Search results for: admission criteria

Authors: Stylianos Galoukas

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since the eve of human societies, the need for survival and covering even the most basic needs such as hunting for food, led to the realization of the need for regulation between the personal and common interest. This led to the establishment of initially unwritten and later on, written rules which then became the Law. Transparency as a word has been used for more than 2.500 years. Born in ancient Greece around the 5th BC century and although it was not originally correlated to political or public administration acts, its enclosed principles and rules, were given even then, great attention. In today’s times of fake news and meta-politics, transparency has greatly correlated with the fight against corruption especially in the financially related matters. It is believed however that transparency, being a much wider than corruption meaning, has an even greater role to play than the corruption counterpart. It can be further used to unveil or examine the genuineness of the will towards the public interest, behind every public policy or political act. Therefore, herein the timeless and fundamental principles of institutional and public administration transparency are made clear as well as their application rules that can and ought to be used as evaluation criteria.

Keywords: evaluation citeria, policies, politics, principles, rules, transparency

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Authors: A. T. Nakysh, A. S. Idrisov, S. A. Baidurin

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This work presents the results of a study the incidence of metabolic syndrome (MetS) in women with impaired reproductive function (IRF) according to the data of Astana, Kazakhstan. The anthropometric, biochemical and instrumental studies were conducted among 515 women, of which 53 patients with MetS according to IDF criteria, 2006, were selected. The frequency of occurrence of the IRF, due to MetS – 10.3% of cases according to the data of Astana. In women of childbearing age with IRF and the MetS, blood pressure (BP), indicators of carbohydrate and lipid metabolism were significantly higher and the level of high density lipoprotein (HDL) significantly lower compared to the same in women with the IRF without MetS. The hyperandrogenism, the hyperestrogenemia, the hyperprolactinemia and the hypoprogesteronemia were found in the patients with MetS and IRF, indicating the impact of MetS on the development of the polycystic ovary syndrome in 28% of cases and hyperplastic processes of the myometrium in 20% of cases.

Keywords: dyslipidemia, insulin resistance, metabolic syndrome, reproductive disorders, obesity

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Authors: Vivek Hokam, Vishrut Landge

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An ideal maintenance program for an industrial road network is one that would maintain all sections at a sufficiently high level of functional and structural conditions. However, due to various constraints such as budget, manpower and equipment, it is not possible to carry out maintenance on all the needy industrial road sections within a given planning period. A rational and systematic priority scheme needs to be employed to select and schedule industrial road sections for maintenance. Priority analysis is a multi-criteria process that determines the best ranking list of sections for maintenance based on several factors. In priority setting, difficult decisions are required to be made for selection of sections for maintenance. It is more important to repair a section with poor functional conditions which includes uncomfortable ride etc. or poor structural conditions i.e. sections those are in danger of becoming structurally unsound. It would seem therefore that any rational priority setting approach must consider the relative importance of functional and structural condition of the section. The maintenance priority index and pavement performance models tend to focus mainly on the pavement condition, traffic criteria etc. There is a need to develop the model which is suitably used with respect to limited budget provisions for maintenance of pavement. Linear programming is one of the most popular and widely used quantitative techniques. A linear programming model provides an efficient method for determining an optimal decision chosen from a large number of possible decisions. The optimum decision is one that meets a specified objective of management, subject to various constraints and restrictions. The objective is mainly minimization of maintenance cost of roads in industrial area. In order to determine the objective function for analysis of distress model it is necessary to fix the realistic data into a formulation. Each type of repair is to be quantified in a number of stretches by considering 1000 m as one stretch. A stretch considered under study is having 3750 m length. The quantity has to be put into an objective function for maximizing the number of repairs in a stretch related to quantity. The distress observed in this stretch are potholes, surface cracks, rutting and ravelling. The distress data is measured manually by observing each distress level on a stretch of 1000 m. The maintenance and rehabilitation measured that are followed currently are based on subjective judgments. Hence, there is a need to adopt a scientific approach in order to effectively use the limited resources. It is also necessary to determine the pavement performance and deterioration prediction relationship with more accurate and economic benefits of road networks with respect to vehicle operating cost. The infrastructure of road network should have best results expected from available funds. In this paper objective function for distress model is determined by linear programming and deterioration model considering overloading is discussed.

