Search results for: Erick Rafael Dias Rates
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3003

Search results for: Erick Rafael Dias Rates

2133 Transgressing Gender Norms in Addiction Treatment

Authors: Sara Matsuzaka

Abstract:

At the center of emerging policy debates on the rights of transgender individuals in public accommodations is the collision of gender binary views with transgender perspectives that challenge conventional gender norms. The results of such socio-political debates could have significant ramifications for the policies and infrastructures of public and private institutions nationwide, including within the addiction treatment field. Despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in addiction treatment programs. Inpatient addiction treatment centers were originally designed to treat heterosexual cisgender populations and, as such, feature gender segregated housing, bathrooms, and counseling sessions. Such heteronormative structural barriers, combined with exposures to stigmatic al attitudes, may dissuade transgender populations from benefiting from the addiction treatment they so direly need. A literature review is performed to explore the mechanisms by which gender segregation alienates transgender populations within inpatient addiction treatment. The constituent parts of the current debate on the rights of transgender individuals in public accommodations are situated the context of inpatient addiction treatment facilities. Minority Stress Theory is used as a theoretical framework for understanding substance abuse issues among transgender populations as a maladaptive behavioral response for coping with chronic stressors related to gender minority status and intersecting identities. The findings include that despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in and benefiting from addiction treatment. These barriers are present in the form of anticipated or real interpersonal stigma and discrimination by service providers and structural stigma in the form of policy and programmatic components in addiction treatment that marginalize transgender populations. Transphobic manifestations within addiction treatment may dissuade transgender individuals from seeking help, if not reinforce a lifetime of stigmatic experience, potentially exacerbating their substance use issues. Conclusive recommendations for social workers and addiction treatment professionals include: (1) dismantling institutional policies around gender segregation that alienate transgender individuals, (2) developing policies that provide full protections for transgender clients against discrimination based on their gender identity, and (3) implementing trans-affirmative cultural competency training requirements for all staff. Directions for future research are provided.

Keywords: addiction treatment, gender segregation, stigma, transgender

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2132 The Effect of Gender and Resources on Entrepreneurial Activity

Authors: Frederick Nyakudya

Abstract:

In this paper, we examine the relationship between human capital, personal wealth and social capital to explain the differential start-up rates between female and male entrepreneurs. Since our dependent variable is dichotomous, we examine the determinants of these using a maximum likelihood logit estimator. We used the Global Entrepreneurship Monitor database covering the period 2006 to 2009 with 421 usable cases drawn from drawn from the Lower Layer Super Output Areas in the East Midlands in the United Kingdom. we found evidence that indicates that a female positively moderate the positive relationships between indicators of human capital, personal wealth and social capital with start-up activity. The findings have implications for programs, policies, and practices to encourage more females to engage in start-up activity.

Keywords: entrepreneurship, star-up, gender, GEM

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2131 The Negative Implications of Childhood Obesity and Malnutrition on Cognitive Development

Authors: Stephanie Remedios, Linda Veronica Rios

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Background. Pediatric obesity is a serious health problem linked to multiple physical diseases and ailments, including diabetes, heart disease, and joint issues. While research has shown pediatric obesity can bring about an array of physical illnesses, it is less known how such a condition can affect children’s cognitive development. With childhood overweight and obesity prevalence rates on the rise, it is essential to understand the scope of their cognitive consequences. The present review of the literature tested the hypothesis that poor physical health, such as childhood obesity or malnutrition, negatively impacts a child’s cognitive development. Methodology. A systematic review was conducted to determine the relationship between poor physical health and lower cognitive functioning in children ages 4-16. Electronic databases were searched for studies dating back to ten years. The following databases were used: Science Direct, FIU Libraries, and Google Scholar. Inclusion criteria consisted of peer-reviewed academic articles written in English from 2012 to 2022 that analyzed the relationship between childhood malnutrition and obesity on cognitive development. A total of 17,000 articles were obtained, of which 16,987 were excluded for not addressing the cognitive implications exclusively. Of the acquired articles, 13 were retained. Results. Research suggested a significant connection between diet and cognitive development. Both diet and physical activity are strongly correlated with higher cognitive functioning. Cognitive domains explored in this work included learning, memory, attention, inhibition, and impulsivity. IQ scores were also considered objective representations of overall cognitive performance. Studies showed physical activity benefits cognitive development, primarily for executive functioning and language development. Additionally, children suffering from pediatric obesity or malnutrition were found to score 3-10 points lower in IQ scores when compared to healthy, same-aged children. Conclusion. This review provides evidence that the presence of physical activity and overall physical health, including appropriate diet and nutritional intake, has beneficial effects on cognitive outcomes. The primary conclusion from this research is that childhood obesity and malnutrition show detrimental effects on cognitive development in children, primarily with learning outcomes. Assuming childhood obesity and malnutrition rates continue their current trade, it is essential to understand the complete physical and psychological implications of obesity and malnutrition in pediatric populations. Given the limitations encountered through our research, further studies are needed to evaluate the areas of cognition affected during childhood.

