Search results for: decision matrix
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6015

Search results for: decision matrix

5235 On the Optimality of Blocked Main Effects Plans

Authors: Rita SahaRay, Ganesh Dutta

Abstract:

In this article, experimental situations are considered where a main effects plan is to be used to study m two-level factors using n runs which are partitioned into b blocks, not necessarily of same size. Assuming the block sizes to be even for all blocks, for the case n ≡ 2 (mod 4), optimal designs are obtained with respect to type 1 and type 2 optimality criteria in the class of designs providing estimation of all main effects orthogonal to the block effects. In practice, such orthogonal estimation of main effects is often a desirable condition. In the wider class of all available m two level even sized blocked main effects plans, where the factors do not occur at high and low levels equally often in each block, E-optimal designs are also characterized. Simple construction methods based on Hadamard matrices and Kronecker product for these optimal designs are presented.

Keywords: design matrix, Hadamard matrix, Kronecker product, type 1 criteria, type 2 criteria

Procedia PDF Downloads 356
5234 Development and Analysis of Waste Human Hair Fiber Reinforced Composite

Authors: Tesfaye Worku

Abstract:

Human hair, chicken feathers, and hairs of other birds and animals are commonly described as waste products, and the currently available disposal methods, such as burying and burning these waste products, are contributing to environmental pollution. However, those waste products are used to develop fiber-reinforced textile composite material. In this research work, the composite was developed using human hair fiber and analysis of the mechanical and physical properties of the developed composite sample. A composite sample was made with different ratios of human hair and unsaturated polyester resin, and an analysis of the mechanical and physical properties of the developed composite sample was tested according to standards. The fabricated human hair fibers reinforced polymer matrix composite sample has given encouraging results in terms of high strength and rigidity for lightweight house ceiling board material.

Keywords: composite, human hair fiber, matrix, unsaturated polyester

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5233 Adversary Emulation: Implementation of Automated Countermeasure in CALDERA Framework

Authors: Yinan Cao, Francine Herrmann

Abstract:

Adversary emulation is a very effective concrete way to evaluate the defense of an information system or network. It is about building an emulator, which depending on the vulnerability of a target system, will allow to detect and execute a set of identified attacks. However, emulating an adversary is very costly in terms of time and resources. Verifying the information of each technique and building up the countermeasures in the middle of the test is also needed to be accomplished manually. In this article, a synthesis of previous MITRE research on the creation of the ATT&CK matrix will be as the knowledge base of the known techniques and a well-designed adversary emulation software CALDERA based on ATT&CK Matrix will be used as our platform. Inspired and guided by the previous study, a plugin in CALDERA called Tinker will be implemented, which is aiming to help the tester to get more information and also the mitigation of each technique used in the previous operation. Furthermore, the optional countermeasures for some techniques are also implemented and preset in Tinker in order to facilitate and fasten the process of the defense improvement of the tested system.

Keywords: automation, adversary emulation, CALDERA, countermeasures, MITRE ATT&CK

Procedia PDF Downloads 190
5232 Decision-Making in the Internationalization Process of Small and Medium Sized Companies: Experience from Managers in a Small Economy

Authors: Gunnar Oskarsson, Gudjon Helgi Egilsson

Abstract:

Due to globalization, small and medium-sized enterprises (SME) increasingly offer their products and services in foreign markets. The main reasons are either to compensate for a decreased market share in their home market or to exploit opportunities in foreign markets, which are becoming less distant and better accessible than before. International markets are particularly important for companies located in a small economy and offering specialized products. Although more accessible, entering international markets is both expensive and difficult. In order to select the most appropriate markets, it is, therefore, important to gain an insight into the factors that have an impact on success, or potential failure. Although there has been a reasonable volume of research into the theory of internationalization, there is still a need to gain further understanding of the decision-making process of SMEs in small economies and the most important characteristics that distinguish between success and failure. The main objective of this research is to enhance knowledge on the internationalization of SMEs, including the drivers for the decision to internationalize, and the most important factors contributing to success in their internationalization activities. A qualitative approach was found to be most appropriate for this kind of research, with the objective of gaining a deeper understanding and discovering factors which impact a company’s decision-making and potential success. In-depth interviews were conducted with 14 companies in different industries located in Iceland, a country extensively dependent on export revenues. The interviews revealed several factors as drivers of internationalization and, not surprisingly, the most frequently mentioned source of motivation was that the local market is inadequate to maintain a sustainable operation. Good networking relationships were seen as a particular priority for potential success, searching for new markets was mainly carried out through the internet, although sales exhibitions and sales trips were also considered important. When it comes to the final decision as to whether a market should be considered for further analysis, economy, labor cost, legal environment, and cultural barriers were the most common factors to be weighted. The ultimate answer to successful internationalization, however, is largely dependent on a coordinated and experienced management team. The main contribution of this research is offering an insight into factors affecting decision-making in the internationalization process of SMEs, based on the opinion and experience of managers of SMEs in a small economy.