Keywords: budget, maintenance, deterioration, priority

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Authors: Çağrı Özgün Kibiroğlu, Zeynep Turgut

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This paper considers a hub location problem where the network service area partitioned into predetermined zones (represented by node clusters is given) and potential hub nodes capacity levels are determined a priori as a selection criteria of hub to investigate congestion effect on network. The objective is to design hub network by determining all required hub locations in the node clusters and also allocate non-hub nodes to hubs such that the total cost including transportation cost, opening cost of hubs and penalty cost for exceed of capacity level at hubs is minimized. A mixed integer linear programming model is developed introducing additional constraints to the traditional model of capacitated multiple allocation hub location problem and empirically tested.

Keywords: hub location problem, p-hub median problem, clustering, congestion

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Authors: Tímea Gerzsenyi, Ágnes M. Ilosvai, László Vanyorek, Emma Szőri-Dorogházi

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DNA isolation is a crucial step in many molecular biological applications for diagnostic and research purposes. However, traditional extraction requires toxic reagents, and commercially available kits are expensive, this leading to the recently wide-spread method, the magnetic nanoparticle (MNP)-based DNA isolation. Different ferrite containing MNPs were examined and compared in their plasmid DNA isolation efficiency. Among the tested MNPs, one has never been used for the extraction of plasmid molecules, marking a distinct application. pDNA isolation process was optimized for each type of nanoparticle and the best protocol was selected based on different criteria: DNA quantity, quality and integrity. With the best-performing magnetic nanoparticle, which excelled in all aspects, further tests were performed to recover genomic DNA from bacterial cells and a protocol was developed.

Keywords: DNA isolation, nanobiotechnology, magnetic nanoparticles, protocol optimization, pDNA, gDNA

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Authors: Mohammad Reza Ostad Ali Naghi Kashani, Esfanji Elia

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Nowadays, the amounts of companies which tend to have an Enterprise Resource Planning (ERP) application are increasing particularly in developing countries like Iran. ERP projects are expensive, time consuming, and complex, in addition the failure rate is high among these projects. It is important to know whether these projects could meet their goals or not. Furthermore, the area which should be improved should be identified. In this paper we made a framework to evaluate ERP projects success implementation. First, based on literature review we made a framework based on BSC model, financial, customer, processes, learning and knowledge, because of the importance of change management it was added to model. Then an organization was divided in three layers. We choose corporate, managerial, and operational levels. Then to find criteria to assess each aspect, we use Delphi method in two rounds. And for the second round we made a questionnaire and did some statistical tasks on them. Based on the statistical results some of them are accepted and others are rejected.

Keywords: ERP, BSC, ERP project evaluation, IT projects

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Authors: Bindhiya Thomas, Rehana Hafeez

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Background: The Surgical Ambulatory Unit (SAU) also known as the Same Day Emergency Care (SDEC) is an established part of many hospitals providing same day emergency care service to surgical patients who would have otherwise required admission through the A&E. Prior to Covid, the SAU was functioning as a 12-hour service, but during the Covid crisis this service was transformed to a 24 hour functioning Surgical Ambulatory Assessment unit (SAAU). We studied the effects that this change brought about in-patient care in our hospital. Objective: The objective of the study was to assess the impact of a 24-hour Surgical Ambulatory Assessment unit on patient care during the time of Covid, in particular its role in freeing A&E capacity and delivering effective patient care. Methods: We collected two sets of data retrospectively. The first set was collected over a 6-week period when the SAU was functioning at the Princess Royal University Hospital. On March 23rd, 2020, the SAU was transformed into a 24-hour SAAU. Following this transformation, a second set of patient data was collected over a period of 6 weeks. A comparison was made between data collected from when the hospital had a 12-hour Surgical Ambulatory unit and later when it was transformed into a 24-hour facility. Its effects on the change in the number of patients breaching the four hour waiting period and the number of emergency surgical admissions. Results: The 24-hour Surgical Ambulatory Assessment unit brought significant reductions in the number of patients breaching the waiting period of 4 hours in A&E from 44% during the period of the 12-hour Surgical Ambulatory care facility to 0% from when the 24-hour Surgical Ambulatory Assessment Unit was established. A 28% reduction was also seen in the number of surgical patients' admissions from A&E. Conclusions: The 24-hour SAAU was found to have a profound positive impact on emergency care of surgical patients. Especially during the Covid crisis, it played a crucial role in providing not only effective and accessible patient care but also in reducing the A&E workload and admissions. It thus proved to be a strategic tool that helped to deal with the immense workload in emergency care during the Covid crisis and helped free much needed headspace at a time of uncertainty for the A&E to better configure their services. If sustained, the 24-hour SAAU could be relied on to augment the NHS emergency services in the future, especially in the event of another crisis.

