Search results for: clinical trial optimization
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7433

Search results for: clinical trial optimization

6773 Analysis of CO₂ Two-Phase Ejector with Taguchi and ANOVA Optimization and Refrigerant Selection with Enviro Economic Concerns by TOPSIS Analysis

Authors: Karima Megdouli, Bourhan tachtouch

Abstract:

Ejector refrigeration cycles offer an alternative to conventional systems for producing cold from low-temperature heat. In this article, a thermodynamic model is presented. This model has the advantage of simplifying the calculation algorithm and describes the complex double-throttling mechanism that occurs in the ejector. The model assumption and calculation algorithm are presented first. The impact of each efficiency is evaluated. Validation is performed on several data sets. The ejector model is then used to simulate a RES (refrigeration ejector system), to validate its robustness and suitability for use in predicting thermodynamic cycle performance. A Taguchi and ANOVA optimization is carried out on a RES. TOPSIS analysis was applied to decide the optimum refrigerants with cost, safety, environmental and enviro economic concerns along with thermophysical properties.

Keywords: ejector, velocity distribution, shock circle, Taguchi and ANOVA optimization, TOPSIS analysis

Procedia PDF Downloads 85
6772 Statistical Optimization and Production of Rhamnolipid by P. aeruginosa PAO1 Using Prickly Pear Peel as a Carbon Source

Authors: Mostafa M. Abo Elsoud, Heba I. Elkhouly, Nagwa M. Sidkey

Abstract:

Production of rhamnolipids by Pseudomonas aeruginosa has attracted a growing interest during the last few decades due to its high productivity compared with other microorganisms. In the current work, rhamnolipids production by P. aeruginosa PAO1 was statistically modeled using Taguchi orthogonal array, numerically optimized and validated. Prickly Pear Peel (Opuntia ficus-indica) has been used as a carbon source for production of rhamnolipid. Finally, the optimum conditions for rhamnolipid production were applied in 5L working volume bioreactors at different aerations, agitation and controlled pH for maximum rhamnolipid production. In addition, kinetic studies of rhamnolipids production have been reported. At the end of the batch bioreactor optimization process, rhamnolipids production by P. aeruginosa PAO1 has reached the worldwide levels and can be applied for its industrial production.

Keywords: rhamnolipids, pseudomonas aeruginosa, statistical optimization, tagushi, opuntia ficus-indica

Procedia PDF Downloads 174
6771 A Modified Nonlinear Conjugate Gradient Algorithm for Large Scale Unconstrained Optimization Problems

Authors: Tsegay Giday Woldu, Haibin Zhang, Xin Zhang, Yemane Hailu Fissuh

Abstract:

It is well known that nonlinear conjugate gradient method is one of the widely used first order methods to solve large scale unconstrained smooth optimization problems. Because of the low memory requirement, attractive theoretical features, practical computational efficiency and nice convergence properties, nonlinear conjugate gradient methods have a special role for solving large scale unconstrained optimization problems. Large scale optimization problems are with important applications in practical and scientific world. However, nonlinear conjugate gradient methods have restricted information about the curvature of the objective function and they are likely less efficient and robust compared to some second order algorithms. To overcome these drawbacks, the new modified nonlinear conjugate gradient method is presented. The noticeable features of our work are that the new search direction possesses the sufficient descent property independent of any line search and it belongs to a trust region. Under mild assumptions and standard Wolfe line search technique, the global convergence property of the proposed algorithm is established. Furthermore, to test the practical computational performance of our new algorithm, numerical experiments are provided and implemented on the set of some large dimensional unconstrained problems. The numerical results show that the proposed algorithm is an efficient and robust compared with other similar algorithms.

Keywords: conjugate gradient method, global convergence, large scale optimization, sufficient descent property

Procedia PDF Downloads 198
6770 Optimization of Roster Construction In Sports

Authors: Elijah Cavan

Abstract:

In Major League Sports (MLB, NBA, NHL, NFL), it is the Front Office Staff (FOS) who make decisions about who plays for their respective team. The FOS bear the brunt of the responsibility for acquiring players through drafting, trading and signing players in free agency while typically contesting with maximum roster salary constraints. The players themselves are volatile assets of these teams- their value fluctuates with age and performance. A simple comparison can be made when viewing players as assets. The problem here is similar to that of optimizing your investment portfolio. The The goal is ultimately to maximize your periodic returns while tolerating a fixed risk (degree of uncertainty/ potential loss). Each franchise may value assets differently, and some may only tolerate lower risk levels- these are examples of factors that introduce additional constraints into the model. In this talk, we will detail the mathematical formulation of this problem as a constrained optimization problem- which can be solved with classical machine learning methods but is also well posed as a problem to be solved on quantum computers

Keywords: optimization, financial mathematics, sports analytics, simulated annealing

