Search results for: ANOVA score model
Commenced in January 2007
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Edition: International
Paper Count: 18914

Search results for: ANOVA score model

17774 The Outcome of Early Balance Exercises and Agility Training in Sports Rehabilitation for Patients Post Anterior Cruciate Ligament (ACL) Reconstruction

Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

Abstract:

Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

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17773 A Two Stage Stochastic Mathematical Model for the Tramp Ship Routing with Time Windows Problem

Authors: Amin Jamili

Abstract:

Nowadays, the majority of international trade in goods is carried by sea, and especially by ships deployed in the industrial and tramp segments. This paper addresses routing the tramp ships and determining the schedules including the arrival times to the ports, berthing times at the ports, and the departure times in an operational planning level. In the operational planning level, the weather can be almost exactly forecasted, however in some routes some uncertainties may remain. In this paper, the voyaging times between some of the ports are considered to be uncertain. To that end, a two-stage stochastic mathematical model is proposed. Moreover, a case study is tested with the presented model. The computational results show that this mathematical model is promising and can represent acceptable solutions.

Keywords: routing, scheduling, tram ships, two stage stochastic model, uncertainty

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17772 Conduction Model Compatible for Multi-Physical Domain Dynamic Investigations: Bond Graph Approach

Authors: A. Zanj, F. He

Abstract:

In the current paper, a domain independent conduction model compatible for multi-physical system dynamic investigations is suggested. By means of a port-based approach, a classical nonlinear conduction model containing physical states is first represented. A compatible discrete configuration of the thermal domain in line with the elastic domain is then generated through the enhancement of the configuration of the conventional thermal element. The presented simulation results of a sample structure indicate that the suggested conductive model can cover a wide range of dynamic behavior of the thermal domain.

Keywords: multi-physical domain, conduction model, port based modeling, dynamic interaction, physical modeling

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17771 Enhancement of Indexing Model for Heterogeneous Multimedia Documents: User Profile Based Approach

Authors: Aicha Aggoune, Abdelkrim Bouramoul, Mohamed Khiereddine Kholladi

Abstract:

Recent research shows that user profile as important element can improve heterogeneous information retrieval with its content. In this context, we present our indexing model for heterogeneous multimedia documents. This model is based on the combination of user profile to the indexing process. The general idea of our proposal is to operate the common concepts between the representation of a document and the definition of a user through his profile. These two elements will be added as additional indexing entities to enrich the heterogeneous corpus documents indexes. We have developed IRONTO domain ontology allowing annotation of documents. We will present also the developed tool validating the proposed model.

Keywords: indexing model, user profile, multimedia document, heterogeneous of sources, ontology

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17770 Cognitive Impairment in Chronic Renal Patients on Hemodialysis

Authors: Fabiana Souza Orlandi, Juliana Gomes Duarte, Gabriela Dutra Gesualdo

Abstract:

Chronic renal disease (CKD), accompanied by hemodialysis, causes chronic renal failure in a number of situations that compromises not only physical, personal and environmental aspects, but also psychological, social and family aspects. Objective: To verify the level of cognitive impairment of chronic renal patients on hemodialysis. Methodology: This is a descriptive, cross-sectional study. The present study was performed in a Dialysis Center of a city in the interior of the State of São Paulo. The inclusion criteria were: being 18 years or older; have a medical diagnosis of CKD; being in hemodialysis treatment in this unit; and agree to participate in the research, with the signature of the Informed Consent (TCLE). A total of 115 participants were evaluated through the Participant Characterization Instrument and the Addenbrooke Cognitive Exam - Revised Version (ACE-R), being scored from 0 to 100, stipulating the cut-off note for the complete battery <78 and subdivided into five domains: attention and guidance; memory; fluency; language; (66.9%) and caucasian (54.7%), 53.7 (±14.8) years old. Most of the participants were retired (74.7%), with incomplete elementary schooling (36.5%) and the average time of treatment was 46 months. Most of the participants (61.3%) presented impairment in the area of attention and orientation, 80.4% in the spatial visual domain. Regarding the total ACE-R score, 75.7% of the participants presented scores below the established cut grade. Conclusion: There was a high percentage (75.7%) below the cut-off score established for ACE-R, suggesting that there may be some cognitive impairment among these participants, since the instrument only performs a screening on cognitive health. The results of the study are extremely important so that possible interventions can be traced in order to minimize impairment, thus improving the quality of life of chronic renal patients.