Keywords: Princess Royal University Hospital, surgical ambulatory assessment unit, surgical ambulatory unit, same day emergency care

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Authors: Eva Štěpánková

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The decision-making process is theoretically clearly defined. Generally, it includes the problem identification and analysis, data gathering, goals and criteria setting, alternatives development and optimal alternative choice and its implementation. In practice however, various modifications of the theoretical decision-making process can occur. The managers can consider some of the phases to be too complicated or unfeasible and thus they do not carry them out and conversely some of the steps can be overestimated. The aim of the paper is to reveal and characterize the perception of the individual phases of decision-making process by the managers. The research is concerned with managers in the military environment–commanders. Quantitative survey is focused cross-sectionally in the individual levels of management of the Ministry of Defence of the Czech Republic. On the total number of 135 respondents the analysis focuses on which of the decision-making process phases are problematic or not carried out in practice and which are again perceived to be the easiest. Then it is examined the reasons of the findings.

Keywords: decision making, decision making process, decision problems, concrete organization

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Authors: Katja Ignatieva, Patrick Wong

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We investigated the dynamics of high frequency energy prices, including crude oil and electricity prices. The returns of underlying quantities are modelled using various parametric models such as stochastic framework with jumps and stochastic volatility (SVCJ) as well as non-parametric alternatives, which are purely data driven and do not require specification of the drift or the diffusion coefficient function. Using different statistical criteria, we investigate the performance of considered parametric and nonparametric models in their ability to forecast price series and volatilities. Our models incorporate possible seasonalities in the underlying dynamics and utilise advanced estimation techniques for the dynamics of energy prices.

Keywords: stochastic volatility, affine jump-diffusion models, high frequency data, model specification, markov chain monte carlo

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Authors: Hari Pulapaka

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This paper defines and develops the notion of a traceability index for food and may be used by any consumer (restaurant, distributor, average consumer etc.). The concept is then extended to a region's food system as a way to measure how well a regional food system utilizes its own bounty or at least, is connected to its food sources. With increasing emphases on the sustainability of aspects of regional and ultimately, the global food system, it is reasonable to accept that if we know how close (in relative terms) an end-user of a set of ingredients (as they traverse through the maze of supply chains) is from the sources, we may be better equipped to evaluate the quality of the set as measured by any number of qualitative and quantitative criteria. We propose a mathematical model which may be adapted to a number of contexts and sizes. Two hypothetical cases of different scope are presented which highlight how the model works as an evaluator of steps between an end-user and the source(s) of the ingredients they consume. The variables in the model are flexible enough to be adapted to other applications beyond food systems.

Keywords: food, traceability, supply chain, mathematical model

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Authors: Jason Sah

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Music ensemble class is a non-traditional classroom in the sense that it is always a group effort during rehearsal. When measuring student performance ability in class, it is imperative that the grading rubric includes a collaborative skill component. Assessments that stop short of testing students' ability to make music with others undermine the group mentality by elevating individual prowess. Applying empirical and evidence-based methodology, this research develops a grading rubric that defines the criteria for assessing collaborative skill, and then explores different strategies for implementing this rubric in a timely and effective manner. Findings show that when collaborative skill is regularly tested, students gradually shift their attention from playing their own part well to sharing their part with others.

