Search results for: clinical decision support systems

Authors: Mohammad Hamed Asosheh

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The development of nanobiomaterials has opened new avenues in the field of biomedical engineering, offering unparalleled possibilities for advanced therapeutic applications. This study explores the synthesis and characterization of a distinct class of nanobiomaterials designed to enhance drug delivery systems and support tissue engineering. By integrating biodegradable polymers with bioactive nanoparticles, we have engineered a multifunctional platform that ensures controlled drug release, targeted delivery, and improved biocompatibility. Our findings demonstrate that these nanobiomaterials not only exhibit excellent mechanical properties but also promote cell proliferation and differentiation, making them ideal candidates for regenerative medicine. Furthermore, in vitro and in vivo assessments reveal that the engineered materials significantly reduce cytotoxicity while enhancing the therapeutic efficacy of encapsulated drugs. This research presents a promising approach to addressing current challenges in drug delivery and tissue regeneration, with the potential to revolutionize the treatment of chronic diseases and injury repair. Future work will focus on optimizing the material composition for specific clinical applications and conducting large-scale studies to evaluate long-term safety and effectiveness.

Keywords: nanobiomaterials, drug delivery systems, therapeutic efficacy, bioactive nanoparticles

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Authors: Ghanem Al-Ghamdi

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African Horse Sickness causes significant challenges to horse practitioners and owners in Africa and possibly in certain locations in the Arab Pensila. The aim of this work was to observe a hot spot of epidemic in Al-Baha, Southwestern of Saudi Arabia that could be AHS. A five year-old horse farm that had eight horses with no history of clinical problems was visited in late October 2014. In August 2014, horses showed clinical signs of severe pain, congestion of mucus membranes, foam oozing of the nose, recumbency, difficult breath and ultimately death. The course of the disease averaged 2 days. The farm had no previous history of this episode. Other animals including camel, sheep reside the same farm sharing feeding and water sources however no obvious similar clinical problems were noticed among the two species. Five horses showed the clinical disease and all horses were lost. Veterinary help was not available for diagnosis or treatment. A follow up visit to the farm after one year indicated that the three remaining horses were healthy but were relocated to a different facility out the Al-Baha Region. The most likely cause of such clinical problem is African Horse Sickness, however clinical exam and sampling of other horses in the region is absolute must as well as examining arthropods.

Keywords: African horse sickness, horses, Al-Baha, Saudi Arabia

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Authors: Fawaz Saad, Hamid Alalwany

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Sweden has succeeded to maintain a high level of growth and development and has managed to sustain highly ranked position among the world’s developed countries. In this regard, Swedish universities are playing a vital role in supporting innovation and entrepreneurship at all levels and developing Swedish knowledge economy. This paper is aiming to draw on the experiences of two leading Swedish universities, addressing their transformation approach to create entrepreneurial universities and fulfilling their objectives in the era of knowledge economy. The objectives of the paper include: (1) Introducing the Swedish higher education and its characteristics. (2) Examining the infrastructure elements for innovation and Entrepreneurship at two of the Swedish entrepre-neurial universities. (3) Addressing the key aspects of support systems in the initiatives of both Chalmers and Gothenburg universities to support innovation and advance entrepreneurial practices. The paper will contribute to two discourses: (1) Examining the relationship between support systems for innovation and entrepreneurship and the Universities’ policies and practices. (2) Lessons for University leaders to assist the development and implementation of effective innovation and en-trepreneurship policies and practices.

Keywords: Entrepreneurial University, Chalmers University, Gothenburg University, innovation and entrepreneurship policies, entrepreneurial transformation

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Authors: S. Ghorbani, N. I. Polushin

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The machinability of workpieces (AISI 1045 Steel, AA2024 aluminum alloy, A48-class30 gray cast iron) in turning operation has been carried out using different types of cutting tool (conventional, cutting tool with holes in toolholder and cutting tool filled up with composite material) under dry conditions on a turning machine at different stages of spindle speed (630-1000 rpm), feed rate (0.05-0.075 mm/rev), depth of cut (0.05-0.15 mm) and tool overhang (41-65 mm). Experimentation was performed as per Taguchi’s orthogonal array. To evaluate the relative importance of factors affecting surface roughness the single decision tree (SDT), Decision tree forest (DTF) and Group method of data handling (GMDH) were applied.

