Search results for: network diagnostic tool
2118 Developing Students’ Academic Writing Skills through Scientific Reading: Using Questions and Answer Activities
Authors: Makhim Artikova, Shavkat Duschanov
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So far, there have been a plethora of attempts to improve learners’ academic writing skills. However, this issue remains to be a real concern among the majority of students, especially those who are standing on their academic life threshold. The purpose of this research is improving students’ academic writing skills through 'Questions and Answer Reading' activities. Using well-prepared and well-chosen reading materials (from textbooks, scientific journals, or magazines) and applying questions and answer activities in the classroom facilitate learners to become great critical readers. Furthermore, it boosts their writing skills, which are the most crucial part of students’ personal and academic developments. In this activity, the class is divided into small groups of four. Then, the instructor will give students whether one section of the text or full text asking them to read and to find unfamiliar words within the group. After discovering the meaning of unknown words, each group has to share their findings with the class. In the next stage of the activity, students should be asked to create questions in a group based on the given reading material. Follow by each group should ask the other groups their questions which are an excellent opportunity to challenge leads to improve critical thinking skills. In the last part, the students are asked to write the text or article summary, which is the activity core that pilots to the writing skills perfection. This engaging activity highlights the effectiveness of incorporating reading materials into the classroom when it comes to improving students’ composition writings. Structural writing after every reading activity resulted in improving students’ coherence and cohesion in writing well-organized essays. Having experimented with high school 9th and 11th-grade students, implementing reading activities into the classroom is proved to be a productive tool to enhance one’s academic writing skills. In the future, this method planning to be implemented among university students.Keywords: academic writing, coherence and cohesion, questions and answer activities, scientific reading
Procedia PDF Downloads 1102117 Bridging the Gaping Levels of Information Entree for Visually Impaired Students in the Sri Lankan University Libraries
Authors: Wilfred Jeyatheese Jeyaraj
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Education is a key determinant of future success, and every person deserves non-discriminant access to information for educational inevitabilities in any case. Analysing and understanding complex information is a crucial learning tool, especially for students. In order to compete equally with sighted students, visually impaired students require the unhinged access to access to all the available information resources. When the education of visually impaired students comes to a focal point, it can be stated that visually impaired students encounter several obstacles and barriers before they enter the university and during their time there as students. These obstacles and barriers are spread across technical, organizational and social arenas. This study reveals the possible approaches to absorb and benefit from the information provided by the Sri Lankan University Libraries for visually impaired students. Purposive sampling technique was used to select sample visually impaired students attached to the Sri Lankan National universities. There are 07 National universities which accommodate the visually impaired students and with the identified data, they were selected for this study and 80 visually impaired students were selected as the sample group. Descriptive type survey method was used to collect data. Structured questionnaires, interviews and direct observation were used as research instruments. As far as the Sri Lankan context spread is concerned, visually impaired students are able to finish their courses through their own determination to overcome the barriers they encounter on their way to graduation, through moral and practical support from their own friends and very often through a high level of creativity. According to the findings there are no specially trained university librarians to serve visually impaired users and less number of assistive technology equipment are available at present. This paper enables all university libraries in Sri Lanka to be informed about the social isolation of visually compromised students at the Sri Lankan universities and focuses on the rectification issues by considering their distinct case for interaction.Keywords: information access, Sri Lanka, university libraries, visual impairment
Procedia PDF Downloads 2352116 Hybridization of Manually Extracted and Convolutional Features for Classification of Chest X-Ray of COVID-19
Authors: M. Bilal Ishfaq, Adnan N. Qureshi
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COVID-19 is the most infectious disease these days, it was first reported in Wuhan, the capital city of Hubei in China then it spread rapidly throughout the whole world. Later on 11 March 2020, the World Health Organisation (WHO) declared it a pandemic. Since COVID-19 is highly contagious, it has affected approximately 219M people worldwide and caused 4.55M deaths. It has brought the importance of accurate diagnosis of respiratory diseases such as pneumonia and COVID-19 to the forefront. In this paper, we propose a hybrid approach for the automated detection of COVID-19 using medical imaging. We have presented the hybridization of manually extracted and convolutional features. Our approach combines Haralick texture features and convolutional features extracted from chest X-rays and CT scans. We also employ a minimum redundancy maximum relevance (MRMR) feature selection algorithm to reduce computational complexity and enhance classification performance. The proposed model is evaluated on four publicly available datasets, including Chest X-ray Pneumonia, COVID-19 Pneumonia, COVID-19 CTMaster, and VinBig data. The results demonstrate high accuracy and effectiveness, with 0.9925 on the Chest X-ray pneumonia dataset, 0.9895 on the COVID-19, Pneumonia and Normal Chest X-ray dataset, 0.9806 on the Covid CTMaster dataset, and 0.9398 on the VinBig dataset. We further evaluate the effectiveness of the proposed model using ROC curves, where the AUC for the best-performing model reaches 0.96. Our proposed model provides a promising tool for the early detection and accurate diagnosis of COVID-19, which can assist healthcare professionals in making informed treatment decisions and improving patient outcomes. The results of the proposed model are quite plausible and the system can be deployed in a clinical or research setting to assist in the diagnosis of COVID-19.Keywords: COVID-19, feature engineering, artificial neural networks, radiology images
Procedia PDF Downloads 752115 Efficiency of a Molecularly Imprinted Polymer for Selective Removal of Chlorpyrifos from Water Samples
Authors: Oya A. Urucu, Aslı B. Çiğil, Hatice Birtane, Ece K. Yetimoğlu, Memet Vezir Kahraman