Keywords: childhood malnutrition, childhood obesity, cognitive development, cognitive functioning

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2130 The Fire Performance of Exposed Timber Panels

Authors: Bernice V. Y. Wong, Kong Fah Tee

Abstract:

Cross-laminated timber is increasingly being used in the construction of high-rise buildings due to its simple manufacturing system. In term of fire resistance, cross-laminated timber panels are promoted as having excellent fire resistance, comparable to that of non-combustible materials and to heavy timber construction, due to the ability of thick wood assemblies to char slowly at a predictable rate while maintaining most of their strength during the fire exposure. This paper presents an overview of fire performance of cross-laminated timber and evaluation of its resistance to elevated temperature in comparison to homogeneous timber panels. Charring rates for cross-laminated timber panels of those obtained experimentally were compared with those provided by Eurocode simplified calculation methods.

Keywords: timber structure, cross-laminated timber, charring rate, timber fire resistance

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2129 The Religious Economic Behavior of People in Dusit Province

Authors: Sivilai Jayankura

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This research aims to study the religious economic behavior that effect the lifestyle of the people in Dusit area. The result shows that religious identity salience makes people increase contributions to public goods. Most of the Buddhism decrease contributions to public goods, expect others to contribute less to public goods, and become less risk averse. We find no evidence of religious identity salience effects on disutility of work effort, discount rates or generosity in life spending. Mostly the people like to make merit in the temple during special day of religion. The atmosphere in the temple leads the people like to travel and merit at the temple near their home.

Keywords: Dusit province, identity, lifestyle, religious economic behavior

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2128 Impact of Microwave and Air Velocity on Drying Kinetics and Rehydration of Potato Slices

Authors: Caiyun Liu, A. Hernandez-Manas, N. Grimi, E. Vorobiev

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Drying is one of the most used methods for food preservation, which extend shelf life of food and makes their transportation, storage and packaging easier and more economic. The commonly dried method is hot air drying. However, its disadvantages are low energy efficiency and long drying times. Because of the high temperature during the hot air drying, the undesirable changes in pigments, vitamins and flavoring agents occur which result in degradation of the quality parameters of the product. Drying process can also cause shrinkage, case hardening, dark color, browning, loss of nutrients and others. Recently, new processes were developed in order to avoid these problems. For example, the application of pulsed electric field provokes cell membrane permeabilisation, which increases the drying kinetics and moisture diffusion coefficient. Microwave drying technology has also several advantages over conventional hot air drying, such as higher drying rates and thermal efficiency, shorter drying time, significantly improved product quality and nutritional value. Rehydration kinetics of dried product is a very important characteristic of dried products. Current research has indicated that the rehydration ratio and the coefficient of rehydration are dependent on the processing conditions of drying. The present study compares the efficiency of two processes (1: room temperature air drying, 2: microwave/air drying) in terms of drying rate, product quality and rehydration ratio. In this work, potato slices (≈2.2g) with a thickness of 2 mm and diameter of 33mm were placed in the microwave chamber and dried. Drying kinetics and drying rates of different methods were determined. The process parameters included inlet air velocity (1 m/s, 1.5 m/s, 2 m/s) and microwave power (50 W, 100 W, 200 W and 250 W) were studied. The evolution of temperature during microwave drying was measured. The drying power had a strong effect on drying rate, and the microwave-air drying resulted in 93% decrease in the drying time when the air velocity was 2 m/s and the power of microwave was 250 W. Based on Lewis model, drying rate constants (kDR) were determined. It was observed an increase from kDR=0.0002 s-1 to kDR=0.0032 s-1 of air velocity of 2 m/s and microwave/air (at 2m/s and 250W) respectively. The effective moisture diffusivity was calculated by using Fick's law. The results show an increase of effective moisture diffusivity from 7.52×10-11 to 2.64×10-9 m2.s-1 for air velocity of 2 m/s and microwave/air (at 2m/s and 250W) respectively. The temperature of the potato slices increased for higher microwaves power, but decreased for higher air velocity. The rehydration ratio, defined as the weight of the the sample after rehydration per the weight of dried sample, was determined at different water temperatures (25℃, 50℃, 75℃). The rehydration ratio increased with the water temperature and reached its maximum at the following conditions: 200 W for the microwave power, 2 m/s for the air velocity and 75°C for the water temperature. The present study shows the interest of microwave drying for the food preservation.

