld bead plates. Two tensile specimens were manufactured from each welded plate, resulting in 54 tensile specimens for testing. When evaluating the four models used to predict the stress-strain curve in the welded specimens, only one model (Rasmussen) presented a good correlation in predicting the strain stress curve.

Keywords: duplex stainless steels, modeling, stress-stress curve, tensile test, welding

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Authors: Riccardo Patriarca, Giulio Di Gravio, Francesco Costantino, Massimo Tronci

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An accurate inventory management policy acquires a crucial role in the several high-availability sectors. In these sectors, due to the high-cost of spares and backorders, an (S-1, S) replenishment policy is necessary for high-availability items. The policy enables the shipment of a substitute efficient item anytime the inventory size decreases by one. This policy can be modelled following the Multi-Echelon Technique for Recoverable Item Control (METRIC). The METRIC is a system-based technique that allows defining the optimum stock level in a multi-echelon network, adopting measures in line with the decision-maker’s perspective. The METRIC defines an availability-cost function with inventory costs and required service levels, using as inputs data about the demand trend, the supplying and maintenance characteristics of the network and the budget/availability constraints. The traditional METRIC relies on the hypothesis that a Poisson distribution well represents the demand distribution in case of items with a low failure rate. However, in this research, we will explore the effects of using a Poisson distribution to model the demand of low failure rate items characterized by an irregular demand trend. This characteristic of a demand is not included in the traditional METRIC formulation leading to the need of revising its traditional formulation. Using the CV (Coefficient of Variation) and ADI (Average inter-Demand Interval) classification, we will define the inherent flaws of Poisson-based METRIC for irregular demand items, defining an innovative ad hoc distribution which can better fit the irregular demands. This distribution will allow defining proper stock levels to reduce stocking and backorder costs due to the high irregularities in the demand trend. A case study in the aviation domain will clarify the benefits of this innovative METRIC approach.

Keywords: METRIC, inventory management, irregular demand, spare parts

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Authors: Rowland Brucken

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This paper argues that nation-building theories that prioritize democratic governance best explain the successful post-independence development of Botswana. Three main competing schools of thought exist regarding the sequencing of policies that should occur to re-build weakened or failed states. The first posits that economic development should receive foremost attention, while democratization and a binding sense of nationalism can wait. A second group of experts identified constructing a sense of nationalism among a populace is necessary first, so that the state receives popular legitimacy and obedience that are prerequisites for development. Botswana, though, transitioned into a multi-party democracy and prosperous open economy due to the utilization of traditional democratic structures, enlightened and accountable leadership, and an educated technocratic civil service. With these political foundations already in place when the discovery of diamonds occurred, the resulting revenues were spent wisely on projects that grew the economy, improved basic living standards, and attracted foreign investment. Thus democratization preceded, and therefore provided an accountable basis for, economic development that might otherwise have been squandered by greedy and isolated elites to the detriment of the greater population. Botswana was one of the poorest nations in the world at the time of its independence in 1966, with little infrastructure, a dependence on apartheid South Africa for trade, and a largely subsistence economy. Over the next thirty years, though, its economy grew the fastest of any nation in the world. The transparent and judicious use of diamond returns is only a partial explanation, as the government also pursued economic diversification, mass education, and rural development in response to public needs. As nation-building has become a project undertaken by nations and multilateral agencies such as the United Nations and the North Atlantic Treaty Organization, Botswana may provide best practices that others should follow in attempting to reconstruct economically and politically unstable states.

Keywords: Botswana, democratization, economic development, nation-building

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Authors: Naveen Kumar Perumalla, Devadas Kuna, Mohammed Akhter Ali