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Chlorpyrifos is an organophosphorus pesticide which can be found in environmental water samples. The efficiency and reuse of a molecularly imprinted polymer (chlorpyrifos - MIP) were investigated for the selective removal of chlorpyrifos residues. MIP was prepared with UV curing thiol-ene polymerization technology by using multifunctional thiol and ene monomers. The thiol-ene curing reaction is a radical induced process, however unlike other photoinitiated polymerization processes, this polymerization process is a free-radical reaction that proceeds by a step-growth mechanism, involving two main steps; a free-radical addition followed by a chain transfer reaction. It assures a very rapidly formation of a uniform crosslinked network with low shrinkage, reduced oxygen inhibition during curing and excellent adhesion. In this study, thiol-ene based UV-curable polymeric materials were prepared by mixing pentaerythritol tetrakis(3-mercaptopropionate), glyoxal bis diallyl acetal, polyethylene glycol diacrylate (PEGDA) and photoinitiator. Chlorpyrifos was added at a definite ratio to the prepared formulation. Chemical structure and thermal properties were characterized by FTIR and thermogravimetric analysis (TGA), respectively. The pesticide analysis was performed by gas chromatography-mass spectrometry (GC-MS). The influences of some analytical parameters such as pH, sample volume, amounts of analyte concentration were studied for the quantitative recoveries of the analyte. The proposed MIP method was applied to the determination of chlorpyrifos in river and tap water samples. The use of the MIP provided a selective and easy solution for removing chlorpyrifos from the water.Keywords: molecularly imprinted polymers, selective removal, thilol-ene, uv-curable polymer
Procedia PDF Downloads 3012114 Engineering Thermal-Hydraulic Simulator Based on Complex Simulation Suite “Virtual Unit of Nuclear Power Plant”
Authors: Evgeny Obraztsov, Ilya Kremnev, Vitaly Sokolov, Maksim Gavrilov, Evgeny Tretyakov, Vladimir Kukhtevich, Vladimir Bezlepkin
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Over the last decade, a specific set of connected software tools and calculation codes has been gradually developed. It allows simulating I&C systems, thermal-hydraulic, neutron-physical and electrical processes in elements and systems at the Unit of NPP (initially with WWER (pressurized water reactor)). In 2012 it was called a complex simulation suite “Virtual Unit of NPP” (or CSS “VEB” for short). Proper application of this complex tool should result in a complex coupled mathematical computational model. And for a specific design of NPP, it is called the Virtual Power Unit (or VPU for short). VPU can be used for comprehensive modelling of a power unit operation, checking operator's functions on a virtual main control room, and modelling complicated scenarios for normal modes and accidents. In addition, CSS “VEB” contains a combination of thermal hydraulic codes: the best-estimate (two-liquid) calculation codes KORSAR and CORTES and a homogenous calculation code TPP. So to analyze a specific technological system one can build thermal-hydraulic simulation models with different detalization levels up to a nodalization scheme with real geometry. And the result at some points is similar to the notion “engineering/testing simulator” described by the European utility requirements (EUR) for LWR nuclear power plants. The paper is dedicated to description of the tools mentioned above and an example of the application of the engineering thermal-hydraulic simulator in analysis of the boron acid concentration in the primary coolant (changed by the make-up and boron control system).Keywords: best-estimate code, complex simulation suite, engineering simulator, power plant, thermal hydraulic, VEB, virtual power unit
Procedia PDF Downloads 3802113 The Event of Extreme Precipitation Occurred in the Metropolitan Mesoregion of the Capital of Para
Authors: Natasha Correa Vitória Bandeira, Lais Cordeiro Soares, Claudineia Brazil, Luciane Teresa Salvi
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The intense rain event that occurred between February 16 and 18, 2018, in the city of Barcarena in Pará, located in the North region of Brazil, demonstrates the importance of analyzing this type of event. The metropolitan mesoregion of Belem was severely punished by rains much above the averages normally expected for that time of year; this phenomenon affected, in addition to the capital, the municipalities of Barcarena, Murucupi and Muruçambá. Resulting in a great flood in the rivers of the region, whose basins were affected with great intensity of precipitation, causing concern for the local population because in this region, there are located companies that accumulate ore tailings, and in this specific case, the dam of any of these companies, leaching the ore to the water bodies of the Murucupi River Basin. This article aims to characterize this phenomenon through a special analysis of the distribution of rainfall, using data from atmospheric soundings, satellite images, radar images and data from the GPCP (Global Precipitation Climatology Project), in addition to rainfall stations located in the study region. The results of the work demonstrated a dissociation between the data measured in the meteorological stations and the other forms of analysis of this extreme event. Monitoring carried out solely on the basis of data from pluviometric stations is not sufficient for monitoring and/or diagnosing extreme weather events, and investment by the competent bodies is important to install a larger network of pluviometric stations sufficient to meet the demand in a given region.Keywords: extreme precipitation, great flood, GPCP, ore dam
Procedia PDF Downloads 1082112 Estimating Water Balance at Beterou Watershed, Benin Using Soil and Water Assessment Tool (SWAT) Model
Authors: Ella Sèdé Maforikan
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Sustained water management requires quantitative information and the knowledge of spatiotemporal dynamics of hydrological system within the basin. This can be achieved through the research. Several studies have investigated both surface water and groundwater in Beterou catchment. However, there are few published papers on the application of the SWAT modeling in Beterou catchment. The objective of this study was to evaluate the performance of SWAT to simulate the water balance within the watershed. The inputs data consist of digital elevation model, land use maps, soil map, climatic data and discharge records. The model was calibrated and validated using the Sequential Uncertainty Fitting (SUFI2) approach. The calibrated started from 1989 to 2006 with four years warming up period (1985-1988); and validation was from 2007 to 2020. The goodness of the model was assessed using five indices, i.e., Nash–Sutcliffe efficiency (NSE), the ratio of the root means square error to the standard deviation of measured data (RSR), percent bias (PBIAS), the coefficient of determination (R²), and Kling Gupta efficiency (KGE). Results showed that SWAT model successfully simulated river flow in Beterou catchment with NSE = 0.79, R2 = 0.80 and KGE= 0.83 for the calibration process against validation process that provides NSE = 0.78, R2 = 0.78 and KGE= 0.85 using site-based streamflow data. The relative error (PBIAS) ranges from -12.2% to 3.1%. The parameters runoff curve number (CN2), Moist Bulk Density (SOL_BD), Base Flow Alpha Factor (ALPHA_BF), and the available water capacity of the soil layer (SOL_AWC) were the most sensitive parameter. The study provides further research with uncertainty analysis and recommendations for model improvement and provision of an efficient means to improve rainfall and discharges measurement data.Keywords: watershed, water balance, SWAT modeling, Beterou
Procedia PDF Downloads 552111 Cybersecurity Challenges in the Era of Open Banking
Authors: Krish Batra