Keywords: decision tree forest, GMDH, surface roughness, Taguchi method, turning process

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Authors: Muhammad Saqlain, Poom Kumam

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Language being an abstract system and creative act, is quite complicated as its meaning varies depending on the context. The context is determined by the empirical knowledge of a person, which is derived from observation and experience. About further subdivided attributes, the decision-making challenges may entail quantitative and qualitative factors. However, because there is no norm for putting a numerical value on language, existing approaches cannot carry out the operations of linguistic knowledge. The assigning of mathematical values (fuzzy, intuitionistic, and neutrosophic) to any decision-making problem; without considering any rule of linguistic knowledge is ambiguous and inaccurate. Thus, this paper aims to provide a generic model for these issues. This paper provides the linguistic set structure of the fuzzy hypersoft set (FLHSS) to solve decision-making issues. We have proposed the definition some basic operations like AND, NOT, OR, AND, compliment, negation, etc., along with Topology and examples, and properties. Secondly, the operational laws for the fuzzy linguistic hypersoft set have been proposed to deal with the decision-making issues. Implementing proposed aggregate operators and operational laws can be used to convert linguistic quantifiers into numerical values. This will increase the accuracy and precision of the fuzzy hypersoft set structure to deal with decision-making issues.

Keywords: linguistic quantifiers, aggregate operators, multi-criteria decision making (mcdm)., fuzzy topology

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Authors: Mohamed Asaad Abdelrazek, Amir Taher El-Sheikh, M. Zayan, A.M. Elhady

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The successful realization of complex systems is dependent not only on the technology issues and the process for implementing them, but on the management issues as well. Managing the systems development lifecycle requires technical management. Systems engineering management is the technical management. Systems engineering management is accomplished by incorporating many activities. The three major activities are development phasing, systems engineering process and lifecycle integration. Systems engineering management activities are performed across the system development lifecycle. Due to the ever-increasing complexity of systems as well the difficulty of managing and tracking the development activities, new ways to achieve systems engineering management activities are required. This paper presents a systematic approach used as a design management tool applied across systems engineering management roles. In this approach, Transdisciplinary System Development Lifecycle (TSDL) Model has been modified and integrated with Quality Function Deployment. Hereinafter, the name of the systematic approach is the Transdisciplinary Quality System Development Lifecycle (TQSDL) Model. The QFD translates the voice of customers (VOC) into measurable technical characteristics. The modified TSDL model is based on Axiomatic Design developed by Suh which is applicable to all designs: products, processes, systems and organizations. The TQSDL model aims to provide a robust structure and systematic thinking to support the implementation of systems engineering management roles. This approach ensures that the customer requirements are fulfilled as well as satisfies all the systems engineering manager roles and activities.

Keywords: axiomatic design, quality function deployment, systems engineering management, system development lifecycle

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Authors: J. Fernandez, N. Aguilar, R. Fernandez de Canete, J. C. Ramos-Diaz

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In this paper, a simulation model of the glucose-insulin system for a patient undergoing diabetes Type 1 is developed by using a causal modeling approach under system dynamics. The OpenModelica simulation environment has been employed to build the so called causal model, while the glucose-insulin model parameters were adjusted to fit recorded mean data of a diabetic patient database. Model results under different conditions of a three-meal glucose and exogenous insulin ingestion patterns have been obtained. This simulation model can be useful to evaluate glucose-insulin performance in several circumstances, including insulin infusion algorithms in open-loop and decision support systems in closed-loop.

Keywords: causal modeling, diabetes, glucose-insulin system, diabetes, causal modeling, OpenModelica software

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Authors: Agoston Restas

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Introduction: In case of managing disasters decision makers can face many times such a special situation where any pre-sign of the drastically change is missing therefore the improvised decision making can be required. The complexity, ambiguity, uncertainty or the volatility of the situation can require many times the improvisation as decision making. It can be taken at any level of the management (strategic, operational and tactical) but at tactical level the main reason of the improvisation is surely time pressure. It is certainly the biggest problem during the management. Methods: The author used different tools and methods to achieve his goals; one of them was the study of the relevant literature, the other one was his own experience as a firefighting manager. Other results come from two surveys that are referred to; one of them was an essay analysis, the second one was a word association test, specially created for the research. Results and discussion: This article proves that, in certain situations, the multi-criteria, evaluating decision-making processes simply cannot be used or only in a limited manner. However, it can be seen that managers, directors or commanders are many times in situations that simply cannot be ignored when making decisions which should be made in a short time. The functional background of decisions made in a short time, their mechanism, which is different from the conventional, was studied lately and this special decision procedure was given the name recognition-primed decision. In the article, author illustrates the limits of the possibilities of analytical decision-making, presents the general operating mechanism of recognition-primed decision-making, elaborates on its special model relevant to managers at tactical level, as well as explore and systemize the factors that facilitate (catalyze) the processes with an example with fire managers.

