Search results for: deceleration delay

Authors: Rocio Herrero Romero, Lucie Cluver, James Hall, Janina Steinert

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Educational delay and non-completion are major policy concerns in South Africa. However, little research has focused on predictors for educational delay amongst adolescents in disadvantaged areas. This study has two aims: first, to use data integration approaches to compare the educational delay of 599 adolescents aged 16 to 18 from disadvantaged communities to national and provincial representative estimates in South Africa. Second, the paper also explores predictors for educational delay by comparing adolescents out of school (n=64) and at least one year behind (n=380), with adolescents in the age-appropriate grade or higher (n=155). Multinomial logistic regression models using self-report and administrative data were applied to look for significant associations of risk and protective factors. Significant risk factors for being behind (rather than in age-appropriate grade) were: male gender, past grade repetition, rural location and larger school size. Risk factors for being out of school (rather than in the age-appropriate grade) were: past grade repetition, having experienced problems concentrating at school, household poverty, and food insecurity. Significant protective factors for being in the age-appropriate grade (rather than out of school) were: living with biological parents or grandparents and access to school counselling. Attending school in wealthier communities was a significant protective factor for being in the age-appropriate grade (rather than behind). Our results suggest that both personal and contextual factors –family and school- predicted educational delay. This study provides new evidence to the significant effects of personal, family, and school characteristics on the educational outcomes of adolescents from disadvantaged communities in South Africa. This is the first longitudinal and quantitative study to systematically investigate risk and protective factors for post-compulsory educational outcomes amongst South African adolescents living in disadvantaged communities.

Keywords: disadvantaged communities, quantitative analysis, school delay, South Africa

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Authors: Beata Jackowska-Zduniak

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We formulate and analyze a mathematical model describing dynamics of the hypothalamus-pituitary-thyroid homoeostatic mechanism in endocrine system. We introduce to this system two types of couplings and delay. In our model, feedback controls the secretion of thyroid hormones and delay reflects time lags required for transportation of the hormones. The influence of delayed feedback on the stability behaviour of the system is discussed. Analytical results are illustrated by numerical examples of the model dynamics. This system of equations describes normal activity of the thyroid and also a couple of types of malfunctions (e.g. hyperthyroidism).

Keywords: mathematical modeling, ordinary differential equations, endocrine system, delay differential equation

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Authors: K. Shaji Mon, P. R. John Sreenidhi

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In deep-submicrometer CMOS processes, time-domain resolution of a digital signal is becoming higher than voltage resolution of analog signals. This claim is nowadays pushing toward a new circuit design paradigm in which the traditional analog signal processing is expected to be progressively substituted by the processing of times in the digital domain. Within this novel paradigm, digitally controlled delay lines (DCDL) should play the role of digital-to-analog converters in traditional, analog-intensive, circuits. Digital delay locked loops are highly prevalent in integrated systems.The proposed paper addresses the glitches present in delay circuits along with area,power dissipation and signal integrity.The digitally controlled delay lines(DCDL) under study have been designed in a 90 nm CMOS technology 6 layer metal Copper Strained SiGe Low K Dielectric. Simulation and synthesis results show that the novel circuits exhibit no glitches for dual output coarse DCDL with less power dissipation and consumes less area compared to the glitch free NAND based DCDL.

Keywords: glitch free, NAND-based DCDL, CMOS, deep-submicrometer

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Authors: M. A. Sohaly, M. A. Elfouly

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Parkinson's disease (PD) is a heterogeneous movement disorder that often appears in the elderly. PD is induced by a loss of dopamine secretion. Some drugs increase the secretion of dopamine. In this paper, we will simply study the stability of PD models as a nonlinear delay differential equation. After a period of taking drugs, these act as positive feedback and increase the tremors of patients, and then, the differential equation has positive coefficients and the system is unstable under these conditions. We will present a set of suggested modifications to make the system more compatible with the biodynamic system. When giving a set of numerical examples, this research paper is concerned with the mathematical analysis, and no clinical data have been used.