Keywords: internationalization, success factors, small and medium-sized enterprises (SMEs), drivers, decision making

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5231 The Best Prediction Data Mining Model for Breast Cancer Probability in Women Residents in Kabul

Authors: Mina Jafari, Kobra Hamraee, Saied Hossein Hosseini

Abstract:

The prediction of breast cancer disease is one of the challenges in medicine. In this paper we collected 528 records of women’s information who live in Kabul including demographic, life style, diet and pregnancy data. There are many classification algorithm in breast cancer prediction and tried to find the best model with most accurate result and lowest error rate. We evaluated some other common supervised algorithms in data mining to find the best model in prediction of breast cancer disease among afghan women living in Kabul regarding to momography result as target variable. For evaluating these algorithms we used Cross Validation which is an assured method for measuring the performance of models. After comparing error rate and accuracy of three models: Decision Tree, Naive Bays and Rule Induction, Decision Tree with accuracy of 94.06% and error rate of %15 is found the best model to predicting breast cancer disease based on the health care records.

Keywords: decision tree, breast cancer, probability, data mining

Procedia PDF Downloads 127
5230 Contribution of Automated Early Warning Score Usage to Patient Safety

Authors: Phang Moon Leng

Abstract:

Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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5229 Unintended Health Inequity: Using the Relationship Between the Social Determinants of Health and Employer-Sponsored Health Insurance as a Catalyst for Organizational Development and Change

Authors: Dinamarie Fonzone

Abstract:

Employer-sponsored health insurance (ESI) strategic decision-making processes rely on financial analysis to guide leadership in choosing plans that will produce optimal organizational spending outcomes. These financial decision-making methods have not abated ESI costs. Previously unrecognized external social determinants, the impact on ESI plan spending, and other organizational strategies are emerging and are important considerations for organizational decision-makers and change management practitioners. The purpose of thisstudy is to examine the relationship between the social determinants of health (SDoH), employer-sponsored health insurance (ESI) plans, andthe unintended consequence of health inequity. A quantitative research design using selectemployee records from an existing employer human capital management database will be analyzed. Statistical regressionmethods will be used to study the relationships between certainSDoH (employee income, neighborhood geographic living area, and health care access) and health plan utilization, cost, and chronic disease prevalence. The discussion will include an application of the social gradient of health theory to the study findings, organizational transformation through changes in ESI decision-making mental models, and the connection of ESI health inequity to organizational development and changediversity, equity, and inclusion strategies.

Keywords: employer-sponsored health insurance, social determinants of health, health inequity, mental models, organizational development, organizational change, social gradient of health theory

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5228 A Prioritisation Guide for More Sustainable Manufacturing Processes

Authors: Cansu Kandemir, Marco Franchino

Abstract:

To attain sustainability goals, the manufacturing industries must assess and improve their processes, adopt the latest technologies, and ensure minimal environmental impact. Ongoing debates claim that the definition of sustainability and its assessment is vague. Companies struggle with understanding which processes they should prioritise and necessitate a methodology to aid decision-making. For that reason, our investigation focused on defining a prioritisation guide to help to manufacture engineers identify areas of a facility to prioritise de-carbonisation efforts based on existing sources of data. The authors at the University of Sheffield Advanced Manufacturing Research Centre (AMRC) worked with a range of major businesses, including Food and Drink (Moy Park), Automotive (Nissan), Aerospace and Defence (BAE, Meggitt, Leonardo, and GKN) and Technology (Accenture and Intellium AI). Collected information has been integrated into a prioritisation guide framework that helps process comparison and decision-making. The framework developed in this study aims to ensure that companies have guidance on where to focus their efforts whilst striving to fulfil their environmental and societal obligations.

Keywords: decision making, sustainability, carbon emissions, manufacturing

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5227 Evaluation of Corrosion Property of Aluminium-Zirconium Dioxide (AlZrO2) Nanocomposites

Authors: M. Ramachandra, G. Dilip Maruthi, R. Rashmi

Abstract:

This paper aims to study the corrosion property of aluminum matrix nanocomposite of an aluminum alloy (Al-6061) reinforced with zirconium dioxide (ZrO2) particles. The zirconium dioxide particles are synthesized by solution combustion method. The nanocomposite materials are prepared by mechanical stir casting method, varying the percentage of n-ZrO2 (2.5%, 5% and 7.5% by weight). The corrosion behavior of base metal (Al-6061) and Al/ZrO2 nanocomposite in seawater (3.5% NaCl solution) is measured using the potential control method. The corrosion rate is evaluated by Tafel extrapolation technique. The corrosion potential increases with the increase in wt.% of n-ZrO2 in the nanocomposite which means the decrease in corrosion rate. It is found that on addition of n-ZrO2 particles to the aluminum matrix, the corrosion rate has decreased compared to the base metal.