Keywords: decision making, disaster managers, recognition primed decision, model for making decisions in emergencies

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Authors: Valerie A. Conrade

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Introduction: A large body of literature suggests patients who complete fecal immunochemical testing (FIT) kits are likely to identify colorectal cancer sooner than those who do not complete FIT kits. Background: Patients who do not participate in preventative measures such as the FIT kit are at a higher risk of colorectal cancer growing unnoticed. The objective was to see if the method the principal investigator (PI) uses to educate clinical staff on the importance of FIT kit administration provides an increased amount of FIT kit dissemination to patients post clinical education. Methodologies: Data collection via manual tallies took place before and after the clinical staff was educated on the importance of FIT kits. Results: The results showed an increase in FIT kit dissemination post clinical staff education. Through enhanced instruction to the clinical staff regarding the importance of FIT kits, expanding their knowledge on preventative measures to detect colorectal cancer positively impacted nurses and, in turn, their patients.

Keywords: colon cancer, education, fecal immunochemical testing, nursing

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Authors: Tania Breton, Dorina Simeonov, Shauna MacEachern

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Ontario’s 10 Year Mental Health and Addictions Strategy has included the establishment of 18 Service Collaborative across the province; cross-sector tables in a specific region coming together to explore mental health and addiction system needs and adopting an intervention to address that need. The process is community led and supported by implementation teams from the Centre for Addiction and Mental Health (CAMH), using the framework of implementation science (IS) to enable evidence-based and sustained change. These justice initiatives are focused on the intersection of the justice system and the mental health and addiction systems. In this presentation, we will share the learnings, achievements and challenges of implementing innovative practices to the mental health and addictions needs of Ontarians within the justice system. Specifically, we will focus on the key points across the justice system - from early intervention and trauma-informed, culturally appropriate services to post-sentence support and community reintegration. Our approach to this work involves external implementation support from the CAMH team including coaching, knowledge exchange, evaluation, Aboriginal engagement and health equity expertise. Agencies supported the implementation of tools and processes which changed practice at the local level. These practices are being scaled up across Ontario and community agencies have come together in an unprecedented collaboration and there is a shared vision of the issues overlapping between the mental health, addictions and justice systems. Working with ministry partners has allowed space for innovation and created an environment where better approaches can be nurtured and spread.

Keywords: implementation, innovation, early identification, mental health and addictions, prevention, systems

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Authors: Jeffrey M. Byford

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The conceptualized theory of decision making on historical events often does not conform to uniform beliefs among students. When presented the opportunity, many students have differing opinions and rationales associated with historical events and outcomes. The intent of this paper was to provide students with the economic, social and political dilemmas associated with the autonomy of East Berlin. Students ranked seven possible actions from the most to least acceptable. In addition, students were required to provide both positive and negative factors for each decision and relative ranking. Results from this activity suggested that while most students chose a financial action towards West Berlin, some students had trouble justifying their actions.

Keywords: content-centered learning, cold war, Berlin, decision-making

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Authors: Sadiya S. Silvee

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Generally, the decision of the higher court is binding on its subordinate courts. As provided in Article 111 of the Constitution, 'the law declared by the Appellate Division (AD) shall be binding on the High Court Division (HCD) and the law declared by either division of the Supreme Court shall be binding on all courts subordinate to it.' This means the judicial discipline requires the HCD to follow the decision of the AD and that it is necessary for the lower tiers of courts to accept the decision of the higher tiers as a binding precedent. Analyzing the application of Article 111 of the Constitution in the criminal justice system as a sentencing guideline, the paper, by examining whether there is any consistency in decision between one HC Bench and another HC Bench, explores whether HCD can per incuriam its previous decision. In doing so, the Death Reference (DR) Cases are contemplated. Furthermore, the paper shall examine whether the Court of Session follows the decision of the HCD while using their discretion to make the choice between death and imprisonment for life under section 302 of PC. The paper argues due to the absence of any specific direction for sentencing and inconsistency in jurisprudence among the HCD; the subordinate courts are in a dilemma.