Keywords: drying, microwave, potato, rehydration

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2127 Bioprophylaxis of Saprolegniasis in Incubated Clarias gariepinus Eggs Using Pyocyanin Extracted from Pseudomonas aeruginosa

Authors: G. A. Oladosu1, P. O. Ogbodogbo, C. I. Makinde1, M. O. Tijani, O. A. Adegboyega

Abstract:

Saprolegniasis is a major pathogenic infection that contributes significantly to poor hatching rates in incubated fish eggs in the Africa catfish hatchery in Nigeria. Malachite green known to be very effective against this condition has been banned because it is carcinogenic. There is, therefore, the need for other effective yet safer methods of controlling saprolegniasis in incubated fish eggs. A total of 50 ml crude, chloroform extract of pyocyanin from which solvent was removed to attain 30 ml, having a concentration of 12.16 ug/ml was produced from 700 ml broth culture of Pseudomonas aeruginosa isolated from a previous study. In-vitro susceptibility of the fungus was investigated by exposing fungal infected eggs to two different time-concentration ratios of pyocyanin; 0.275 ug/ml and 2.75 ug/ml for 1 and 24 hours, and 5 mg/L malachite green as positive control while normal saline was the control. The efficacy of pyocyanin was evaluated using the degree of mycelial growth inhibition in different treatments. Fertilized Clarias gariepinus eggs (between 45 to 64 eggs) were then incubated in 20 ml of medium containing similar concentrations of pyocyanin and malachite green, with freshwater as a control for 24 hours. Hatching rates of the incubated eggs were observed. Three samples of un-hatched eggs were taken from each medium and observed for the presence of fungal pathogens using microscopy. Another batch of three samples of un-hatched eggs from each treatment was also inoculated on Sabourand dextrose agar (SDA) using Egg-Agar Transfer Technique to observe for fungal growth. Mycelial growth was inhibited in fungal infected eggs treated with 2.75 ug/ml for 24 hrs and the 5 mg/L malachite green for both 1 hr and 24 hrs. The mortality rate was 100% in fertilized C. gariepinus eggs exposed for 24 hrs to 0.275 and 2.75 ug/ml of pyocyanin. The mortality rate was least in malachite green followed by the control treatment. Embryonic development was observed to be arrested in the eggs treated with the two pyocyanin concentrations as they maintain their colour but showed no development beyond the gastrula stage, whereas viable eggs in the control and malachite green treatments developed fully into healthy hatchlings. Furthermore, microscopy of the un-hatched eggs revealed the presence of a protozoan ciliate; Colpidium sp, (Tetrahymenidae), as well as a pathogenic fungus; Saprolegnia sp. in the control but not in the malachite green and pyocyanin treatments. Growth of Saprolegnia sp was also observed in SDA culture of un-hatched eggs from the control, but not from pyocyanin and malachite green treated eggs. Pyocyanin treatment of incubated eggs of Clarias gariepinus effectively prevented fungal infection in the eggs, but also arrested the development of the embryo. Therefore, crude chloroform extract of pyocyanin from Pseudomonas aeruginosa cannot be used in the control of Saprolegniasis in incubated Clarias gariepinus eggs at the concentration and duration tested in this study.

Keywords: African catfish, bioprophylaxis, catfish embryo, Saprolegniasis

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2126 Polymerization: An Alternative Technology for Heavy Metal Removal

Authors: M. S. Mahmoud

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In this paper, the adsorption performance of a novel environmental friendly material, calcium alginate gel beads as a non-conventional technique for the successful removal of copper ions from aqueous solution are reported on. Batch equilibrium studies were carried out to evaluate the adsorption capacity and process parameters such as pH, adsorbent dosages, initial metal ion concentrations, stirring rates and contact times. It was observed that the optimum pH for maximum copper ions adsorption was at pH 5.0. For all contact times, an increase in copper ions concentration resulted in decrease in the percent of copper ions removal. Langmuir and Freundlich's isothermal models were used to describe the experimental adsorption. Adsorbent was characterization using Fourier transform-infrared (FT-IR) spectroscopy and Transmission electron microscopy (TEM).

Keywords: adsorption, alginate polymer, isothermal models, equilibrium

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2125 Currency Exchange Rate Forecasts Using Quantile Regression

Authors: Yuzhi Cai

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In this paper, we discuss a Bayesian approach to quantile autoregressive (QAR) time series model estimation and forecasting. Together with a combining forecasts technique, we then predict USD to GBP currency exchange rates. Combined forecasts contain all the information captured by the fitted QAR models at different quantile levels and are therefore better than those obtained from individual models. Our results show that an unequally weighted combining method performs better than other forecasting methodology. We found that a median AR model can perform well in point forecasting when the predictive density functions are symmetric. However, in practice, using the median AR model alone may involve the loss of information about the data captured by other QAR models. We recommend that combined forecasts should be used whenever possible.