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Satellite Navigation System such as the United States Global Positioning System (GPS) plays a significant role in determining the user position. Similar to that of GPS, Indian Regional Navigation Satellite System (IRNSS) is a Satellite Navigation System indigenously developed by Indian Space Research Organization (ISRO), India, to meet the country’s navigation applications. This system is also known as Navigation with Indian Constellation (NavIC). The NavIC system’s main objective, is to offer Positioning, Navigation and Timing (PNT) services to users in its two service areas i.e., covering the Indian landmass and the Indian Ocean. Six NavIC satellites are already deployed in the space and their receivers are in the performance evaluation stage. Four NavIC dual frequency receivers are installed in the ‘Advanced GNSS Research Laboratory’ (AGRL) in the Department of Electronics and Communication Engineering, University College of Engineering, Osmania University, India. The NavIC receivers can be operated in two positioning modes: Stand-alone IRNSS and Hybrid (IRNSS+GPS) modes. In this paper, analysis of various parameters such as Dilution of Precision (DoP), three Dimension (3D) Root Mean Square (RMS) Position Error and Horizontal Position Error with respect to Visibility of Satellites is being carried out using the real-time IRNSS data, obtained by operating the receiver in both positioning modes. Two typical days (6th July 2017 and 7th July 2017) are considered for Hyderabad (Latitude-17°24'28.07’N, Longitude-78°31'4.26’E) station are analyzed. It is found that with respect to the considered parameters, the Hybrid mode operation of NavIC receiver is giving better results than that of the standalone positioning mode. This work finds application in development of NavIC receivers for civilian navigation applications.

Keywords: DoP, GPS, IRNSS, GNSS, position error, satellite visibility

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Authors: Sellidj Abdelaziz, Lebaili Soltane

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A cobalt-based alloy type Co-Cr-Ni-WC was deposited by plasma transferred arc projection (PTA) on a stainless steel valve. The alloy is characterized at the equilibrium by a solid solution Co (γ) mainly dendritic, and eutectic carbides M₇C₃ and ηM₆C. At the deposit/substrate interface, this microstructure is modified by the fast cooling mode of the alloy when applied in the liquid state on the relatively cold steel substrate. The structure formed in this case is heterogeneous and metastable phases can occur and evolve over temperature service. Coating properties and reliability are directly related to microstructures formed during deposition. We were interested more particularly in this microstructure formed during the solidification of the deposit in the region of the interface joining the soldered couple and its evolution during cyclic heat treatments at temperatures similar to those of the thermal environment of the valve. The characterization was carried out by SEM-EDS microprobe CAMECA, XRD, and micro hardness profiles. The deposit obtained has a linear and regular appearance that is free of cracks and with little porosity. The morphology of the microstructure represents solidification stages that are relatively fast with a temperature gradient high at the beginning of the interface by forming a plane front solid solution Co (γ). It gradually changes with the decreasing temperature gradient by getting farther from the junction towards the outer limit of the deposit. The matrix takes the forms: cellular, mixed (cells and dendrites) and dendritic. Dendritic growth is done according to primary ramifications in the direction of the heat removal which takes place in the direction perpendicular to the interface, towards the external surface of the deposit, following secondary and tertiary undeveloped arms. The eutectic carbides M₇C₃ and ηM₆C formed are very thin and are located in the intercellular and interdendritic spaces of the solid solution Co (γ).

Keywords: Co-Ni-Cr-W-C alloy, solid deposit, microstructure, carbides, cyclic heat treatment

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Authors: Windy Rakhmawati, Suryani Suryani, Sri Hendrawati, Nenden Nur Asriyani Maryam

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Tuberculosis (TB) is one of the leading causes of death in the world. Fear of COVID-19 has made people reluctant to visit health facilities, leading to disruptions to childhood TB control programs, which may increase household transmission and delay diagnosis and treatment. This study aimed to describe parents' knowledge, attitudes, and health-seeking behaviour towards childhood TB during the COVID-19 pandemic. This cross-sectional study was performed on 392 parents with TB children in three provinces with the highest proportion of TB cases in Indonesia. This study was conducted from February to December 2022. The inclusion criteria of respondents were parents with a child aged 0-14 years old with TB diagnosis who live with their parents. Data were collected using the Knowledge, Attitude, and Practice (KAP) survey guidelines from the World Health Organization and analyzed descriptively, as well as Spearman’s correlation. Overall, 392 parents of children with TB had poor knowledge (51.8%) including about causes, risk factors, transmission, symptoms, treatment, and prevention, which about 52.3%, 55.1%, 61.2%, 69.6%, 100%, 59.2%, respectively. Parents' health service-seeking behaviour towards Child TB was not normally distributed (P < 0.05) with knowledge test results (.000) and Seeking Health Services (.000). Health-seeking behaviour of parents in pediatric TB care was self-medication or self-treatment (86.2%), Traditional health seeking behaviour (4.8%), and modern health seeking behaviour (8.9%). The correlation between knowledge and seeking health services (Sig= .609) means there is no correlation between knowledge about TB and parents' health-seeking behaviour. Furthermore, 60.2% of the respondents would be shocked if their child had TB. More than half of the families in this study have poor knowledge and did self-medication or self-treatment regarding health-seeking behaviour for TB disease. Therefore, health workers, especially nurses, must provide TB-related education and health promotion and emphasize the importance of early detection. Health workers can also optimize their role in caring for and providing care to patients by increasing their trust in health workers, which will impact health-seeking behaviour in the future.