Keywords: death reference, sentencing factor, sentencing guideline, criminal justice system and constitution

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Authors: Li Wang, Dan Shu, Shiguang Pang, Lixiu Wang, Bing Xiang Yang, Qian Liu

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Background: Cancer is one of the most severe diseases in childhood; long-term treatment and its side effects significantly impact the patient's physical, psychological, social functioning and quality of life while also placing substantial physical and psychological burdens on caregivers and families. Family resilience is crucial for children with cancer, helping them cope better with the disease and supporting the family in facing challenges together. As a family-level variable, family resilience requires information from multiple family members. However, to our best knowledge, there is currently no research investigating family resilience from both the perspectives of pediatric cancer patients and their caregivers. Therefore, this study aims to investigate the family resilience and quality of life of pediatric cancer patients from a patient–caregiver dyadic perspective. Methods: A total of 149 dyads of patients diagnosed with pediatric cancer patients and their principal caregivers were recruited from oncology departments of 4 tertiary hospitals in Wuhan and Taiyuan, China. All participants completed questionnaires that identified their demographic and clinical characteristics as well as assessed their family resilience and quality of life for both the patients and their caregivers. K-means cluster analysis was used to identify different clusters of family resilience based on the reports from patients and caregivers. Multivariate logistic regression and linear regression are used to analyze the factors influencing family resilience and quality of life, as well as the relationship between the two. Results: Three clusters of family resilience were identified: a cluster of high family resilience (HR), a cluster of low family resilience (LR), and a cluster of discrepant family resilience (DR). Most (67.1%) families fell into the cluster with low resilience. Characteristics such as the types of caregivers perceived social support of the patient were different among the three clusters. Compared to the LR group, families where the mother is the caregiver and where the patient has high social support are more likely to be assigned to the HR. The quality of life for caregivers was consistently highest in the HR cluster and lowest in the LR cluster. The patient's quality of life is not related to family resilience. In the linear regression analysis of the patient's quality of life, patients who are the first-born have higher quality of life, while those living with their parents have lower quality of life. The participants' characteristics were not associated with the quality of life for caregivers. Conclusions: In most families, family resilience was low. Families with maternal caregivers and patients receiving high levels of social support are more inclined to be higher levels of family resilience. Family resilience was linked to the quality of life of caregivers of pediatric cancer patients. The clinical implications of this findings suggest that healthcare and social support organizations should prioritize and support the participation of mothers in caregiving responsibilities. Furthermore, they should assist families in accessing social support to enhance family resilience. This study also emphasizes the importance of promoting family resilience for enhancing family health and happiness, as well as improving the quality of life for caregivers.

Keywords: pediatric cancer, cluster analysis, family resilience, quality of life

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Authors: Mariann Veresne Somosi, Zoltan Nagy, Krisztina Varga

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Innovation is the key element of economic development and a key factor in social processes. Technical innovations can be identified as prerequisites and causes of social change and cannot be created without the renewal of society. The study of social innovation can be characterised as one of the significant research areas of our day. The study’s aim is to identify the process of social innovation, which can be defined by input, transformation, and output factors. This approach divides the social innovation process into three parts: situation analysis, implementation, follow-up. The methods associated with each stage of the process are illustrated by the chronological line of social innovation. In this study, we have sought to present methodologies that support long- and short-term decision-making that is easy to apply, have different complementary content, and are well visualised for different user groups. When applying the methods, the reference objects are different: county, district, settlement, specific organisation. The solution proposed by the study supports the development of a methodological combination adapted to different situations. Having reviewed metric and conceptualisation issues, we wanted to develop a methodological combination along with a change management logic suitable for structured support to the generation of social innovation in the case of a locality or a specific organisation. In addition to a theoretical summary, in the second part of the study, we want to give a non-exhaustive picture of the two counties located in the north-eastern part of Hungary through specific analyses and case descriptions.

Keywords: factors of social innovation, methodological combination, social innovation process, supporting decision-making

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Authors: Aliyah Dosani, Kerri Alderson

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Two different simulations using standardized patients were developed to reinforce content and foster undergraduate nursing students’ practice and development of interpersonal skills in difficult clinical situations in the classroom. The live actor simulations focused on fostering interpersonal skills, traditionally considered by students to be simple and easy. However, seemingly straightforward interactions can be very stressful, particularly in women’s complex social/emotional situations. Supporting patients in these contexts is fraught with complexity and high emotion, requiring skillful support, assessment and intervention by a registered nurse. In this presentation, the personal and professional perspectives of the development, incorporation, and execution of the live actor simulations will be discussed, as well as the inclusion of student perceptions, and the learning gained by the involved faculty.