Keywords: combining forecasts, MCMC, predictive density functions, quantile forecasting, quantile modelling

Procedia PDF Downloads 240
2124 Beneficial Effect of Autologous Endometrial Stromal Cell Co-Culture on Day 3 Embryo Quality

Authors: I. Bochev, A. Shterev, S. Kyurkchiev

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One of the factors associated with poor success rates in human in vitro fertilization (IVF) is the suboptimal culture conditions in which fertilization and early embryonic growth occur. Co-culture systems with helper cell lines appear to enhance the in vitro conditions and allow embryos to demonstrate improved in vitro development. The co-culture of human embryos with monolayers of autologous endometrial stromal cell (EnSCs) results in increased blastocyst development with a larger number of blastomeres, lower incidence of fragmentation and higher pregnancy rates in patients with recurrent implantation failure (RIF). The aim of the study was to examine the influence of autologous endometrial stromal cell (EnSC) co-culture on day 3 embryo quality by comparing the morphological status of the embryos from the same patients undergoing consecutive IVF/Intracytoplasmic sperm injection (ICSI) cycles without and with EnSC co-culture. This retrospective randomized study (2015-2017) includes 20 couples and a total of 46 IVF/ICSI cycles. Each patient couple included had at least two IVF/ICSI procedures – one with and one without autologous EnSC co-culture. Embryo quality was assessed at 68±1 hours in culture, according to Istanbul consensus criteria (2010). Day 3 embryos were classified into three groups: good – grade 1; fair – grade 2; poor – grade 3. Embryos from all cycles were divided into two groups (A – co-cultivated; B – not co-cultivated) and analyzed. Second, for each patient couple, embryos from matched IVF/ICSI cycles (with and without co-culture) were analyzed separately. When an analysis of co-cultivated day 3 embryos from all cycles was performed (n=137; group A), 43.1% of the embryos were graded as “good”, which was not significantly different from the respective embryo quality rate of 42.2% (p = NS) in group B (n=147) with non-co-cultivated embryos. The proportions of fair and poor quality embryos in group A and group B were similar as well – 11.7% vs 10.2% and 45.2% vs 47.6% (p=NS), respectively. Nevertheless, the separate embryo analysis by matched cycles for each couple revealed that in 65% of the cases the proportion of morphologically better embryos was increased in cycles with co-culture in comparison with those without co-culture. A decrease in this proportion after endometrial stromal cell co-cultivation was found in 30% of the cases, whereas no difference was observed in only one couple. The results demonstrated that there is no marked difference in the overall morphological quality between co-cultured and non-co-cultured embryos on day 3. However, in significantly greater percentage of couples the process of autologous EnSC co-culture could increase the proportion of morphologically improved day 3 embryos. By mimicking the in vivo relationship between embryo and maternal environment, co-culture in autologous EnSC system represents a perspective approach to improve the quality of embryos in cases with elevated risk for development of embryos with impaired morphology.

Keywords: autologous endometrial stromal cells, co-culture, day 3 embryo, morphological quality

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2123 A Study on the Effects of Urban Density, Sociodemographic Vulnerability, and Medical Service on the Impact of COVID-19

Authors: Jang-hyun Oh, Kyoung-ho Choi, Jea-sun Lee

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The outbreak of the COVID-19 pandemic brought reconsiderations and doubts about urban density as compact cities became epidemic hot spots. Density, though, provides an upside in that medical services required to protect citizens against the spread of disease are concentrated within compact cities, which helps reduce the mortality rate. Sociodemographic characteristics are also a crucial factor in determining the vulnerability of the population, and the purpose of this study is to empirically discover how these three urban factors affect the severity of the epidemic impacts. The study aimed to investigate the influential relationships between urban factors and epidemic impacts and provide answers to whether superb medical service in compact cities can scale down the impacts of COVID-19. SEM (Structural Equation Modeling) was applied as a suitable research method for verifying interrelationships between factors based on theoretical grounds. The study accounted for 144 municipalities in South Korea during periods from the first emergence of COVID-19 to December 31st, 2022. The study collected data related to infection and mortality cases from each municipality, and it holds significance as primary research that enlightens the aspects of epidemic impact concerning urban settings and investigates for the first time the mediated effects of medical service. The result of the evaluation shows that compact cities are most likely to have lower sociodemographic vulnerability and better quality of medical service, while cities with low density contain a higher portion of vulnerable populations and poorer medical services. However, the quality of medical service had no significant influence in reducing neither the infection rate nor the mortality rate. Instead, density acted as the major influencing factor in the infection rate, while sociodemographic vulnerability was the major determinant of the mortality rate. Thus, the findings strongly paraphrase that compact cities, although with high infection rates, tend to have lower mortality rates due to less vulnerability in sociodemographics, Whereas death was more frequent in less dense cities due to higher portions of vulnerable populations such as the elderly and low-income classes. Findings suggest an important lesson for post-pandemic urban planning-intrinsic characteristics of urban settings, such as density and population, must be taken into account to effectively counteract future epidemics and minimize the severity of their impacts. Moreover, the study is expected to contribute as a primary reference material for follow-up studies that further investigate related subjects, including urban medical services during the pandemic.