Keywords: cognition, chronic renal insufficiency, adult health, dialysis

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17769 An Improved C-Means Model for MRI Segmentation

Authors: Ying Shen, Weihua Zhu

Abstract:

Medical images are important to help identifying different diseases, for example, Magnetic resonance imaging (MRI) can be used to investigate the brain, spinal cord, bones, joints, breasts, blood vessels, and heart. Image segmentation, in medical image analysis, is usually the first step to find out some characteristics with similar color, intensity or texture so that the diagnosis could be further carried out based on these features. This paper introduces an improved C-means model to segment the MRI images. The model is based on information entropy to evaluate the segmentation results by achieving global optimization. Several contributions are significant. Firstly, Genetic Algorithm (GA) is used for achieving global optimization in this model where fuzzy C-means clustering algorithm (FCMA) is not capable of doing that. Secondly, the information entropy after segmentation is used for measuring the effectiveness of MRI image processing. Experimental results show the outperformance of the proposed model by comparing with traditional approaches.

Keywords: magnetic resonance image (MRI), c-means model, image segmentation, information entropy

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17768 Image Quality and Dose Optimisations in Digital and Computed Radiography X-ray Radiography Using Lumbar Spine Phantom

Authors: Elhussaien Elshiekh

Abstract:

A study was performed to management and compare radiation doses and image quality during Lumbar spine PA and Lumbar spine LAT, x- ray radiography using Computed Radiography (CR) and Digital Radiography (DR). Standard exposure factors such as kV, mAs and FFD used for imaging the Lumbar spine anthropomorphic phantom obtained from average exposure factors that were used with CR in five radiology centres. Lumbar spine phantom was imaged using CR and DR systems. Entrance surface air kerma (ESAK) was calculated X-ray tube output and patient exposure factor. Images were evaluated using visual grading system based on the European Guidelines on Quality Criteria for diagnostic radiographic images. The ESAK corresponding to each image was measured at the surface of the phantom. Six experienced specialists evaluated hard copies of all the images, the image score (IS) was calculated for each image by finding the average score of the Six evaluators. The IS value also was used to determine whether an image was diagnostically acceptable. The optimum recommended exposure factors founded here for Lumbar spine PA and Lumbar spine LAT, with respectively (80 kVp,25 mAs at 100 cm FFD) and (75 kVp,15 mAs at 100 cm FFD) for CR system, and (80 kVp,15 mAs at100 cm FFD) and (75 kVp,10 mAs at 100 cm FFD) for DR system. For Lumbar spine PA, the lowest ESAK value required to obtain a diagnostically acceptable image were 0.80 mGy for DR and 1.20 mGy for CR systems. Similarly for Lumbar spine LAT projection, the lowest ESAK values to obtain a diagnostically acceptable image were 0.62 mGy for DR and 0.76 mGy for CR systems. At standard kVp and mAs values, the image quality did not vary significantly between the CR and the DR system, but at higher kVp and mAs values, the DR images were found to be of better quality than CR images. In addition, the lower limit of entrance skin dose consistent with diagnostically acceptable DR images was 40% lower than that for CR images.

Keywords: image quality, dosimetry, radiation protection, optimization, digital radiography, computed radiography

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17767 The Effect of Leadership Style on Employee Engagement in Ethiopian Airlines

Authors: Mahlet Nigussie Worku

Abstract:

The main purpose of this study was to examine the effects of different leadership styles on employee engagement in Ethiopian Airlines headquarters located in Addis Ababa. Specific objectives of the study were stated to examine the effects of five leadership styles, namely transformational, transactional, democratic, lassies fair and autocratic leadership styles on employees’ engagement. The study was conducted on 288 sample sizes, and a simple random sampling technique was employed. The quantitative findings were presented and analyzed by table, ANOVA, bivariate correlation and regression model through SPSS software version 23. Out of 288 total distributed questionnaires, 280 were returned, and 8 of the returned were rejected due to missing data, while the remaining 280 responses were used for data analysis. Data was analyzed using the Statistical Package for Social Sciences (SPSS). The study employed both descriptive and explanatory research design. Correlation and regression were used to analyze the relationship and its effect between leadership Style and employee engagement. The regression results showed that transformational, transactional and democratic leadership Styles have significant contributions to employee engagement. Similarly, the transformational, transactional land democratic leadership style had a positive and strong correlation with employee engagement. However, lassies-fair and autocratic leadership styles showed a negative and insignificant effect on employee engagement. Finally, based on the findings, workable recommendations and implications for further studies were forwarded.

