Search results for: Clinical decision support system

Authors: Bright C. Opara, Gideon C. Uboegbulam

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This study can be appreciated from the significant role culture exert in purchase decision of durable goods the world over. This study is motivated by cultural diversity in Nigeria and socio-economic changes that have taken place in the recent times. These call for the validation of similarly studies in order to formulate informed marketing strategies that will enhance purchase behaviour. This study therefore, is set out to examine the cultural influence in family purchase decision-making for durable goods in the three major ethnic groups in Nigeria (Hausa, Ibo, and Yoruba). The primary data was sourced using structured and semi-structured research questionnaire, while the secondary information was generated from existing / available relevant literature journals / periodicals. A judgmental sampling technique was used to determine the sample size of 300 households. The Analysis of Variance (ANOVA) statistical tool was used to test the hypotheses, with the aid of Statistical Packages for Social Sciences (SPSS) version 17.0. The finding showed that cultural influence on the family Purchase Decision of Durable Goods does not significantly differ in three ethnic groups, and that family Purchase Decision Making for Durable Goods does not significantly differ in the three ethnic groups. We therefore, conclude that culture do not really impact significantly on the purchase behaviour of the three ethnic groups in the Nigeria as it does in some others. However, there is need for marketers and marketing decision makers not to generalise the findings of this study. This is because of the significant role culture play in purchase behaviour which differs from one culture or country to another.

Keywords: cultural, durable goods, influence, purchase decision

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Authors: Kevin Soubly, Kaysara Khatun

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This study applies the existing Middle-Out Perspective (MOP) as a complementing analytical alternative to the customary dichotomous options of top-down vs. bottom-up strategies of international development and commons governance. It expands the framework by applying it to a new context of land management and environmental change, enabling fresh understandings of decision making around land use. Using a case study approach in Central Kalimantan, Indonesia among a village of indigenous Dayak, this study explores influences from both internal and external middle actors, utilizing qualitative empirical evidence and incorporating responses across 25 village households and 11 key stakeholders. Applying the factors of 'agency' and 'capacity' specific to the MOP, this study demonstrates middle actors’ unique capabilities and criticality to change due to their influence across various levels of decision-making. Study results indicate that middle actors play a large role, both passively and actively, both directly and indirectly, across various levels of decision-making, perception-shaping, and commons governance. In addition, the prominence of novel 'passive' middle actors, such as the internet, can provide communities themselves with a level of agency beyond that provided by other middle actors such as NGOs and palm oil industry entities – which often operate at the behest of the 'top' or out of self-interest. Further, the study posits that existing development and decision-making frameworks may misidentify the 'bottom' as the 'middle,' raising questions about traditional development and livelihood discourse, strategies, and support, from agricultural production to forest management. In conclusion, this study provides recommendations including that current policy preconceptions be reevaluated to engage middle actors in locally-adapted, integrative manners in order to improve governance and rural development efforts more broadly.

Keywords: environmental management, governance, Indonesia, land use, middle actors, middle-out perspective

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Authors: Giovanni Cicceri, Roberta Maisano, Nathalie Morey, Salvatore Distefano

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The main goal of this paper is to present a solution for a water purification system based on an Environmental Internet of Things (EIoT) platform to monitor and control water quality and machine learning (ML) models to support decision making and speed up the processes of purification of water. A real case study has been implemented by deploying an EIoT platform and a network of devices, called Gramb meters and belonging to the Gramb project, on wastewater purification systems located in Calabria, south of Italy. The data thus collected are used to control the wastewater quality, detect anomalies and predict the behaviour of the purification system. To this extent, three different statistical and machine learning models have been adopted and thus compared: Autoregressive Integrated Moving Average (ARIMA), Long Short Term Memory (LSTM) autoencoder, and Facebook Prophet (FP). The results demonstrated that the ML solution (LSTM) out-perform classical statistical approaches (ARIMA, FP), in terms of both accuracy, efficiency and effectiveness in monitoring and controlling the wastewater purification processes.

Keywords: environmental internet of things, EIoT, machine learning, anomaly detection, environment monitoring

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Authors: Yusra Ibrahim

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This study explores the online discourse of justice-involved youth on Reddit, focusing on how anonymity and asynchronicity influence their ability to share and reflect on their incarceration experiences within the "Ask Me Anything" (AMA) community. The study utilizes a quantitative analysis of speech acts to examine the varied communication patterns exhibited by youths and commenters across two AMA threads. The results indicate that, although Reddit is not specifically designed for formerly incarcerated youths, its features provide a supportive environment for them to share their incarceration experiences with non-incarcerated individuals. The level of empathy and support from the audience varies based on the audience’s perspectives on incarceration and related traumatic experiences. Additionally, the study identifies a reciprocal relationship where youths benefit from community support while offering insights into the juvenile justice system and helping the audience understand the experience of incarceration. The study also reveals cultural shocks in physical and digital environments that youth experience after release and when using social media platforms and the internet. The study has implications for juvenile justice personnel, policymakers, and researchers in the juvenile justice system.