Keywords: urban planning, sociodemographic vulnerability, medical service, COVID-19, pandemic

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2122 Trust in Virtual Groups: An Exploratory Study Applied to University Students in Kuwait

Authors: Bashaiar Alsanaa

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Emerging technologies present human interaction with new challenges. Individuals are required to interact and collaborate to achieve mutual gain. Accomplishing shared goals requires all parties involved to trust others’ commitment to fulfilling their specified obligations. Trust is harder to establish when groups work virtually and members transcend time, space, and culture. This paper identifies the importance of trust in virtual groups of students at Kuwait University by exposing them to electronic projects on which they collaborate. Students respond to a survey to assess their range of trust within their teams and how the outcome is affected. Gender differences and other demographic factors are analyzed to understand results and rates of trust. The paper concludes with summarizing factors influencing trust development and possible implications.

Keywords: groups, students, trust, virtual

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2121 The Optimal Public Debt Ceiling in Taiwan: A Simulation Approach

Authors: Ho Yuan-Hong, Huang Chiung-Ju

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This study conducts simulation analyses to find the optimal debt ceiling of Taiwan, while factoring in welfare maximization under a dynamic stochastic general equilibrium framework. The simulation is based on Taiwan's 2001 to 2011 economic data and shows that welfare is maximized at a "debt"⁄"GDP" ratio of 0.2, increases in the "debt"⁄"GDP " ratio leads to increases in both tax and interest rates and decreases in the consumption ratio and working hours. The study results indicate that the optimal debt ceiling of Taiwan is 20% of GDP, where if the "debt"⁄"GDP" ratio is greater than 40%, the welfare will be negative and result in welfare loss.

Keywords: debt sustainability, optimal debt ceiling, dynamic stochastic general equilibrium, welfare maximization

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2120 Type A Quadricuspid Aortic Valve; Rarer than a Four-Leaf Clover, an Example of Availability Heuristic

Authors: Frazer Kirk, Rohen Skiba, Pankaj Saxena

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The natural history of the QAV is poorly understood due to the exceeding rarity of the condition. Incidence rates vary between 0.00028-1%. Classically patients present with Aortic Regurgitation (AR) between 40-60 years of age experiencing palpitations, chest pain, or heart failure. (1, 2) Echocardiography is the mainstay of diagnosis for this condition; however, given the rarity of this condition, it can easily be overlooked, as demonstrated here. The case report that follows serves as a reminder of the condition to reduce the innate cognitive bias to overlook the diagnosis due to the availability heuristic. Intraoperative photography, echocardiographic and magnetic resonance imaging from this case for reference to demonstrate that while the diagnosis of Aortic regurgitation was recognized early, the valve morphology was underappreciated.

Keywords: quadricuspid aortic valve, cardiac surgery, echocardiography, congenital

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2119 Data Refinement Enhances The Accuracy of Short-Term Traffic Latency Prediction

Authors: Man Fung Ho, Lap So, Jiaqi Zhang, Yuheng Zhao, Huiyang Lu, Tat Shing Choi, K. Y. Michael Wong