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The advent of open banking has revolutionized the financial services industry by fostering innovation, enhancing customer experience, and promoting competition. However, this paradigm shift towards more open and interconnected banking ecosystems has introduced complex cybersecurity challenges. This research paper delves into the multifaceted cybersecurity landscape of open banking, highlighting the vulnerabilities and threats inherent in sharing financial data across a network of banks and third-party providers. Through a detailed analysis of recent data breaches, phishing attacks, and other cyber incidents, the paper assesses the current state of cybersecurity within the open banking framework. It examines the effectiveness of existing security measures, such as encryption, API security protocols, and authentication mechanisms, in protecting sensitive financial information. Furthermore, the paper explores the regulatory response to these challenges, including the implementation of standards such as PSD2 in Europe and similar initiatives globally. By identifying gaps in current cybersecurity practices, the research aims to propose a set of robust, forward-looking strategies that can enhance the security and resilience of open banking systems. This includes recommendations for banks, third-party providers, regulators, and consumers on how to mitigate risks and ensure a secure open banking environment. The ultimate goal is to provide stakeholders with a comprehensive understanding of the cybersecurity implications of open banking and to outline actionable steps for safeguarding the financial ecosystem in an increasingly interconnected world.Keywords: open banking, financial services industry, cybersecurity challenges, data breaches, phishing attacks, encryption, API security protocols, authentication mechanisms, regulatory response, PSD2, cybersecurity practices
Procedia PDF Downloads 602110 Signs, Signals and Syndromes: Algorithmic Surveillance and Global Health Security in the 21st Century
Authors: Stephen L. Roberts
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This article offers a critical analysis of the rise of syndromic surveillance systems for the advanced detection of pandemic threats within contemporary global health security frameworks. The article traces the iterative evolution and ascendancy of three such novel syndromic surveillance systems for the strengthening of health security initiatives over the past two decades: 1) The Program for Monitoring Emerging Diseases (ProMED-mail); 2) The Global Public Health Intelligence Network (GPHIN); and 3) HealthMap. This article demonstrates how each newly introduced syndromic surveillance system has become increasingly oriented towards the integration of digital algorithms into core surveillance capacities to continually harness and forecast upon infinitely generating sets of digital, open-source data, potentially indicative of forthcoming pandemic threats. This article argues that the increased centrality of the algorithm within these next-generation syndromic surveillance systems produces a new and distinct form of infectious disease surveillance for the governing of emergent pathogenic contingencies. Conceptually, the article also shows how the rise of this algorithmic mode of infectious disease surveillance produces divergences in the governmental rationalities of global health security, leading to the rise of an algorithmic governmentality within contemporary contexts of Big Data and these surveillance systems. Empirically, this article demonstrates how this new form of algorithmic infectious disease surveillance has been rapidly integrated into diplomatic, legal, and political frameworks to strengthen the practice of global health security – producing subtle, yet distinct shifts in the outbreak notification and reporting transparency of states, increasingly scrutinized by the algorithmic gaze of syndromic surveillance.Keywords: algorithms, global health, pandemic, surveillance
Procedia PDF Downloads 1852109 Supervisory Controller with Three-State Energy Saving Mode for Induction Motor in Fluid Transportation
Authors: O. S. Ebrahim, K. O. Shawky, M. O. S. Ebrahim, P. K. Jain
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Induction Motor (IM) driving pump is the main consumer of electricity in a typical fluid transportation system (FTS). It was illustrated that changing the connection of the stator windings from delta to star at no load could achieve noticeable active and reactive energy savings. This paper proposes a supervisory hysteresis liquid-level control with three-state energy saving mode (ESM) for IM in FTS including storage tank. The IM pump drive comprises modified star/delta switch and hydromantic coupler. Three-state ESM is defined, along with the normal running, and named analog to computer ESMs as follows: Sleeping mode in which the motor runs at no load with delta stator connection, hibernate mode in which the motor runs at no load with a star connection, and motor shutdown is the third energy saver mode. A logic flow-chart is synthesized to select the motor state at no-load for best energetic cost reduction, considering the motor thermal capacity used. An artificial neural network (ANN) state estimator, based on the recurrent architecture, is constructed and learned in order to provide fault-tolerant capability for the supervisory controller. Sequential test of Wald is used for sensor fault detection. Theoretical analysis, preliminary experimental testing and, computer simulations are performed to show the effectiveness of the proposed control in terms of reliability, power quality and energy/coenergy cost reduction with the suggestion of power factor correction.Keywords: ANN, ESM, IM, star/delta switch, supervisory control, FT, reliability, power quality
Procedia PDF Downloads 1932108 Numerical and Experimental Investigation of Fracture Mechanism in Paintings on Wood
Authors: Mohammad Jamalabadi, Noemi Zabari, Lukasz Bratasz
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Panel paintings -complex multi-layer structures consisting of wood support and a paint layer composed of a preparatory layer of gesso, paints, and varnishes- are among the category of cultural objects most vulnerable to relative humidity fluctuations and frequently found in museum collections. The current environmental specifications in museums have been derived using the criterion of crack initiation in an undamaged, usually new gesso layer laid on wood. In reality, historical paintings exhibit complex crack patterns called craquelures. The present paper analyses the structural response of a paint layer with a virtual network of rectangular cracks under environmental loadings using a three-dimensional model of a panel painting. Two modes of loading are considered -one induced by one-dimensional moisture response of wood support, termed the tangential loading, and the other isotropic induced by drying shrinkage of the gesso layer. The superposition of the two modes is also analysed. The modelling showed that minimum distances between cracks parallel to the wood grain depended on the gesso stiffness under the tangential loading. In spite of a non-zero Poisson’s ratio, gesso cracks perpendicular to the wood grain could not be generated by the moisture response of wood support. The isotropic drying shrinkage of gesso produced cracks that were almost evenly spaced in both directions. The modelling results were cross-checked with crack patterns obtained on a mock-up of a panel painting exposed to a number of extreme environmental variations in an environmental chamber.Keywords: fracture saturation, surface cracking, paintings on wood, wood panels
Procedia PDF Downloads 2672107 Selection of Developmental Stages of Bovine in vitro-Derived Blastocysts Prior to Vitrification and Embryo Transfer: Implications for Cattle Breeding Programs