Keywords: attitude, child, health seeking behaviour, knowledge, tuberculosis

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Authors: Septiany Trisnaningtyas

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Purpose: This research aims to examine the factors affecting the profitability of pharmaceutical company during the Covid-19 Pandemic in Indonesia. A sharp decline in the number of patients coming to the hospital for treatment during the pandemic has an impact on the growth of the pharmaceutical sector and brought major changes in financial position and business performance. Pharmaceutical companies that provide products related to the Covid-19 pandemic can survive and continue to grow. This study investigates the factors affecting the profitability of pharmaceutical company during the Covid-19 Pandemic in Indonesia associated with the number of Covid-19 cases. Design/methodology/approach: This study uses panel-data regression models to evaluate the influence of the number of Covid-19 confirmed cases on profitability of ninelisted pharmaceuticalcompanies in Indonesia. This research is based on four independent variables that were empirically examined for their relationship with profitability. These variables are liquidity (current ratio), growth rate (sales growth), firm size (total sales), and market power (the Lerner index). Covid-19 case is used as moderating variable. Data of nine pharmaceutical companies listed on the Indonesia Stock Exchange covering the period of 2018–2021 were extracted from companies’ quarterly annual reports. Findings: In the period during Covid-19, company growth (sales growth) and market power (lerner index) have a positive and significant relationship to ROA and ROE. Total of confirmed Covid-19 cases has a positive and significant relationship to ROA and is proven to have a moderating effect between company’s growth (sales growth) to ROA and ROE and market power (Lerner index) to ROA. Research limitations/implications: Due to data availability, this study only includes data from nine listed pharmaceutical companies in Indonesian Stock exchange and quarterly annual reportscovering the period of 2018-2021. Originality/value: This study focuses onpharmaceutical companies in Indonesia during Covid-19 pandemic. Previous study analyzes the data from pharmaceutical companies’ annual reports since 2014 and focus on universal health coverage (national health insurance) implementation from the Indonesian government. This study analyzes the data using fixed effect panel-data regression models to evaluate the influence of Covid-19 confirmed cases on profitability. Pooled ordinary least squares regression and fixed effects were used to analyze the data in previous study. This study also investigate the moderating effect of Covid-19 confirmed cases to profitability in relevant with the pandemic situation.

Keywords: profitability, indonesia, pharmaceutical, Covid-19

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Authors: Marc Sango, Olimpia Hoinaru, Christophe Gransart, Laurence Duchien

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Ontologies offer a means for representing and sharing information in many domains, particularly in complex domains. For example, it can be used for representing and sharing information of System Requirement Specification (SRS) of complex systems like the SRS of ERTMS/ETCS written in natural language. Since this system is a real-time and critical system, generic ontologies, such as OWL and generic ERTMS ontologies provide minimal support for modeling temporal information omnipresent in these SRS documents. To support the modeling of temporal information, one of the challenges is to enable representation of dynamic features evolving in time within a generic ontology with a minimal redesign of it. The separation of temporal information from other information can help to predict system runtime operation and to properly design and implement them. In addition, it is helpful to provide a reasoning and querying techniques to reason and query temporal information represented in the ontology in order to detect potential temporal inconsistencies. Indeed, a user operation, such as adding a new constraint on existing planning constraints can cause temporal inconsistencies, which can lead to system failures. To address this challenge, we propose a lightweight 3-layer temporal Quality of Service (QoS) ontology for representing, reasoning and querying over temporal and non-temporal information in a complex domain ontology. Representing QoS entities in separated layers can clarify the distinction between the non QoS entities and the QoS entities in an ontology. The upper generic layer of the proposed ontology provides an intuitive knowledge of domain components, specially ERTMS/ETCS components. The separation of the intermediate QoS layer from the lower QoS layer allows us to focus on specific QoS Characteristics, such as temporal or integrity characteristics. In this paper, we focus on temporal information that can be used to predict system runtime operation. To evaluate our approach, an example of the proposed domain ontology for handover operation, as well as a reasoning rule over temporal relations in this domain-specific ontology, are given.