Keywords: Al6061 alloy, corrosion, solution, stir casting, combustion, potentiostat, zirconium dioxide

Procedia PDF Downloads 387
5226 Importance of Developing a Decision Support System for Diagnosis of Glaucoma

Authors: Murat Durucu

Abstract:

Glaucoma is a condition of irreversible blindness, early diagnosis and appropriate interventions to make the patients able to see longer time. In this study, it addressed that the importance of developing a decision support system for glaucoma diagnosis. Glaucoma occurs when pressure happens around the eyes it causes some damage to the optic nerves and deterioration of vision. There are different levels ranging blindness of glaucoma disease. The diagnosis at an early stage allows a chance for therapies that slows the progression of the disease. In recent years, imaging technology from Heidelberg Retinal Tomography (HRT), Stereoscopic Disc Photo (SDP) and Optical Coherence Tomography (OCT) have been used for the diagnosis of glaucoma. This better accuracy and faster imaging techniques in response technique of OCT have become the most common method used by experts. Although OCT images or HRT precision and quickness, especially in the early stages, there are still difficulties and mistakes are occurred in diagnosis of glaucoma. It is difficult to obtain objective results on diagnosis and placement process of the doctor's. It seems very important to develop an objective decision support system for diagnosis and level the glaucoma disease for patients. By using OCT images and pattern recognition systems, it is possible to develop a support system for doctors to make their decisions on glaucoma. Thus, in this recent study, we develop an evaluation and support system to the usage of doctors. Pattern recognition system based computer software would help the doctors to make an objective evaluation for their patients. It is intended that after development and evaluation processes of the software, the system is planning to be serve for the usage of doctors in different hospitals.

Keywords: decision support system, glaucoma, image processing, pattern recognition

Procedia PDF Downloads 283
5225 An Improved Total Variation Regularization Method for Denoising Magnetocardiography

Authors: Yanping Liao, Congcong He, Ruigang Zhao

Abstract:

The application of magnetocardiography signals to detect cardiac electrical function is a new technology developed in recent years. The magnetocardiography signal is detected with Superconducting Quantum Interference Devices (SQUID) and has considerable advantages over electrocardiography (ECG). It is difficult to extract Magnetocardiography (MCG) signal which is buried in the noise, which is a critical issue to be resolved in cardiac monitoring system and MCG applications. In order to remove the severe background noise, the Total Variation (TV) regularization method is proposed to denoise MCG signal. The approach transforms the denoising problem into a minimization optimization problem and the Majorization-minimization algorithm is applied to iteratively solve the minimization problem. However, traditional TV regularization method tends to cause step effect and lacks constraint adaptability. In this paper, an improved TV regularization method for denoising MCG signal is proposed to improve the denoising precision. The improvement of this method is mainly divided into three parts. First, high-order TV is applied to reduce the step effect, and the corresponding second derivative matrix is used to substitute the first order. Then, the positions of the non-zero elements in the second order derivative matrix are determined based on the peak positions that are detected by the detection window. Finally, adaptive constraint parameters are defined to eliminate noises and preserve signal peak characteristics. Theoretical analysis and experimental results show that this algorithm can effectively improve the output signal-to-noise ratio and has superior performance.

Keywords: constraint parameters, derivative matrix, magnetocardiography, regular term, total variation

Procedia PDF Downloads 143
5224 Building a Lean Construction Body of Knowledge

Authors: Jyoti Singh, Ahmed Stifi, Sascha Gentes

Abstract:

The process of construction significantly contributes to high level of risks, complexity and uncertainties leading to cost and time overrun, customer dissatisfaction etc. lean construction is important as it is a comprehensive system of tools and concepts focusing on moving closer to customer satisfaction by understanding the process, identifying the waste and eliminating it. The proposed work includes identification of knowledge areas from lean perspective, lean tools/concepts used in lean construction and establishing a relationship matrix between knowledge areas and lean tools/concepts, thus developing and building up a lean construction body of knowledge (LCBOK), i.e. a guide to lean construction, aiming to provide guidelines to manage individual projects and also helping construction industry to minimise waste and maximize value to the customer. In this study, we identified 8 knowledge areas and 62 lean tools/concepts from lean perspective and also one tool can help to manage two or more knowledge areas.

Keywords: knowledge areas, lean body matrix, lean construction, lean tools

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5223 Biodegradable and Bioactive Scaffold for Bone Tissue Engineering

Authors: A. M. Malagon Escandon, J. A. Arenas Alatorre, C. P. Chaires Rosas, N. A. Vazquez Torres, B. Hernandez Tellez, G. Pinon Zarate, M. Herrera Enriquez, A. E. Castell Rodriguez

Abstract:

The current approach to the treatment of bone defects involves the use of scaffolds that provide a biological and mechanically stable niche to favor tissue repair. Despite the significant progress in the field of bone tissue engineering, several main problems associated are attributed to giving a low biodegradation degree, does not promote osseointegration and regeneration, if the bone is not healing as well as expected or fails to heal, will not be given a proper ossification or new bone formation. The actual approaches of bone tissue regeneration are directed to the use of decellularized native extracellular matrices, which are able of retain their own architecture, mechanic properties, biodegradability and promote new bone formation because they are capable of conserving proteins and other factors that are founded in physiological concentrations. Therefore, we propose an extracellular matrix-based bioscaffolds derived from bovine cancellous bone, which is processed by decellularization, demineralization, and hydrolysis of the collagen protein, these protocols have been successfully carried out in other organs and tissues; the effectiveness of its biosafety has also been previously evaluated in vivo and Food and Drug Administration (FDA) approved. In the specific case of bone, a more complex treatment is needed in comparison with other organs and tissues because is necessary demineralization and collagen denaturalization. The present work was made in order to obtain a temporal scaffold that succeed in degradation in an inversely proportional way to the synthesis of extracellular matrix and the maturation of the bone by the cells of the host.