Keywords: juvenile justice, online discourse, reddit AMA, anonymity, speech acts taxonomy, reintegration, online community support

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Authors: Dejenie Birile Gemeda, Wilhelm Stork

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The power system is one of the most important systems in modern society. The existing power system is approaching the critical operating limits as views of several power system operators. With the increase of load demand, high capacity and long transmission networks are widely used to meet the requirement. With the integration of renewable energies such as wind and solar, the uncertainty, intermittence bring bigger challenges to the operation of power systems. These dynamic uncertainties in the power system lead to power disturbances. The disturbances in a heavily stressed power system cause distance relays to mal-operation or false alarms during post fault power oscillations. This unintended operation of these relays may propagate and trigger cascaded trappings leading to total power system blackout. This is due to relays inability to take an appropriate tripping decision based on ensuing power swing. According to the N-1 criterion, electric power systems are generally designed to withstand a single failure without causing the violation of any operating limit. As a result, some overloaded components such as overhead transmission lines can still work for several hours under overload conditions. However, when a large power swing happens in the power system, the settings of the distance relay of zone 3 may trip the transmission line with a short time delay, and they will be acting so quickly that the system operator has no time to respond and stop the cascading. Misfiring of relays in absence of fault due to power swing may have a significant loss in economic performance, thus a loss in revenue for power companies. This research paper proposes a method to distinguish stable power swing from unstable using dynamic line rating (DLR) in response to power swing or disturbances. As opposed to static line rating (SLR), dynamic line rating support effective mitigation actions against propagating cascading outages in a power grid. Effective utilization of existing transmission lines capacity using machine learning DLR predictions will improve the operating point of distance relay protection, thus reducing unintended power outages due to power swing.

Keywords: blackout, cascading outages, dynamic line rating, power swing, overhead transmission lines

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Authors: Kristin Lewis, Howard Steele, Anne Murphy, Miriam Steele, Karen Bonuck, Paul Meissner

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The present study examines data collected during the randomized control trial (RCT) of the Group Attachment-Based Intervention (GABI©), a trauma-informed, attachment-based intervention aimed at promoting healthy parent-child relationships that support child development. Families received treatment at Treatment Center and were randomly assigned to either the GABI condition or the treatment as usual condition, a parenting class called Systematic Training for Effective Parenting (STEP). Significant improvements in the parent-child relationship have been reported for families participating in GABI, but not in the STEP control group relying on Coding Interactive Behavior (CIB) as applied to 5-minute video-films of mothers and their toddlers in a free play context. This report considers five additional attachment-relevant 'clinical codes' that were also applied to the 5-minute free play sessions. Seventy-two parent-child dyads (38 in GABI and 34 in STEP) were compared to one another at intake and end-of-treatment, on these five-point dimensions: two-parent codes—the dissociation and ignoring; two child codes—simultaneous display of contradictory behavior and fear; and one parent-child code, i.e., role reversal. Overall, scores were low for these clinical codes; thus, a binary measure was computed contrasting no evidence with some evidence of each clinical code. Crosstab analyses indicate that child fear at end-of-treatment was significantly lower among children who participated in GABI (7% or 3 children) as compared to those whose mothers participated in STEP (29% or 10 children) Chi Sq= 6.57 (1), p < .01. Discussion focuses on the potential for GABI to reduce childhood fearfulness and so enhance the child's health.

Keywords: coding interactive behavior, clinical codes, group attachment based intervention, GABI, attachment, fear

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Authors: Maggie Hall, Haley O'Neill