Keywords: adult learning, interpersonal skill development, simulation learning, teaching and learning

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Authors: Anisa Luli, Alessandra Santona

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Wanting a child and experiencing the impossibility to conceive is a painful condition that often is linked to infertility and often leads infertile individuals to experience psychological, relational and social problems. In this situation, infertile couples have to review their choices and take into consideration new ones. Few studies have focused on the decision-making style used by infertile individuals to solve their problem and on the factors that influences it. The aim of this paper is to define the style of decision-making used by infertile persons to give a solution to the “problem” and the predictive role of the attachment, of the representations of the relationship with parents in childhood and of the dyadic adjustment. The total sample is composed by 251 participants, divided in two groups: the experimental group composed by 114 participants, 62 males and 52 females, age between 25 and 59 years, and the control group composed by 137 participants, 65 males and 72 females, age between 22 and 49 years. The battery of instruments comprises: General Decision Making Style (GDMS), Experiences in Close Relationships Questionnaire Revised (ECR-R), Dyadic Adjustment Scale (DAS), Parental Bonding Instrument (PBI) and Symptom Checklist-90-R (SCL-90-R). The results from the analysis of the samples showed a prevalence of the rational decision-making style for both males and females, experimental and control group. There have been founded significant statistical relationships between the attachment scales, the representations of the parenting style, the dyadic adjustment and the decision-making styles. These results contribute to enrich the literature on the subject of decision-making in infertile people and show the relationship between the attachment and decision-making styles, confirming the few results in literature.

Keywords: attachment, decision-making style, infertility, dyadic adjustment

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Authors: Tayfun Çay, Yasar İnceyol, Abdurrahman Özbeyaz

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Land reallocation is one of the most important steps in land consolidation projects. Many different models were proposed for land reallocation in the literature such as Fuzzy Logic, block priority based land reallocation and Spatial Decision Support Systems. A model including four parts is considered for automatic block reallocation with genetic algorithm method in land consolidation projects. These stages are preparing data tables for a project land, determining conditions and constraints of land reallocation, designing command steps and logical flow chart of reallocation algorithm and finally writing program codes of Genetic Algorithm respectively. In this study, we designed the first three steps of the considered model comprising four steps.

Keywords: land consolidation, landholding, land reallocation, optimization, genetic algorithm

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Authors: Afolabi O.J, Simon-Oke I.A., Oniya M.O., Okaka C.E.

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River blindness is a skin, and an eye disease caused by Onchocerca volvulus and vectored by a female hematophagous blackfly. The study aims to evaluate the distribution of the clinical signs of river blindness and the efficacy of ivermectin in the treatment of river blindness in Idogun. Observational studies in epidemiology that involve the use of a structured questionnaire to obtain useful epidemiological information from the respondents, physical assessment via palpation from head to ankle was used to assess clinical signs from the respondents and skin snip test was used to evaluate the prevalence of the disease. The efficacy of the drug was evaluated and expressed in percentages. One hundred and ninety-two (192) out of the 384 respondents examined, showed various signs of river blindness. However, it was only 108 (28.1%) respondents with the clinical signs that demonstrated Onchocerca volvulus microfilariae in their skin snips. The clinical signs observed among the respondents include skin depigmentation such as dermatitis, leopard skin, papules, pruritus and self-inflicted injury, while ocular symptoms include cataract, ocular lesion and partial blindness. Among these clinical signs, papules, and pruritus were the most dominant in the community. The prevalence of the clinical signs was observed to vary significantly among the age groups and gender (P<0.05). The efficacy of the drug after 6 and 12 months of treatments shows that the drug is more effective at age groups 10-50 years than the age groups 51-90 years. Ivermectin is observed to be efficacious in the treatment of the disease. However, to achieve eradication of the disease, the drug may be administered at 0.15mg/kg twice a year.

Keywords: riverblindness, clinical signs, ivermectin, Idogun

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Authors: Suleiman Hassan Otuoze, Dexter Vernon Lloyd Hunt, Ian Jefferson

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Urbanization has continued to widen the gap between demand and resources available to provide resilient and sustainable transport services in many fast-growing developing countries' cities. Transport demand management is a decision-based optimization concept for both benchmarking and ensuring efficient use of transport resources. This study assesses the service quality of infrastructure and mobility services in the Nigerian cities of Kano and Lagos through five dimensions of quality (i.e., Tangibility, Reliability, Responsibility, Safety Assurance and Empathy). The methodology adopts a hybrid AHP-SERVQUAL model applied on questionnaire surveys to gauge the quality of satisfaction and the views of experts in the field. The AHP results prioritize tangibility, which defines the state of transportation infrastructure and services in terms of satisfaction qualities and intervention decision weights in the two cities. The results recorded ‘unsatisfactory’ indices of quality of performance and satisfaction rating values of 48% and 49% for Kano and Lagos, respectively. The satisfaction indices are identified as indicators of low performances of transportation demand management (TDM) measures and the necessity to re-order priorities and take proactive steps towards infrastructure. The findings pilot a framework for comparative assessment of recognizable standards in transport services, best ethics of management and a necessity of quality infrastructure to guarantee both resilient and sustainable urban mobility.