Keywords: leadership, autocratic leadership style, democratic leadership style, employee engagement

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17766 Perspectives and Challenges Functional Bread with Yeast Extract to Improve Human Diet

Authors: Jelena Filipović, Milenko Košutić, Vladimir Filipović

Abstract:

In the last decades, the urban population has been characterized by sedentary lifestyles, low physical activity, and "fast food". These changes in diet and physical nonactivity have been associated with an increase in chronic diseases. Bread is one of the most popular wheat products consumed worldwide. Spelt wheat has shown potential in various food applications, including bread, pasta, breakfast cereal, and other products of altered nutritional characteristics compared to conventional wheat products. It has very high protein content and even 30 to 60% higher concentration of mineral elements Fe, Zn, Cu, Mg and P compared to Triticum Aestivum. Spelt wheat is growing without the use of pesticides in harsh ecological conditions and it is an old cultivar. So it can be used for organic and health-safe food. Changes in the formulation of bread with the aim of improving its nutritional and functional properties usually lead to changes in the dough's properties, which are related to the quality of the finished product. The aim of this paper is to research the impact of adding yeast extract to bread on sensory characteristics and consumer acceptance of a new product as a key factor for the successful marketing of a distinct product. The sensory analysis of bread with 5% yeast extract is as follows: the technological quality is very good (3.8), and the color of the product is excellent (4.85). Based on data, consumers' survey declared that they liked the taste of bread with 5% yeast extract (74%), consumers marked the product as likable (70%), and 75% of the total number of respondents would buy this new product. This paper is promoting a type of bread with 5% yeast extract (Z score 0.80) to improve diet and a product intended for consumers conscious about their health and diet.

Keywords: bread, yeast extract, sensory analysis, consumer survey, score analysis

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17765 A Model for Solid Transportation Problem with Three Hierarchical Objectives under Uncertain Environment

Authors: Wajahat Ali, Shakeel Javaid

Abstract:

In this study, we have developed a mathematical programming model for a solid transportation problem with three objective functions arranged in hierarchical order. The mathematical programming models with more than one objective function to be solved in hierarchical order is termed as a multi-level programming model. Our study explores a Multi-Level Solid Transportation Problem with Uncertain Parameters (MLSTPWU). The proposed MLSTPWU model consists of three objective functions, viz. minimization of transportation cost, minimization of total transportation time, and minimization of deterioration during transportation. These three objective functions are supposed to be solved by decision-makers at three consecutive levels. Three constraint functions are added to the model, restricting the total availability, total demand, and capacity of modes of transportation. All the parameters involved in the model are assumed to be uncertain in nature. A solution method based on fuzzy logic is also discussed to obtain the compromise solution for the proposed model. Further, a simulated numerical example is discussed to establish the efficiency and applicability of the proposed model.

Keywords: solid transportation problem, multi-level programming, uncertain variable, uncertain environment

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17764 Experimental and Numerical Analyses of Tehran Research Reactor

Authors: A. Lashkari, H. Khalafi, H. Khazeminejad, S. Khakshourniya

Abstract:

In this paper, a numerical model is presented. The model is used to analyze a steady state thermo-hydraulic and reactivity insertion transient in TRR reference cores respectively. The model predictions are compared with the experiments and PARET code results. The model uses the piecewise constant and lumped parameter methods for the coupled point kinetics and thermal-hydraulics modules respectively. The advantages of the piecewise constant method are simplicity, efficiency and accuracy. A main criterion on the applicability range of this model is that the exit coolant temperature remains below the saturation temperature, i.e. no bulk boiling occurs in the core. The calculation values of power and coolant temperature, in steady state and positive reactivity insertion scenario, are in good agreement with the experiment values. However, the model is a useful tool for the transient analysis of most research reactor encountered in practice. The main objective of this work is using simple calculation methods and benchmarking them with experimental data. This model can be used for training proposes.