Keywords: Parkinson's disease, stability, simulation, two delay differential equation

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Authors: Latif Adnane, Benaatou Wafa, Pla Vicent

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Handover is of great significance to achieve seamless connectivity in wireless networks. This paper gives an impression of the main factors which are being affected by the soft and the hard handovers techniques. To know and understand the handover process in The Universal Mobile Telecommunications System (UMTS) network, different statistics are calculated. This paper focuses on the quality of service (QoS) of soft and hard handover in UMTS network, which includes the analysis of received power, signal to noise radio, throughput, delay traffic, traffic received, delay, total transmit load, end to end delay and upload response time using OPNET simulator.

Keywords: handover, UMTS, mobility, simulation, OPNET modeler

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Authors: Abasali Amini, Alireza Mirbagheri, Amir Homayoun Jafari

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In this paper, a new structure for teleoperation systems with time varying delay has been modeled and proposed. A random time varying the delay of up to 150 msec is simulated in teleoperation channel of both masters to slave and vice versa. The system stability and transparency have been investigated, comparing the result of a PID controller and an optimal controller on each master and slave sub-systems separately. The controllers have been designed in slave subsystem for reducing position errors between master and slave, and another controller has been designed in the master subsystem to establish stability, transparency and force tracking. Results have been compared together. The results showed PID controller is appropriate in position tracking, but force response oscillates in contact with the environment. We showed the optimal control established position tracking properly. Also, force tracking is achieved in this controller appropriately.

Keywords: optimal control, time varying delay, teleoperation systems, stability and transparency

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Authors: Ji-yang Yu, Dan Huang, Guo-ping Feng, Xin Li, Lu-yuan Wang

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The navigation satellite network, especially the Beidou MEO Constellation, can relay data effectively with wide coverage and is applied in navigation, detection, and position widely. But the constellation has not been completed, and the amount of satellites on-board is not enough to cover the earth, which makes the data-relay disrupted or delayed in the transition process. The data-relay function needs to tolerant the delay or disruption in some extension, which make the Beidou MEO Constellation a delay/disruption-tolerant network (DTN). The traditional DTN designs mainly employ the relay table as the basic of data path schedule computing. But in practical application, especially in critical condition, such as the war-time or the infliction heavy losses on the constellation, parts of the nodes may become invalid, then the traditional DTN design could be useless. Furthermore, when transmitting the critical message in the navigation system, the maximum priority strategy is used, but the nodes still inquiry the relay table to design the path, which makes the delay more than minutes. Under this circumstances, it needs a function which could compute the optimum data path on-board in real-time according to the constellation states. The on-board critical message transmission design for navigation satellite delay/disruption-tolerant network (DTN) is proposed, according to the characteristics of navigation satellite network. With the real-time computation of parameters in the network link, the least-delay transition path is deduced to retransmit the critical message in urgent conditions. First, the DTN model for constellation is established based on the time-varying matrix (TVM) instead of the time-varying graph (TVG); then, the least transition delay data path is deduced with the parameters of the current node; at last, the critical message transits to the next best node. For the on-board real-time computing, the time delay and misjudges of constellation states in ground stations are eliminated, and the residual information channel for each node can be used flexibly. Compare with the minute’s delay of traditional DTN; the proposed transmits the critical message in seconds, which improves the re-transition efficiency. The hardware is implemented in FPGA based on the proposed model, and the tests prove the validity.

Keywords: critical message, DTN, navigation satellite, on-board, real-time

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Authors: Kreangkri Ratchagit

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This paper is concerned with exponential stability of switched linear systems with interval time-varying delays. The time delay is any continuous function belonging to a given interval, in which the lower bound of delay is not restricted to zero. By constructing a suitable augmented Lyapunov-Krasovskii functional combined with Leibniz-Newton’s formula, a switching rule for the exponential stability of switched linear systems with interval time-varying delays and new delay-dependent sufficient conditions for the exponential stability of the systems are first established in terms of LMIs. Finally, some examples are exploited to illustrate the effectiveness of the proposed schemes.