Procedia PDF Downloads 112
6769 Optimal Trailing Edge Flap Positions of Helicopter Rotor for Various Thrust Coefficient to Solidity (Ct/σ) Ratios

Authors: K. K. Saijaand, K. Prabhakaran Nair

Abstract:

This study aims to determine change in optimal lo-cations of dual trailing-edge flaps for various thrust coefficient to solidity (Ct /σ) ratios of helicopter to achieve minimum hub vibration levels, with low penalty in terms of required trailing-edge flap control power. Polynomial response functions are used to approximate hub vibration and flap power objective functions. Single objective and multi-objective optimization is carried with the objective of minimizing hub vibration and flap power. The optimization results shows that the inboard flap location at low Ct/σ ratio move farther from the baseline value and at high Ct/σ ratio move towards the root of the blade for minimizing hub vibration.

Keywords: helicopter rotor, trailing-edge flap, thrust coefficient to solidity (Ct /σ) ratio, optimization

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6768 Optimal Design of Storm Water Networks Using Simulation-Optimization Technique

Authors: Dibakar Chakrabarty, Mebada Suiting

Abstract:

Rapid urbanization coupled with changes in land use pattern results in increasing peak discharge and shortening of catchment time of concentration. The consequence is floods, which often inundate roads and inhabited areas of cities and towns. Management of storm water resulting from rainfall has, therefore, become an important issue for the municipal bodies. Proper management of storm water obviously includes adequate design of storm water drainage networks. The design of storm water network is a costly exercise. Least cost design of storm water networks assumes significance, particularly when the fund available is limited. Optimal design of a storm water system is a difficult task as it involves the design of various components, like, open or closed conduits, storage units, pumps etc. In this paper, a methodology for least cost design of storm water drainage systems is proposed. The methodology proposed in this study consists of coupling a storm water simulator with an optimization method. The simulator used in this study is EPA’s storm water management model (SWMM), which is linked with Genetic Algorithm (GA) optimization method. The model proposed here is a mixed integer nonlinear optimization formulation, which takes care of minimizing the sectional areas of the open conduits of storm water networks, while satisfactorily conveying the runoff resulting from rainfall to the network outlet. Performance evaluations of the developed model show that the proposed method can be used for cost effective design of open conduit based storm water networks.

Keywords: genetic algorithm (GA), optimal design, simulation-optimization, storm water network, SWMM

Procedia PDF Downloads 245
6767 A Nutritional Wellness Program for Overweight Health Care Providers in Hospital Setting: A Randomized Controlled Trial Pilot Study

Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

Abstract:

Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: weight management, weight control, health care providers, hospital

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6766 A Qualitative Study to Analyze Clinical Coders’ Decision Making Process of Adverse Drug Event Admissions

Authors: Nisa Mohan

Abstract:

Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.

Keywords: adverse drug events, clinical coders, decision making, hospital admissions

Procedia PDF Downloads 117
6765 Ant System with Acoustic Communication

Authors: Saad Bougrine, Salma Ouchraa, Belaid Ahiod, Abdelhakim Ameur El Imrani

Abstract:

Ant colony optimization is an ant algorithm framework that took inspiration from foraging behaviour of ant colonies. Indeed, ACO algorithms use a chemical communication, represented by pheromone trails, to build good solutions. However, ants involve different communication channels to interact. Thus, this paper introduces the acoustic communication between ants while they are foraging. This process allows fine and local exploration of search space and permits optimal solution to be improved.

Keywords: acoustic communication, ant colony optimization, local search, traveling salesman problem

Procedia PDF Downloads 581
6764 Clinical Case Report of Fulminating Leptospirosis in a 4-Months Old Caucasian Dog: Public Health Significance and Ramifications

Authors: N. N. Pilau, M. S. Abubakar, A. Danmaigoro, P. C. Mshelia, Y. Sani

Abstract:

A severely debilitated 4months old Caucasian male dog presented dehydration, emaciation, vomiting, icteric ocular and oral mucous membranes, generalized lymphadenopathy, hematuria, anorexia and prolonged recumbency. Clinical workup was done in established protocols for diagnosis based on history, clinical signs and selected laboratory tests. Treatment course were administered over 48hours during which the patient died of overwhelming hepatopathy, nephropathy and pneumonia. Postmortem findings supported by ante mortem laboratory test results tentatively diagnosed leptospirosis, a disease endemic and presenting potentially fatal epidemics and zoonoses in some countries amongst the developing regions of the world. This disease is reviewed and a call for attention on the public health significance of the disease is hereby presented through this case report.