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The U.S. faces a severe shortage of abortion providers, exacerbated by the June 2022 Dobbs v. Jackson Women’s Health Organization decision. Midwives, especially certified nurse midwives, are well-positioned to fill this gap in abortion care. However, a lack of clinical education and training prevents midwives from exercising their full scope of practice. National and international organizations that set obstetrics and midwifery education standards, including the International Confederation of Midwives, American College of Obstetricians and Gynecologists, and American Public Health Association, call for expansion of midwifery-managed abortion care through the first trimester. In the U.S., midwifery programs are accredited based on compliance with ACME standards and compliance is a prerequisite for the American Midwifery Certification Board exams. We conducted a literature review of studies in the last five years regarding abortion didactic and clinical education barriers via CINAHL, EBSCO and PubMed database reviews. We gave preference for primary sources within the last five years; however, due to the rapid changes in abortion education and access, we also included literature from 2012-2022. We evaluated ACME-accredited programs in relation to their geography within abortion-protected or restricted states and assessed state-specific barriers to abortion care education and provision as clinical students. There are 43 AMCB-accredited midwifery schools in 28 states across the U.S. Twenty schools (47%) are in the 15 states in which advanced practice clinicians can provide non-surgical abortion care, such as medication abortion and MVA procedures. Twenty-four schools (56%) are in the 16 states in which abortion care provision is restricted to Licensed Physicians and cannot offer in-state clinical training opportunities for midwifery students. Six schools are in the five states in which abortion is completely banned and are geographically concentrated in the southernmost region of the U.S., including Alabama, Kentucky, Louisiana, Tennessee, and Texas. Subsequently, these programs cannot offer in-state clinical training opportunities for midwifery students. Notably, there are seven ACME programs in six states that do not restrict abortion access by gestational age, including Colorado, Connecticut, Washington, D.C., New Jersey, New Mexico, and Oregon. These programs may be uniquely positioned for midwifery involvement in abortion care beyond the first trimester. While the following states don’t house ACME programs, abortion care can be provided by advanced practice clinicians in Rhode Island, Delaware, Hawaii, Maine, Maryland, Montana, New Hampshire, and Vermont, offering clinical placement and/or new ACME program development opportunities. We identify existing barriers to clinical education and training opportunities for midwifery-managed abortion care, which are both geographic and institutional in nature. We recommend expansion and standardization of clinical education and training opportunities for midwifery-managed abortion care in ACME-accredited programs to improve access to abortion care. Midwifery programs and teaching hospitals need to expand education, training, and residency opportunities for midwifery students to strengthen access to midwife-managed abortion care. ACNM and ACME should re-evaluate accreditation criteria and the implications of ACME programs in states where students are not able to learn abortion care in clinical contexts due to state-specific abortion restrictions.

Keywords: midwifery education, abortion, abortion education, abortion access

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Authors: Yong Cang

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RJV001 is a subcutaneous injection containing mutated recombinant Collagenase H (ColH), leading to disruption of collagen matrix in adipose tissue and programmed cell death of adipocytes. Here we reported our clinical investigation of the safety, tolerance and pharmacodynamics of localized RJV001 injection into healthy human abdominal fat tissues (NCT04821648, Arizona Research Center). Investigate the safety, tolerance and clinical pharmacodynamics of subcutaneous RJV001 in humans. In the dose-escalating study, 18 subjects completed the study, 100% female, 78% white, with a mean age of 42[±9.9]. All three tested dose (0.05, 0.075 and 0.15 mg/injection), up to 30 injections, were safe and well-tolerated. Bruising and tenderness to palpation, mild to moderate, were the most frequent local skin reactions but nearly all resolved within 30 days. Additionally, physician-monitored ultrasound measurement showed that a reduction in abdominal fat tissue thickness was consistently observed in Cohort C (0.075, 0.15 mg/injection, 30injections), with a mean reduction of 7.37 [± 2.020] mm. Based on this clinical study, RJV001 has been advanced to phase II clinical studies. In the dose-escalating study, subcutaneously administered RJV001 was safe and well-tolerated in healthy adults up to 0.15 mg/injection, 30 injections. Fat reduction and adipocytolysis were observed by ultrasound measurements and histological analysis for exploratory purposes.

Keywords: fat reduction, mutant collagenase, clinical trial, subcutaneous injection

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Authors: Recep Sait Arpat, Hakan Güreşci

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Emergency, disaster and crisis management terms are generally perceived as the same processes. This conflict effects the approach and delegating policy of the political order. Crisis management starts in the aftermath of the mismanagement of disaster and emergency. In the light of the information stated above in this article Turkey and United Kingdom(UK)’s crisis management systems are analyzed. This article’s main aim is to clarify the main points of the emergency management system of United Kingdom and Turkey’s disaster management system by comparing them. To do this: A prototype model of the political decision making processes of the countries is drawn, decision making mechanisms and the planning functions are compared. As a result it’s found that emergency management policy in Turkey is reactive whereas it’s proactive in UK; as the delegating policy Turkey’s system is similar to UK; levels of emergency situations are similar but not the same; the differences are stemming from the civil order and nongovernmental organizations effectiveness; UK has a detailed government engagement model to emergencies, which shapes the doctrine of the approach to emergencies, and it’s successful in gathering and controlling the whole state’s efforts; crisis management is a sub-phase of UK emergency management whereas it’s accepted as a outmoded management perception and the focal point of crisis management perception in UK is security crisis and natural disasters while in Turkey it is natural disasters. In every anlysis proposals are given to Turkey.