Keywords: transportation demand management, multi-criteria decision support, transport infrastructure, service quality, sustainable transport

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Authors: Bashaiar Alsanaa

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The process of decision making requires environment surveillance and public opinion monitoring, both of which can be attained through effective use of social media. This study aims to investigate the extent to which new media influence the decision making process by the Kuwaiti government. The research explores how unprecedented access to information as well as dynamic user-interaction made possible by new technologies play a significant role in all aspects of decision making whether on the end of the public or decision makers themselves. The research analyzes two case studies where public opinion was forceful on social media in order to explore how such media create interactive and liberal environments for individuals to participate in the process of taking action with regards to political, economic and social issues. The findings of this descriptive study indicate the overwhelming extent to which social media are being used in Kuwait to create new social reform by the government based on citizen interaction with current topics.

Keywords: communication, descriptive, new media technologies, social media.

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Authors: H. Moalla, A. Frikha

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Multi-criteria decision aid methods consider decision problems where numerous alternatives are evaluated on several criteria. These methods are used to deal with perfect information. However, in practice, it is obvious that this information requirement is too much strict. In fact, the imperfect data provided by more or less reliable decision makers usually affect decision results since any decision is closely linked to the quality and availability of information. In this paper, a PROMETHEE-BELIEF approach is proposed to help multi-criteria decisions based on incomplete information. This approach solves problems with incomplete decision matrix and unknown weights within PROMETHEE method. On the base of belief function theory, our approach first determines the distributions of belief masses based on PROMETHEE’s net flows and then calculates weights. Subsequently, it aggregates the distribution masses associated to each criterion using Murphy’s modified combination rule in order to infer a global belief structure. The final action ranking is obtained via pignistic probability transformation. A case study of real-world application concerning the location of a waste treatment center from healthcare activities with infectious risk in the center of Tunisia is studied to illustrate the detailed process of the BELIEF-PROMETHEE approach.

Keywords: belief function theory, incomplete information, multiple criteria analysis, PROMETHEE method

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Authors: Sanjal Gavande, Thomas Mazzuchi, Shahram Sarkani

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In a complex aerospace operational environment, identifying failures in a procedure involving multiple human-machine interactions are difficult. These failures could lead to accidents causing loss of hardware or human life. The likelihood of failure further increases if operational procedures are tested for a novel system with multiple human-machine interfaces and with no prior performance data. The existing approach in the literature of reviewing complex operational tasks in a flowchart or tabular form doesn’t provide any insight into potential system failures due to human decision-making ability. To address these challenges, this research explores an agent-based simulation approach for reliability assessment and fault detection in complex human-machine systems while utilizing a human decision-making model. The simulation will predict the emergent behavior of the system due to the interaction between humans and their decision-making capability with the varying states of the machine and vice-versa. Overall system reliability will be evaluated based on a defined set of success-criteria conditions and the number of recorded failures over an assigned limit of Monte Carlo runs. The study also aims at identifying high-likelihood failure locations for the system. The research concludes that system reliability and failures can be effectively calculated when individual human and machine agent states are clearly defined. This research is limited to the operations phase of a system lifecycle process in an aerospace environment only. Further exploration of the proposed agent-based and human decision-making model will be required to allow for a greater understanding of this topic for application outside of the operations domain.

Keywords: agent-based model, complex human-machine system, human decision-making model, system reliability assessment

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Authors: Javier Menéndez, Jorge Loredo

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Large scale energy storage systems (LSESS) such as pumped-storage hydro-power (PSH) are required in the current energy transition towards a low carbon economy by using green energies that produce low levels of greenhouse gas (GHG) emissions. Coal mines are currently being closed in the European Union and their underground facilities may be used to build PSH plants. However, the development of this projects requires the excavation of a network of tunnels and a large cavern that would be used as a powerhouse to install the Francis turbine and motor-generator. The technical feasibility to excavate the powerhouse cavern has been analyzed in the North of Spain. Three-dimensional numerical models have been conducted to analyze the stability considering shale and sandstone rock mass. Total displacements and thickness of plastic zones were examined considering different support systems. Systematic grouted rock bolts and fibre reinforced shotcrete were applied at the cavern walls and roof. The results obtained show that the construction of the powerhouse is feasible applying proper support systems.