Keywords: canine, endemic, leptospirosis, prevalence

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6763 Response Surface Methodology for the Optimization of Paddy Husker by Medium Brown Rice Peeling Machine 6 Rubber Type

Authors: S. Bangphan, P. Bangphan, C. Ketsombun, T. Sammana

Abstract:

Optimization of response surface methodology (RSM) was employed to study the effects of three factor (rubber of clearance, spindle of speed, and rice of moisture) in brown rice peeling machine of the optimal good rice yield (99.67, average of three repeats). The optimized composition derived from RSM regression was analyzed using Regression analysis and Analysis of Variance (ANOVA). At a significant level α=0.05, the values of Regression coefficient, R2 adjust were 96.55% and standard deviation were 1.05056. The independent variables are initial rubber of clearance, spindle of speed and rice of moisture parameters namely. The investigating responses are final rubber clearance, spindle of speed and moisture of rice.

Keywords: brown rice, response surface methodology (RSM), peeling machine, optimization, paddy husker

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6762 Epidemiological and Clinical Profile of Patients with Chorioamnionitis

Authors: Isabel Cristina Ortiz Trujillo, Lina Maria Martinez Sanchez, Felipe Hernández Restrepo, Daniel Gallego Gonzalez, Natalia Vargas Grisales, Camilo Andrés Agudelo Vélez

Abstract:

Chorioamnionitis, is a pregnancy infection, causes different fetal and maternal symptoms. Streptococcus agalactiae present in the normal vaginal microflora of some women, favouring its abnormal multiplication during pregnancy, causing perinatal morbidity and mortality. Objective. Describe the clinical and epidemiological profile of the patients with diagnosis of clinical chorioanmionitis. Methodology. Descriptive, cross-sectional study. The population was patients with diagnosis of clinical chorioanmionitis. The information was taken from the medical records. The research was approved by the Ethics Committee. We used the program SPSS ® version 17.0 (SPSS Inc; Chicago, Illinois, USA) for the information analysis, descriptive statistics were used. Results. 78 patients in total with clinical chorioamnionitis, with a mean age of 26.3 ±5, 8 years old, the 69.2% primigravid women. 2.6% of women had positive culture for Streptococcus agalactiae in urine sample during current pregnancy and 30.7% had received some kind of antibiotics during current pregnancy. The 57.7% had 37 to 40 weeks of gestation in the current pregnancy it was calculated more frequently by ultrasound (66.7% in first quarter, 11.5% in the second and 1.9% in the third). In a 60.3% way of termination of pregnancy was vaginal and a 35.9 percent were caesarean section. Among the women in the study, a 30.8% had premature rupture of membranes. Conclusion. The chorioamnionitis continues to be an important cause of antibiotic use during pregnancy or labour and the decision to do a caesarean, with highest percentage in pregnancies-preterm and preterm premature rupture of membranes.

Keywords: chorioamnionitis, Streptococcus agalactiae, pregnancy complications, infectious

Procedia PDF Downloads 418
6761 Coefficient of Performance (COP) Optimization of an R134a Cross Vane Expander Compressor Refrigeration System

Authors: Y. D. Lim, K. S. Yap, K. T. Ooi

Abstract:

Cross Vane Expander Compressor (CVEC) is a newly invented expander-compressor combined unit, where it is introduced to replace the compressor and the expansion valve in traditional refrigeration system. The mathematical model of CVEC has been developed to examine its performance, and it was found that the energy consumption of a conventional refrigeration system was reduced by as much as 18%. It is believed that energy consumption can be further reduced by optimizing the device. In this study, the coefficient of performance (COP) of CVEC has been optimized under predetermined operational parameters and constrained main design parameters. Several main design parameters of CVEC were selected to be the variables, and the optimization was done with theoretical model in a simulation program. The theoretical model consists of geometrical model, dynamic model, heat transfer model and valve dynamics model. Complex optimization method, which is a constrained, direct search and multi-variables method was used in the study. As a result, the optimization study suggested that with an appropriate combination of design parameters, a 58% COP improvement in CVEC R134a refrigeration system is possible.

Keywords: COP, cross vane expander-compressor, CVEC, design, simulation, refrigeration system, air-conditioning, R134a, multi variables

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6760 Challenge of the Credibility of Witnesses in the International Criminal Court and the Precondition to Establish the Truth

Authors: Romina Beqiri

Abstract:

In the context of the prosecution of those responsible for the commission of the most hideous crimes and the fight against impunity, a fundamental role is played by witnesses of the crimes who contribute to ascertaining the ‘procedural truth’. This article examines recent decisions and legislation of the Hague-based International Criminal Court in terms of the endangerment of the integrity of the criminal proceedings in consequence of witness tampering. The analysis focuses on the new developments in the courtroom and the academia, in particular, on the first-ever sentence confirming the charges of corruptly influencing witnesses, interpretation of presenting false evidence and giving false testimony when under an obligation to tell the truth. Confronted with recent tampering with witnesses and their credibility at stake in the ongoing cases, the research explores different Court’s decisions and scholars’ legal disputes concerning the deterrence approach to punish the authors of offences against the administration of justice when committed intentionally. Therefore, the analysis concludes that the Court cannot tolerate any witness false testimony and should enhance consistency and severity of sanctions for the sake of fair trial and end impunity.