Authors: Van Huong Do, Simon Walton, German Amaya, Madeline Batsiokis, Sally Catt, Andrew Taylor-Robinson
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Identification of the most suitable stages of bovine in vitro-derived blastocysts (early, expanded and hatching) prior to vitrification is a straightforward process that facilitates the decision as to which blastocyst stage to use for transfer of fresh and vitrified embryos. Research on in vitro evaluation of suitable stages has shown that the more advanced developmental stage of blastocysts is recommended for fresh embryo transfer while the earlier stage is proposed for embryo transfer following vitrification. There is, however, limited information on blastocyst stages using in vivo assessment. Hence, the aim of the present study was to determine the optimal stage of a blastocyst for vitrification and embryo transfer through a two-step procedure of embryo transfer followed by pregnancy testing at 35, 60 and 90 days of pregnancy. 410 good quality oocytes aspirated by the ovum pick-up technique from 8 donor cows were subjected to in vitro embryo production, vitrification and embryo transfer. Good quality embryos were selected, subjected to vitrification and embryo transfer. Subsequently, 77 vitrified embryos at different blastocyst stages were transferred to synchronised recipient cows. The overall cleavage and blastocyst rates of oocytes were 68.8% and 41.7%, respectively. In addition, the fertility and blastocyst production of 6 bulls used for in vitro fertilization was examined and shown to be statistically different (P<0.05). Results of ongoing pregnancy trials conducted at 35 days, 60 days and 90 days will be discussed. However, preliminary data indicate that individual bulls demonstrate distinctly different fertility performance in vitro. Findings from conception rates would provide a useful tool to aid selection of bovine in vitro-derived embryos for vitrification and embryo transfer in commercial settings.Keywords: blastocyst, embryo transfer, in vitro-derived embryos, ovum pick-up, vitrification
Procedia PDF Downloads 3072106 Literature as a Strategic Tool to Conscientise Africans: An Attempt by Postcolonial Writers and Critics to Reverse the Socio-Economics Imbalances of Colonialism
Authors: Lutendo Nendauni
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Colonialism breaks things, colonisers exploded native cultural solidarity, producing the spiritual confusion, psychic wounding, and economic exploitation of a new and dominated ‘other’. Colonialism as the cultural and economic exploitation began when the West defended in their seizure of foreign territories for the exploitation of its natural resources; this resulted in brutal socio-economic imbalances. The Western profited at the detriment of the weak Africa. However, colonialism has since passed, but the effects are still evident culturally, socially, and economically. This paper explored how postcolonial writers and critics attempt to reverse the socio-economic imbalances resulting from the fragmentation of colonialism, with a focus on the play 'I will Marry When I Want' by Ngugi wa Thiong’o and Ngugi wa Mirii, as a primary text. Using qualitative discourse-textual analysis as the research methodology, the researcher purposively extracts discourse segments from the text for analysis and interpretation. The findings reveal that Postcolonial critics and writers attempt to reverse the socio-economic effects of colonialism through various counter discourses; their literature is concerned with the destruction of colonised identity, the search for this identity, and its assertion. It is manifest in the text that writers offer corrective views about Africans; they stress that they write their literary texts to conscientise their fellow Africans. Postcolonial writers and critics argue that language is a carrier of culture and that the only way to break free from colonial influence is by not adopting a foreign language. They further through their poems, novels, plays, and music strategically shine the spotlight on the previously nameless and destitute people so that they can develop the human spirit’s desire to overcome defeat, socio-political deprivation, and isolation.Keywords: colonialism, postcoloniality, critics, socio-economic imbalances
Procedia PDF Downloads 1572105 The Integration Challenges of Women Refugees in Sweden from Socio-Cultural Perspective
Authors: Khadijah Saeed Khan
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One of the major current societal issues of Swedish society is to integrate newcomer refugees well into the host society. The cultural integration issue is one of the under debated topic in the literature, and this study intends to meet this gap from the Swedish perspective. The purpose of this study is to explore the role and types of cultural landscapes of refugee women in Sweden and how these landscapes help or hinder the settlement process. The cultural landscapes are referred to as a set of multiple cultural activities or practices which refugees perform in a specific context and circumstances (i.e., being in a new country) to seek, share or use relevant information for their settlement. Information plays a vital role in various aspects of newcomers' lives in a new country. This article has an intention to highlight the importance of multiple cultural landscapes as a source of information (regarding employment, language learning, finding accommodation, immigration matters, health concerns, school and education, family matters, and other everyday matters) for refugees to settle down in Sweden. Some relevant theories, such as information landscapes and socio-cultural theories, are considered in this study. A qualitative research design is employed, including semi-structured deep interviews and participatory observation with 20 participants. The initial findings show that the refugee women encounter many information-related and integration-related challenges in Sweden and have built a network of cultural landscapes in which they practice various co-ethnic cultural and religious activities at different times of the year. These landscapes help them to build a sense of belonging with people from their own or similar land and assist them to seek and share relevant information in everyday life in Sweden.Keywords: cultural integration, cultural landscapes, information, women refugees
Procedia PDF Downloads 1422104 Improving the Training for Civil Engineers by Introducing Virtual Reality Technique
Authors: Manar Al-Ateeq
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The building construction industry plays a major role in the economy of the word and the state of Kuwait. This paper evaluates existing new civil site engineers, describes a new system for improvement and insures the importance of prequalifying and developing for new engineers. In order to have a strong base in engineering, educational institutes and workplaces should be responsible to continuously train engineers and update them with new methods and techniques in engineering. As to achieve that, school of engineering should constantly update computational resources to be used in the professions. A survey was prepared for graduated Engineers based on stated objectives to understand the status of graduate engineers in both the public and private sector. Interviews were made with different sectors in Kuwait, and several visits were made to different training centers within different workplaces in Kuwait to evaluate training process and try to improve it. Virtual Reality (VR) technology could be applied as a complement to three-dimensional (3D) modeling, leading to better communication whether in job training, in education or in professional practice. Techniques of 3D modeling and VR can be applied to develop the models related to the construction process. The 3D models can support rehabilitation design as it can be considered as a great tool for monitoring failure and defaults in structures; also it can support decisions based on the visual analyses of alternative solutions. Therefore, teaching computer-aided design (CAD) and VR techniques in school will help engineering students in order to prepare them to site work and also will assist them to consider these technologies as important supports in their later professional practice. This teaching technique will show how the construction works developed, allow the visual simulation of progression of each type of work and help them to know more about the necessary equipment needed for tasks and how it works on site.Keywords: three dimensional modeling (3DM), civil engineers (CE), professional practice (PP), virtual reality (VR)