Keywords: exponential stability, hybrid systems, timevarying delays, Lyapunov-Krasovskii functional, Leibniz-Newton’s formula

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Authors: Seyed Ali Mohammadiborna, Mehdi Ravanshadnia

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Project delays usually detrimentally affect perceptions of project success and can in some instances, result in increased costs and other time-related damages to project stakeholders. One of the realities in the national infrastructure projects is that since the primary stakeholders are state-affiliated, the delay factors of the projects have not been seriously taken into account despite the importance of on-time completion of projects. Project postponement has different economic and social consequences and leads to the technical and economic infeasibility of the infrastructure projects in the form of reduced productivity and exploitation capacity. The present study aimed at investigating delay factors of Iranian national infrastructure projects according to regulatory reports of the Plan and Budget Organization (BPO) of Iran. The present study scrutinized the influence of each of the factors that caused delays in national Iranian infrastructure projects according to the supervision reports of the planning and budget organization in 8 years. For this purpose, the study analyzed the information regarding the impact of 12 key delay factors causing delays in average 4867 projects per year in all provinces. The said factors were classified into the three groups of executive, credit, and financial and environmental-procurement factors.

Keywords: delays, infrastructure, projects, regulatory

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Authors: Grienggrai Rajchakit

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This paper is concerned with the exponential stability of switched linear systems with interval time-varying delays. The time delay is any continuous function belonging to a given interval, in which the lower bound of delay is not restricted to zero. By constructing a suitable augmented Lyapunov-Krasovskii functional combined with Leibniz-Newton's formula, a switching rule for the exponential stability of switched linear systems with interval time-varying delays and new delay-dependent sufficient conditions for the exponential stability of the systems are first established in terms of LMIs. Finally, some examples are exploited to illustrate the effectiveness of the proposed schemes.

Keywords: exponential stability, hybrid systems, time-varying delays, lyapunov-krasovskii functional, leibniz-newton's formula

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Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

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The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

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Authors: Si-Gwan Kim

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In Delay Tolerant Networks (DTN), there may not exist an end-to-end path between source and destination at the time of message transmission. Employing ‘Store Carry and Forward’ delivery mechanism for message transmission in such networks usually incurs long message delays. In this paper, we present the modified Binary Spray and Wait (BSW) routing protocol that enhances the performance of the original one. Our proposed algorithm adjusts the number of forward messages depending on the number of neighbor nodes. By using beacon messages periodically, the number of neighbor nodes can be managed. The simulation using ONE simulator results shows that our modified version gives higher delivery ratio and less latency as compared to BSW.

Keywords: delay tolerant networks, store carry and forward, one simulator, binary spray and wait

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Authors: Muhammad Swilam

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Solutions for the wrong division problem of the Extended Multi-Modulus Divider (EMMD) that occurs during modulus extension (i.e. switching the modulus value between two different ranges of division ratios), in open loop fractional dividers and fractional multiplying delay locked loop, is proposed. A detailed study for the MMD with Sigma-Delta is also presented. Moreover, extensive simulations for the divider are presented to ensure and verify its functionality and compared with the conventional dividers.

Keywords: extended multi-modulus divider (EMMD), fractional multiplying delay locked loop, open loop fractional divider, sigma delta modulator

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Authors: D. Anderlini, G. Wallis