Keywords: International Criminal Court, administration of justice, credibility of witness, fair trial, false testimony, witness tampering

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6759 The Association of IL-17 Serum Levels with Disease Severity and Onset of Symptoms in Rheumatoid Arthritis Patients

Authors: Fatemeh Keshavarz

Abstract:

Background: Rheumatoid arthritis (RA) is one of the most common autoimmune diseases, often leading to joint damage and physical disability. This study aimed to investigate the relationship of serum levels of interleukin 17 and anti-CCP factor with disease severity in RA patients. Materials and Methods: Fifty-four patients with RA confirmed by clinical and laboratory criteria were recruited. A 5 ml venous blood sample was taken from every patient, its serum was separated. Based on clinical data and severity of symptoms, patients were classified into three groups of those with mild, moderate, and severe symptoms. Serum levels of IL-17 and anti-CCP in all samples were measured using ELISA. Results: Analysis of IL-17 serum levels in different groups showed that its amount was higher in the group with mild clinical symptoms than in other groups. Comparison of IL-17 serum levels between mild and moderate disease severity groups showed a statistically significant relationship. There was also a positive linear relationship between anti-CCP and serum IL-17 levels in different groups of the disease, and serum IL-17 levels were inversely related to the duration of exposure to the disease. Conclusion: Higher IL-17 serum levels in patients with mild symptom severity confirm that this highly specific marker is involved in the pathogenesis of RA and may be effective in initiating patients’ clinical symptoms.

Keywords: IL-17, anti-CCP, rheumatoid arthritis, autoimmune

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6758 Optimization of Double-Layered Microchannel Heat Sinks

Authors: Tu-Chieh Hung, Wei-Mon Yan, Xiao-Dong Wang, Yu-Xian Huang

Abstract:

This work employs a combined optimization procedure including a simplified conjugate-gradient method and a three-dimensional fluid flow and heat transfer model to study the optimal geometric parameter design of double-layered microchannel heat sinks. The overall thermal resistance RT is the objective function to be minimized with number of channels, N, the channel width ratio, β, the bottom channel aspect ratio, αb, and upper channel aspect ratio, αu, as the search variables. It is shown that, for the given bottom area (10 mm×10 mm) and heat flux (100 W cm-2), the optimal (minimum) thermal resistance of double-layered microchannel heat sinks is about RT=0.12 ℃/m2W with the corresponding optimal geometric parameters N=73, β=0.50, αb=3.52, and, αu= 7.21 under a constant pumping power of 0.05 W. The optimization process produces a maximum reduction by 52.8% in the overall thermal resistance compared with an initial guess (N=112, β=0.37, αb=10.32 and, αu=10.93). The results also show that the optimal thermal resistance decreases rapidly with the pumping power and tends to be a saturated value afterward. The corresponding optimal values of parameters N, αb, and αu increase while that of β decrease as the pumping power increases. However, further increasing pumping power is not always cost-effective for the application of heat sink designs.

Keywords: optimization, double-layered microchannel heat sink, simplified conjugate-gradient method, thermal resistance

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6757 Impact of Self-Efficacy, Resilience, and Social Support on Vicarious Trauma among Clinical Psychologists, Counselors, and Teachers of Special Schools

Authors: Hamna Hamid, Kashmala Zaman

Abstract:

The aim of this study was to evaluate the relationship between self-efficacy, resilience, and social support among clinical psychologists, counselors, and teachers of special schools. The study also assesses the gender differences in self-efficacy, resilience, social support, and vicarious trauma and also vicarious trauma differences among three professions, i.e., clinical psychologists, counselors, and teachers of special schools. A sample of 150 women and 97 men were handed out a set questionnaire to complete: a General Self-Efficacy Scale, Brief Resilience Scale, Multidimensional Scale of Perceived Social Support, and Vicarious Trauma Scale. Results showed that there is a significant negative correlation between self-efficacy, resilience, and vicarious trauma. Women experience higher levels of vicarious trauma as compared to men. At the same time, clinical psychologists and counselors experience higher levels of vicarious trauma as compared to teachers of special schools. The moderation effect of social support is not significant towards resilience and vicarious trauma.