Keywords: thermal-hydraulic, research reactor, reactivity insertion, numerical modeling

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17763 Modeling Stream Flow with Prediction Uncertainty by Using SWAT Hydrologic and RBNN Neural Network Models for Agricultural Watershed in India

Authors: Ajai Singh

Abstract:

Simulation of hydrological processes at the watershed outlet through modelling approach is essential for proper planning and implementation of appropriate soil conservation measures in Damodar Barakar catchment, Hazaribagh, India where soil erosion is a dominant problem. This study quantifies the parametric uncertainty involved in simulation of stream flow using Soil and Water Assessment Tool (SWAT), a watershed scale model and Radial Basis Neural Network (RBNN), an artificial neural network model. Both the models were calibrated and validated based on measured stream flow and quantification of the uncertainty in SWAT model output was assessed using ‘‘Sequential Uncertainty Fitting Algorithm’’ (SUFI-2). Though both the model predicted satisfactorily, but RBNN model performed better than SWAT with R2 and NSE values of 0.92 and 0.92 during training, and 0.71 and 0.70 during validation period, respectively. Comparison of the results of the two models also indicates a wider prediction interval for the results of the SWAT model. The values of P-factor related to each model shows that the percentage of observed stream flow values bracketed by the 95PPU in the RBNN model as 91% is higher than the P-factor in SWAT as 87%. In other words the RBNN model estimates the stream flow values more accurately and with less uncertainty. It could be stated that RBNN model based on simple input could be used for estimation of monthly stream flow, missing data, and testing the accuracy and performance of other models.

Keywords: SWAT, RBNN, SUFI 2, bootstrap technique, stream flow, simulation

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17762 Sliding Mode Control of a Bus Suspension System

Authors: Mujde Turkkan, Nurkan Yagiz

Abstract:

The vibrations, caused by the irregularities of the road surface, are to be suppressed via suspension systems. In this paper, sliding mode control for a half bus model with air suspension system is presented. The bus is modelled as five degrees of freedom (DoF) system. The mathematical model of the half bus is developed using Lagrange Equations. For time domain analysis, the bus model is assumed to travel at certain speed over the bump road. The numerical results of the analysis indicate that the sliding mode controllers can be effectively used to suppress the vibrations and to improve the ride comfort of the busses.

Keywords: active suspension system, air suspension, bus model, sliding mode control

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17761 A Novel Approach of NPSO on Flexible Logistic (S-Shaped) Model for Software Reliability Prediction

Authors: Pooja Rani, G. S. Mahapatra, S. K. Pandey

Abstract:

In this paper, we propose a novel approach of Neural Network and Particle Swarm Optimization methods for software reliability prediction. We first explain how to apply compound function in neural network so that we can derive a Flexible Logistic (S-shaped) Growth Curve (FLGC) model. This model mathematically represents software failure as a random process and can be used to evaluate software development status during testing. To avoid trapping in local minima, we have applied Particle Swarm Optimization method to train proposed model using failure test data sets. We drive our proposed model using computational based intelligence modeling. Thus, proposed model becomes Neuro-Particle Swarm Optimization (NPSO) model. We do test result with different inertia weight to update particle and update velocity. We obtain result based on best inertia weight compare along with Personal based oriented PSO (pPSO) help to choose local best in network neighborhood. The applicability of proposed model is demonstrated through real time test data failure set. The results obtained from experiments show that the proposed model has a fairly accurate prediction capability in software reliability.

Keywords: software reliability, flexible logistic growth curve model, software cumulative failure prediction, neural network, particle swarm optimization

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17760 The Relationship between Land Use Factors and Feeling of Happiness at the Neighbourhood Level

Authors: M. Moeinaddini, Z. Asadi-Shekari, Z. Sultan, M. Zaly Shah

Abstract:

Happiness can be related to everything that can provide a feeling of satisfaction or pleasure. This study tries to consider the relationship between land use factors and feeling of happiness at the neighbourhood level. Land use variables (beautiful and attractive neighbourhood design, availability and quality of shopping centres, sufficient recreational spaces and facilities, and sufficient daily service centres) are used as independent variables and the happiness score is used as the dependent variable in this study. In addition to the land use variables, socio-economic factors (gender, race, marital status, employment status, education, and income) are also considered as independent variables. This study uses the Oxford happiness questionnaire to estimate happiness score of more than 300 people living in six neighbourhoods. The neighbourhoods are selected randomly from Skudai neighbourhoods in Johor, Malaysia. The land use data were obtained by adding related questions to the Oxford happiness questionnaire. The strength of the relationship in this study is found using generalised linear modelling (GLM). The findings of this research indicate that increase in happiness feeling is correlated with an increasing income, more beautiful and attractive neighbourhood design, sufficient shopping centres, recreational spaces, and daily service centres. The results show that all land use factors in this study have significant relationship with happiness but only income, among socio-economic factors, can affect happiness significantly. Therefore, land use factors can affect happiness in Skudai more than socio-economic factors.