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Background: The number of people experiencing stroke is steadily increasing due to changes in diet and lifestyle, to longer life expectancy resulting in older population, to higher survival rates as a consequence of improvements during the acute phase. This study considers what risk factors might contribute to delayed entry to hospital for treatment. Methods: We analyzed data from 2472 patients admitted to the Stroke Unit of the Royal Brisbane Women's Hospital, Australia, between 2002 to 2011. Results: Previous studies have reported that factors which can contribute to delay include the patient’s age, the time of day, physical location, visit the GP instead of going to the emergency, means of transport, severity of symptoms and type of stroke. Contrary to findings of other studies, we found a strong correlation between side of lesion and delay in admission: patients with right hemisphere lesions had an average delay of 3.78 days, while patients with left hemisphere lesions had an average delay of 1.49 days. Damage to the right hemisphere generally ends in motor impairment in the non-dominant hand and no speech impediment. In contrast, left hemisphere lesions can result in deficit to; dominant hand function and aphasia which will be noticed even if their impact on performance is relatively minor. A finding which goes against many previous studies, is the fact that women get to the hospital much sooner than men, showing an average delay of 0.92 days in women vs. 3.36 days in men. Conclusion: Acute surgical-pharmacological therapies are most effective if applied immediately after stroke. Hence delays to admission can be crucial to the degree of recovery. The tendency of patients to overlook symptoms of right hemisphere lesion should be the target of information campaigns both for the general public and GPs. Why do men go to hospital so late? We don't know yet! Nevertheless an awareness plan specifically direct to male population should be on the agenda of Health Departments.

Keywords: gender, admission delay, stroke location, bioinformatics, biomedicine

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Authors: Chang-Jen Lan

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Current Level of Service (LOS) index adopted in Highway Capacity Manual (HCM) for signalized intersections on surface streets is based on the intersection average delay. The delay thresholds for defining LOS grades are subjective and is unrelated to critical traffic condition. For example, an intersection delay of 80 sec per vehicle for failing LOS grade F does not necessarily correspond to the intersection capacity. Also, a specific measure of average delay may result from delay minimization, delay equality, or other meaningful optimization criteria. To that end, a reliability version of the intersection critical degree of saturation (v/c) as the LOS index is introduced. Traditionally, the level of saturation at a signalized intersection is defined as the ratio of critical volume sum (per lane) to the average saturation flow (per lane) during all available effective green time within a cycle. The critical sum is the sum of the maximal conflicting movement-pair volumes in northbound-southbound and eastbound/westbound right of ways. In this study, both movement volume and saturation flow are assumed log-normal distributions. Because, when the conditions of central limit theorem obtain, multiplication of the independent, positive random variables tends to result in a log-normal distributed outcome in the limit, the critical degree of saturation is expected to be a log-normal distribution as well. Derivation of the risk index predictive limits is complex due to the maximum and absolute value operators, as well as the ratio of random variables. A fairly accurate functional form for the predictive limit at a user-specified significant level is yielded. The predictive limit is then compared with the designated LOS thresholds for the intersection critical degree of saturation (denoted as X

Keywords: reliability analysis, level of service, intersection critical degree of saturation, risk based index

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Authors: Manlika Ratchagit

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This paper is concerned with robust mean square stability of uncertain stochastic switched discrete time-delay systems. The system to be considered is subject to interval time-varying delays, which allows the delay to be a fast time-varying function and the lower bound is not restricted to zero. Based on the discrete Lyapunov functional, a switching rule for the robust mean square stability for the uncertain stochastic discrete time-delay system is designed via linear matrix inequalities. Finally, some examples are exploited to illustrate the effectiveness of the proposed schemes.

Keywords: robust mean square stability, discrete-time stochastic systems, hybrid systems, interval time-varying delays, Lyapunov functional, linear matrix inequalities

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Authors: Manlika Rajchakit

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This paper is concerned with robust mean square stability of uncertain stochastic switched discrete time-delay systems. The system to be considered is subject to interval time-varying delays, which allows the delay to be a fast time-varying function and the lower bound is not restricted to zero. Based on the discrete Lyapunov functional, a switching rule for the robust mean square stability for the uncertain stochastic discrete time-delay system is designed via linear matrix inequalities. Finally, some examples are exploited to illustrate the effectiveness of the proposed schemes.