Keywords: self-efficacy, resilience, vicarious-trauma social-support, social support

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6756 An Approach for Estimation in Hierarchical Clustered Data Applicable to Rare Diseases

Authors: Daniel C. Bonzo

Abstract:

Practical considerations lead to the use of unit of analysis within subjects, e.g., bleeding episodes or treatment-related adverse events, in rare disease settings. This is coupled with data augmentation techniques such as extrapolation to enlarge the subject base. In general, one can think about extrapolation of data as extending information and conclusions from one estimand to another estimand. This approach induces hierarchichal clustered data with varying cluster sizes. Extrapolation of clinical trial data is being accepted increasingly by regulatory agencies as a means of generating data in diverse situations during drug development process. Under certain circumstances, data can be extrapolated to a different population, a different but related indication, and different but similar product. We consider here the problem of estimation (point and interval) using a mixed-models approach under an extrapolation. It is proposed that estimators (point and interval) be constructed using weighting schemes for the clusters, e.g., equally weighted and with weights proportional to cluster size. Simulated data generated under varying scenarios are then used to evaluate the performance of this approach. In conclusion, the evaluation result showed that the approach is a useful means for improving statistical inference in rare disease settings and thus aids not only signal detection but risk-benefit evaluation as well.

Keywords: clustered data, estimand, extrapolation, mixed model

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6755 Design and Optimization of a 6 Degrees of Freedom Co-Manipulated Parallel Robot for Prostate Brachytherapy

Authors: Aziza Ben Halima, Julien Bert, Dimitris Visvikis

Abstract:

In this paper, we propose designing and evaluating a parallel co-manipulated robot dedicated to low-dose-rate prostate brachytherapy. We developed 6 degrees of freedom compact and lightweight robot easy to install in the operating room thanks to its parallel design. This robotic system provides a co-manipulation allowing the surgeon to keep control of the needle’s insertion and consequently to improve the acceptability of the plan for the clinic. The best dimension’s configuration was solved by calculating the geometric model and using an optimization approach. The aim was to ensure the whole coverage of the prostate volume and consider the allowed free space around the patient that includes the ultrasound probe. The final robot dimensions fit in a cube of 300 300 300 mm³. A prototype was 3D printed, and the robot workspace was measured experimentally. The results show that the proposed robotic system satisfies the medical application requirements and permits the needle to reach any point within the prostate.

Keywords: medical robotics, co-manipulation, prostate brachytherapy, optimization

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6754 Effectiveness of Clinical Practice Guidelines for Jellyfish Stings Treatment at the Emergency Room of Songkhla Hospital Thailand

Authors: Prataksitorn Chonlakan, Tiparat Wongsilarat

Abstract:

The traditional clinical practice guideline used at the emergency room at Songkhla Hospital in caring for patients who come in contact with jellyfish venom took a long time for the pain to reduce to the level that patients can cope with. To investigate the effectiveness of clinical practice guidelines by comparing the effectiveness of a newly developed clinical practice guideline with the traditional clinical practice guideline in the following aspects: 1) pain reduction, 2) length of pain, 3) the rate of patient’s re-visit, 4) the rate of severe complications such as anaphylactic shock, and cardiac arrest, and death, and 5) patient satisfaction. This study employed a quasi-experimental research design. Thirty subjects were selected with purposive sampling from jellyfish-sting patients who came for treatment at the Emergency Room of Songkhla Hospital. The subjects were divided using random assignment into two groups of 15 each: an experimental group, and the control group. The control group was treated using the traditional clinical practice guideline consisting of rinsing the affected area with 0.9% normal saline, using a cloth soaked with vinegar to press against the affected area, and controlling pain using tramadol or diclofenac intramuscular injection. The data were analyzed using descriptive statistics and paired t-test at the significance level p < 0.05. The results of the study revealed the following. The pain level in the experimental group was significantly lower than that of the control group (the average pain score of the experimental group was 3.46 while that of the control group was 6.33) (p < 0.05).The length of pain in the experimental group was significantly lower than that of the control group (the average length of pain in the experimental group was 48.67 minutes while that of the control group was 105.35 minutes) (p < 0.05). The rate of re-visit within 12 hours in the experimental group was significantly lower than that of the control group (the rate of re-visit within 12 hours of the experimental group was 0.07 while that of the control group was 0.00) (p < 0.05).No severe complications such as anaphylactic shock, and cardiac arrest were found in the two groups of subjects.The rate of satisfaction among the subjects in the experimental group was significantly higher than that of the control group (the rate of satisfaction among the subjects of the experimental group was 90.00 percent while that among the control group was 66.33 percent) (p < 0.05). The newly develop clinical practice guideline could reduce pain and increase satisfaction among jellyfish-sting patients better than the traditional clinical practice guideline.