Keywords: system requirement specification, ERTMS/ETCS, temporal ontologies, domain ontologies

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Authors: Makarios Mosaad Thabet Ibrahim

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the existing context paper targets to give the important position of ‘scholar voice’ and the track trainer inside the study room, which contributes to greater scholar-focused song training. The goal is to consciousness at the capabilities of the scholar voice via the tune spectrum, which has been born in the music school room, and the instructor’s methodologies and techniques used within the song classroom. The tune curriculum, the principles of pupil-centered song schooling, and the function of students and teachers as tune ambassadors have been taken into consideration the essential song parameters of scholar voice. The scholar- voice is a well worth-mentioning factor of a scholar-focused training, and all instructors have to take into account and sell its life in their lecture room. student affairs services play a critical function in contributing to the wholistic development and success of college students as they progress through their educational careers. The examine incorporates a multifaceted examination of student affairs carrier offerings among 10 personal and three public Baghdad universities. scholar affairs administrators (thirteen) have been surveyed together with over 300 students to determine university-subsidized services and pupil pride and attention. The pupil affairs service studies findings various drastically among non-public and public establishments and people that observed a country wide and international curriculum. Universities need to persist to conform to changing demographics and technological improvements to enhance students' private and academic successes, and pupil affairs services are key to preparing graduates to thrive in a diverse international world.

Keywords: college student-athletes, self-concept, use of social media training, social networking student affairs, student success, higher education, Iraq, universities, Baghdad student's voice, student-centered education, music ambassadors, music teachers

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Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

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Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

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Authors: Vaishali Joshi

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In the past, companies and buyers operated as if there was infinite availability of natural resources for usage, which has resulted in the loss of our globe's natural ecosystem. People's consciousness of ecological concerns had increased, which showed the way for the evolution of the green revolution with the objective of discontinuing the use of products that are harmful to the ecosystem of the earth. This green revolution has made the consumers head toward those companies which are providing eco-friendly products s/service s through less eco-harmful ways. Studies show that companies started gaining a reputation in the market through their eco-friendly activities in their business. Hence companies should be alert to understand the consumer's environmentally friendly consumption behavior to survive and be in the game of the competition. Green marketing efforts guarantee beneficial exchanges without harmful consequences for current and /or upcoming generations. This hits the green policies of those companies which are claiming environmental concern. This means that these companies not only focus on the impact of their production and products on the ecosystem but also on every small activity in their value chain. One of the most ignored parts of the value chain is the medium through which the marketing of products/services is done. These companies should also take into account to what degree their selection of advertising media affects the ecosystem of the earth. In this study, a hypothetical fashion apparel brand known as "Dolphin" will be studied. In particular, the following objectives are framed: i) to study the brand attitude of the given fashion brand due to its selection of eco-friendly advertising medium ii) to study the advertisement attitude of the given fashion brand due to its selection of eco-friendly advertising medium and iii) to study the purchase intention of the given fashion brand due to its selection of eco-friendly advertising medium. An online experiment will be conducted. Respondents between the ages of 20-and 64 years will be selected randomly from the online consumer panel database. The findings of this study will have a great impact on the companies that are claiming environmental concerns by understanding how the advertising media is affecting the company’s brand image in the long run.