Keywords: robust mean square stability, discrete-time stochastic systems, hybrid systems, interval time-varying delays, lyapunov functional, linear matrix inequalities

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Authors: Bernard Ewuoso

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Introduction: Induction of labor (IOL) usually involves the patient moving between antenatal, labor, and postnatal wards. Delay in IOL has been defined as delay in the time it takes a woman to wait for induction after her cervix is assessed to be favorable. Opinions vary on the acceptable time the patient is allowed to wait for once the cervix is adjudged ripe for induction. What has been considered a benchmark is a delay of up to 12 hours. There is evidence that delay in IOL is associated with adverse outcomes. Aim: To determine the number of women experiencing delay in induction of labor and their outcomes. Method: This audit was retrospective and observational. It included women who had induction of labor in the month of October 2023 in two hospitals. Clinical data was collected from electronic medical records into an Excel sheet for analysis. Women had cervical ripening as inpatient or outpatient. The primary objective was to determine the number of women experiencing delay in induction of labor, while the secondary objective was to outcome these women. Result: 136 women had IOL. The least percentage of data retrieved for any parameter was 80%. The mean gestational age at IOL was 278.26 days. The mean waiting time was 905.34mins. Seventy-five women had their IOL at the Royal Infirmary of Edinburgh (RIE), fifty-seven at St. John’s Hospital (SJH), and three women were transferred from RIE to SJH. The preferred method of cervical ripening was balloon closely followed by prostaglandin. Twenty-seven women did not require cervical ripening and had their process started with amniotomy. Prostaglandin was the method of choice of cervical ripening at RIE, while balloon was preferred in SJH. Of the thirty-five women found to be suitable for outpatient cervical ripening, thirteen had outpatient ripening. There was a significant increase in the number of women undergoing outpatient cervical ripening at RIE from 10.5% in April 2022 to 42.9%. The preferred method for outpatient cervical ripening at the RIE was balloon, while it was prostaglandin for SJH. These were contradictory to the preferred method of inpatient cervical ripening at both centers. The average waiting time for IOL at RIE, 1166.92mins, is more than double that of SJH, 442.93mins, and far exceed 12hours, which is the proposed benchmark. The waiting time tends to be shorter with prostaglandin. Out of the women that had outpatient cervical ripening 63.6% had to wait for more than 12hrs before being induced while it was 36.1% for women that had inpatient cervical ripening. Overall, 38.5% women waited for more than 12 hours before having their induction. A lesser proportion of the women who waited for more than 12 hours had caesarean section, assisted vaginal delivery, and postpartum hemorrhage, whereas a greater proportion had spontaneous vaginal delivery and intrapartum or postpartum infection. Conclusion: A significant number of the women included in the study experienced delay in their induction process, and this was associated with an increased occurrence of intrapartum or postpartum infection. Outpatient cervical ripening contributed to delay.

Keywords: delay in induction of labor, inpatient, outpatient, intrapartum, postpartum, infection

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Authors: K. Senthil Kumar, A. Vasumalaikannan

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In this paper, teleoperation of the quadrotor using Internet with Force feedback is addressed. Teleoperation with Force feedback is the ability to remotely control a robot, where contact (obstacle) or environment (wind gust etc) information (force feedback) is communicated from the quadrotor to the master joystick and thus giving the operator a sense of telepresence. The stability and performance of such a teleoperator is highly dependent on the amount of time delay present in the control loop. This problem is further complicated given the fact that for network based communication the time delay is itself time varying and highly non deterministic. In this paper, a novel method using Neural based Smith Predictor at the master side the stability is achieved. The performance of the system even during worst case scenario is within acceptable.

Keywords: teleoperation, quadrotor, neural smith predictor, time delay

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Authors: Govindaraj Ramanathan

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The time delay and the structural stability are major issues in big size projects due to several factors. Improper planning and poor coordination lead to delay in construction, which sometimes result in reworking or rebuilding. This definitely increases the cost and time of project. This situation stresses the structural engineers to plan out of the limits of contemporary technology utilizing non-chronological approach with creative ideas. One of the strategies to solve this issue is through structural integrity solutions in a cost-effective way. We have faced several problems in a project worth 470 million USD, and one such issue is crane girder installation with composite steel beams. We have applied structural integrity approach with the proper and revised planning schedule to solve the problem efficiently with minimal expenses.