Keywords: assessment, ensemble class, grading rubric, student collaboration

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Authors: Kim Toyer, Belinda Thompson, Louise Koelmeyer

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Lymphoedema is a chronic condition caused by dysfunction of the lymphatic system, which limits the drainage of fluid and tissue waste from the interstitial space of the affected body part. The normal physiological changes in pregnancy cause an increased load on a normal lymphatic system which can result in a transient lymphatic overload (oedema). The interaction between lymphoedema and pregnancy oedema is unclear. Women with pre-existing lymphoedema require accurate information and additional strategies to manage their lymphoedema during pregnancy. Currently, no resources are available to guide women or their healthcare providers with accurate advice and additional management strategies for coping with lymphoedema during pregnancy until they have recovered postnatally. This study explored the experiences of Australian women with pre-existing lymphoedema during recent pregnancy and the early postnatal period to determine how their usual lymphoedema management strategies were adapted and what were their additional or unmet needs. Interactions with their obstetric care providers, the hospital maternity services, and usual lymphoedema therapy services were detailed. Participants were sourced from several Australian lymphoedema community groups, including therapist networks. Opportunistic sampling is appropriate to explore this topic in a small target population as lymphoedema in women of childbearing age is uncommon, with prevalence data unavailable. Inclusion criteria were aged over 18 years, diagnosed with primary or secondary lymphoedema of the arm or leg, pregnant within the preceding ten years (since 2012), and had their pregnancy and postnatal care in Australia. Exclusion criteria were a diagnosis of lipedema and if unable to read or understand a reasonable level of English. A mixed-method qualitative design was used in two phases. This involved an online survey (REDCap platform) of the participants followed by online semi-structured interviews or focus groups to provide the transcript data for inductive thematic analysis to gain an in-depth understanding of issues raised. Women with well-managed pre-existing lymphoedema coped well with the additional oedema load of pregnancy; however, those with limited access to quality conservative care prior to pregnancy were found to be significantly impacted by pregnancy, including many reporting deterioration of their chronic lymphoedema. Misinformation and a lack of support increased fear and apprehension in planning and enjoying their pregnancy experience. Collaboration between maternity and lymphoedema therapy services did not happen despite study participants suggesting it. Helpful resources and unmet needs were identified in the recent Australian context to inform further research and the development of resources to assist women with lymphoedema who are considering or are pregnant and their supporters, including health care providers.

Keywords: lymphoedema, management strategies, pregnancy, qualitative

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Authors: Maritsa Kurashvili, George Adamia, Tamar Ananiashvili, Lia Amiranasvili, Tamar Varazi, Marina Pruidze, Marlen Gordeziani, Gia Khatisashvili

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The goal of presented work is the development phytoremediation method targeted to cleaning environment polluted with organochlorine pesticides, based on joint application of plants and microorganisms. For this aim the selection of plants and microorganisms with corresponding capabilities towards three organochlorine pesticides (Lindane, DDT and PCP) has been carried out. The tolerance of plants to tested pesticides and induction degree of plant detoxification enzymes by these compounds have been used as main criteria for estimating the applicability of plants in proposed technology. Obtained results show that alfalfa, maize and soybean among tested six plant species have highest tolerance to pesticides. As a result of screening, more than 30 strains from genera Pseudomonas have been selected. As a result of GC analysis of incubation area, 11 active cultures for investigated pesticides are carefully chosen.

Keywords: DDT, Lindane, organochlorine pesticides, PCP, phytoremediation

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Authors: Anas Hourani, Batool Ahmad

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Software applications play an important role inside any institute. They are employed to manage all processes and store entities-related data in the computer. Therefore, choosing the right software product that meets institute requirements is not an easy decision in view of considering multiple criteria, different points of views, and many standards. As a case study, Mutah University, located in Jordan, is in essential need of customized software, and several companies presented their software products which are very similar in quality. In this regard, an analytic hierarchy process (AHP) and a fuzzy analytic hierarchy process (Fuzzy-AHP) models are proposed in this research to identify the most suitable and best-fit software product that meets the institute requirements. The results indicate that both modules are able to help the decision-makers to make a decision, especially in complex decision problems.

Keywords: analytic hierarchy process, decision modeling, fuzzy analytic hierarchy process, software product

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Authors: Mabrouka Morri, Amel Soualmia, Philippe Belleudy

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Vegetation affects the mean and turbulent flow structure. It may increase flood risks and sediment transport. Therefore, it is important to develop analytical approaches for the bed shear stress on vegetated bed, to predict resistance caused by vegetation. In the recent years, experimental and numerical models have both been developed to model the effects of submerged vegetation on open-channel flow. In this paper, different analytic models are compared and tested using the criteria of deviation, to explore their capacity for predicting the mean velocity and select the suitable one that will be applied in real case of rivers. The comparison between the measured data in vegetated flume and simulated mean velocities indicated, a good performance, in the case of rigid vegetation, whereas, Huthoff model shows the best agreement with a high coefficient of determination (R2=80%) and the smallest error in the prediction of the average velocities.