Keywords: crisis management, disaster management, emergency management, turkey, united kingdom

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Authors: Tadaaki Tomiie, Hiroki Shinkawa

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The present study was aimed to examine the structure of children’s adaptation during school transition and to identify a commonality and dissimilarity at the elementary and junior high school. 1,983 students in the 6th grade and 2,051 students in the 7th grade were extracted by stratified two-stage random sampling and completed the ASSESS that evaluated the school adaptation from the view point of ‘general satisfaction’, ‘teachers’ support’, ‘friends’ support’, ‘anti-bullying relationship’, ‘prosocial skills’, and ‘academic adaptation’. The 7th graders tend to be worse adaptation than the 6th graders. A structural equation modeling showed the goodness of fit for each grades. Both models were very similar but the 7th graders’ model showed a lower coefficient at the pass from ‘teachers’ support’ to ‘friends’ support’. The role of ‘teachers’ support’ was decreased to keep a good relation in junior high school. We also discussed how we provide a continuous assistance for prevention of the 7th graders’ gap.

Keywords: school transition, social support, psychological adaptation, K-12

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Authors: Shivani Singh, Shantanu Nakhare, Kalyani Nair, Rohan Shetty

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As social networking is growing at a rapid pace today it is vital that we work on improving its management. Research has shown that the content present in online social networks may have significant influence on impressionable minds. If such platforms are misused, it will lead to negative consequences. Detecting insults or inappropriate messages continues to be one of the most challenging aspects of Online Social Networks (OSNs) today. We address this problem through a Machine Learning Based Soft Text Classifier approach using Support Vector Machine algorithm. The proposed system acts as a screening mechanism the alerts the user about such messages. The messages are classified according to their subject matter and each comment is labeled for the presence of profanity and insults.

Keywords: machine learning, online social networks, soft text classifier, support vector machine

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Authors: Frederic Jumelle, Kelvin So, Didan Deng

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In this paper, we are introducing a model of artificial general intelligence (AGI), the functional neural network (FNN), for modeling human decision-making processes. The FNN is composed of multiple artificial mirror neurons (AMN) racing in the network. Each AMN has a similar structure programmed independently by the users and composed of an intention wheel, a motor core, and a sensory core racing at a specific velocity. The mathematics of the node’s formulation and the racing mechanism of multiple nodes in the network will be discussed, and the group decision process with fuzzy logic and the transformation of these conceptual methods into practical methods of simulation and in operations will be developed. Eventually, we will describe some possible future research directions in the fields of finance, education, and medicine, including the opportunity to design an intelligent learning agent with application in AGI. We believe that FNN has a promising potential to transform the way we can compute decision-making and lead to a new generation of AI chips for seamless human-machine interactions (HMI).

Keywords: neural computing, human machine interation, artificial general intelligence, decision processing

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Authors: Xin Wang, Munkbayar Munkhjargal, Kumiko Miyajima, Takahiro Arakawa, Kohji Mitsubayashi

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The measurement of gaseous ethanol plays an important role of evaluation of alcohol metabolic capacity in clinical and forensic analysis. A 2-dimensional visualization system for gaseous ethanol was constructed and tested in visualization of breath and transdermal alcohol. We demonstrated breath ethanol measurement using developed high-sensitive visualization system. The concentration of breath ethanol calculated with the imaging signal was significantly different between the volunteer subjects of ALDH2 (+) and (-).

Keywords: breath ethanol, ethnaol imaging, biochemical luminescence, alcohol metabolism

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Authors: Taha Benarbia, Kay W. Axhausen, Anugrah Ilahi

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Electric car sharing system as ecologic transportation increasing in the world. The complexity of managing electric car sharing systems, especially one-way trips and battery autonomy have direct influence to on supply and demand of system. One must be able to precisely model the demand and supply of these systems to better operate electric car sharing and estimate its effect on mobility management and the accessibility that it provides in urban areas. In this context, our work focus to develop performances optimization model of the system based on discrete event simulation and stochastic Petri net. The objective is to search optimal decisions and management parameters of the system in order to fulfil at best demand while minimizing undesirable situations. In this paper, we present new model of electric cars sharing with relocation based on monitoring system. The proposed approach also help to precise the influence of battery charging level on the behaviour of system as important decision parameter of this complex and dynamical system.

Keywords: electric car-sharing systems, smart mobility, Petri nets modelling, discrete event simulation

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Authors: Musthaya Patchanee

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The aim of this research is to study potential factors relating to the decision of return migration of Myanmar migrant workers in Prachuap Khiri Khan Province by conducting a random sampling of 400 people aged between 15-59 who migrated from Myanmar. The information collected through interviews was analyzed to find a percentage and mean using the Stepwise Multiple Regression Analysis. The results have shown that 33.25% of Myanmar migrant workers want to return to their home country within the next 1-5 years, 46.25%, in 6-10 years and the rest, in over 10 years. The factors relating to such decision can be concluded that the scale of the decision of return migration has a positive relationship with a statistical significance at 0.05 with a conformity with friends and relatives (r=0.886), a relationship with family and community (r=0.782), possession of land in hometown (r=0.756) and educational level (r=0.699). However, the factor of property possession in Prachuap Khiri Khan is the only factor with a high negative relationship (r=0.-537). From the Stepwise Multiple Regression Analysis, the results have shown that the conformity with friends and relatives and educational level factors are influential to the decision of return migration of Myanmar migrant workers in Prachuap Khiri Khan Province, which can predict the decision at 86.60% and the multiple regression equation from the analysis is Y= 6.744+1.198 conformity + 0.647 education.