Keywords: eco-friendly advertising media, fashion, attitude, purchase intention

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Authors: Ali M. Al-Shaery

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The purpose of this paper is to address the functions of sustainability dimensions in city information modelling and to present the required sustainability criteria that support establishing a sustainable planning framework for enhancing existing cities and developing future smart cities. The paper is divided into two sections. The first section is based on the examination of a wide and extensive array of cross-disciplinary literature in the last decade and a half to conceptualize the terms ‘sustainable’ and ‘smart city,' and map their associated criteria to city information modelling. The second section is based on analyzing two approaches relating to city information modelling, namely statistical and dynamic approaches, and their suitability in the development of cities’ action plans. The paper argues that the use of statistical approaches to embedding sustainability dimensions in city information modelling have limited value. Despite the popularity of such approaches in addressing other dimensions like utility and service management in development and action plans of the world cities, these approaches are unable to address the dynamics across various city sectors with regards to economic, environmental and social criteria. The paper suggests an integrative dynamic and cross-disciplinary planning approach to embedding sustainability dimensions in city information modelling frameworks. Such an approach will pave the way towards optimal planning and implementation of priority actions of projects and investments. The approach can be used to achieve three main goals: (1) better development and action plans for world cities (2) serve the development of an integrative dynamic and cross-disciplinary framework that incorporates economic, environmental and social sustainability criteria and (3) address areas that require further attention in the development of future sustainable and smart cities. The paper presents an innovative approach for city information modelling and a well-argued, balanced hierarchy of sustainability criteria that can contribute to an area of research which is still in its infancy in terms of development and management.

Keywords: information modelling, smart city, sustainable city, sustainability dimensions, sustainability criteria, city development planning

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Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Physical activity is an important factor in the treatment and prevention of type 2 diabetes mellitus (T2DM). Reduction in HbA1c level, an important diabetes biomarker, was reported in patients who increased their daily physical activity. Although the ambient temperature was reported to be positively correlated to a negative impact on health and increase the incidences of diabetes, the exposure to bright sunlight was recently found to be associated with enhanced insulin sensitivity and improved beta-cell function. How Ramadan alters physical activity, and especially sunlight exposure, has not been adequately investigated. Aim: This study aimed to assess the physical activity and sun exposure of Saudis with T2DM over different periods (before, during, and after Ramadan) and related this to HbA1c levels. Methods: This study recruited 82 Saudis with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for this study were obtained from De Montfort University and Saudi Ministry of Health. Physical activity and sun exposure were assessed by a self-administered questionnaire. Physical activity was estimated using the International Physical Activity Questionnaire (IPAQ), while the sun exposure was assessed by asking the patients about their hours per week of direct exposure to the sun, and daily hours spent outdoors. Blood samples were collected in each period for measuring HbA1c. Results: Low physical activity was observed in more than 60% of the patients, with no significant changes between periods. There were no significant variances between periods in the daily hours spent outdoors and the total number of weekly hours of direct exposure to the sun. The majority of patients reported only few hours of exposure to the sun (1h or less per week) and time spent outdoors (1h or less per day). The mean HbA1c significantly changed between periods (P = 0.001), with lowest level during Ramadan. There were significant differences in the mean HbA1c between the groups for the level of physical activity (P < 0.001), with significant lower mean HbA1c in the higher-level group. There were no significant variances in the mean of HbA1c between the groups for the daily hours spent outdoors. The mean HbA1c of the patients, who reported never in their total weekly hours of exposure to the sun, was significantly lower than the mean HbA1c of those who reported 1 hour or less (P = 0.001). Conclusion: Physical inactivity was prevalent among the study population with very little exposure to the sun or time spent outdoors. Higher level of physical activity was associated with lower mean HbA1c levels. Encouraging T2DM patients to achieve the recommended levels of physical activity may help them to obtain greater benefits of Ramadan fasting, such as reducing their HbA1c levels. The impact of low direct exposure to the sun and the time spent outdoors needs to be further investigated in both healthy and diabetic patients.