Keywords: construction management, delay, non-chronological approach, composite beam, structural integrity

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Authors: Anuraj Singh

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The complex dynamics is explored in a prey predator system with multiple delays. The predator dynamics is governed by Leslie-Gower scheme. The existence of periodic solutions via Hopf bifurcation with respect to delay parameters is established. To substantiate analytical findings, numerical simulations are performed. The system shows rich dynamic behavior including chaos and limit cycles.

Keywords: chaos, Hopf bifurcation, stability, time delay

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Authors: D. Muley, H. S. Al-Mandhari

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This paper evaluates the performance of a multi-lane four-legged modern roundabout operating in Muscat using SIDRA model. The performance measures include Degree of Saturation (DOS), average delay, and queue lengths. The geometric and traffic data were used for model preparation. Gap acceptance parameters, critical gap, and follow-up headway were used for calibration of SIDRA model. The results from the analysis showed that currently the roundabout is experiencing delays up to 610 seconds with DOS 1.67 during peak hour. Further, sensitivity analysis for general and roundabout parameters was performed, amongst lane width, cruise speed, inscribed diameter, entry radius, and entry angle showed that inscribed diameter is the most crucial factor affecting delay and DOS. Upgradation of the roundabout to the fully signalized junction was found as the suitable solution which will serve for future years with LOS C for design year having DOS of 0.9 with average control delay of 51.9 seconds per vehicle.

Keywords: performance analysis, roundabout, sensitivity analysis, SIDRA

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Authors: M. J. Park, S. H. Lee, C. H. Lee, O. M. Kwon

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This paper investigates stability problem for linear systems of neutral type with time-varying delay. By constructing various Lyapunov-Krasovskii functional, and utilizing some mathematical techniques, the sufficient stability conditions for the systems are established in terms of linear matrix inequalities (LMIs), which can be easily solved by various effective optimization algorithms. Finally, some illustrative examples are given to show the effectiveness of the proposed criterion.

Keywords: neutral systems, time-delay, stability, Lyapnov method, LMI

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Authors: Ramin Karimi

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One of common highly mobile wireless ad hoc networks is Vehicular Ad Hoc Networks. Hence routing in vehicular ad hoc network (VANET) has attracted much attention during the last few years. VANET is characterized by its high mobility of nodes and specific topology patterns. Moreover these networks encounter a significant loss rate and a very short duration of communication. In vehicular ad hoc networks, one of challenging is routing of data due to high speed mobility and changing topology of vehicles. Geographic routing protocols are becoming popular due to advancement and availability of GPS devices. Delay Tolerant Networks (DTNs) are a class of networks that enable communication where connectivity issues like sparse connectivity, intermittent connectivity; high latency, long delay, high error rates, asymmetric data rate, and even no end-to-end connectivity exist. In this paper, we review the existing Geographic Routing Protocols for VANETs and also provide a qualitative comparison of them.

Keywords: vehicular ad hoc networks, mobility, geographic routing, delay tolerant networks

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Authors: David Mafullul, Jiang Lei, Edward Goacher, Jibin Francis

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PURPOSE: Timely decompressive surgery for cauda equina syndrome (CES) is dependent on efficient referral pathways for patients presenting at local primary or secondary centres to tertiary spinal centres in the United Kingdom (UK). Identifying modifiable points of delay within this process is important as minimising time between presentation and surgery may improve patient outcomes. This study aims to analyse whether adequacy of referral impacts on time to surgery in CES. MATERIALS AND METHODS: Data from all cases of confirmed CES referred to a single tertiary UK hospital between August 2017 to December 2019, via a suspected CES e-referral pathway, were obtained retrospectively. Referral adequacy was defined by the inclusion of sufficient information to determine the presence or absence of several NICE ‘red flags’. Correlation between referral adequacy and delay from referral-to-surgery was then analysed. RESULTS: In total, 118 confirmed CES cases were included. Adequate documentation for saddle anaesthesia was associated with reduced delays of more than 48 hours from referral-to-surgery [X2(1, N=116)=7.12, p=.024], an effect partly attributable to these referrals being accepted sooner [U=16.5; n1=27, n2=4, p=.029, r=.39]. Other red flags had poor association with delay. Referral adequacy was better for somatic red flags [bilateral sciatica (97.5%); severe or progressive bilateral neurological deficit of the legs (95.8%); saddle anaesthesia (91.5%)] compared to autonomic red flags [loss of anal tone (80.5%); urinary retention (79.7%); faecal incontinence or lost sensation of rectal fullness (57.6%)]. Although referral adequacy for urinary retention was 79.7%, only 47.5% of referrals documented a post-void residual numerical value. CONCLUSIONS: Adequate documentation of saddle anaesthesia in e-referrals is associated with reduced delay-to-surgery for confirmed CES, partly attributable to these referrals being accepted sooner. Other red flags had poor association with delay to surgery. Referral adequacy for autonomic red flags, including documentation for post-void residuals, has significant room for improvement.