Keywords: bioactive, biodegradable, bone, extracellular matrix-based bioscaffolds, stem cells, tissue engineering

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5222 Developing a Spatial Decision Support System for Rationality Assessment of Land Use Planning Locations in Thai Binh Province, Vietnam

Authors: Xuan Linh Nguyen, Tien Yin Chou, Yao Min Fang, Feng Cheng Lin, Thanh Van Hoang, Yin Min Huang

Abstract:

In Vietnam, land use planning is the most important and powerful tool of the government for sustainable land use and land management. Nevertheless, many of land use planning locations are facing protests from surrounding households due to environmental impacts. In addition, locations are planned completely based on the subjective decisions of planners who are unsupported by tools or scientific methods. Hence, this research aims to assist the decision-makers in evaluating the rationality of planning locations by developing a Spatial Decision Support System (SDSS) using approaches of Geographic Information System (GIS)-based technology, Analytic Hierarchy Process (AHP) multi-criteria-based technique and Fuzzy set theory. An ArcGIS Desktop add-ins named SDSS-LUPA was developed to support users analyzing data and presenting results in friendly format. The Fuzzy-AHP method has been utilized as analytic model for this SDSS. There are 18 planned locations in Hung Ha district (Thai Binh province, Vietnam) as a case study. The experimental results indicated that the assessment threshold higher than 0.65 while the 18 planned locations were irrational because of close to residential areas or close to water sources. Some potential sites were also proposed to the authorities for consideration of land use planning changes.

Keywords: analytic hierarchy process, fuzzy set theory, land use planning, spatial decision support system

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5221 The Impact of Online Advertising on Generation Y’s Purchase Decision in Malaysia

Authors: Mui Joo Tang, Eang Teng Chan

Abstract:

Advertising is commonly used to foster sales and reputation of an institution. It is at first the growth of print advertising that has increased the population and number of periodicals of newspaper and its circulation. The rise of Internet and online media has somehow blurred the role of media and advertising though the intention is still to reach out to audience and to increase sales. The relationship between advertising and audience on a product purchase through persuasion has been developing from print media to online media. From the changing media environment and audience, it is the concern of this research to study the impact of online advertising to such a relationship cycle. The content of online advertisements is much of text, multimedia, photo, audio and video. The messages of such content format may indeed bring impacts to its audience and its credibility. This study is therefore reflecting the effectiveness of online advertisement and its influences on generation Y in their purchasing behavior. This study uses Media Dependency Theory to analyze the relationship between the impact of online advertisement and media usage pattern of generation Y. Hierarchy of Effectiveness Model is used as a marketing communication model to study the effectiveness of advertising and further to determine the impact of online advertisement on generation Y in their purchasing decision making. This research uses online survey to reach out the sample of generation Y. The results have shown that online advertisements do not affect much on purchase decision making even though generation Y relies much on the media content including online advertisement for its information and believing in its credibility. There are few other external factors that may interrupt the effectiveness of online advertising. The very obvious influence of purchasing behavior is actually derived from the peers.

Keywords: generation Y, purchase decision, print media, online advertising, persuasion

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5220 Health Seeking Manners of Road Traffic Accident Victims: A Qualitative Study

Authors: Mohammad Mahbub Alam Talukder, Shahnewaz, Hasanat-E-Rabbi, Mohammed Nazrul Islam

Abstract:

Road traffic accident is a global problem which is severe in the developing countries like Bangladesh. In consequence, in developing countries road trauma has now been recognized as an increasing public health hazards and economic burning issue. And after road traffic accidents the lack of management and economic costs related with health seeking behavior have a disproportionate impact on lower income groups, thus contributing to the persistence of poverty in conjunction with disability. This cross sectional study, carried out during July 2012 to June 2013, aimed to explore health seeking decision and culture of handling the road traffic accident related victims, as taken from experiences of the poor disabled people of slum dwellers of Dhaka city. The present study has been designed based on qualitative techniques such as in-depth interview and case studies. Additionally, a survey questionnaire was used to collect the demographic characteristics of the study population (n=150) and to select participants purposely for in-depth interview (n=50) and case study (n=30). Content analysis of qualitative data was done through theme coding and matrix analysis of case study was done to use relevant verbatim. Most of the time the health seeking decision totally depended on the surrounded people of the accidental place, their knowledge, awareness and remaining facility and capacity regarding proper management of the victims. However, most of the cases the victims did not get any early treatment and it took 2-12 hours to get even the first aid because of distance, shortage of money, lack of availability of getting the aid, lack of mass awareness etc. Under the reality of discriminated and unaffordable health service provision better treatment could not turn out due to economic inability of the poor victims. To avoid the severe trauma, treatment delay must be reduced by providing first aid within very short time and to do so, mass awareness campaign is necessary for handing the victims. Moreover, necessary measures should be taken to ensure cost free health service provision to treat the chronic disabled condition of the road traffic accident related poor victims.