Keywords: neighbourhood land use, neighbourhood design, happiness, socio-economic factors, generalised linear modelling

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17759 How to Applicate Knowledge Management in Security Environment within the Scope of Optimum Balance Model

Authors: Hakan Erol, Altan Elibol, Ömer Eryılmaz, Mehmet Şimşek

Abstract:

Organizations aim to manage information in a most possible effective way for sustainment and development. In doing so, they apply various procedures and methods. The very same situation is valid for each service of Armed Forces. During long-lasting endeavors such as shaping and maintaining security environment, supporting and securing peace, knowledge management is a crucial asset. Optimum Balance Model aims to promote the system from a decisive point to a higher decisive point. In this context, this paper analyses the application of optimum balance model to knowledge management in Armed Forces and tries to find answer to the question how Optimum Balance Model is integrated in knowledge management.

Keywords: optimum balance model, knowledge management, security environment, supporting peace

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17758 A Sustainable Design Model by Integrated Evaluation of Closed-loop Design and Supply Chain Using a Mathematical Model

Authors: Yuan-Jye Tseng, Yi-Shiuan Chen

Abstract:

The paper presented a sustainable design model for integrated evaluation of the design and supply chain of a product for the sustainable objectives. To design a product, there can be alternative ways to assign the detailed specifications to fulfill the same design objectives. In the design alternative cases, different material and manufacturing processes with various supply chain activities may be required for the production. Therefore, it is required to evaluate the different design cases based on the sustainable objectives. In this research, a closed-loop design model is developed by integrating the forward design model and reverse design model. From the supply chain point of view, the decisions in the forward design model are connected with the forward supply chain. The decisions in the reverse design model are connected with the reverse supply chain considering the sustainable objectives. The purpose of this research is to develop a mathematical model for analyzing the design cases by integrated evaluating the criteria in the closed-loop design and the closed-loop supply chain. The decision variables are built to represent the design cases of the forward design and reverse design. The cost parameters in a forward design include the costs of material and manufacturing processes. The cost parameters in a reverse design include the costs of recycling, disassembly, reusing, remanufacturing, and disposing. The mathematical model is formulated to minimize the total cost under the design constraints. In practical applications, the decisions of the mathematical model can be used for selecting a design case for the purpose of sustainable design of a product. An example product is demonstrated in the paper. The test result shows that the sustainable design model is useful for integrated evaluation of the design and the supply chain to achieve the sustainable objectives.

Keywords: closed-loop design, closed-loop supply chain, design evaluation, supply chain management, sustainable design model

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17757 Finite Element Modeling of Stockbridge Damper and Vibration Analysis: Equivalent Cable Stiffness

Authors: Nitish Kumar Vaja, Oumar Barry, Brian DeJong

Abstract:

Aeolian vibrations are the major cause for the failure of conductor cables. Using a Stockbridge damper reduces these vibrations and increases the life span of the conductor cable. Designing an efficient Stockbridge damper that suits the conductor cable requires a robust mathematical model with minimum assumptions. However it is not easy to analytically model the complex geometry of the messenger. Therefore an equivalent stiffness must be determined so that it can be used in the analytical model. This paper examines the bending stiffness of the cable and discusses the effect of this stiffness on the natural frequencies. The obtained equivalent stiffness compensates for the assumption of modeling the messenger as a rod. The results from the free vibration analysis of the analytical model with the equivalent stiffness is validated using the full scale finite element model of the Stockbridge damper.

Keywords: equivalent stiffness, finite element model, free vibration response, Stockbridge damper

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17756 Partnering With Key Stakeholders for Successful Implementation of Inhaled Analgesia for Specific Emergency Department Presentations

Authors: Sarah Hazelwood, Janice Hay

Abstract:

Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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17755 Port Governance Model by International Freight Forwarders’ Point of View: A Study at Port of Santos - Brazil

Authors: Guilherme B. B. Vieira, Rafael M. da Silva, Eliana T. P. Senna, Luiz A. S. Senna, Francisco J. Kliemann Neto

Abstract:

Due to the importance of ports to trade and economic development of the regions in which they are inserted, in recent decades the number of studies devoted to this subject has increased. Part of these studies consider the ports as business agglomerations and focuses on port governance. This is an important approach since the port performance is the result of activities performed by actors belonging to the port-logistics chain, which need to be properly coordinated. This coordination takes place through a port governance model. Given this context, this study aims to analyze the governance model of the port of Santos from the perspective of port customers. To do this, a closed-ended questionnaire based on a conceptual model that considers the key dimensions associated with port governance was applied to the international freight forwarders that operate in the port. The results show the applicability of the considered model and highlight improvement opportunities to be implemented at the port of Santos.