Keywords: cauda equina, cauda equina syndrome, neurosurgery, spinal surgery, decompression, delay, referral, referral adequacy

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Authors: Soroush Rasti Boroujeni, S. Hassan Mousavi, Javad Ebrahimizadeh, Ardeshir Palizban, Mohammad-Reza Nezhad-Ahmadi, Safieddin Safavi-Naeini

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This paper presents a wideband True Time Delay (TTD) phase shifter with low insertion loss variation. The circuit benefits from a controllable resistive load shunt with transmission line segments to optimize return loss variations, addressing the unbalanced capacitive nature of the varactor. The phase shifter reduces the complexity of the calibration process because the dependency of insertion loss on voltage controls is improved up to 3 dB. The TTD phase shifter provides a continuous changing delay time of 6.4 ps with low insertion loss (IL) in the 10-35 GHz frequency range. The proposed circuit benefits from lowloss phase shifters with a small footprint. Fabricated using a 65 nm CMOC process, the TTD phase shifter occupies only 388 × 615 µm 2 of chip area, achieving a 20% improvements compared to conventional TTD phase shifters.

Keywords: millimeter-wave phased-array, true time delay phase shifter, insertion loss variation, compact size

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Authors: Sisay Tiroro Salato

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Background: Ethiopia has been implementing the maternal death surveillance and response system to provide real-time actionable information, including causes of death and contributing factors. Analysis of maternal mortality surveillance data was conducted to identify the causes and underlying factors in Addis Ababa, Ethiopia. Methods: We carried out a retrospective surveillance data analysis of 324 maternal deaths reported in Addis Ababa, Ethiopia, from 2017 to 2021. The data were extracted from the national maternal death surveillance and response database, including information from case investigation, verbal autopsy, and facility extraction forms. The data were analyzed by computing frequency and presented in numbers, proportions, and ratios. Results: Of 324 maternal deaths, 92% died in the health facilities, 6.2% in transit, and 1.5% at home. The mean age at death was 28 years, ranging from 17 to 45. The maternal mortality ratio per 100,000 live births was 77for the five years, ranging from 126 in 2017 to 21 in 2021. The direct and indirect causes of death were responsible for 87% and 13%, respectively. The direct causes included obstetric haemorrhage, hypertensive disorders in pregnancy, puerperal sepsis, embolism, obstructed labour, and abortion. The third delay (delay in receiving care after reaching health facilities) accounted for 57% of deaths, while the first delay (delay in deciding to seek health care) and the second delay (delay in reaching health facilities) and accounted for 34% and 24%, respectively. Late arrival to the referral facility, delayed management after admission, andnon-recognition of danger signs were underlying factors. Conclusion: Over 86% of maternal deaths were attributed by avoidable direct causes. The majority of women do try to reach health services when an emergency occurs, but the third delays present a major problem. Improving the quality of care at the healthcare facility level will help to reduce maternal death.