Keywords: diabetes, fasting, physical activity, sunlight, Ramadan

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Authors: Thaminda Liyanage, Anuga Liyanage, Chamila Kurukulasuriya, Sidath Bandara

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Background: The burden of chronic kidney disease (CKD) is growing rapidly around the world, particularly in Asia. Over the last two decades Sri Lanka has experienced an epidemic of CKD with ever growing number of patients pursuing medical care due to CKD and its complications, specially in the “Mahaweli” river basin in north central region of the island nation. This was apparently a new form of CKD which was not attributable to conventional risk factors such as diabetes mellitus, hypertension or infection and widely termed as “CKD-unknown” or “CKDu”. In the past decade a number of small scale studies were conducted to determine the aetiology, prevalence and complications of CKDu in North Central region. These hospital-based studies did not provide an accurate estimate of the problem as merely 10% or less of the people with CKD are aware of their diagnosis even in developed countries with better access to medical care. Interestingly, similar observations were made on the changing epidemiology of obesity in the region but no formal study was conducted to date to determine the magnitude of obesity burden. Moreover, if increasing obesity in the region is associated with CKD epidemic is yet to be explored. Methods: We will conduct an area wide cross sectional survey among all adult residents of the “Mahaweli” development project area 5, in the North Central Province of Sri Lanka. We will collect relevant medical history, anthropometric measurements, blood and urine for hematological and biochemical analysis. We expect a participation rate of 75%-85% of all eligible participants. Participation in the study is voluntary, there will be no incentives provided for participation. Every analysis will be conducted in a central laboratory and data will be stored securely. We will calculate the prevalence of obesity and chronic kidney disease, overall and by stage using total number of participants as the denominator and report per 1000 population. The association of obesity and CKD will be assessed with regression models and will be adjusted for potential confounding factors and stratified by potential effect modifiers where appropriate. Results: This study will provide accurate information on the prevalence of obesity and CKD in the region. Furthermore, this will explore the association between obesity and CKD, although causation may not be confirmed. Conclusion: Obesity and CKD are increasingly recognized as major public health problems in Sri Lanka. Clearly, documenting the magnitude of the problem is the essential first step. Our study will provide this vital information enabling the government to plan a coordinated response to tackle both obesity and CKD in the region.

Keywords: BMI, Chronic Kidney Disease, obesity, Sri Lanka

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Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

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Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

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Authors: Georgios Pardalis, Krushna Mahapatra, Brijesh Mainali

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Compared to other sectors, the residential and service sector in Sweden is responsible for almost 40% of the national final energy use and faces great challenges towards achieving reduction of energy intensity. The one- and two-family (henceforth 'detached') houses, constituting 60% of the residential floor area and using 32 TWh for space heating and hot water purposes, offers significant opportunities for improved energy efficiency. More than 80% of those houses are more than 35 years of old and a large share of them need major renovations. However, the rate of energy renovations for such houses is significantly low. The renovation market is dominated by small and medium-sized local companies (SMEs), who mostly offer individual solutions. A one-stop-shop business framework, where a single actor collaborates with other actors and coordinates them to offer a full package for holistic renovations, may speed up the rate of renovation. Such models are emerging in some European countries. This paper aims to understand the willingness of the SMEs to adopt a one-stop-shop business framework. Interviews were conducted with 13 SMEs in Kronoberg county in Sweden, a geographic region known for its initiatives towards sustainability and energy efficiency. The examined firms seem reluctant to adopt one-stop-shop for nonce due to the perceived risks they see in such a business move and due to their characteristics, although they agree that such a move will advance their position in the market and their business volume. By using threat-rigidity and prospect theory, we illustrate how this type of companies can move from being reluctant to adopt one-stop-shop framework to its adoption. Additionally, with the use of behavioral theory, we gain deeper knowledge on those exact reasons preventing those firms from adopting the one-stop-shop framework.

Keywords: construction SMEs, innovation adoption, one-stop-shop, perceived risks

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Authors: Laurie U. deBettencourt