Keywords: decision of return migration, factors of return migration, Myanmar migrant workers, Prachuap Khiri Khan Province

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Authors: Wann-Ming Wey

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In recent years, in addition to face the external threats such as energy shortages and climate change, traffic congestion and environmental pollution have become anxious problems for many cities. Considering private automobile-oriented urban development had produced many negative environmental and social impacts, the transit-oriented development (TOD) has been considered as a sustainable urban model. TOD encourages public transport combined with friendly walking and cycling environment designs, however, non-motorized modes help improving human health, energy saving, and reducing carbon emissions. Due to environmental changes often affect the planners’ decision-making; this research applies dynamic network process (DNP) which includes the time dependent concept to promoting friendly walking and cycling environmental designs as an advanced planning support system for environment improvements. This research aims to discuss what kinds of design strategies can improve a friendly walking and cycling environment under TOD. First of all, we collate and analyze environment designing factors by reviewing the relevant literatures as well as divide into three aspects of “safety”, “convenience”, and “amenity” from fifteen environment designing factors. Furthermore, we utilize fuzzy Delphi Technique (FDT) expert questionnaire to filter out the more important designing criteria for the study case. Finally, we utilized DNP expert questionnaire to obtain the weights changes at different time points for each design criterion. Based on the changing trends of each criterion weight, we are able to develop appropriate designing strategies as the reference for planners to allocate resources in a dynamic environment. In order to illustrate the approach we propose in this research, Taipei city as one example has been used as an empirical study, and the results are in depth analyzed to explain the application of our proposed approach.

Keywords: environment planning support systems, walking and cycling, transit-oriented development (TOD), dynamic network process (DNP)

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Authors: Uwe C. Fischer

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Mental health and well-being for employees working in the human service system are getting more and more important given the increasing rate of absenteeism at work. Besides individual capacities, social and community factors seem to be important in the working setting. Starting from a demand resource framework including the classical demand control aspects, social support systems, specific demands and resources of the client work, and work-family conflict were considered in the present study. We state hypothetically, that these factors have a meaningful association with the mental quality of life of employees working in the field of social, educational and health sectors. 1140 employees, working in human service organizations (education, youth care, nursing etc.) were asked for strains and resources at work (selected scales from Salutogenetic Subjective Work Assessment SALSA and own new scales for client work), work-family conflict, and mental quality of life from the German Short Form Health Survey. Considering the complex influences of the variables, we conducted a multiple hierarchical regression analysis. One third of the whole variance of the mental quality of life can be declared by the different variables of the model. When the variables concerning social influences were included in the hierarchical regression, the influence of work related control resource decreased. Excessive workload, work-family conflict, social support by supervisors, co-workers and other persons outside work, as well as strains and resources associated with client work had significant regression coefficients. Conclusions: Social support systems are crucial in the social, educational and health related service sector, regarding the influence on mental well-being. Especially the work-family conflict focuses on the importance of the work-life balance. Also the specific strains and resources of the client work, measured with new constructed scales, showed great impact on mental health. Therefore occupational health promotion should focus more on the social factors within and outside the working place.

Keywords: client interaction, human service system, mental health, social support, work-family conflict

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Authors: Luca Martignoni, Joseph Nserat, Eric Arand, Marvin Braun

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The increasing application of conversational agents in healthcare and the demand for applications that enable patients to take informed decisions is changing the way patients access healthcare and take decisions. Promising results related to the acceptance of CAs in healthcare have been accomplished. In that regard, understanding how to design CAs in a way that patients trust their recommendations and decisions constitutes an important area of research. Our study examines self-disclosure and transparency as drivers of trust to enhance the medical assistance of CAs for patients. Accordingly, we examined the effects of self-disclosure and transparency on patients trust and service satisfaction by conducting an online experiment with 136 participants. Our results show that the expression of both self-disclosure and conversational agents transparency leads to an increased perception of trust but does not necessarily improve the service satisfaction. Therefore, developers should implement self-disclosure and transparency to create a trustworthy environment.