Keywords: closed mines, mine water, numerical model, pumped-storage, renewable energies

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Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

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Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

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Authors: Ph. Fauquet-Alekhine

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Decision-making occurs several times an hour when working in high risk industry and an erroneous choice might have undesirable outcomes for people and the environment surrounding the industrial plant. Industrial decisions are very often made in a context of acute stress. Time pressure is a crucial stressor leading decision makers sometimes to boost up the decision-making process and if it is not possible then shift to the simplest strategy. We thus found it interesting to update the characterization of the stress factors impairing decision-making at Chinon Nuclear Power Plant (France) in order to optimize decision making contexts and/or associated processes. The investigation was based on the analysis of reports addressing safety events over the last 3 years. Among 93 reports, those explicitly addressing decision-making issues were identified. Characterization of each event was undertaken in terms of three criteria: stressors, biases impairing decision making and weaknesses of the decision-making process. The statistical analysis showed that biases were distributed over 10 possibilities among which the hypothesis confirmation bias was clearly salient. No significant correlation was found between criteria. The analysis indicated that the main stressor was time pressure and highlights an unexpected form of stressor: the trust asymmetry principle of the expert. The analysis led to the conclusion that this stressor impaired decision-making from a psychological angle rather than from a physiological angle: it induces defensive bias of self-esteem, self-protection associated with a bias of confirmation. This leads to the hypothesis that this stressor can intervene in some cases without being detected, and to the hypothesis that other stressors of the same kind might occur without being detected too. Further investigations addressing these hypotheses are considered. The analysis also led to the conclusion that dealing with these issues implied i) decision-making methods being well known to the workers and automated and ii) the decision-making tools being well known and strictly applied. Training was thus adjusted.

Keywords: bias, expert, high risk industry, stress.

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Authors: Ali Abbas

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Industrial Engineering is a broad multidisciplinary field with intersections and applications in numerous areas. In out current environment, the path from a phenomenon to value involves numerous people with expertise in various areas including domain knowledge of a field and the ability to make decisions within an operating environment that lead to value creation. We propose some skills that industrial engineering programs should focus on, and argue that an industrial engineer is a decision maker instead of a problem solver.

Keywords: decision analysis, problem-solving, value creation, industrial engineering

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Authors: Abeer Alhazmi

Abstract:

Introduction: Clinical education is considered a significant part of the learning process for nurses and nursing students. However, recruiting high- caliber individuals to train them to be tomorrow’s educators/teachers has been a recurrent challenge. One of the troubling challenges in this field is the absent of proper training programmes to train educators to be future education professionals and leaders. Aim: To explore the impact of a stage 1 and stage 2 clinical instructor courses on developing leadership skills for nurses as educators.Theoretical Framework: Informed by a symbolic interactionist framework, this research explored the Impact of stage 1 and stage 2 clinical instructor courses on nurses' knowledge, attitudes, and leadership skills. Method: Using Glaserian grounded theory method the data were derived from 3 focus groups and 15 in-depth interviews with nurse educators/clinical instructors and nurses who attended stage 1 and stage 2 clinical instructor courses at King Abdu-Aziz University Hospital (KAUH). Findings: The findings of the research are represented in the core category exploring new identity as educator and its two constituent categories Accepting change, and constructing educator identity. The core and sub- categories were generated through a theoretical exploration of the development of educator’s identity throughout stage 1 and stage 2 clinical instructor courses. Conclusion: The social identity of the nurse educators was developed and changed during and after attending stage 1 and stage 2 clinical instructor courses. In light of an increased understanding of the development process of educators identity and role, the research presents implications and recommendations that may contribute to the development of nursing educators in general and in Saudi Arabia in specific.