Keywords: effectiveness, clinical practice guideline, jellyfish-sting patients, cardiac arrest

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6753 Efficiency of Robust Heuristic Gradient Based Enumerative and Tunneling Algorithms for Constrained Integer Programming Problems

Authors: Vijaya K. Srivastava, Davide Spinello

Abstract:

This paper presents performance of two robust gradient-based heuristic optimization procedures based on 3n enumeration and tunneling approach to seek global optimum of constrained integer problems. Both these procedures consist of two distinct phases for locating the global optimum of integer problems with a linear or non-linear objective function subject to linear or non-linear constraints. In both procedures, in the first phase, a local minimum of the function is found using the gradient approach coupled with hemstitching moves when a constraint is violated in order to return the search to the feasible region. In the second phase, in one optimization procedure, the second sub-procedure examines 3n integer combinations on the boundary and within hypercube volume encompassing the result neighboring the result from the first phase and in the second optimization procedure a tunneling function is constructed at the local minimum of the first phase so as to find another point on the other side of the barrier where the function value is approximately the same. In the next cycle, the search for the global optimum commences in both optimization procedures again using this new-found point as the starting vector. The search continues and repeated for various step sizes along the function gradient as well as that along the vector normal to the violated constraints until no improvement in optimum value is found. The results from both these proposed optimization methods are presented and compared with one provided by popular MS Excel solver that is provided within MS Office suite and other published results.

Keywords: constrained integer problems, enumerative search algorithm, Heuristic algorithm, Tunneling algorithm

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6752 Linear Array Geometry Synthesis with Minimum Sidelobe Level and Null Control Using Taguchi Method

Authors: Amara Prakasa Rao, N. V. S. N. Sarma

Abstract:

This paper describes the synthesis of linear array geometry with minimum sidelobe level and null control using the Taguchi method. Based on the concept of the orthogonal array, Taguchi method effectively reduces the number of tests required in an optimization process. Taguchi method has been successfully applied in many fields such as mechanical, chemical engineering, power electronics, etc. Compared to other evolutionary methods such as genetic algorithms, simulated annealing and particle swarm optimization, the Taguchi method is much easier to understand and implement. It requires less computational/iteration processing to optimize the problem. Different cases are considered to illustrate the performance of this technique. Simulation results show that this method outperforms the other evolution algorithms (like GA, PSO) for smart antenna systems design.

Keywords: array factor, beamforming, null placement, optimization method, orthogonal array, Taguchi method, smart antenna system

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6751 Nursing Preceptors' Perspectives of Assessment Competency

Authors: Watin Alkhelaiwi, Iseult Wilson, Marian Traynor, Katherine Rogers

Abstract:

Clinical nursing education allows nursing students to gain essential knowledge from practice experience and develop nursing skills in a variety of clinical environments. Integrating theoretical knowledge and practical skills is made easier for nursing students by providing opportunities for practice in a clinical environment. Nursing competency is an essential capability required to fulfill nursing responsibilities. Effective mentoring in clinical settings helps nursing students develop the necessary competence and promotes the integration of theory and practice. Preceptors play a considerable role in clinical nursing education, including the supervision of nursing students undergoing a rigorous clinical practicum. Preceptors are also involved in the clinical assessment of nursing students’ competency. The assessment of nursing students’ competence by professional practitioners is essential to investigate whether nurses have developed an adequate level of competence to deliver safe nursing care. Competency assessment remains challenging among nursing educators and preceptors, particularly owing to the complexity of the process. Consistency in terms of assessment methods and tools and valid and reliable assessment tools for measuring competence in clinical practice are lacking. Nurse preceptors must assess students’ competencies to prepare them for future professional responsibilities. Preceptors encounter difficulties in the assessment of competency owing to the nature of the assessment process, lack of standardised assessment tools, and a demanding clinical environment. The purpose of the study is to examine nursing preceptors’ experiences of assessing nursing interns’ competency in Saudi Arabia. There are three objectives in this study; the first objective is to examine the preceptors’ view of the Saudi assessment tool in relation to preceptorship, assessment, the assessment tool, the nursing curriculum, and the grading system. The second and third objectives are to examine preceptors’ view of "competency'' in nursing and their interpretations of the concept of competency and to assess the implications of the research in relation to the Saudi 2030 vision. The study uses an exploratory sequential mixed-methods design that involves a two-phase project: a qualitative focus group study is conducted in phase 1, and a quantitative study- a descriptive cross-sectional design (online survey) is conducted in phase 2. The results will inform the preceptors’ view of the Saudi assessment tool in relation to specific areas, including preceptorship and how the preceptors are prepared to be assessors, and assessment and assessment tools through identifying the appropriateness of the instrument for clinical practice. The results will also inform the challenges and difficulties that face the preceptors. These results will be analysed thematically for the focus group interview data, and SPSS software will be used for the analysis of the online survey data.