Keywords: analytic models, comparison, mean velocity, vegetation

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Authors: Brahmia Nadjet

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The growing needs of displacements led advanced countries in this field install new specific transport systems, able to palliate any deficiencies, especially when regular public transport does not adequately meet the requests of users. In this context, on-demand transport systems (ODT) are very efficient; they rely on techniques based on the location of trip generators which should be assured effectively with the use of operators responsible of the advance reservation, planning and organization, and studying the different ODT criteria (organizational, technical, geographical, etc.). As the advanced countries in the field of transport, some developing countries are involved in the adaptation of the new technologies to reduce the deficit in their communication system. This communication presents the study of an ODT implementation in the west of Algeria, by developing the Geomatics side of the study. This part requires the use of specific systems (such as GIS, RDBMS), so we developed the process through an application in an environment of mobility by using the computer tools dedicated to the management of the entities related to the transport field.

Keywords: ODT, geomatics, GIS, transport systems

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Authors: Bo Yang, Hali̇l Ceylan, Ali Ulvi̇ Uzer

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This experimental study was performed to investigate the effect of biofuel co-products (BCPs) with sulfur-free lignin addition on the unconsolidated on strength and durability behavior in pavement soil stabilization subjected to freezing–thawing cycles. For strength behavior, a series of unconfined compression tests were conducted. Mass losses were also calculated after freezing–thawing cycles as criteria for durability behavior. To investigate the effect of the biofuel co-products on the durability behavior of the four type’s soils, mass losses were calculated after 12 freezing–thawing cycles. The co-products tested are promising additives for improving durability under freeze-thaw conditions, and each type has specific advantages.

Keywords: durability, mass lose, freezing–thawing test, bio-energy co-product, soil stabilization

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Authors: Burak Erkayman

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The manufacturing and service organizations are in the need of using ERP systems to integrate many functions from purchasing to storage, production planning to calculation of costs. Using ERP systems by the integration in the level of information provides companies remarkable advantages in terms of profitability, productivity and efficiency in processes. Cloud computing is one of the most significant changes in information and communication technology. The developments in Cloud Computing attract business world to take advantage of this field. Cloud Computing means much more storage area, more cost saving and faster data transfer rate. In addition to these, it presents new business models, new field of study and practicable solutions for anyone’s use. These developments make inevitable the implementation of ERP systems to cloud environment. In this study, the performance of ERP systems in cloud environment is analyzed through various performance criteria and a comparison between traditional and cloud-ERP systems is presented. At the end of study the transformation and the future of ERP systems is discussed.

Keywords: cloud-ERP, ERP system performance, information system transformation

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Authors: K. Roushanger, A. Soleymanzadeh

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Weirs are structures often used in irrigation techniques, sewer networks and flood protection. However, the hydraulic behavior of this type of weir is complex and difficult to predict accurately. An accurate flow prediction over a weir mainly depends on the proper estimation of discharge coefficient. In this study, the Genetic Expression Programming (GEP) approach was used for predicting trapezoidal and rectangular sharp-crested side weirs discharge coefficient. Three different performance indexes are used as comparing criteria for the evaluation of the model’s performances. The obtained results approved capability of GEP in prediction of trapezoidal and rectangular side weirs discharge coefficient. The results also revealed the influence of downstream Froude number for trapezoidal weir and upstream Froude number for rectangular weir in prediction of the discharge coefficient for both of side weirs.

Keywords: discharge coefficient, genetic expression programming, trapezoidal weir

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Authors: Guillaume Craveur

Abstract:

This study highlights the impact of an onboard fire for the evacuation of a rolling stock. Two fires models are achieved. The first one is a zone model realized with the CFAST software. Then, this fire is imported in a building EXODUS model in order to determine the evacuation time with effects of fire effluents (temperature, smoke opacity, smoke toxicity) on passengers. The second fire is achieved with Fire Dynamics Simulator software. The fire defined is directly imported in the FDS+Evac model which will permit to determine the evacuation time and effects of fire effluents on passengers. These effects will be compared with tenability criteria defined in some standards in order to see if the situation is acceptable. Different power of fire will be underlined to see from what power source the hazard become unacceptable.