Procedia PDF Downloads 1762103 Healthcare Workers' Attitudes Towards People Living With Hiv And Drug Users
Authors: Delband Yekta Moazami
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Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.Keywords: hiv, addiction, attitudes, healthcare workers
Procedia PDF Downloads 782102 Optimum Dewatering Network Design Using Firefly Optimization Algorithm
Authors: S. M. Javad Davoodi, Mojtaba Shourian
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Groundwater table close to the ground surface causes major problems in construction and mining operation. One of the methods to control groundwater in such cases is using pumping wells. These pumping wells remove excess water from the site project and lower the water table to a desirable value. Although the efficiency of this method is acceptable, it needs high expenses to apply. It means even small improvement in a design of pumping wells can lead to substantial cost savings. In order to minimize the total cost in the method of pumping wells, a simulation-optimization approach is applied. The proposed model integrates MODFLOW as the simulation model with Firefly as the optimization algorithm. In fact, MODFLOW computes the drawdown due to pumping in an aquifer and the Firefly algorithm defines the optimum value of design parameters which are numbers, pumping rates and layout of the designing wells. The developed Firefly-MODFLOW model is applied to minimize the cost of the dewatering project for the ancient mosque of Kerman city in Iran. Repetitive runs of the Firefly-MODFLOW model indicates that drilling two wells with the total rate of pumping 5503 m3/day is the result of the minimization problem. Results show that implementing the proposed solution leads to at least 1.5 m drawdown in the aquifer beneath mosque region. Also, the subsidence due to groundwater depletion is less than 80 mm. Sensitivity analyses indicate that desirable groundwater depletion has an enormous impact on total cost of the project. Besides, in a hypothetical aquifer decreasing the hydraulic conductivity contributes to decrease in total water extraction for dewatering.Keywords: groundwater dewatering, pumping wells, simulation-optimization, MODFLOW, firefly algorithm
Procedia PDF Downloads 2942101 Strategies for a Sustainable Neighbourhood in a Smart City: A Case of Pattoor, Thiruvananthapuram
Authors: Vijaya Nhaloor, Suja Kumari Leela, Jose Devadasan
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Planning of neighbourhood development strategies in Tier 2 Indian city is highly significant when it has also been selected as a Smart city by the Ministry of Urban Development in India. Smart city mission of India proposes the development of infrastructure in a city in an inclusive way. Thiruvananthapuram, the capital city of Kerala state, India, has been selected as the city to conduct the research. The master plan for the city of Thiruvananthapuram envisions it as a Compact city and proposes densification as a tool for development. Densification may adversely affect the quality of life after a tipping point. This may lead to urban decay which in turn directly or indirectly affects the surrounding neighbourhoods also, thus spreading blight areas in the city. The author thinks that density in urban planning is not a well detailed subject in India, with respect to its varied links on infrastructure, quality of life, transportation, scope of vertical planning, affordability etc. Neighbourhoods are vital tissues of an urban area, and their development directly affects the development of the region. The methodology would involve skimming of proactive neighbourhood planning principles compatible with the Smart city mission in India. United Nations proposes sustainability as a way of planning development of a neighbourhood. After defining various terminologies involved, a framework shall be developed to analyse an existing neighbourhood and prepare planning guidelines in a sustainable manner. The framework shall comply with international and national policy guidelines. The research shall explore and identify a neighbourhood with the potential to meet the housing demand from the investment regions nearby and analyse its potential and weakness as per this framework. Later, a set of indicators shall be enlisted to guide the development of the neighbourhood, leading to recommendations that shall serve as a replicable model for the other neighbourhoods in the Smart city.Keywords: key indicators, neighbourhood planning, sustainability, smart city
Procedia PDF Downloads 1492100 Fabrication and Characterization Analysis of La-Sr-Co-Fe-O Perovskite Hollow Fiber Catalyst for Oxygen Removal in Landfill Gas
Authors: Seong Woon Lee, Soo Min Lim, Sung Sik Jeong, Jung Hoon Park
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The atmospheric concentration of greenhouse gas (GHG, Green House Gas) is increasing continuously as a result of the combustion of fossil fuels and industrial development. In response to this trend, many researches have been conducted on the reduction of GHG. Landfill gas (LFG, Land Fill Gas) is one of largest sources of GHG emissions containing the methane (CH₄) as a major constituent and can be considered renewable energy sources as well. In order to use LFG by connecting to the city pipe network, it required a process for removing impurities. In particular, oxygen must be removed because it can cause corrosion of pipes and engines. In this study, methane oxidation was used to eliminate oxygen from LFG and perovskite-type ceramic catalysts of La-Sr-Co-Fe-O composition was selected as a catalyst. Hollow fiber catalysts (HFC, Hollow Fiber Catalysts) have attracted attention as a new concept alternative because they have high specific surface area and mechanical strength compared to other types of catalysts. HFC was prepared by a phase-inversion/sintering technique using commercial La-Sr-Co-Fe-O powder. In order to measure the catalysts' activity, simulated LFG was used for feed gas and complete oxidation reaction of methane was confirmed. Pore structure of the HFC was confirmed by SEM image and perovskite structure of single phase was analyzed by XRD. In addition, TPR analysis was performed to verify the oxygen adsorption mechanism of the HFC. Acknowledgement—The project is supported by the ‘Global Top Environment R&D Program’ in the ‘R&D Center for reduction of Non-CO₂ Greenhouse gases’ (Development and demonstration of oxygen removal technology of landfill gas) funded by Korea Ministry of Environment (ME).Keywords: complete oxidation, greenhouse gas, hollow fiber catalyst, land fill gas, oxygen removal, perovskite catalyst
Procedia PDF Downloads 1172099 Performance Evaluation of Routing Protocol in Cognitive Radio with Multi Technological Environment