Keywords: maternal death, surveillance, delays, factors

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Authors: Nathaniel C. Villanueva, Ian K. H. Chun, Alyssa S. Fujiwara, Emily R. Leibovitch, Brennan E. Yamamoto, Loren G. Yamamoto

Abstract:

Introduction: In previous studies of high school sports, over 15% of concussions were attributed to contact with the playing surface. While artificial turf fields are increasing in popularity due to lower maintenance costs, artificial turf has been associated with more ankle and knee injuries, with inconclusive data on concussions. In this study, natural grass and artificial football fields were compared in terms of deceleration on fall impact. Methods: Accelerometers were placed on the forehead, apex of the head, and right ear of a Century Body Opponent Bag (BOB) manikin. A Riddell HITS football helmet was secured onto the head of the manikin over the accelerometers. This manikin was dropped onto natural grass (n = 10) and artificial turf (n = 9) high school football fields. The manikin was dropped from a stationary position at a height of 60 cm onto its front, back, and left side. Each of these drops was conducted 10 times at the 40-yard line, 20-yard line, and endzone. The net deceleration on impact was calculated as a net vector from each of the three accelerometers’ x, y, and z vectors from the three different locations on the manikin’s head (9 vector measurements per drop). Results: Mean values for the multiple drops were calculated for each accelerometer and drop type for each field. All accelerometers in forward and backward falls and one accelerometer in side falls showed significantly greater impact force on synthetic turf compared to the natural grass surfaces. Conclusion: Impact force was higher on synthetic fields for all drop types for at least one of the accelerometer locations. These findings suggest that concussion risk might be higher for athletes playing on artificial turf fields.

Keywords: concussion, football, biomechanics, sports

Procedia PDF Downloads 158

Authors: Jui-Chen Huang

Abstract:

The purpose of this study is to explore the effects of telecare on preventing and delaying the quality of disability care in elderly people with portable comfort Bluetooth brainwave devices with remote healthcare functions. Through the teaching videos and remotely teaching the elderly, which had ever learned the care courses of the prevent and delay disability, these elderly did muscle strength training. Then this paper explores the effect of training with the data by SPSS 18.0 statistical software. The data is collected with pre-test, post-test and analyze data from the measure of the Bluetooth brain wave equipment including the pressure index, relaxation index, attention and fatigue index of the elderly. In this study, 30 elderly people who had taken preventive and delayed disability care courses were studied to explore the effect of their care quality improvement. The results showed that the pressure index, relaxation index, attention, and fatigue index of the elderly had statistically significant differences in two months. It can be seen that elderly people who have been treated to prevent and delay disability care courses can significantly improve their care quality if they continue to receive intensive training to prevent and delay disability through remote mode. This telecare is applied to the elderly program that has been used to prevent and delay disability care courses. It is worth continuing to promote, and it is recommended that follow-up studies be conducted in a longer-term manner to explore long-term benefits. It can solve the current insufficiency of long-term care resources, but the demand is urgent.

Keywords: telecare, bluetooth brainwave equipment, prevention and delay of disability, the elderly, care quality

Procedia PDF Downloads 148

Authors: Fuming Yang, Telma Sousa Almeida, Xinyu Li, Yunxi Deng, Heying Zhang, Michael E. Lamb

Abstract:

Twenty-seven children aged 6-15 years with autism spectrum disorder (ASD) and 32 typically developing children were questioned about their participation in a set of activities after a two-week delay and again after a two-month delay, using a best-practice interview protocol. This paper assessed the narrative coherence of children’s reports based on key story grammar elements and temporal features included in their accounts of the event. Results indicated that, over time, both children with ASD and typically developing (TD) children decreased their narrative coherence. Children with ASD were no different from TD peers with regards to story length and syntactic complexity. However, they showed significantly less coherence than TD children. They were less likely to use the gist of the story to organize their narrative coherence. Interviewer prompts influenced children’s narrative coherence. The findings indicated that children with ASD could provide meaningful and reliable testimony about an event they personally experienced, but the narrative coherence of their reports deteriorates over time and is affected by interviewer prompts.

Keywords: autism spectrum disorders, delay, eyewitness testimony, narrative coherence

Procedia PDF Downloads 288