Keywords: accident, injury, disabled, qualitative, slum

Procedia PDF Downloads 347
5219 The Estimation of Human Vital Signs Complexity

Authors: L. Bikulciene, E. Venskaityte, G. Jarusevicius

Abstract:

Non-stationary and nonlinear signals generated by living complex systems defy traditional mechanistic approaches, which are based on homeostasis. Previous our studies have shown that the evaluation of the interactions of physiological signals by using special analysis methods is suitable for observation of physiological processes. It is demonstrated the possibility of using deep physiological model, based interpretation of the changes of the human body’s functional states combined with an application of the analytical method based on matrix theory for the physiological signals analysis, which was applied on high risk cardiac patients. It is shown that evaluation of cardiac signals interactions show peculiar for each individual functional changes at the onset of hemodynamic restoration procedure. Therefore we suggest that the alterations of functional state of the body, after patients overcome surgery can be complemented by the data received from the suggested approach of the evaluation of functional variables interactions.

Keywords: cardiac diseases, complex systems theory, ECG analysis, matrix analysis

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5218 Polymer Dispersed Liquid Crystals Based on Poly Vinyl Alcohol Boric Acid Matrix

Authors: Daniela Ailincai, Bogdan C. Simionescu, Luminita Marin

Abstract:

Polymer dispersed liquid crystals (PDLC) represent an interesting class of materials which combine the ability of polymers to form films and their mechanical strength with the opto-electronic properties of liquid crystals. The proper choice of the two components - the liquid crystal and the polymeric matrix - leads to materials suitable for a large area of applications, from electronics to biomedical devices. The objective of our work was to obtain PDLC films with potential applications in the biomedical field, using poly vinyl alcohol boric acid (PVAB) as a polymeric matrix for the first time. Presenting all the tremendous properties of poly vinyl alcohol (such as: biocompatibility, biodegradability, water solubility, good chemical stability and film forming ability), PVAB brings the advantage of containing the electron deficient boron atom, and due to this, it should promote the liquid crystal anchoring and a narrow liquid crystal droplets polydispersity. Two different PDLC systems have been obtained, by the use of two liquid crystals, a nematic commercial one: 4-cyano-4’-penthylbiphenyl (5CB) and a new smectic liquid crystal, synthesized by us: buthyl-p-[p’-n-octyloxy benzoyloxy] benzoate (BBO). The PDLC composites have been obtained by the encapsulation method, working with four different ratios between the polymeric matrix and the liquid crystal, from 60:40 to 90:10. In all cases, the composites were able to form free standing, flexible films. Polarized light microscopy, scanning electron microscopy, differential scanning calorimetry, RAMAN- spectroscopy and the contact angle measurements have been performed, in order to characterize the new composites. The new smectic liquid crystal has been characterized using 1H-NMR and single crystal X-ray diffraction and its thermotropic behavior has been established using differential scanning calorimetry and polarized light microscopy. The polarized light microscopy evidenced the formation of round birefringent droplets, anchored homeotropic in the first case and planar in the second, with a narrow dimensional polydispersity, especially for the PDLC containing the largest amount of liquid crystal, fact evidenced by SEM, also. The obtained values for the water to air contact angle showed that the composites have a proper hydrophilic-hydrophobic balance, making them potential candidates for bioapplications. More than this, our studies demonstrated that the water to air contact angle varies as a function of PVAB matrix crystalinity degree, which can be controled as a function of time. This fact allowed us to conclude that the use of PVAB as matrix for PDLCs obtaining offers the possibility to modulate their properties for specific applications.

Keywords: 4-cyano-4’-penthylbiphenyl, buthyl-p-[p’-n-octyloxy benzoyloxy] benzoate, contact angle, polymer dispersed liquid crystals, poly vinyl alcohol boric acid

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5217 Comparison of Anterolateral Thigh Flap with or without Acellular Dermal Matrix in Repair of Hypopharyngeal Squamous Cell Carcinoma Defect: A Retrospective Study

Authors: Yaya Gao, Bing Zhong, Yafeng Liu, Fei Chen

Abstract:

Aim: The purpose of this study was to explore the difference between acellular dermal matrix (ADM) combined with anterolateral thigh (ALT) flap and ALT flap alone. Methods: HSCC patients were treated and divided into group A (ALT) and group B (ALT+ADM) between January 2014 and December 2018. We compared and analyzed the intraoperative information and postoperative outcomes of the patients. Results: There were 21 and 17 patients in group A and group B, respectively. The operation time, blood loss, defect size and anastomotic vessel selection showed no significant difference between two groups. The postoperative complications, including wound bleeding (n=0 vs. 1, p=0.459), wound dehiscence (n=0 vs. 1, p=0.459), wound infection (n=5vs.3, p=0.709), pharyngeal fistula (n=5vs.4, p=1.000) and hypoproteinemia (n=11 vs. 12, p=0.326) were comparable between the groups. Dysphagia at 6 months (number of liquid diets=0vs. 0; number of partial tube feedings=1vs. 1; number of total tube feedings=1vs. 0, p=0.655) also showed no significant differences. However, significant differences was observed in dysphagia at 12 months (number of liquid diets=0vs. 0; number of partial tube feedings=3 vs. 1; number of total tube feedings=10vs. 1, p=0.006). Conclusion: For HSCC patients, the use of the ALT flap combined ADM, compared to ALT treatment, showed better swallowing function at 12 months. The ALT flap combined ADM may serve as a safe and feasible alternative for selected HSCC patients.

Keywords: hypopharyngeal squamous cell carcinoma, anterolateral thigh free flap, acellular dermal matrix, reconstruction, dysphagia

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5216 Intuitive Decision Making When Facing Risks

Authors: Katharina Fellnhofer

Abstract:

The more information and knowledge that technology provides, the more important are profoundly human skills like intuition, the skill of using nonconscious information. As our world becomes more complex, shaken by crises, and characterized by uncertainty, time pressure, ambiguity, and rapidly changing conditions, intuition is increasingly recognized as a key human asset. However, due to methodological limitations of sample size or time frame or a lack of real-world or cross-cultural scope, precisely how to measure intuition when facing risks on a nonconscious level remains unclear. In light of the measurement challenge related to intuition’s nonconscious nature, a technique is introduced to measure intuition via hidden images as nonconscious additional information to trigger intuition. This technique has been tested in a within-subject fully online design with 62,721 real-world investment decisions made by 657 subjects in Europe and the United States. Bayesian models highlight the technique’s potential to measure skill at using nonconscious information for conscious decision making. Over the long term, solving the mysteries of intuition and mastering its use could be of immense value in personal and organizational decision-making contexts.

Keywords: cognition, intuition, investment decisions, methodology

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5215 Technology Management for Early Stage Technologies

Authors: Ming Zhou, Taeho Park

Abstract:

Early stage technologies have been particularly challenging to manage due to high degrees of their numerous uncertainties. Most research results directly out of a research lab tend to be at their early, if not the infant stage. A long while uncertain commercialization process awaits these lab results. The majority of such lab technologies go nowhere and never get commercialized due to various reasons. Any efforts or financial resources put into managing these technologies turn fruitless. High stake naturally calls for better results, which make a patenting decision harder to make. A good and well protected patent goes a long way for commercialization of the technology. Our preliminary research showed that there was not a simple yet productive procedure for such valuation. Most of the studies now have been theoretical and overly comprehensive where practical suggestions were non-existent. Hence, we attempted to develop a simple and highly implementable procedure for efficient and scalable valuation. We thoroughly reviewed existing research, interviewed practitioners in the Silicon Valley area, and surveyed university technology offices. Instead of presenting another theoretical and exhaustive research, we aimed at developing a practical guidance that a government agency and/or university office could easily deploy and get things moving to later steps of managing early stage technologies. We provided a procedure to thriftily value and make the patenting decision. A patenting index was developed using survey data and expert opinions. We identified the most important factors to be used in the patenting decision using survey ratings. The rating then assisted us in generating good relative weights for the later scoring and weighted averaging step. More importantly, we validated our procedure by testing it with our practitioner contacts. Their inputs produced a general yet highly practical cut schedule. Such schedule of realistic practices has yet to be witnessed our current research. Although a technology office may choose to deviate from our cuts, what we offered here at least provided a simple and meaningful starting point. This procedure was welcomed by practitioners in our expert panel and university officers in our interview group. This research contributed to our current understanding and practices of managing early stage technologies by instating a heuristically simple yet theoretical solid method for the patenting decision. Our findings generated top decision factors, decision processes and decision thresholds of key parameters. This research offered a more practical perspective which further completed our extant knowledge. Our results could be impacted by our sample size and even biased a bit by our focus on the Silicon Valley area. Future research, blessed with bigger data size and more insights, may want to further train and validate our parameter values in order to obtain more consistent results and analyze our decision factors for different industries.