Keywords: clinical assessment tools, clinical competence, competency assessment, mentor, nursing, nurses, preceptor

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6750 Developing and Evaluating Clinical Risk Prediction Models for Coronary Artery Bypass Graft Surgery

Authors: Mohammadreza Mohebbi, Masoumeh Sanagou

Abstract:

The ability to predict clinical outcomes is of great importance to physicians and clinicians. A number of different methods have been used in an effort to accurately predict these outcomes. These methods include the development of scoring systems based on multivariate statistical modelling, and models involving the use of classification and regression trees. The process usually consists of two consecutive phases, namely model development and external validation. The model development phase consists of building a multivariate model and evaluating its predictive performance by examining calibration and discrimination, and internal validation. External validation tests the predictive performance of a model by assessing its calibration and discrimination in different but plausibly related patients. A motivate example focuses on prediction modeling using a sample of patients undergone coronary artery bypass graft (CABG) has been used for illustrative purpose and a set of primary considerations for evaluating prediction model studies using specific quality indicators as criteria to help stakeholders evaluate the quality of a prediction model study has been proposed.

Keywords: clinical prediction models, clinical decision rule, prognosis, external validation, model calibration, biostatistics

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6749 The Connection between the Schwartz Theory of Basic Values and Ethical Principles in Clinical Psychology

Authors: Matej Stritesky

Abstract:

The research deals with the connection between the Schwartz Theory of Basic Values and the ethical principles in psychology, on which the meta-code of ethics the European Federation of Psychological Associations is based. The research focuses on ethically problematic situations in clinical psychology in the Czech Republic. Based on the analysis of papers that identified ethically problematic situations faced by clinical psychologists, a questionnaire of ethically problematic situations in clinical psychology (EPSCP) was created for the purposes of the research. The questionnaire was created to represent situations that correspond to the 4 principles on which the meta-code of ethics the European Federation of Psychological Associations is based. The questionnaire EPSCP consists of descriptions of 32 situations that respondents evaluate on a scale from 1 (psychologist's behaviour is ethically perfectly fine) to 10 (psychologist's behaviour is ethically completely unacceptable). The EPSCP questionnaire, together with Schwartz's PVQ questionnaire, will be presented to 60 psychology students. The relationship between principles in clinical psychology and the values on Schwartz´s value continuum will be described using multidimensional scaling. A positive correlation is assumed between the higher-order value of openness to change and problematic ethical situations related to the principle of integrity; a positive correlation between the value of the higher order of self-transcendence and the principle of respect and responsibility; a positive correlation between the value of the higher order of conservation and the principle of competence; and negative correlation between the value of the higher order of ego strengthening and sensitivity to ethically problematic situations. The research also includes an experimental part. The first half of the students are presented with the code of ethics of the Czech Association of Clinical Psychologists before completing the questionnaires, and to the second half of the students is the code of ethics presented after completing the questionnaires. In addition to reading the code of ethics, students describe the three rules of the code of ethics that they consider most important and state why they chose these rules. The output of the experimental part will be to determine whether the presentation of the code of ethics leads to greater sensitivity to ethically problematic situations.

Keywords: clinical psychology, ethically problematic situations in clinical psychology, ethical principles in psychology, Schwartz theory of basic values

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6748 Speed Control of DC Motor Using Optimization Techniques Based PID Controller

Authors: Santosh Kumar Suman, Vinod Kumar Giri

Abstract:

The goal of this paper is to outline a speed controller of a DC motor by choice of a PID parameters utilizing genetic algorithms (GAs), the DC motor is extensively utilized as a part of numerous applications such as steel plants, electric trains, cranes and a great deal more. DC motor could be represented by a nonlinear model when nonlinearities such as attractive dissemination are considered. To provide effective control, nonlinearities and uncertainties in the model must be taken into account in the control design. The DC motor is considered as third order system. Objective of this paper three type of tuning techniques for PID parameter. In this paper, an independently energized DC motor utilizing MATLAB displaying, has been outlined whose velocity might be examined utilizing the Proportional, Integral, Derivative (KP, KI , KD) addition of the PID controller. Since, established controllers PID are neglecting to control the drive when weight parameters be likewise changed. The principle point of this paper is to dissect the execution of optimization techniques viz. The Genetic Algorithm (GA) for improve PID controllers parameters for velocity control of DC motor and list their points of interest over the traditional tuning strategies. The outcomes got from GA calculations were contrasted and that got from traditional technique. It was found that the optimization techniques beat customary tuning practices of ordinary PID controllers.