Keywords: fire safety engineering, numerical tools, rolling stock, evacuation

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Authors: Emilia K. H. Danielsson-Waters, Malaz Elsaddig, Kevin Jones

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Unfortunately, it is well known that neonatal deaths are a common and potentially preventable occurrence across the world. Neonatal resuscitation is a simple and inexpensive intervention that can effectively reduce this rate, and can be taught and implemented globally. This project is a follow-on from one in 2012, which found that neonatal resuscitation simulation was valuable for education, but would be better improved by being delivered by local staff. Methods: This study involved auditing the neonatal admission and death records within a rural Ugandan hospital, alongside implementing a Train-The-Trainer teaching scheme to teach Neonatal Resuscitation. One local doctor was trained for simulating neonatal resuscitation, whom subsequently taught an additional 14 staff members in one-afternoon session. Participants were asked to complete questionnaires to assess their knowledge and confidence pre- and post-simulation, and a survey to identify barriers and drivers to simulation. Results: The results found that the neonatal mortality rate in this hospital was 25% between July 2016- July 2017, with birth asphyxia, prematurity and sepsis being the most common causes. Barriers to simulation that were identified predominantly included a lack of time, facilities and opportunity, yet all members stated simulation was beneficial for improving skills and confidence. The simulation session received incredibly positive qualitative feedback, and also a 0.58-point increase in knowledge (p=0.197) and 0.73-point increase in confidence (0.079). Conclusion: This research shows that it is possible to create a teaching scheme in a rural hospital, however, many barriers are in place for its sustainability, and a larger sample size with a more sensitive scale is required to achieve statistical significance. This is undeniably important, because teaching neonatal resuscitation can have a direct impact on neonatal mortality. Subsequently, recommendations include that efforts should be put in place to create a sustainable training scheme, for example, by employing a resuscitation officer. Moreover, neonatal resuscitation teaching should be conducted more frequently in hospitals, and conducted in a wider geographical context, including within the community, in order to achieve its full effect.

Keywords: neonatal resuscitation, sustainable medical education, train-the-trainer, Uganda

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Authors: Chen Xi, Lao Xuerui, Li Junjie, Jiang Yike, Wang Hanwei, Zeng Zihao

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To further promote the development of smart cities, the microscopic "nerve endings" of the City Intelligent Model (CIM) are extended to be more sensitive. In this paper, we develop a pedestrian trajectory twin terminal based on the CIM and CNN technology. It also uses 5G networks, architectural and geoinformatics technologies, convolutional neural networks, combined with deep learning networks for human behaviour recognition models, to provide empirical data such as 'pedestrian flow data and human behavioural characteristics data', and ultimately form spatial performance evaluation criteria and spatial performance warning systems, to make the empirical data accurate and intelligent for prediction and decision making.

Keywords: urban planning, urban governance, CIM, artificial intelligence, convolutional neural network

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Authors: Nadjet Brahmia

Abstract:

The growing needs of displacements led advanced countries in this field install new specific transport systems, able to palliate any deficiencies, especially when regular public transport does not adequately meet the requests of users. In this context, on-demand transportation (ODT) are very efficient; they rely on techniques based on the location of trip generators which should be assured effectively with the use of operators responsible of the advance reservation, planning and organization, and studying the different ODT criteria (organizational, technical, geographical, etc.). As the advanced countries in the field of transport, some developing countries are involved in the adaptation of the new technologies to reduce the deficit in their communication system. This communication presents the study of an ODT implementation in the west of Algeria, by developing the Geomatics side of the study. This part requires the use of specific systems (such as GIS, RDBMS…), so we developed the process through an application in an environment of mobility by using the computer tools dedicated to the management of the entities related to the transport field.