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Nowadays, a tremendous amount of data is available in the transportation system, enabling the development of various machine learning approaches to make short-term latency predictions. A natural question is then the choice of relevant information to enable accurate predictions. Using traffic data collected from the Taiwan Freeway System, we consider the prediction of short-term latency of a freeway segment with a length of 17 km covering 5 measurement points, each collecting vehicle-by-vehicle data through the electronic toll collection system. The processed data include the past latencies of the freeway segment with different time lags, the traffic conditions of the individual segments (the accumulations, the traffic fluxes, the entrance and exit rates), the total accumulations, and the weekday latency profiles obtained by Gaussian process regression of past data. We arrive at several important conclusions about how data should be refined to obtain accurate predictions, which have implications for future system-wide latency predictions. (1) We find that the prediction of median latency is much more accurate and meaningful than the prediction of average latency, as the latter is plagued by outliers. This is verified by machine-learning prediction using XGBoost that yields a 35% improvement in the mean square error of the 5-minute averaged latencies. (2) We find that the median latency of the segment 15 minutes ago is a very good baseline for performance comparison, and we have evidence that further improvement is achieved by machine learning approaches such as XGBoost and Long Short-Term Memory (LSTM). (3) By analyzing the feature importance score in XGBoost and calculating the mutual information between the inputs and the latencies to be predicted, we identify a sequence of inputs ranked in importance. It confirms that the past latencies are most informative of the predicted latencies, followed by the total accumulation, whereas inputs such as the entrance and exit rates are uninformative. It also confirms that the inputs are much less informative of the average latencies than the median latencies. (4) For predicting the latencies of segments composed of two or three sub-segments, summing up the predicted latencies of each sub-segment is more accurate than the one-step prediction of the whole segment, especially with the latency prediction of the downstream sub-segments trained to anticipate latencies several minutes ahead. The duration of the anticipation time is an increasing function of the traveling time of the upstream segment. The above findings have important implications to predicting the full set of latencies among the various locations in the freeway system.

Keywords: data refinement, machine learning, mutual information, short-term latency prediction

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2118 Design and Development of an Algorithm to Predict Fluctuations of Currency Rates

Authors: Nuwan Kuruwitaarachchi, M. K. M. Peiris, C. N. Madawala, K. M. A. R. Perera, V. U. N Perera

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Dealing with businesses with the foreign market always took a special place in a country’s economy. Political and social factors came into play making currency rate changes fluctuate rapidly. Currency rate prediction has become an important factor for larger international businesses since large amounts of money exchanged between countries. This research focuses on comparing the accuracy of mainly three models; Autoregressive Integrated Moving Average (ARIMA), Artificial Neural Networks(ANN) and Support Vector Machines(SVM). series of data import, export, USD currency exchange rate respect to LKR has been selected for training using above mentioned algorithms. After training the data set and comparing each algorithm, it was able to see that prediction in SVM performed better than other models. It was improved more by combining SVM and SVR models together.

Keywords: ARIMA, ANN, FFNN, RMSE, SVM, SVR

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2117 Applying the Global Trigger Tool in German Hospitals: A Retrospective Study in Surgery and Neurosurgery

Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

Abstract:

Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

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2116 GRCNN: Graph Recognition Convolutional Neural Network for Synthesizing Programs from Flow Charts

Authors: Lin Cheng, Zijiang Yang

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Program synthesis is the task to automatically generate programs based on user specification. In this paper, we present a framework that synthesizes programs from flow charts that serve as accurate and intuitive specification. In order doing so, we propose a deep neural network called GRCNN that recognizes graph structure from its image. GRCNN is trained end-to-end, which can predict edge and node information of the flow chart simultaneously. Experiments show that the accuracy rate to synthesize a program is 66.4%, and the accuracy rates to recognize edge and node are 94.1% and 67.9%, respectively. On average, it takes about 60 milliseconds to synthesize a program.

Keywords: program synthesis, flow chart, specification, graph recognition, CNN

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2115 Recognising the Importance of Smoking Cessation Support in Substance Misuse Patients

Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

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Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

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2114 Designing a Waitlist Intervention for Adult Patients Awaiting Outpatient Treatment for Eating Disorders: Preliminary Findings from a Pilot Test

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

Abstract:

In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

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2113 Detecting of Crime Hot Spots for Crime Mapping

Authors: Somayeh Nezami

Abstract:

The management of financial and human resources of police in metropolitans requires many information and exact plans to reduce a rate of crime and increase the safety of the society. Geographical Information Systems have an important role in providing crime maps and their analysis. By using them and identification of crime hot spots along with spatial presentation of the results, it is possible to allocate optimum resources while presenting effective methods for decision making and preventive solutions. In this paper, we try to explain and compare between some of the methods of hot spots analysis such as Mode, Fuzzy Mode and Nearest Neighbour Hierarchical spatial clustering (NNH). Then the spots with the highest crime rates of drug smuggling for one province in Iran with borderline with Afghanistan are obtained. We will show that among these three methods NNH leads to the best result.

Keywords: GIS, Hot spots, nearest neighbor hierarchical spatial clustering, NNH, spatial analysis of crime

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2112 Performance of an Anaerobic Baffled Reactor (ABR) Treating High-Strength Food Industrial Wastewater with Fluctuating pH

Authors: D. M. Bassuney, W. A. Ibrahim, Medhat A. E. Moustafa

Abstract:

As awareness of the variable nature of food industrial wastewater and its environmental impact grows, a more stable treatment reactor is needed to treat such wastewater. In this paper, a performance of 5-compartment lab-scale Anaerobic Baffled Reactor (ABR) treating high strength wastewater with high pH variation was studied under three organic loading rates (OLRs). The reactor showed high COD removal efficiencies: 92.67, 97.44, and 98.19% corresponding to OLRs of 2.0, 3.0, and 4.8 KgCOD/m3 d, respectively. The first compartment showed a good buffering capacity and a distinct phase separation occurred in the ABR.