Keywords: DC motor, PID controller, optimization techniques, genetic algorithm (GA), objective function, IAE

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6747 An Assessment of the Hip Muscular Imbalance for Patients with Rheumatism

Authors: Anthony Bawa, Konstantinos Banitsas

Abstract:

Rheumatism is a muscular disorder that affects the muscles of the upper and lower limbs. This condition could potentially progress to impair the movement of patients. This study aims to investigate the hip muscular imbalance in patients with chronic rheumatism. A clinical trial involving a total of 15 participants, made up of 10 patients and 5 control subjects, took place in KATH Hospital between August and September. Participants recruited for the study were of age 54 ± 8years, weight 65± 8kg, and height 176 ± 8cm. Muscle signals were recorded from the rectus femoris, and vastus lateralis on the right and left hip of participants. The parameters used in determining the hip muscular imbalances were the maximum voluntary contraction (MVC%), the mean difference, and hip muscle fatigue levels. The mean signals were compared using a t-test, and the metrics for muscle fatigue assessment were based on the root mean square (RMS), mean absolute value (MAV) and mean frequency (MEF), which were computed between the hip muscles of participants. The results indicated that there were significant imbalances in the muscle coactivity between the right and left hip muscles of patients. The patients’ MVC values were observed to be above 10% when compared with control subjects. Furthermore, the mean difference was seen to be higher with p > 0.002 among patients, which indicated clear differences in the hip muscle contraction activities. The findings indicate significant hip muscular imbalances for patients with rheumatism compared with control subjects. Information about the imbalances among patients will be useful for clinicians in designing therapeutic muscle-strengthening exercises.

Keywords: muscular, imbalances, rheumatism, Hip

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6746 Comparison of Two Transcranial Magnetic Stimulation Protocols on Spasticity in Multiple Sclerosis - Pilot Study of a Randomized and Blind Cross-over Clinical Trial

Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa

Abstract:

Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.

Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation

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6745 A Perspective of Digital Formation in the Solar Community as a Prototype for Finding Sustainable Algorithmic Conditions on Earth

Authors: Kunihisa Kakumoto

Abstract:

“Purpose”: Global environmental issues are now being raised in a global dimension. By predicting sprawl phenomena beyond the limits of nature with algorithms, we can expect to protect our social life within the limits of nature. It turns out that the sustainable state of the planet now consists in maintaining a balance between the capabilities of nature and the possibilities of our social life. The amount of water on earth is finite. Sustainability is therefore highly dependent on water capacity. A certain amount of water is stored in the forest by planting and green space, and the amount of water can be considered in relation to the green space. CO2 is also absorbed by green plants. "Possible measurements and methods": The concept of the solar community has been introduced in technical papers on the occasion of many international conferences. The solar community concept is based on data collected from one solar model house. This algorithmic study simulates the amount of water stored by lush green vegetation. In addition, we calculated and compared the amount of CO2 emissions from the Taiyo Community and the amount of CO2 reduction from greening. Based on the trial calculation results of these solar communities, we are simulating the sustainable state of the earth as an algorithm trial calculation result. We believe that we should also consider the composition of this solar community group using digital technology as control technology. "Conclusion": We consider the solar community as a prototype for finding sustainable conditions for the planet. The role of water is very important as the supply capacity of water is limited. However, the circulation of social life is not constructed according to the mechanism of nature. This simulation trial calculation is explained using the total water supply volume as an example. According to this process, algorithmic calculations consider the total capacity of the water supply and the population and habitable numbers of the area. Green vegetated land is very important to keep enough water. Green vegetation is also very important to maintain CO2 balance. A simulation trial calculation is possible from the relationship between the CO2 emissions of the solar community and the amount of CO2 reduction due to greening. In order to find this total balance and sustainable conditions, the algorithmic simulation calculation takes into account lush vegetation and total water supply. Research to find sustainable conditions is done by simulating an algorithmic model of the solar community as a prototype. In this one prototype example, it's balanced. The activities of our social life must take place within the permissive limits of natural mechanisms. Of course, we aim for a more ideal balance by utilizing auxiliary digital control technology such as AI.

Keywords: solar community, sustainability, prototype, algorithmic simulation

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6744 Portfolio Optimization under a Hybrid Stochastic Volatility and Constant Elasticity of Variance Model

Authors: Jai Heui Kim, Sotheara Veng

Abstract:

This paper studies the portfolio optimization problem for a pension fund under a hybrid model of stochastic volatility and constant elasticity of variance (CEV) using asymptotic analysis method. When the volatility component is fast mean-reverting, it is able to derive asymptotic approximations for the value function and the optimal strategy for general utility functions. Explicit solutions are given for the exponential and hyperbolic absolute risk aversion (HARA) utility functions. The study also shows that using the leading order optimal strategy results in the value function, not only up to the leading order, but also up to first order correction term. A practical strategy that does not depend on the unobservable volatility level is suggested. The result is an extension of the Merton's solution when stochastic volatility and elasticity of variance are considered simultaneously.

Keywords: asymptotic analysis, constant elasticity of variance, portfolio optimization, stochastic optimal control, stochastic volatility

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