Keywords: ODT, geomatics, GIS, transport systems

Procedia PDF Downloads 557

Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

Abstract:

Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

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Authors: C. Scurr, J. Jeans, S. Srivastava

Abstract:

Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

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Authors: Halima Sadia Qureshi, Urooj Sadiq, Noshi Eram Zaman

Abstract:

The goal of this study was to see how cognitive behavior hypnotherapy affected nonsuicidal self-injury. DSM 5 invites the researchers to explore the newly added condition under the chapter of conditions under further study named Nonsuicidal self-injury disorder. To date, no empirical sound intervention has been proven effective for NSSI as given in DSM 5. Nonsuicidal self-injury is defined by DSM 5 as harming one's self physically, without suicidal intention. Around 7.6% of teenagers are expected to fulfill the NSSI disorder criteria. 3 Adolescents, particularly university students, account for around 87 percent of self-harm studies. Furthermore, one of the risks associated with NSSI is an increased chance of suicide attempts, and in most cases, the cycle repeats again. 6 The emotional and psychological components of the illness might lead to suicide, either intentionally or unintentionally. 7 According to a research done at a Pakistani military hospital, over 80% of participants had no intention of committing suicide. Furthermore, it has been determined that improvements in NSSI prevention and intervention are necessary as a stand-alone strategy. The quasi-experimental study took place in Islamabad and Rawalpindi, Pakistan, from May 2019 to April 2020 and included students aged 18 to 25 years old from several institutions and colleges in the twin cities. According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, the individuals were assessed for >2 episodes without suicidal intent using the intentional self-harm questionnaire. The Clinician Administered Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess the individual for NSSI condition. Symptom checklist-90 (SCL-90) was used to screen the participants for differential diagnosis. Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was used to rule out the BPD cases. The selected participants, n=106 from the screening sample of 600, were selected. They were further screened to meet the inclusion and exclusion criteria, and the total of n=71 were split into two groups: intervention and control. The intervention group received cognitive behavior hypnotherapy for the next three months, whereas the control group received no treatment. After the period of three months, both the groups went through the post assessment, and after the three months’ period, follow-up assessment was conducted. The groups were evaluated, and SPSS 25 was used to analyse the data. The results showed that each of the two groups had 30 (50 percent) of the 60 participants. There were 41 males (68 percent) and 19 girls (32 percent) in all. The bulk of the participants were between the ages of 21 and 23. (48 percent). Self-harm events were reported by 48 (80 percent) of the pupils, and suicide ideation was found in 6 (ten percent). In terms of pre- and post-intervention values (d=4.90), post-intervention and follow-up assessment values (d=0.32), and pre-intervention and follow-up values (d=5.42), the study's effect size was good. The comparison of treatment and no-treatment groups revealed that treatment was more successful than no-treatment, F (1, 58) = 53.16, p.001. The results reveal that the treatment manual of CBH is effective for Nonsuicidal self-injury disorder.

Keywords: NSSI, nonsuicidal self injury disorder, self-harm, self-injury, Cognitive behaviour hypnotherapy, CBH

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Authors: Raphael Udeh, Luis García De Guadiana Romualdo, Xenia Dolje-Gore

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Background: Quite disturbing is the huge public health impact of COVID-19: As at today [25th March 2021, the COVID-19 global burden shows over 123 million cases and over 2.7 million deaths worldwide. Rationale: Recent evidence shows calprotectin’s potential as a therapeutic target, stating that tasquinimod, from the Quinoline-3-Carboxamide family is capable of blocking the interaction between calprotectin and TLR4. Hence preventing the cytokine release syndrome, that heralds the functional exhaustion in COVID-19. Early preclinical studies showed that tasquinimod inhibit tumor growth and prevent angiogenesis/cytokine storm. Phase I – III clinical studies in prostate cancer showed it has a good safety profile with good radiologic progression free survival but no effect on overall survival. Rationale/hypothesis: Strategic endeavors have been amplified globally to assess new therapeutic interventions for COVID-19 management – thus the clinical and antiviral efficacy of tasquinimod in COVID-19 remains to be explored. Hence the primary objective of this trial will be to evaluate the efficacy of tasquinimod in the treatment of adult patients with severe COVID-19 infections. Therefore, I hypothesise that among adults with COVID19 infection, tasquinimod will reduce the severe respiratory distress associated with COVID-19 compared to placebo, over a 28-day study period. Method: The setting is in Europe. Design – a randomized, placebo-controlled, phase II double-blinded trial. Trial lasts for 28 days from randomization, Tasquinimod capsule given as 0.5mg daily 1st fortnight, then 1mg daily 2nd fortnight. I0 outcome - assessed using six-point ordinal scale alongside eight 20 outcomes. 125 participants to be enrolled, data collection at baseline and subsequent data points, and safety reporting monitored via serological profile. Significance: This work could potentially establish tasquinimod as an effective and safe therapeutic agent for COVID-19 by reducing the severe respiratory distress, related time to recovery, time on oxygen/admission. It will also drive future research – as in larger multi-centre RCT.