Keywords: conversational agent, transparency, self-disclosure, healthcare

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Authors: Katharina Eberhardt, Florian Klaus Kaiser, Frank Schultmann

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Last-mile distribution is one of the most critical parts of a disaster relief operation. Various uncertainties, such as infrastructure conditions, resource availability, and fluctuating beneficiary demand, render last-mile distribution challenging in disaster relief operations. The need to balance critical performance criteria like response time, meeting demand and cost-effectiveness further complicates the task. The occurrence of disasters cannot be controlled, and the magnitude is often challenging to assess. In summary, these uncertainties create a need for additional flexibility, agility, and preparedness in logistics operations. As a result, strategic planning and efficient network design are critical for an effective and efficient response. Furthermore, the increasing frequency of disasters and the rising cost of logistical operations amplify the need to provide robust and resilient solutions in this area. Therefore, we formulate a scenario-based bi-objective optimization model that integrates pre-positioning, allocation, and distribution of relief supplies extending the general form of a covering location problem. The proposed model aims to minimize underlying logistics costs while maximizing demand coverage. Using a set of disruption scenarios, the model allows decision-makers to identify optimal network solutions to address the risk of disruptions. We provide an empirical case study of the public authorities’ emergency food storage strategy in Germany to illustrate the potential applicability of the model and provide implications for decision-makers in a real-world setting. Also, we conduct a sensitivity analysis focusing on the impact of varying stockpile capacities, single-site outages, and limited transportation capacities on the objective value. The results show that the stockpiling strategy needs to be consistent with the optimal number of depots and inventory based on minimizing costs and maximizing demand satisfaction. The strategy has the potential for optimization, as network coverage is insufficient and relies on very high transportation and personnel capacity levels. As such, the model provides decision support for public authorities to determine an efficient stockpiling strategy and distribution network and provides recommendations for increased resilience. However, certain factors have yet to be considered in this study and should be addressed in future works, such as additional network constraints and heuristic algorithms.

Keywords: humanitarian logistics, bi-objective optimization, pre-positioning, last mile distribution, decision support, disaster relief networks

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Authors: Wided Khiari, Adel Karaa

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This study aims to establish a typology of Tunisian listed firms according to their corporate governance characteristics and disclosure quality. The paper uses disclosed scores to examine corporate governance practices of Tunisian listed firms. A content analysis of 46 Tunisian listed firms from 2001 to 2010 has been carried out and a disclosure index developed to determine the level of disclosure of the companies. The disclosure quality is appreciated through the quantity and also through the nature (type) of information disclosed. Applying the decision tree method, the obtained tree diagrams provide ways to know the characteristics of a particular firm regardless of its level of disclosure. Obtained results show that the characteristics of corporate governance to achieve good quality of disclosure are not unique for all firms. These structures are not necessarily all of the recommendations of best practices, but converge towards the best combination. Indeed, in practice, there are companies which have a good quality of disclosure, but are not well-governed. However, we hope that by improving their governance system their level of disclosure may be better. These findings show, in a general way, a convergence towards the standards of corporate governance with a few exceptions related to the specificity of Tunisian listed firms and show the need for the adoption of a code for each context. These findings shed the light on corporate governance features that enhance incentives for good disclosure. It allows identifying, for each firm and in any date, corporate governance determinants of disclosure quality. More specifically, and all being equal, obtained tree makes a rule of decision for the company to know the level of disclosure based on certain characteristics of the governance strategy adopted by the latter.

Keywords: corporate governance, disclosure, decision tree, economics

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Nurullah Ekmekci, Ömer Akkaya, Kazım Karaboğa, Mahmut Tekin

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Job selection is one of the most important decisions that affect their lives in the name of being more useful to themselves and the society. There are many criteria to consider in the job selection. The amount of criteria in the job selection makes it a multi-criteria decision-making (MCDM) problem. In this study; job selection has been discussed as multi-criteria decision-making problem and has been solved by Analytic Hierarchy Process (AHP), one of the multi-criteria decision making methods. A survey, contains 5 different job selection criteria (finding a job friendliness, salary status, job , social security, work in the community deems reputation and business of the degree of difficulty) within many job selection criteria and 4 different job alternative (being academician, working at the civil service, working at the private sector and working at in their own business), has been conducted to the students of Selcuk University Faculty of Economics and Administrative Sciences. As a result of pairwise comparisons, the highest weighted criteria in the job selection and the most coveted job preferences were identified.

Keywords: analytical hierarchy process, job selection, multi-criteria, decision making

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Authors: Vasiliki Vlachou, Christos Kontzinos, Ourania Markaki, Panagiotis Kokkinakos, Vagelis Karakolis, John Psarras

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Higher Education is resisting the pull of technology, especially as this concerns the issuance and verification of degrees and certificates. It is widely known that education certificates are largely produced in paper form making them vulnerable to damage while holders of such certificates are dependent on the universities and other issuing organisations. QualiChain is an EU Horizon 2020 (H2020) research project aiming to transform and revolutionise the domain of public education and its ties with the job market by leveraging blockchain, analytics and decision support to develop a platform for the verification and sharing of education certificates. Blockchain plays an integral part in the QualiChain solution in providing a trustworthy environment to store, share and manage such accreditations. Under the context of this paper, three prominent blockchain platforms (Ethereum, Hyperledger Fabric, Hyperledger Iroha) were considered as a means of experimentation for creating a system with the basic functionalities that will be needed for trustworthy degree verification. The methodology and respective system developed and presented in this paper used Hyperledger Iroha and proved that this specific platform can be used to easily develop decentralize applications. Future papers will attempt to further experiment with other blockchain platforms and assess which has the best potential.