Authors: M. Yosra, A. Mohamed, T. Sami
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Over the past few years, mobile communication technologies have seen significant evolution. This fact promoted the implementation of many systems in a multi-technological setting. From one system to another, the Quality of Service (QoS) provided to mobile consumers gets better. The growing number of normalized standards extends the available services for each consumer, moreover, most of the available radio frequencies have already been allocated, such as 3G, Wifi, Wimax, and LTE. A study by the Federal Communications Commission (FCC) found that certain frequency bands are partially occupied in particular locations and times. So, the idea of Cognitive Radio (CR) is to share the spectrum between a primary user (PU) and a secondary user (SU). The main objective of this spectrum management is to achieve a maximum rate of exploitation of the radio spectrum. In general, the CR can greatly improve the quality of service (QoS) and improve the reliability of the link. The problem will reside in the possibility of proposing a technique to improve the reliability of the wireless link by using the CR with some routing protocols. However, users declared that the links were unreliable and that it was an incompatibility with QoS. In our case, we choose the QoS parameter "bandwidth" to perform a supervised classification. In this paper, we propose a comparative study between some routing protocols, taking into account the variation of different technologies on the existing spectral bandwidth like 3G, WIFI, WIMAX, and LTE. Due to the simulation results, we observe that LTE has significantly higher availability bandwidth compared with other technologies. The performance of the OLSR protocol is better than other on-demand routing protocols (DSR, AODV and DSDV), in LTE technology because of the proper receiving of packets, less packet drop and the throughput. Numerous simulations of routing protocols have been made using simulators such as NS3.Keywords: cognitive radio, multi technology, network simulator (NS3), routing protocol
Procedia PDF Downloads 632098 Rethinking the Air Quality Health Index: Harmonizing Health Protection and Climate Mitigation
Authors: Kimberly Tasha Jiayi Tang, Changqing Lin, Zhe Wang, Tze-Wai Wong, Md. Shakhaoat Hossain, Jian Yu, Alexis Lau
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Hong Kong has practiced a risk-based Air Quality Health Index (AQHI) system that sums hospitalization risks associated with short-term exposure to air pollu-tants. As an air pollution risk communication tool, it informs the public about the current air quality, anchoring around the World Health Organization's (WHO) 2005 Air Quality Guidelines (AQGs). Given the WHO's recent update in 2021, assessing how Hong Kong’s air quality risk communication can be en-hanced using these updated guidelines is essential. Hong Kong’s AQHI is lim-ited by solely focusing on short-term health risks, which could lead the public to underestimate cumulative health impacts. Therefore, we propose the intro-duction of a composite AQHI that reports both long-term and short-term health risks. Additionally, the WHO interim targets will be considered as anchor points for various health risk categories. Furthermore, with the increasing ozone levels in Hong Kong and Southern China due to improved NOx mitigation measures, it has been a challenging task in balancing health protection against climate mitigation. However, our findings present a promising outlook. Despite the rise in ozone levels, the combined health risks in Hong Kong and Guang-dong have seen a decline, largely due to reductions in NO2 and PM concentra-tions, both having significant health implications. By shifting from a concentra-tion-based approach to a health risk-based system like the AQHI, our study highlights the prospective of harmonizing health protection and climate mitiga-tion goals. This health-focused framework suggests that rigorous NOx controls can effective-ly serve both objectives in parallel.Keywords: air quality management, air quality health index, health risk management, air pollution
Procedia PDF Downloads 722097 Innovative Predictive Modeling and Characterization of Composite Material Properties Using Machine Learning and Genetic Algorithms
Authors: Hamdi Beji, Toufik Kanit, Tanguy Messager
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This study aims to construct a predictive model proficient in foreseeing the linear elastic and thermal characteristics of composite materials, drawing on a multitude of influencing parameters. These parameters encompass the shape of inclusions (circular, elliptical, square, triangle), their spatial coordinates within the matrix, orientation, volume fraction (ranging from 0.05 to 0.4), and variations in contrast (spanning from 10 to 200). A variety of machine learning techniques are deployed, including decision trees, random forests, support vector machines, k-nearest neighbors, and an artificial neural network (ANN), to facilitate this predictive model. Moreover, this research goes beyond the predictive aspect by delving into an inverse analysis using genetic algorithms. The intent is to unveil the intrinsic characteristics of composite materials by evaluating their thermomechanical responses. The foundation of this research lies in the establishment of a comprehensive database that accounts for the array of input parameters mentioned earlier. This database, enriched with this diversity of input variables, serves as a bedrock for the creation of machine learning and genetic algorithm-based models. These models are meticulously trained to not only predict but also elucidate the mechanical and thermal conduct of composite materials. Remarkably, the coupling of machine learning and genetic algorithms has proven highly effective, yielding predictions with remarkable accuracy, boasting scores ranging between 0.97 and 0.99. This achievement marks a significant breakthrough, demonstrating the potential of this innovative approach in the field of materials engineering.Keywords: machine learning, composite materials, genetic algorithms, mechanical and thermal proprieties
Procedia PDF Downloads 542096 Adaptive Motion Compensated Spatial Temporal Filter of Colonoscopy Video
Authors: Nidhal Azawi
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Colonoscopy procedure is widely used in the world to detect an abnormality. Early diagnosis can help to heal many patients. Because of the unavoidable artifacts that exist in colon images, doctors cannot detect a colon surface precisely. The purpose of this work is to improve the visual quality of colonoscopy videos to provide better information for physicians by removing some artifacts. This work complements a series of work consisting of three previously published papers. In this paper, Optic flow is used for motion compensation, and then consecutive images are aligned/registered to integrate some information to create a new image that has or reveals more information than the original one. Colon images have been classified into informative and noninformative images by using a deep neural network. Then, two different strategies were used to treat informative and noninformative images. Informative images were treated by using Lucas Kanade (LK) with an adaptive temporal mean/median filter, whereas noninformative images are treated by using Lucas Kanade with a derivative of Gaussian (LKDOG) with adaptive temporal median images. A comparison result showed that this work achieved better results than that results in the state- of- the- art strategies for the same degraded colon images data set, which consists of 1000 images. The new proposed algorithm reduced the error alignment by about a factor of 0.3 with a 100% successfully image alignment ratio. In conclusion, this algorithm achieved better results than the state-of-the-art approaches in case of enhancing the informative images as shown in the results section; also, it succeeded to convert the non-informative images that have very few details/no details because of the blurriness/out of focus or because of the specular highlight dominate significant amount of an image to informative images.Keywords: optic flow, colonoscopy, artifacts, spatial temporal filter