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During pre-service field experiences teacher candidates are often asked to reflect as part of their training and in this investigation candidates’ reflective journal entries were reviewed, coded and analyzed with results suggesting teacher candidates need more direct instruction on how to describe, analyze, and make judgements on their instructional practices so that their practices improve over time. Teacher education programs often incorporate reflective-based activities during field experiences. The purpose of this investigation was to determine if special education teacher candidate’s reflective practices changed as they completed their two supervised field experiences and to determine what topics the candidates focused on in their reflections. The six females graduate students were completing two field experiences in special education classrooms within one academic year as part of their coursework leading to a master’s degree and special education teacher state certification. Each candidate wrote 15 reflection journal entries (approximately 200 words each) per field experience. Each of the journal entries were reviewed sentence by sentence to determine a reflective practice score and to determine the topics discussed. The reflective practice score was calculated using four dimensions of reflection (describe, analyze, judge, and apply) in order to create a continuous variable representing their reflective practice across four points of time. A One-way Repeated Measures Analysis of Variance (ANOVA) suggested that special education teacher candidates did not change their reflective practices over time (i.e., at time-point one the practitioner’s mean score was 56.0 out of 100 (SD = 7.6), 53.8 (SD = 4.3) at time-point two, 51.2 (SD = 4.5) at time-point three, and 57.7 (SD = 8.2) at time-point four). Qualitative findings suggest candidates focused mostly on themselves in their reflections. Conclusions suggest the need for teacher preparation programs to provide more direct instruction on how a teacher should reflect. Specific implications are provided for teacher training and future research.

Keywords: field experiences, reflective practices, special educators, teacher preparation

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Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

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Authors: Sourabh Jain, Sukhvir Singh Jain, Gaurav V. Jain

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Intelligent Transportation System (ITS) is the application of technology for developing a user–friendly transportation system for urban areas in developing countries. The goal of urban corridor management using ITS in road transport is to achieve improvements in mobility, safety, and the productivity of the transportation system within the available facilities through the integrated application of advanced monitoring, communications, computer, display, and control process technologies, both in the vehicle and on the road. This paper attempts to present the past studies regarding several ITS available that have been successfully deployed in urban corridors of India and abroad, and to know about the current scenario and the methodology considered for planning, design, and operation of Traffic Management Systems. This paper also presents the endeavor that was made to interpret and figure out the performance of the 27.4 Km long study corridor having eight intersections and four flyovers. The corridor consisting of 6 lanes as well as 8 lanes divided road network. Two categories of data were collected on February 2016 such as traffic data (traffic volume, spot speed, delay) and road characteristics data (no. of lanes, lane width, bus stops, mid-block sections, intersections, flyovers). The instruments used for collecting the data were video camera, radar gun, mobile GPS and stopwatch. From analysis, the performance interpretations incorporated were identification of peak hours and off peak hours, congestion and level of service (LOS) at mid blocks, delay followed by the plotting speed contours and recommending urban corridor management strategies. From the analysis, it is found that ITS based urban corridor management strategies will be useful to reduce congestion, fuel consumption and pollution so as to provide comfort and efficiency to the users. The paper presented urban corridor management strategies based on sensors incorporated in both vehicles and on the roads.

Keywords: congestion, ITS strategies, mobility, safety

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Authors: Yu-Jia Jian, Emily Chia-Yu Su, Hui-Ling Hsu, Jian-Jhih Chen

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Coronary artery is the major supplier of myocardial blood flow. When fat and cholesterol are deposit in the coronary arterial wall, narrowing and stenosis of the artery occurs, which may lead to myocardial ischemia and eventually infarction. According to the World Health Organization (WHO), estimated 740 million people have died of coronary heart disease in 2015. According to Statistics from Ministry of Health and Welfare in Taiwan, heart disease (except for hypertensive diseases) ranked the second among the top 10 causes of death from 2013 to 2016, and it still shows a growing trend. According to American Heart Association (AHA), the risk factors for coronary heart disease including: age (> 65 years), sex (men to women with 2:1 ratio), obesity, diabetes, hypertension, hyperlipidemia, smoking, family history, lack of exercise and more. We have collected a dataset of 421 patients from a hospital located in northern Taiwan who received coronary computed tomography (CT) angiography. There were 300 males (71.26%) and 121 females (28.74%), with age ranging from 24 to 92 years, and a mean age of 56.3 years. Prior to coronary CT angiography, basic data of the patients, including age, gender, obesity index (BMI), diastolic blood pressure, systolic blood pressure, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary heart disease and exercise habits, were collected and used as input variables. The output variable of the prediction module is the degree of coronary artery stenosis. The output variable of the prediction module is the narrow constriction of the coronary artery. In this study, the dataset was randomly divided into 80% as training set and 20% as test set. Four machine learning algorithms, including logistic regression, stepwise regression, neural network and decision tree, were incorporated to generate prediction results. We used area under curve (AUC) / accuracy (Acc.) to compare the four models, the best model is neural network, followed by stepwise logistic regression, decision tree, and logistic regression, with 0.68 / 79 %, 0.68 / 74%, 0.65 / 78%, and 0.65 / 74%, respectively. Sensitivity of neural network was 27.3%, specificity was 90.8%, stepwise Logistic regression sensitivity was 18.2%, specificity was 92.3%, decision tree sensitivity was 13.6%, specificity was 100%, logistic regression sensitivity was 27.3%, specificity 89.2%. From the result of this study, we hope to improve the accuracy by improving the module parameters or other methods in the future and we hope to solve the problem of low sensitivity by adjusting the imbalanced proportion of positive and negative data.