Keywords: anaerobic baffled reactor, food industrial wastewater, high strength wastewater, organic loading, pH

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2111 Fuzzy Based Stabilizer Control System for Quad-Rotor

Authors: B. G. Sampath, K. C. R. Perera, W. A. S. I. Wijesuriya, V. P. C. Dassanayake

Abstract:

In this paper the design, development and testing of a stabilizer control system for a Quad-rotor is presented which is focused on the maneuverability. The mechanical design is performed along with the design of the controlling algorithm which is devised using fuzzy logic controller. The inputs for the system are the angular positions and angular rates of the Quad-Rotor relative to three axes. Then the output data is filtered from an accelerometer and a gyroscope through a Kalman filter. In the development of the stability controlling system Mandani Fuzzy Model is incorporated. The results prove that the fuzzy based stabilizer control system is superior in high dynamic disturbances compared to the traditional systems which use PID integrated stabilizer control systems.

Keywords: fuzzy stabilizer, maneuverability, PID, quad-rotor

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2110 Reproduction Characteristics of Saanen Goats Raised under Intensive Conditions in Konya Province

Authors: Vahdettin Sariyel, Birol Dag

Abstract:

In this research, it is aimed to determine the effects of several environmental factors on adaptation and some yield parameters of Saanen goats reared under intensive conditions at a private farm in Konya province. Gestation rate, twins rate and litter size were evaluated as reproductive traits. Gestation rate was determined as 93.8% and 90.5% for 2011 and 2012 years respectively. Twins rate was determined as 59.35 % and 70.00 % for 2011 and 2012 years respectively. Litter size was 1.49 and 1.46 for 2011 and 2012 years respectively. Survival rates of kids from birth to weaning at three months of age were found as 87.74 % and 98.54 % for 2011 and 2012 years respectively.

Keywords: gestation rate, reproduction, saanen, twins rate, vitality

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2109 Virucidal, Bactericidal and Fungicidal Efficiency of Dry Microfine Steam on Innate Surfaces

Authors: C. Recchia, M. Bourel, B. Recchia

Abstract:

Microorganisms (viruses, bacteria, fungi) are responsible for most communicable diseases, threatening human health. For domestic use, chemical agents are often criticized because of their potential dangerousness, and natural solutions are needed. Application of the “dry microfine steam” (DMS) technology was tested on a selection of common pathogens (SARS-CoV-2, enterovirus EV-71, human coronavirus 229E, E. coli, S. aureus, C. albicans), on different innate surfaces, for 5 to 10 seconds. Quantification of the remaining pathogens was performed, and the reduction rates ranged from 99.8% (S. aureus on plastic) to over 99.999%. DMS showed high efficacy in the elimination of common microorganisms and could be seen as a natural alternative to chemical agents to improve domestic hygiene.

Keywords: steam, SARS-CoV-2, bactericidal, virucidal, fungicidal, sterilization

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2108 Covariance and Quantum Cosmology: A Comparison of Two Matter Clocks

Authors: Theodore Halnon, Martin Bojowald

Abstract:

In relativity, time is relative between reference frames. However, quantum mechanics requires a specific time coordinate in order to write an evolution equation for wave functions. This difference between the two theories leads to the problem of time in quantum gravity. One method to study quantum relativity is to interpret the dynamics of a matter field as a clock. In order to test the relationship between different reference frames, an isotropic cosmological model with two matter ingredients is introduced. One is given by a scalar field and one by vacuum energy or a cosmological constant. There are two matter fields, and thus two different Hamiltonians are derived from the respective clock rates. Semi-classical solutions are found for these equations and a comparison is made of the physical predictions that they imply.