Keywords: clinical instructor course, educators, identity work, clinical nursing

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Authors: Dries Dulsster

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This research we want to discuss the implications of the concept of ‘lalangue’ and illustrate its importance for lacanian psychoanalysis and its clinical practice. We will look at this concept through an in depth reading of Lacan’s later seminars, his lectures at the North-American universities and his study on James Joyce. We will illustrate the importance of this concept with a case study from a clinical practice. We will argue that the introduction of ‘lalangue’ has several theoretical and clinical implications that will radically change Lacans teachings. We will illustrate the distinction between language and lalangue. Language serves communication, but this is not the case with lalangue. We will claim that there is jouissance in language and will approach this by introducing the concept of ‘lalangue’. We will ask ourselves what the effect will be of this distinction and how we can use this in clinical practice. The concept of ‘lalangue’ will introduce a new way of thinking about the unconscious. It will force us to no longer view the unconscious as Symbolic, but as Imaginary or Real. Another implication will be the approach on the symptom, no longer approaching it as a formation of the unconscious. It will be renamed as ‘sinthome’, as function of the real. Last of all it will force us to rethink the lacanian interpretation and how we direct the treatment. The implications on a clinical level will be how we think about the lacanian interpretation and the direction of the treatment. We will no longer focus on language and meaning, but focus on jouissance and the ways in which the subject deals with this. We will illustrate this importance with a clinical case study. To summarize, the concept of lalangue forces us to radically rethink lacanian psychoanalysis, with major implications on a theoretical and clinical level. It introduces new concepts such as the real unconscious and the sinthome. It will also make us rethink the way we work as lacanian psychoanalysts.

Keywords: Lacan's later teaching, language, Lalangue, the unconscious

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Authors: Mahmoud Mohamed Emam, Yasser Fathy Hendawy Al-Mahdy

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Higher education institutions (HEIs) in Arab countries have witnessed large scope transformations as a result of embracing globalised practices. The introduction of program academic accreditation in HEIs in the Arab context has been regarded as a change enterprise that has proponents and opponents. In essence, introducing new systems or practices trigger changes that may shatter employees at a given organization. Therefore, it is argued that the interaction between organizational, contextual, and individual-related variables are likely to determine how the organization succeeds in facing resistance to change. This study investigated a mediated-effects model of organizational support and citizenship behavior. The model proposes organizational support as an antecedent of citizenship behavior and commitment to change as a mediator in the organizational support–citizenship behavior relationship. Survey data were collected and analyzed from university faculty (n=221) using structural equation modeling. Findings showed that organizational support significantly contributes to increasedcitizenshipbehaviour and the commitment of university faculty to program accreditation as a change enterprise, which has a significant and direct impact on their citizenship behaviour. We conclude that university-level organizational support shapes faculty’s commitment to change both directly and indirectly. The findings have significant practical implications for HEIs in Arab countries when they introduce new practices that aim at improving institutional effectiveness.

Keywords: organizational support, accreditation, commitment, citizenship behaviour

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Authors: Sophie Lemoussu, Jean-Charles Chaudemar, Robertus A. Vingerhoeds

Abstract:

Many innovative projects exist in the field of aeronautics, each addressing specific areas so to reduce weight, increase autonomy, reduction of CO2, etc. In many cases, such innovative developments are being carried out by very small enterprises (VSE’s) or small and medium sized-enterprises (SME’s). A good example concerns airships that are being studied as a real alternative to passenger and cargo transportation. Today, no international regulations propose a precise and sufficiently detailed framework for the development and certification of airships. The absence of such a regulatory framework requires a very close contact with regulatory instances. However, VSE’s/SME’s do not always have sufficient resources and internal knowledge to handle this complexity and to discuss these issues. This poses an additional challenge for those VSE’s/SME’s, in particular those that have system integration responsibilities and that must provide all the necessary evidence to demonstrate their ability to design, produce, and operate airships with the expected level of safety and reliability. The main objective of this research is to provide a methodological framework enabling VSE’s/SME’s with limited resources to organize the development of airships while taking into account the constraints of safety, cost, time and performance. This paper proposes to provide a contribution to this problematic by proposing a Model-Based Systems Engineering approach. Through a comprehensive process modeling approach applied to the development processes, the regulatory constraints, existing best practices, etc., a good image can be obtained as to the process landscape that may influence the development of airships. To this effect, not only the necessary regulatory information is taken on board, also other international standards and norms on systems engineering and project management are being modeled and taken into account. In a next step, the model can be used for analysis of the specific situation for given developments, derive critical paths for the development, identify eventual conflicting aspects between the norms, standards, and regulatory expectations, or also identify those areas where not enough information is available. Once critical paths are known, optimization approaches can be used and decision support techniques can be applied so to better support VSE’s/SME’s in their innovative developments. This paper reports on the adopted modeling approach, the retained modeling languages, and how they all fit together.

Keywords: aeronautics, certification, process modeling, project management, regulation, SME, systems engineering, VSE

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