Keywords: decision support, computed tomography, coronary artery, machine learning

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Authors: Shay Kee Tan, Kok Haur Ng, Jennifer So-Kuen Chan

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This paper extends the conditional autoregressive range (CARR) model to multivariate CARR (MCARR) model and further to the two-stage MCARR-return model to model and forecast volatilities, correlations and returns of multiple financial assets. The first stage model fits the scaled realised Parkinson volatility measures using individual series and their pairwise sums of indices to the MCARR model to obtain in-sample estimates and forecasts of volatilities for these individual and pairwise sum series. Then covariances are calculated to construct the fitted variance-covariance matrix of returns which are imputed into the stage-two return model to capture the heteroskedasticity of assets’ returns. We investigate different choices of mean functions to describe the volatility dynamics. Empirical applications are based on the Standard and Poor 500, Dow Jones Industrial Average and Dow Jones United States Financial Service Indices. Results show that the stage-one MCARR models using asymmetric mean functions give better in-sample model fits than those based on symmetric mean functions. They also provide better out-of-sample volatility forecasts than those using CARR models based on two robust loss functions with the scaled realised open-to-close volatility measure as the proxy for the unobserved true volatility. We also find that the stage-two return models with constant means and multivariate Student-t errors give better in-sample fits than the Baba, Engle, Kraft, and Kroner type of generalized autoregressive conditional heteroskedasticity (BEKK-GARCH) models. The estimates and forecasts of value-at-risk (VaR) and conditional VaR based on the best MCARR-return models for each asset are provided and tested using Kupiec test to confirm the accuracy of the VaR forecasts.

Keywords: range-based volatility, correlation, multivariate CARR-return model, value-at-risk, conditional value-at-risk

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Authors: Camila Plaza, Stefan Felder

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In October 2014, the TARMED reform was implemented in Switzerland. In an effort to even out the financial standing of general practitioners (including pediatricians) relative to that of specialists in the outpatient sector, the reform tackled two aspects: on the one hand, GPs would be able to bill an additional 9 CHF per patient, once per consult per day. This is referred to as the surcharge position. As a second measure, it reduced the fees for certain technical services targeted to specialists (e.g., imaging, surgical technical procedures, etc.). Given the fee-for-service reimbursement system in Switzerland, we predict that physicians reacted to the economic incentives of the reform by increasing the consults per patient and decreasing the average amount of time per consult. Within this framework, our treatment group is formed by GPs and our control group by those specialists who were not affected by the reform. Using monthly insurance claims panel data aggregated at the physician praxis level (provided by SASIS AG), for the period of January 2013-December 2015, we run difference in difference panel data models with physician and time fixed effects in order to test for the causal effects of the reform. We account for seasonality, and control for physician characteristics such as age, gender, specialty, and physician experience. Furthermore, we run the models on subgroups of physicians within our sample so as to account for heterogeneity and treatment intensities. Preliminary results support our hypothesis. We find evidence of an increase in consults per patients and a decrease in time per consult. Robustness checks do not significantly alter the results for our outcome variable of consults per patient. However, we do find a smaller effect of the reform for time per consult. Thus, the results of this paper could provide policymakers a better understanding of physician behavior and their sensitivity to financial incentives of reforms (both past and future) under the current reimbursement system.

Keywords: difference in differences, financial incentives, health reform, physician behavior

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