Keywords: port governance, model, Port of Santos, customers’ perception

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17754 OnabotulinumtoxinA Injection for Glabellar Frown Lines as an Adjunctive Treatment for Depression

Authors: I. Witbooi, J. De Smidt, A. Oelofse

Abstract:

Negative emotions that are common in depression are coupled with the activation of the corrugator supercilli and procerus muscles in the glabellar region of the face. This research investigated the impact of OnabotulinumtoxinA (BOTOX) in the improvement of emotional states in depressed subjects by relaxing the mentioned muscles. The aim of the study was to investigate the effectiveness of BOTOX treatment for glabellar frown lines as an adjunctive therapy for Major Depressive Disorder (MDD) and to improve the quality of life and self-esteem of the subjects. It is hypothesized that BOTOX treatment for glabellar frown lines reduces depressive symptoms significantly and therefore augment conventional antidepressant medication. Forty-five (45) subjects diagnosed with MDD were assigned to a treatment (n = 15), placebo (n = 15), and control (n = 15) group. The treatment group received BOTOX injection, while the placebo group received saline injection into the Procerus and Corrugator supercilli muscles with follow-up visits every 3 weeks (weeks 3, 6 and 12 respectively). The control group received neither BOTOX nor saline injections and were only interviewed again on the 12th week. To evaluate the effect of BOTOX treatment in the glabellar region on depressive symptoms, the Montgomery-Asberg Depression Rating (MADRS) scale and the Beck Depression Inventory (BDI) were used. The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Rosenberg Self-Esteem Scale (RSES) were used in the assessment of self-esteem and quality of life. Participants were followed up for a 12 week period. The expected primary outcome measure is the response to treatment, and it is defined as a ≥ 50% reduction in MADRS score from baseline. Other outcome measures include a clinically significant decrease in BDI scores and the increase in quality of life and self-esteem respectively. Initial results show a clear trend towards such differences. Results showed trends towards expected differences. Patients in the Botox group had a mean MADRS score of 14.0 at 3 weeks compared to 20.3 of the placebo group. This trend was still visible at 6 weeks with the Botox and placebo group scoring an average of 10 vs. 18 respectively. The mean difference in MDRS scores from baseline to 3 weeks were 9.3 and 2.0 for the Botox and placebo group respectively. Similarly, the BDI scores were lower in the Botox group (17.25) compared to the placebo group (19.43). The two self-esteem questionnaires showed expected results at this stage with the RSES 19.1 in the Botox group compared to 18.6 in the placebo group. Similarly, the Botox patients had a higher score for the Q-LES-Q-SF of 49.2 compared to 46.1 for the placebo group. Conclusions: Initial results clearly demonstrated that the use of Botox had positive effects on both scores of depressions and that of self-esteem when compared to a placebo group.

Keywords: adjunctive therapy, depression, glabellar area, OnabotulinumtoxinA

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17753 The Effect Of Leadership Style On Employee Engagment In Ethiopian Airlines

Authors: Mahlet Nigussie Worku

Abstract:

The main purpose of this study was to examine the effects of different leadership styles on employee engagement in Ethiopian Airlines head quarter located in Addis Ababa. Specific objectives of the study were stated to examine the effects of five leadership styles namely transformational, transactional, democratic, lassies fair and autocratic leadership styles on employees’ engagement. The study was conducted on 288 sample size and a simple random sampling technique was employed. The quantitative findings were presented and analyzed by table, ANOVA, bivariate correlation and regression model through SPSS software version 23. Out of 288 total distributed questionnaires 280 were returned and 8 of the returned were rejected due to missing data while the remaining 280 responses were used for data analysis. Data was analyzed using the Statistical Package for Social Sciences (SPSS). The study employed both descriptive and explanatory research design. Correlation and regression were used to analyze the relationship and its effect between leadership Style and employee’s engagement. The regression results showed that transformational, transactional and democratic leadership Styles have significant contribution for employee’s engagement. Similarly transformational, transactional land democratic leadership style had a positive and strong correlation with employee’s engagement. However lassies-fair and autocratic leadership style showed negative and insignificant effect on employee engagement. Finally, based on the findings, workable recommendations and implications for further studies were forwarded