Keywords: Calprotectin, COVID-19, Phase II Trial, Tasquinimod

Procedia PDF Downloads 195

Authors: Yuri Zinchenko

Abstract:

Recently, distributed storage systems have been used more and more in various aspects of everyday life. They provide such necessary properties as Scalability, Fault Tolerance, Durability, and others. At the same time, not only reliable but also fast data storage remains one of the most pressing issues in this area. That brings us to the consensus algorithm as one of the most important components that has a great impact on the functionality of a distributed system. This paper is the result of an analysis of several well-known consensus algorithms, such as Paxos and Raft. The algorithm it offers, called Sync, promotes, but does not insist on simultaneous writing to the nodes (which positively affects the overall writing speed) and tries to minimize the system's inactive time. This allows nodes to reach agreement on the system state in a shorter period, which is a critical factor for distributed systems. Also when developing Sync, a lot of attention was paid to such criteria as simplicity and intuitiveness, the importance of which is difficult to overestimate.

Keywords: sync, consensus algorithm, distributed system, leader-based, synchronization.

Procedia PDF Downloads 62

Authors: Aydin Teymourifar, Gurkan Ozturk

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In this paper, a hybrid Tabu Search (TS) algorithm is suggested for the multi-objective job shop scheduling problems (MO-JSSPs). The algorithm integrates several shifting bottleneck based neighborhood structures with the Giffler & Thompson algorithm, which improve efficiency of the search. Diversification and intensification are provided with local and global left shift algorithms application and also new semi-active, active, and non-delay schedules creation. The suggested algorithm is tested in the MO-JSSPs benchmarks from the literature based on the Pareto optimality concept. Different performances criteria are used for the multi-objective algorithm evaluation. The proposed algorithm is able to find the Pareto solutions of the test problems in shorter time than other algorithm of the literature.

Keywords: tabu search, heuristics, job shop scheduling, multi-objective optimization, Pareto optimality

Procedia PDF Downloads 443

Authors: Michael Mederle, Heinz Bernhardt

Abstract:

The Management of machine fleets or autonomous vehicle control will considerably increase efficiency in future agricultural production. Especially entire process chains, e.g. harvesting complexes with several interacting combine harvesters, grain carts, and removal trucks, provide lots of optimization potential. Organization and pre-planning ensure to get these efficiency reserves accessible. One way to achieve this is to optimize infield path planning. Particularly autonomous machinery requires precise specifications about infield logistics to be navigated effectively and process optimized in the fields individually or in machine complexes. In the past, a lot of theoretical optimization has been done regarding infield logistics, mainly based on field geometry. However, there are reasons why farmers often do not apply the infield strategy suggested by mathematical route planning tools. To make the computational optimization more useful for farmers this study focuses on these influencing factors by expert interviews. As a result practice-oriented navigation not only to the field but also within the field will be possible. The survey study is intended to cover the entire range of German agriculture. Rural mixed farms with simple technology equipment are considered as well as large agricultural cooperatives which farm thousands of hectares using track guidance and various other electronic assistance systems. First results show that farm managers using guidance systems increasingly attune their infield-logistics on direction giving obstacles such as power lines. In consequence, they can avoid inefficient boom flippings while doing plant protection with the sprayer. Livestock farmers rather focus on the application of organic manure with its specific requirements concerning road conditions, landscape terrain or field access points. Cultivation of sugar beets makes great demands on infield patterns because of its particularities such as the row crop system or high logistics demands. Furthermore, several machines working in the same field simultaneously influence each other, regardless whether or not they are of the equal type. Specific infield strategies always are based on interactions of several different influences and decision criteria. Single working steps like tillage, seeding, plant protection or harvest mostly cannot be considered each individually. The entire production process has to be taken into consideration to detect the right infield logistics. One long-term objective of this examination is to integrate the obtained influences on infield strategies as decision criteria into an infield navigation tool. In this way, path planning will become more practical for farmers which is a basic requirement for automatic vehicle control and increasing process efficiency.

Keywords: autonomous vehicle control, infield logistics, path planning, process optimizing

Procedia PDF Downloads 233