Procedia PDF Downloads 1132095 Application of a Model-Free Artificial Neural Networks Approach for Structural Health Monitoring of the Old Lidingö Bridge
Authors: Ana Neves, John Leander, Ignacio Gonzalez, Raid Karoumi
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Systematic monitoring and inspection are needed to assess the present state of a structure and predict its future condition. If an irregularity is noticed, repair actions may take place and the adequate intervention will most probably reduce the future costs with maintenance, minimize downtime and increase safety by avoiding the failure of the structure as a whole or of one of its structural parts. For this to be possible decisions must be made at the right time, which implies using systems that can detect abnormalities in their early stage. In this sense, Structural Health Monitoring (SHM) is seen as an effective tool for improving the safety and reliability of infrastructures. This paper explores the decision-making problem in SHM regarding the maintenance of civil engineering structures. The aim is to assess the present condition of a bridge based exclusively on measurements using the suggested method in this paper, such that action is taken coherently with the information made available by the monitoring system. Artificial Neural Networks are trained and their ability to predict structural behavior is evaluated in the light of a case study where acceleration measurements are acquired from a bridge located in Stockholm, Sweden. This relatively old bridge is presently still in operation despite experiencing obvious problems already reported in previous inspections. The prediction errors provide a measure of the accuracy of the algorithm and are subjected to further investigation, which comprises concepts like clustering analysis and statistical hypothesis testing. These enable to interpret the obtained prediction errors, draw conclusions about the state of the structure and thus support decision making regarding its maintenance.Keywords: artificial neural networks, clustering analysis, model-free damage detection, statistical hypothesis testing, structural health monitoring
Procedia PDF Downloads 2082094 Author Profiling: Prediction of Learners’ Gender on a MOOC Platform Based on Learners’ Comments
Authors: Tahani Aljohani, Jialin Yu, Alexandra. I. Cristea
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The more an educational system knows about a learner, the more personalised interaction it can provide, which leads to better learning. However, asking a learner directly is potentially disruptive, and often ignored by learners. Especially in the booming realm of MOOC Massive Online Learning platforms, only a very low percentage of users disclose demographic information about themselves. Thus, in this paper, we aim to predict learners’ demographic characteristics, by proposing an approach using linguistically motivated Deep Learning Architectures for Learner Profiling, particularly targeting gender prediction on a FutureLearn MOOC platform. Additionally, we tackle here the difficult problem of predicting the gender of learners based on their comments only – which are often available across MOOCs. The most common current approaches to text classification use the Long Short-Term Memory (LSTM) model, considering sentences as sequences. However, human language also has structures. In this research, rather than considering sentences as plain sequences, we hypothesise that higher semantic - and syntactic level sentence processing based on linguistics will render a richer representation. We thus evaluate, the traditional LSTM versus other bleeding edge models, which take into account syntactic structure, such as tree-structured LSTM, Stack-augmented Parser-Interpreter Neural Network (SPINN) and the Structure-Aware Tag Augmented model (SATA). Additionally, we explore using different word-level encoding functions. We have implemented these methods on Our MOOC dataset, which is the most performant one comparing with a public dataset on sentiment analysis that is further used as a cross-examining for the models' results.Keywords: deep learning, data mining, gender predication, MOOCs
Procedia PDF Downloads 1482093 An Evaluation on the Effectiveness of a 3D Printed Composite Compression Mold
Authors: Peng Hao Wang, Garam Kim, Ronald Sterkenburg
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The applications of composite materials within the aviation industry has been increasing at a rapid pace. However, the growing applications of composite materials have also led to growing demand for more tooling to support its manufacturing processes. Tooling and tooling maintenance represents a large portion of the composite manufacturing process and cost. Therefore, the industry’s adaptability to new techniques for fabricating high quality tools quickly and inexpensively will play a crucial role in composite material’s growing popularity in the aviation industry. One popular tool fabrication technique currently being developed involves additive manufacturing such as 3D printing. Although additive manufacturing and 3D printing are not entirely new concepts, the technique has been gaining popularity due to its ability to quickly fabricate components, maintain low material waste, and low cost. In this study, a team of Purdue University School of Aviation and Transportation Technology (SATT) faculty and students investigated the effectiveness of a 3D printed composite compression mold. A 3D printed composite compression mold was fabricated by 3D scanning a steel valve cover of an aircraft reciprocating engine. The 3D printed composite compression mold was used to fabricate carbon fiber versions of the aircraft reciprocating engine valve cover. The 3D printed composite compression mold was evaluated for its performance, durability, and dimensional stability while the fabricated carbon fiber valve covers were evaluated for its accuracy and quality. The results and data gathered from this study will determine the effectiveness of the 3D printed composite compression mold in a mass production environment and provide valuable information for future understanding, improvements, and design considerations of 3D printed composite molds.Keywords: additive manufacturing, carbon fiber, composite tooling, molds
Procedia PDF Downloads 1992092 Assimilating Remote Sensing Data Into Crop Models: A Global Systematic Review
Authors: Luleka Dlamini, Olivier Crespo, Jos van Dam