Keywords: leadership, leadership style, employee engagement, autocratic leadership styles

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17752 Operating Model of Obstructive Sleep Apnea Patients in North Karelia Central Hospital

Authors: L. Korpinen, T. Kava, I. Salmi

Abstract:

This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: sleep, apnea patient, operating model, hospital

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17751 Generating Music with More Refined Emotions

Authors: Shao-Di Feng, Von-Wun Soo

Abstract:

To generate symbolic music with specific emotions is a challenging task due to symbolic music datasets that have emotion labels are scarce and incomplete. This research aims to generate more refined emotions based on the training datasets that are only labeled with four quadrants in Russel’s 2D emotion model. We focus on the theory of Music Fadernet and map arousal and valence to the low-level attributes, and build a symbolic music generation model by combining transformer and GM-VAE. We adopt an in-attention mechanism for the model and improve it by allowing modulation by conditional information. And we show the music generation model could control the generation of music according to the emotions specified by users in terms of high-level linguistic expression and by manipulating their corresponding low-level musical attributes. Finally, we evaluate the model performance using a pre-trained emotion classifier against a pop piano midi dataset called EMOPIA, and by subjective listening evaluation, we demonstrate that the model could generate music with more refined emotions correctly.

Keywords: music generation, music emotion controlling, deep learning, semi-supervised learning

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17750 Active Flutter Suppression of Sports Aircraft Tailplane by Supplementary Control Surface

Authors: Aleš Kratochvíl, Svatomír Slavík

Abstract:

The paper presents an aircraft flutter suppression by active damping of supplementary control surface at trailing edge. The mathematical model of thin oscillation airfoil with control surface driven by pilot is developed. The supplementary control surface driven by control law is added. Active damping of flutter by several control law is present. The structural model of tailplane with an aerodynamic strip theory based on the airfoil model is developed by a finite element method. The optimization process of stiffens parameters is carried out to match the structural model with results from a ground vibration test of a small sport airplane. The implementation of supplementary control surface driven by control law is present. The active damping of tailplane model is shown.

Keywords: active damping, finite element method, flutter, tailplane model

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17749 Generic Model for Timetabling Problems by Integer Linear Programmimg Approach

Authors: Nur Aidya Hanum Aizam, Vikneswary Uvaraja

Abstract:

The agenda of showing the scheduled time for performing certain tasks is known as timetabling. It widely used in many departments such as transportation, education, and production. Some difficulties arise to ensure all tasks happen in the time and place allocated. Therefore, many researchers invented various programming model to solve the scheduling problems from several fields. However, the studies in developing the general integer programming model for many timetabling problems are still questionable. Meanwhile, this thesis describe about creating a general model which solve different types of timetabling problems by considering the basic constraints. Initially, the common basic constraints from five different fields are selected and analyzed. A general basic integer programming model was created and then verified by using the medium set of data obtained randomly which is much similar to realistic data. The mathematical software, AIMMS with CPLEX as a solver has been used to solve the model. The model obtained is significant in solving many timetabling problems easily since it is modifiable to all types of scheduling problems which have same basic constraints.

Keywords: AIMMS mathematical software, integer linear programming, scheduling problems, timetabling

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17748 Integrating Knowledge Distillation of Multiple Strategies

Authors: Min Jindong, Wang Mingxia

Abstract:

With the widespread use of artificial intelligence in life, computer vision, especially deep convolutional neural network models, has developed rapidly. With the increase of the complexity of the real visual target detection task and the improvement of the recognition accuracy, the target detection network model is also very large. The huge deep neural network model is not conducive to deployment on edge devices with limited resources, and the timeliness of network model inference is poor. In this paper, knowledge distillation is used to compress the huge and complex deep neural network model, and the knowledge contained in the complex network model is comprehensively transferred to another lightweight network model. Different from traditional knowledge distillation methods, we propose a novel knowledge distillation that incorporates multi-faceted features, called M-KD. In this paper, when training and optimizing the deep neural network model for target detection, the knowledge of the soft target output of the teacher network in knowledge distillation, the relationship between the layers of the teacher network and the feature attention map of the hidden layer of the teacher network are transferred to the student network as all knowledge. in the model. At the same time, we also introduce an intermediate transition layer, that is, an intermediate guidance layer, between the teacher network and the student network to make up for the huge difference between the teacher network and the student network. Finally, this paper adds an exploration module to the traditional knowledge distillation teacher-student network model. The student network model not only inherits the knowledge of the teacher network but also explores some new knowledge and characteristics. Comprehensive experiments in this paper using different distillation parameter configurations across multiple datasets and convolutional neural network models demonstrate that our proposed new network model achieves substantial improvements in speed and accuracy performance.