Keywords: blockchain, degree verification, higher education certificates, Hyperledger Iroha

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Authors: Saghar Karimi, Mohammad Saeed Ahrari Khafi, Amin Abolhasani Foroughi

Abstract:

In recent decades, keeping exotic species as pet animals has become widespread. Turtles are exotic species from chelonians, which are interested by many people. Caspian pond and European pond turtles from Emydidea family are commonly kept as pets in Iran. Presence of the shell in turtles makes achievement to a comprehensive clinical examination impossible. Respiratory system is one of the most important structures to be examined completely. Presence of the air in the respiratory system makes radiography the first modality to think of; however, image quality would be affected by the shell. Computed tomography (CT) as a radiography-based and non-invasive technique provides cross-sectional scans with little superimposition. The aim of this study was to depict normal computed tomographic anatomy of the respiratory system in Caspian Pond Turtle. Five adult Caspian pond turtle were scanned using a 16-detector CT machine. Our results showed that computed tomography is able to well illustrated different parts of respiratory system in turtle and can be used for detecting abnormalities and disorders.

Keywords: anatomy, computed tomography, respiratory system, turtle

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Authors: Hussain Ali, Ahmad Ali, Syed Rashid Ali

Abstract:

The maternal mortality is one of the basic health issues faced by rural women in Pakistan. There are various structural and socio-cultural determinants which confine women to domestic sphere. Such mobility restriction compels women for home delivery which causes high maternal mortality and morbidity. However, it is hard to find out the research findings and well-organized literature that explain the cultural factors act as determinant to home delivery among Pakhtun women. The overall objective of this research is to study men’s decision making within the household in Pakhtun society as determinant of home delivery among Pakhtun women in Khyber Pakhtunkhwa province of Pakistan. In the present study, researchers used the quantitative research design in which the data are collected through household survey technique from (n=503) ever-married women having reproductive age (15-49 years) by using interview schedule. The data are analyzed through SPSS, and binary logistic regression was applied to draw the association between home as a place of delivery and men’s decision making in the Pakhtun society. The results show that majority (76%) of the husbands are key decision makers about the home delivery due to their superior position within household. Similarly, majority (88%) Pakhtun women prefer to stay in home for their delivery due to their dependency on husband’s decision. The researcher concludes that men are key decision makers in Pakhtun society and their decisions affect women maternal health care. Similarly, the women are in subordinate position, and their limited decision making in the domestic sphere are greatly responsible for home delivery which causing high maternal mortality rate in the study area. In order to achieve Sustainable Development Goal No. 3, the study recommends empowering women in the decision making about accessing and utilizing maternal health care services and given financial autonomy to them.

Keywords: home delivery, men’s decision, Pakhtun women, subordinate position

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Authors: Wei-Jong Yang, Wei-Hau Du, Pau-Choo Chang, Jar-Ferr Yang, Pi-Hsia Hung

Abstract:

The demands of smart visual thing recognition in various devices have been increased rapidly for daily smart production, living and learning systems in recent years. This paper proposed a visual thing recognition system, which combines binary scale-invariant feature transform (SIFT), bag of words model (BoW), and support vector machine (SVM) by using color information. Since the traditional SIFT features and SVM classifiers only use the gray information, color information is still an important feature for visual thing recognition. With color-based SIFT features and SVM, we can discard unreliable matching pairs and increase the robustness of matching tasks. The experimental results show that the proposed object recognition system with color-assistant SIFT SVM classifier achieves higher recognition rate than that with the traditional gray SIFT and SVM classification in various situations.

Keywords: color moments, visual thing recognition system, SIFT, color SIFT

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Authors: J. J. Mathew

Abstract:

Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert

Procedia PDF Downloads 243

Authors: Wan-Ting Kuo, Yi-Wen Liu, Hsiao-Sheng Liu

Abstract:

Annual incidence of bladder cancer increases in the world and occurs frequently in the male. Most common type is transitional cell carcinoma (TCC) which is treated by transurethral resection followed by intravesical administration of agents. In clinical treatment of bladder cancer, chemotherapeutic drugs-induced apoptosis is always used in patients. However, cancers usually develop resistance to chemotherapeutic drugs and often lead to aggressive tumors with worse clinical outcomes. Approximate 70% TCC recurs and 30% recurrent tumors progress to high-grade invasive tumors, indicating that new therapeutic agents are urgently needed to improve the successful rate of overall treatment. Nonapoptotic program cell death may assist to overcome worse clinical outcomes. Autophagy which is one of the nonapoptotic pathways provides another option for bladder cancer patients. Autophagy is reported as a potent anticancer therapy in some cancers. First of all, we established a mouse orthotopic bladder tumor formation model in order to create a similar tumor microenvironment. IVIS system and micro-ultrasound were utilized to noninvasively monitor tumor formation. In addition, we carried out intravesical treatment in our animal model to be consistent with human clinical treatment. In our study, we carried out intravesical instillation of the autophagy inducer in mouse orthotopic bladder tumor to observe tumor formation by noninvasive IVIS system and micro-ultrasound. Our results showed that bladder tumor formation is suppressed by the autophagy inducer, and there are no significant side effects in the physiology of mice. Furthermore, the autophagy inducer upregulated autophagy in bladder tissues of the treated mice was confirmed by Western blot, immunohistochemistry, and immunofluorescence. In conclusion, we reveal that a novel autophagy inducer with low side effects suppresses bladder tumor formation in our mouse orthotopic bladder tumor model, and it provides another therapeutic approach in bladder cancer patients.

Keywords: bladder cancer, transitional cell carcinoma, orthotopic bladder tumor formation model, autophagy

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Authors: Marina Shurupova, Victor Anisimov, Alexander Latanov

Abstract:

Background: The cerebellar lesions inevitably provoke oculomotor impairments in patients of different age. Symptoms of subtentorial tumors, particularly medulloblastomas, include static and dynamic coordination disorders (ataxia, asynergia, imbalance), hypo-muscle tonus, disruption of the cranial nerves, and within the oculomotor system - nystagmus (fine or gross). Subtentorial tumors can also affect the areas of cerebellum that control the oculomotor system. The noninvasive eye-tracking technology allows obtaining multiple oculomotor characteristics such as the number of fixations and their duration, amplitude, latency and velocity of saccades, trajectory and scan path of gaze during the process of the visual field navigation. Eye tracking could be very useful in clinical studies serving as convenient and effective tool for diagnostics. The aim: We studied the dynamics of oculomotor system functioning in patients undergoing remission from cerebellar tumors removal surgeries and following neurocognitive rehabilitation. Methods: 38 children (23 boys, 15 girls, 9-17 years old) that have recovered from the cerebellar tumor-removal surgeries, radiation therapy and chemotherapy and were undergoing course of neurocognitive rehabilitation participated in the study. Two tests were carried out to evaluate oculomotor performance - gaze stability test and counting test. The monocular eye movements were recorded with eye tracker ArringtonResearch (60 Hz). Two experimental sessions with both tests were conducted before and after rehabilitation courses. Results: Within the final session of both tests we observed remarkable improvement in oculomotor performance: 1) in the gaze stability test the spread of gaze positions significantly declined compared to the first session, and 2) the visual path in counting test significantly shortened both compared to the first session. Thus, neurocognitive rehabilitation improved the functioning of the oculomotor system in patients following the cerebellar tumor removal surgeries and subsequent therapy. Conclusions: The experimental data support the effectiveness of the utilization of the eye tracking technique as diagnostic tool in the field of neurooncology.

Keywords: eye tracking, rehabilitation, cerebellar tumors, oculomotor system

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Authors: Emmanuel Kamal Aziz Saba, Hussein Al-Moghazy Sultan

Abstract:

The aim of this study was to evaluate clinically and electro physiologically the autonomic nervous system changes associated with rheumatoid arthritis (RA). The present study included 25 patients with RA [22 women (88%)] and 30 apparently healthy control subjects [27 women (90%)]. A thorough clinical examination was carried out. Disease activity and functional disability were assessed. Tests for assessment of autonomic functions include active and passive orthostatic stress tests, and sympathetic skin response (SSR). The presence of abnormality in 2 tests or more was a clue for the presence of autonomic neuropathy (AN). Sural sensory nerve conduction study and posterior tibial motor nerve conduction study were done. There was a statistically significant decrease in standing systolic and diastolic blood pressure (BP) components of the active orthostatic stress test and SSR amplitude as well as statistically significant prolongation of SSR latency of RA patients when compared to control. Three patients (12%) had clinical symptoms suggestive of AN; increased to 14 patients (56 %) when orthostatic stress tests and SSR were utilized. There were no statistically significant differences between patients with different disease activity score 28 with 4 variables grades of RA activity and SSR latency and amplitude. There were no statistically significant differences between patients with different Stanford Health Assessment Questionnaire Disability Index grades of RA functional disability and SSR latency and amplitude. In conclusion, autonomic neuropathy is a common extra-articular manifestation of RA affecting sympathetic and parasympathetic fibers.

Keywords: autonomic neuropathy, orthostatic stress test, rheumatoid arthritis, sympathetic skin response

Procedia PDF Downloads 352