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Accurately estimating crop growth and yield is pivotal for timely sustainable agricultural management and ensuring food security. Crop models and remote sensing can complement each other and form a robust analysis tool to improve crop growth and yield estimations when combined. This study thus aims to systematically evaluate how research that exclusively focuses on assimilating RS data into crop models varies among countries, crops, data assimilation methods, and farming conditions. A strict search string was applied in the Scopus and Web of Science databases, and 497 potential publications were obtained. After screening for relevance with predefined inclusion/exclusion criteria, 123 publications were considered in the final review. Results indicate that over 81% of the studies were conducted in countries associated with high socio-economic and technological advancement, mainly China, the United States of America, France, Germany, and Italy. Many of these studies integrated MODIS or Landsat data into WOFOST to improve crop growth and yield estimation of staple crops at the field and regional scales. Most studies use recalibration or updating methods alongside various algorithms to assimilate remotely sensed leaf area index into crop models. However, these methods cannot account for the uncertainties in remote sensing observations and the crop model itself. l. Over 85% of the studies were based on commercial and irrigated farming systems. Despite a great global interest in data assimilation into crop models, limited research has been conducted in resource- and data-limited regions like Africa. We foresee a great potential for such application in those conditions. Hence facilitating and expanding the use of such an approach, from which developing farming communities could benefit.Keywords: crop models, remote sensing, data assimilation, crop yield estimation
Procedia PDF Downloads 1312091 Assimilating Remote Sensing Data into Crop Models: A Global Systematic Review
Authors: Luleka Dlamini, Olivier Crespo, Jos van Dam
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Accurately estimating crop growth and yield is pivotal for timely sustainable agricultural management and ensuring food security. Crop models and remote sensing can complement each other and form a robust analysis tool to improve crop growth and yield estimations when combined. This study thus aims to systematically evaluate how research that exclusively focuses on assimilating RS data into crop models varies among countries, crops, data assimilation methods, and farming conditions. A strict search string was applied in the Scopus and Web of Science databases, and 497 potential publications were obtained. After screening for relevance with predefined inclusion/exclusion criteria, 123 publications were considered in the final review. Results indicate that over 81% of the studies were conducted in countries associated with high socio-economic and technological advancement, mainly China, the United States of America, France, Germany, and Italy. Many of these studies integrated MODIS or Landsat data into WOFOST to improve crop growth and yield estimation of staple crops at the field and regional scales. Most studies use recalibration or updating methods alongside various algorithms to assimilate remotely sensed leaf area index into crop models. However, these methods cannot account for the uncertainties in remote sensing observations and the crop model itself. l. Over 85% of the studies were based on commercial and irrigated farming systems. Despite a great global interest in data assimilation into crop models, limited research has been conducted in resource- and data-limited regions like Africa. We foresee a great potential for such application in those conditions. Hence facilitating and expanding the use of such an approach, from which developing farming communities could benefit.Keywords: crop models, remote sensing, data assimilation, crop yield estimation
Procedia PDF Downloads 822090 Design of DNA Origami Structures Using LAMP Products as a Combined System for the Detection of Extended Spectrum B-Lactamases
Authors: Kalaumari Mayoral-Peña, Ana I. Montejano-Montelongo, Josué Reyes-Muñoz, Gonzalo A. Ortiz-Mancilla, Mayrin Rodríguez-Cruz, Víctor Hernández-Villalobos, Jesús A. Guzmán-López, Santiago García-Jacobo, Iván Licona-Vázquez, Grisel Fierros-Romero, Rosario Flores-Vallejo
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The group B-lactamic antibiotics include some of the most frequently used small drug molecules against bacterial infections. Nevertheless, an alarming decrease in their efficacy has been reported due to the emergence of antibiotic-resistant bacteria. Infections caused by bacteria expressing extended Spectrum B-lactamases (ESBLs) are difficult to treat and account for higher morbidity and mortality rates, delayed recovery, and high economic burden. According to the Global Report on Antimicrobial Resistance Surveillance, it is estimated that mortality due to resistant bacteria will ascend to 10 million cases per year worldwide. These facts highlight the importance of developing low-cost and readily accessible detection methods of drug-resistant ESBLs bacteria to prevent their spread and promote accurate and fast diagnosis. Bacterial detection is commonly done using molecular diagnostic techniques, where PCR stands out for its high performance. However, this technique requires specialized equipment not available everywhere, is time-consuming, and has a high cost. Loop-Mediated Isothermal Amplification (LAMP) is an alternative technique that works at a constant temperature, significantly decreasing the equipment cost. It yields double-stranded DNA of several lengths with repetitions of the target DNA sequence as a product. Although positive and negative results from LAMP can be discriminated by colorimetry, fluorescence, and turbidity, there is still a large room for improvement in the point-of-care implementation. DNA origami is a technique that allows the formation of 3D nanometric structures by folding a large single-stranded DNA (scaffold) into a determined shape with the help of short DNA sequences (staples), which hybridize with the scaffold. This research aimed to generate DNA origami structures using LAMP products as scaffolds to improve the sensitivity to detect ESBLs in point-of-care diagnosis. For this study, the coding sequence of the CTM-X-15 ESBL of E. coli was used to generate the LAMP products. The set of LAMP primers were designed using PrimerExplorerV5. As a result, a target sequence of 200 nucleotides from CTM-X-15 ESBL was obtained. Afterward, eight different DNA origami structures were designed using the target sequence in the SDCadnano and analyzed with CanDo to evaluate the stability of the 3D structures. The designs were constructed minimizing the total number of staples to reduce costs and complexity for point-of-care applications. After analyzing the DNA origami designs, two structures were selected. The first one was a zig-zag flat structure, while the second one was a wall-like shape. Given the sequence repetitions in the scaffold sequence, both were able to be assembled with only 6 different staples each one, ranging between 18 to 80 nucleotides. Simulations of both structures were performed using scaffolds of different sizes yielding stable structures in all the cases. The generation of the LAMP products were tested by colorimetry and electrophoresis. The formation of the DNA structures was analyzed using electrophoresis and colorimetry. The modeling of novel detection methods through bioinformatics tools allows reliable control and prediction of results. To our knowledge, this is the first study that uses LAMP products and DNA-origami in combination to delect ESBL-producing bacterial strains, which represent a promising methodology for diagnosis in the point-of-care.Keywords: beta-lactamases, antibiotic resistance, DNA origami, isothermal amplification, LAMP technique, molecular diagnosis
Procedia PDF Downloads 2222089 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic
Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar
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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement
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