Keywords: object detection, knowledge distillation, convolutional network, model compression

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17747 Effects of Research-Based Blended Learning Model Using Adaptive Scaffolding to Enhance Graduate Students' Research Competency and Analytical Thinking Skills

Authors: Panita Wannapiroon, Prachyanun Nilsook

Abstract:

This paper is a report on the findings of a Research and Development (R&D) aiming to develop the model of Research-Based Blended Learning Model Using Adaptive Scaffolding (RBBL-AS) to enhance graduate students’ research competency and analytical thinking skills, to study the result of using such model. The sample consisted of 10 experts in the fields during the model developing stage, while there were 23 graduate students of KMUTNB for the RBBL-AS model try out stage. The research procedures included 4 phases: 1) literature review, 2) model development, 3) model experiment, and 4) model revision and confirmation. The research results were divided into 3 parts according to the procedures as described in the following session. First, the data gathering from the literature review were reported as a draft model; followed by the research finding from the experts’ interviews indicated that the model should be included 8 components to enhance graduate students’ research competency and analytical thinking skills. The 8 components were 1) cloud learning environment, 2) Ubiquitous Cloud Learning Management System (UCLMS), 3) learning courseware, 4) learning resources, 5) adaptive Scaffolding, 6) communication and collaboration tolls, 7) learning assessment, and 8) research-based blended learning activity. Second, the research finding from the experimental stage found that there were statistically significant difference of the research competency and analytical thinking skills posttest scores over the pretest scores at the .05 level. The Graduate students agreed that learning with the RBBL-AS model was at a high level of satisfaction. Third, according to the finding from the experimental stage and the comments from the experts, the developed model was revised and proposed in the report for further implication and references.

Keywords: research based learning, blended learning, adaptive scaffolding, research competency, analytical thinking skills

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17746 Investigation on Machine Tools Energy Consumptions

Authors: Shiva Abdoli, Daniel T.Semere

Abstract:

Several researches have been conducted to study consumption of energy in cutting process. Most of these researches are focusing to measure the consumption and propose consumption reduction methods. In this work, the relation between the cutting parameters and the consumption is investigated in order to establish a generalized energy consumption model that can be used for process and production planning in real production lines. Using the generalized model, the process planning will be carried out by taking into account the energy as a function of the selected process parameters. Similarly, the generalized model can be used in production planning to select the right operational parameters like batch sizes, routing, buffer size, etc. in a production line. The description and derivation of the model as well as a case study are given in this paper to illustrate the applicability and validity of the model.

Keywords: process parameters, cutting process, energy efficiency, Material Removal Rate (MRR)

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17745 Development of EREC IF Model to Increase Critical Thinking and Creativity Skills of Undergraduate Nursing Students

Authors: Kamolrat Turner, Boontuan Wattanakul

Abstract:

Critical thinking and creativity are prerequisite skills for working professionals in the 21st century. A survey conducted in 2014 at the Boromarajonani College of Nursing, Chon Buri, Thailand, revealed that these skills within students across all academic years was at a low to moderate level. An action research study was conducted to develop the EREC IF Model, a framework which includes the concepts of experience, reflection, engagement, culture and language, ICT, and flexibility and fun, to guide pedagogic activities for 75 sophomores of the undergraduate nursing science program at the college. The model was applied to all professional nursing courses. Prior to implementation, workshops were held to prepare lecturers and students. Both lecturers and students initially expressed their discomfort and pointed to the difficulties with the model. However, later they felt more comfortable, and by the end of the project they expressed their understanding and appreciation of the model. A survey conducted four and eight months after implementation found that the critical thinking and creativity skills of the sophomores were significantly higher than those recorded in the pretest. It could be concluded that the EREC IF model is efficient for fostering critical thinking and creativity skills in the undergraduate nursing science program. This model should be used for other levels of students.

Keywords: critical thinking, creativity, undergraduate nursing students, EREC IF model

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