Keywords: technology management, early stage technology, patent, decision

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5214 The Role of Critical Thinking in Disease Diagnosis: A Comprehensive Review

Authors: Mohammad Al-Mousawi

Abstract:

This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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5213 Modeling of Crack Propagation Path in Concrete with Coarse Trapezoidal Aggregates by Boundary Element Method

Authors: Chong Wang, Alexandre Urbano Hoffmann

Abstract:

Interaction between a crack and a trapezoidal aggregate in a single edge notched concrete beam is simulated using boundary element method with an automatic crack extension program. The stress intensity factors of the growing crack are obtained from the J-integral. Three crack extension paths: deflecting around the particulate, growing along the interface and penetrating into the particulate are achieved in terms of the mismatch state of mechanical characteristics of matrix and the particulate. The toughening is also given by the ratio of stress intensity factors. The results reveal that as stress shielding occurs, toughening is obtained when the crack is approaching to a stiff and strong aggregate weakly bonded to a relatively soft matrix. The present work intends to help for the design of aggregate reinforced concretes.

Keywords: aggregate concrete, boundary element method, two-phase composite, crack extension path, crack/particulate interaction

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5212 Power, Values, Rules and Leader Decision Making: A Discourse Perspective

Authors: Cathryn Robinson, Bernard McKenna, David Rooney

Abstract:

This paper argues that the application of values-based leadership increasingly challenges leaders in rules-based organisations, particularly in bureaucratic organisations such as the military, public service, police, and emergency services. Leaders are grappling to reconcile how to enact values-based leadership and decision-making when they are bound by rules, policies, and procedures. This interpretive study used a multi-faceted vignette (critical incident) as the basis of an interview with air force officers at three levels: executive, senior, and junior. In this way, practice is forced to intersect with discourse. The findings revealed a shared set of discourse themes (legal; rules; safety and risk; operational practice/theatre discourses), but also clear dialectical tensions. These tensions were evident in executive officers and senior leaders emphasizing rules and information themes, whereas junior officers emphasized decision making, collateral, and situation. These findings reveal discourse and practice incommensurability that could have grave implications in the conduct of war.

Keywords: critical incident, discourse analysis, rules-based, values-based

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5211 Theorizing about the Determinants of Sustainable Entrepreneurship Intention and Behavior

Authors: Mariella Pinna

Abstract:

Sustainable entrepreneurship is an innovative corporate approach to create value combining economic, social and environmental goals over time. In the last two decades, the interest in sustainable entrepreneurship has flourished thanks to its potential to answer the current challenges of sustainable development. As a result, scholars are increasingly interested in understanding the determinants of the intentions to become a sustainable entrepreneur and consistent behavior. To date, prior studies provided empirical evidence for the influence of attitudes, perceived feasibility and desirability, values, and personality traits on the decision-making process of becoming a sustainable entrepreneur. Conversely, scant effort has been provided to understand which factors inhibit sustainable entrepreneurial intentions and behaviors. Therefore a global understanding of the sustainable entrepreneurship decision-making process is missing. This paper contributes to the debate on sustainable entrepreneurship by proposing a conceptual model that combines the factors which are predicted to facilitate and hinder the proclivity of individuals to become sustainable entrepreneurs. More in particular, the proposed framework theorizes about the role of the characteristics of the prospective sustainable entrepreneur (e.g., socio-demographic, psychological, cultural), the positive antecedents (e.g., attitude, social feasibility and desirability, among others) and the negative precursors (e.g., neutralization) in influencing sustainable entrepreneurship intentions and subsequent behavior. The proposed framework is expected to shed further light on the decision-making process of becoming a sustainable entrepreneur, which in turn, is of practical relevance for public policy institutions and the society as a whole to enhance the favorable conditions to create new sustainable ventures.

Keywords: sustainable entrepreneurship, entrepreneurial intentions, entrepreneurial decision-making, antecedents of entrepreneurial intention and behavior

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5210 Aluminum Matrix Composites Reinforced by Glassy Carbon-Titanium Spatial Structure

Authors: B. Hekner, J. Myalski, P. Wrzesniowski

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This study presents aluminum matrix composites reinforced by glassy carbon (GC) and titanium (Ti). In the first step, the heterophase (GC+Ti), spatial form (similar to skeleton) of reinforcement was obtained via own method. The polyurethane foam (with spatial, open-cells structure) covered by suspension of Ti particles in phenolic resin was pyrolyzed. In the second step, the prepared heterogeneous foams were infiltrated by aluminium alloy. The manufactured composites are designated to industrial application, especially as a material used in tribological field. From this point of view, the glassy carbon was applied to stabilise a coefficient of friction on the required value 0.6 and reduce wear. Furthermore, the wear can be limited due to titanium phase application, which reveals high mechanical properties. Moreover, fabrication of thin titanium layer on the carbon skeleton leads to reduce contact between aluminium alloy and carbon and thus aluminium carbide phase creation. However, the main modification involves the manufacturing of reinforcement in the form of 3D, skeleton foam. This kind on reinforcement reveals a few important advantages compared to classical form of reinforcement-particles: possibility to control homogeneity of reinforcement phase in composite material; low-advanced technique of composite manufacturing- infiltration; possibility to application the reinforcement only in required places of material; strict control of phase composition; High quality of bonding between components of material. This research is founded by NCN in the UMO-2016/23/N/ST8/00994.