Keywords: cosmology, deparameterization, general relativity, quantum mechanics

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2107 Positive Incentives to Reduce Private Car Use: A Theory-Based Critical Analysis

Authors: Rafael Alexandre Dos Reis

Abstract:

Research has shown a substantial increase in the participation of Conventionally Fuelled Vehicles (CFVs) in the urban transport modal split. The reasons for this unsustainable reality are multiple, from economic interventions to individual behaviour. The development and delivery of positive incentives for the adoption of more environmental-friendly modes of transport is an emerging strategy to help in tackling the problem of excessive use of conventionally fuelled vehicles. The efficiency of this approach, like other information-based schemes, can benefit from the knowledge of their potential impacts in theoretical constructs of multiple behaviour change theories. The goal of this research is to critically analyse theories of behaviour that are relevant to transport research and the impacts of positive incentives on the theoretical determinants of behaviour, strengthening the current body of evidence about the benefits of this approach. The main method to investigate this will involve a literature review on two main topics: the current theories of behaviour that have empirical support in transport research and the past or ongoing positive incentives programs that had an impact on car use reduction. The reviewed programs of positive incentives were the following: The TravelSmart®; Spitsmijden®; Incentives for Singapore Commuters® (INSINC); COMMUTEGREENER®; MOVESMARTER®; STREETLIFE®; SUPERHUB®; SUNSET® and the EMPOWER® project. The theories analysed were the heory of Planned Behaviour (TPB); The Norm Activation Theory (NAM); Social Learning Theory (SLT); The Theory of Interpersonal Behaviour (TIB); The Goal-Setting Theory (GST) and The Value-Belief-Norm Theory (VBN). After the revisions of the theoretical constructs of each of the theories and their influence on car use, it can be concluded that positive incentives schemes impact on behaviour change in the following manners: -Changing individual’s attitudes through informational incentives; -Increasing feelings of moral obligations to reduce the use of CFVs; -Increase the perceived social pressure to engage in more sustainable mobility behaviours through the use of comparison mechanisms in social media, for example; -Increase the perceived control of behaviour through informational incentives and training incentives; -Increasing personal norms with reinforcing information; -Providing tools for self-monitoring and self-evaluation; -Providing real experiences in alternative modes to the car; -Making the observation of others’ car use reduction possible; -Informing about consequences of behaviour and emphasizing the individual’s responsibility with society and the environment; -Increasing the perception of the consequences of car use to an individual’s valued objects; -Increasing the perceived ability to reduce threats to environment; -Help establishing goals to reduce car use; - iving personalized feedback on the goal; -Increase feelings of commitment to the goal; -Reducing the perceived complexity of the use of alternatives to the car. It is notable that the emerging technique of delivering positive incentives are systematically connected to causal determinants of travel behaviour. The preliminary results of the reviewed programs evidence how positive incentives might strengthen these determinants and help in the process of behaviour change.

Keywords: positive incentives, private car use reduction, sustainable behaviour, voluntary travel behaviour change

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2106 Influence of Titanium Addition on Wear Properties of AM60 Magnesium Alloy

Authors: H. Zengin, M. E. Turan, Y. Turen, H. Ahlatci, Y. Sun

Abstract:

This study aimed for improving wear resistance of AM60 magnesium alloy by Ti addition (0, 0.2, 0.5, 1wt%Ti). An electric resistance furnace was used to produce alloys. Pure Mg together with Al, Al-Ti and Al-Mn were melted at 750 0C in a stainless steel crucible under controlled Ar gas atmosphere and then poured into a metal mould preheated at 250 0C. Microstructure characterizations were performed by light optical (LOM) and scanning electron microscope (SEM) after the wear test. Wear rates and friction coefficients were measured with a pin-on-disk type UTS-10 Tribometer test device under a load of 20N. The results showed that Ti addition altered the morphology and the amount of b-Mg17Al12 phase in the microstructure of AM60 alloy. b-Mg17Al12 phases on the grain boundaries were refined with increasing amount of Ti. An improvement in wear resistance of AM60 alloy was observed due to the alteration in the microstructure by Ti addition.

Keywords: magnesium alloy, titanium, SEM, wear

Procedia PDF Downloads 318
2105 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic

Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

Abstract:

Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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2104 Implantology Failure: Epidemiological Survey among Tunisian Dentists

Authors: Faten Khanfir, Mohamed Tlili, Ali Medeb Hamrouni, Raki Selmi, M. S. Khalfi, Faten Ben Amor

Abstract:

Introduction: dental implant failure is a major concern for the clinician and the patient. Objectives: The aim of our study is to investigate the way in which 100 Tunisian dentists carried implant treatment for their patients from the early phase of planning and selection of patients to the placement of the implant in order to look for the implant failure factors. Results: significant correlations were found between failure rates > 5 and their corresponding factors as the number of implants placed (p = 0.001<0, 05), smoking (0.046 <0.05), unbalanced diabetes (0.03<0.05), aseptic protocol (= 0.004< 0.05) and the drilling speed (0,002<0.05) Conclusion: It seems that the number of implant placed, smoking, diabetes, aseptic protocol, and the drilling speed may contribute to dental implant failure.

Keywords: failure, implants, survey, risk, osseointegration

Procedia PDF Downloads 160