Keywords: metal matrix composites, MMC, glassy carbon, heterophase composites, tribological application

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5209 Cascade Screening for Beta-Thalassemia in Pakistan: Relatives’ Experiences of a Decision Support Intervention in Routine Practice

Authors: Shenaz Ahmed, Hussain Jafri, Muhammed Faran, Wajeeha Naseer Ahmed, Yasmin Rashid, Yasmin Ehsan, Shabnam Bashir, Mushtaq Ahmed

Abstract:

Low uptake of cascade screening for βeta-Thalassaemia Major (β-TM) in the ‘Punjab Thalassaemia Prevention Project’ (PTPP) in Pakistan led to the development of a ‘decision support intervention for relatives’ (DeSIRe). This paper presents the experiences of relatives of children with β-TM of the DeSIRe following its use by PTPP field officers in routine clinical practice. Fifty-four semi-structured qualitative interviews were conducted (April to June 2021) with relatives in seven cities in the Punjab province (Lahore, Sheikhupura, Nankana Sahab, Kasur, Gujranwala, Multan, and Faisalabad). Thematic analysis shows that participants were satisfied with the content of the DeSIRe and its delivery by the field officers in a family meeting. They understood the main purpose of the DeSIRe was to improve their knowledge of β-TM and its inheritance, to enable them to make decisions about thalassemia carrier testing, particularly before marriage. While participants raised concerns about the stigma of testing positive, they believed the DeSIRe was an appropriate intervention, which supported relatives to make informed decisions. Our findings show the DeSIRe is appropriate for use by healthcare professionals in routine practice in a low-middle income country and has the potential to facilitate shared decision-making about cascade screening for thalassemia. Further research is needed to prove the efficacy of the DeSIRe.

Keywords: thalassemia, Pakistan, cascade screening, decision support

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5208 Microstructure and Sintering of Boron-Alloyed Martensitic Stainless Steel

Authors: Ming-Wei Wu, Yu-Jin Tsai, Ching-Huai Chang

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Liquid phase sintering (LPS) is a versatile technique for achieving effective densification of powder metallurgy (PM) steels and other materials. The aim of this study was to examine the influences of 0.6 wt% boron on the microstructure and LPS behavior of boron-alloyed 410 martensitic stainless steel. The results showed that adding 0.6 wt% boron can obviously promote the LPS due to a eutectic reaction and increase the sintered density of 410 stainless steel. The density was much increased by 1.06 g/cm³ after 1225ºC sintering. Increasing the sintering temperature from 1225ºC to 1275ºC did not obviously improve the sintered density. After sintering at 1225ºC~1275ºC, the matrix was fully martensitic, and intragranular borides were extensively found due to the solidification of eutectic liquid. The microstructure after LPS consisted of the martensitic matrix and (Fe, Cr)2B boride, as identified by electron backscatter diffraction (EBSD) and electron probe micro-analysis (EPMA).

Keywords: powder metallurgy, liquid phase sintering, stainless steel, martensite, boron, microstructure

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5207 Equipment Donation: A Perspective from a Teaching Tertiary Care Hospital in North India

Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora

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Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.

Keywords: equipment donation, teaching hospital, decision-making, North India

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5206 Analyzing the Impact of the COVID-19 Pandemic on Clinicians’ Perceptions of Resuscitation and Escalation Decision-Making Processes: Cross-Sectional Survey of Hospital Clinicians in the United Kingdom

Authors: Michelle Hartanto, Risheka Suthantirakumar

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Introduction Staff redeployment, increased numbers of acutely unwell patients requiring resuscitation decision-making conversations, visiting restrictions, and varying guidance regarding resuscitation for patients with COVID-19 disrupted clinicians’ management of resuscitation and escalation decision-making processes. While it was generally accepted that the COVID-19 pandemic disturbed numerous aspects of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process in the United Kingdom, a process which establishes a patient’s CPR status and treatment escalation plans, the impact of the pandemic on clinicians’ attitudes towards these resuscitation and decision-making conversations was unknown. This was the first study to examine the impact of the COVID-19 pandemic on clinicians’ knowledge, skills, and attitudes towards the ReSPECT process. Methods A cross-sectional survey of clinicians at one acute teaching hospital in the UK was conducted. A questionnaire with a defined five-point Likert scale was distributed and clinicians were asked to recall their pre-pandemic views on ReSPECT and report their current views at the time of survey distribution (May 2020, end of the first COVID-19 wave in the UK). Responses were received from 171 clinicians, and self-reported views before and during the pandemic were compared. Results Clinicians reported they found managing ReSPECT conversations more challenging during the pandemic, especially when conducted over the telephone with relatives, and they experienced an increase in negative emotions before, during, and after conducting ReSPECT conversations. Our findings identified that due to the pandemic there was now a need for clinicians to receive training and support in conducting resuscitation and escalation decision-making conversations over the telephone with relatives and managing these processes.

Keywords: cardiopulmonary resuscitation, COVID-19 pandemic, DNACPR discussion, education, recommended summary plan for emergency care and treatment, resuscitation order

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