Search results for: medication therapy management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11204

Search results for: medication therapy management

9914 Greenlight Laser Prostatectomy: A Safe and Effective Day Case Option for Bladder Outlet Obstruction in the Elderly Population

Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal

Abstract:

Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.

Keywords: urology, endourology, prostate, bladder outlet obstruction, laser

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9913 A Comparative Study of Granisetron and Palonosetron in Postoperative Nausea and Vomiting Following Laparoscopic Surgery

Authors: Burra Vijitha

Abstract:

A prospective randomized comparative study for the prevention of postoperative nausea and vomiting in the patients undergoing general anesthesia ,for elective laparoscopic surgeries with respect to efficacy and side effects of granisetron and palonosetron. Sixty adult patients of class ASA 1,2 of either sex in age group between 20-70 yrs,scheduled for elective laparoscopic surgeries were selected for the study.Patients were randomly divided into two groups 30 each. Group G: Granisetron group (n=30), 40µg/kg; Group P: Palonosetron group (n=30), 0.075 mg. at end of surgery before extubation group G patients 40 µg/kg of inj.granisetron and group P patients received 0.075 mg of inj.palonosetron slow iv over 30 sec.In post anesthesia care unit, episodes of nausea and vomiting experienced by each patient was recorded by direct questioning the patient .study medication was assessed in terms of incidence of nausea and vomiting during periods of 0-4 hrs,4-12 hrs,12-24 hrs,24-48hrs.our study demonstrated that complete response for those patients who received granisetron were 86.66%,80% and 66.66% ,while those received palonosetron were 100%,86.6%,90% between 0-4hrs,4-12hrs,12-24 hrs. It shows no statistically signidficant differences between the baseline values of hemodynamic variables beween two groups during study. Keywords: Granisetron, nausea, palonosetron, vomiting.

Keywords: granisetron, palonosetron, nausea, vomiting

Procedia PDF Downloads 225
9912 A Universal Approach to Categorize Failures in Production

Authors: Konja Knüppel, Gerrit Meyer, Peter Nyhuis

Abstract:

The increasing interconnectedness and complexity of production processes raise the susceptibility of production systems to failure. Therefore, the ability to respond quickly to failures is increasingly becoming a competitive factor. The research project "Sustainable failure management in manufacturing SMEs" is developing a methodology to identify failures in the production and select preventive and reactive measures in order to correct failures and to establish sustainable failure management systems.

Keywords: failure categorization, failure management, logistic performance, production optimization

Procedia PDF Downloads 361
9911 Factors Affecting Cost Efficiency of Municipal Waste Services in Tuscan Municipalities: An Empirical Investigation by Accounting for Different Management

Authors: María Molinos-Senante, Giulia Romano

Abstract:

This paper aims at investigating the effect of ownership in the efficiency assessment of municipal solid waste management. In doing so, the Data Envelopment Analysis meta-frontier approach integrating unsorted waste as undesirable output was applied. Three different clusters of municipalities have been created on the basis of the ownership type of municipal waste operators. In the second stage of analysis, the paper investigates factors affecting efficiency, in order to provide an outlook of levers to be used by policy and decision makers to improve efficiency, taking into account different management models in force. Results show that public waste management firms have better performance than mixed and private ones since their efficiency scores are significantly larger. Moreover, it has been demonstrated that the efficiency of waste management firms is statistically influenced by the age of population, population served, municipal size, population density and tourism rate. It evidences the importance of economies of scale on the cost efficiency of waste management. This issue is relevant for policymakers to define and implement policies aimed to improve the long-term sustainability of waste management in municipalities.

Keywords: data envelopment analysis, efficiency, municipal solid waste, ownership, undesirable output

Procedia PDF Downloads 145
9910 Investigating Role of Traumatic Events in a Pakistani Sample

Authors: Khadeeja Munawar, Shamsul Haque

Abstract:

The claim that traumatic events influence the recalled memories and mental health has received mixed empirical support. This study examines the memories of a sample drawn from Pakistan, a country that has witnessed many life-changing socio-political events, wars, and natural disasters in 72 years of its history. A sample of 210 senior citizens (Mage = 64.35, SD = 6.33) was recruited from Pakistan. The aim was to investigate if participants retrieved more memories related to past traumatic events using a word-cueing technique. Each participant reported ten memories to ten neutral cue words. The results revealed that past traumatic events were not adversely affecting the memories and mental health of participants. When memories were plotted with respect to the ages at which the events happened, a pronounced bump at 11-20 years of age was seen. Memories within as well as outside of the bump were mostly positive. The multilevel logistic regression modelling showed that the memories recalled were personally important and played a role in enhancing resilience. The findings revealed that despite facing an array of ethnic, religious, political, economic, and social conflicts, the participants were resilient, recalled predominantly positive memories, and had intact mental health. The findings have clinical implications in Cognitive Behavioral Therapy (CBT). The patients can be made aware of their negative emotions, troublesome/traumatic memories, and the distorted thinking patterns and their memories can be restructured. The findings can also be used to teach Memory Specificity Training (MEST) by psycho-educating the patients around changes in memory functioning and enhancing the recall of memories, which are more specific, vivid, and filled with sensory details.

Keywords: cognitive behavioral therapy, memories, mental health, resilience, trauma

Procedia PDF Downloads 136
9909 Prediction of Super-Response to Cardiac Resynchronisation Therapy

Authors: Vadim A. Kuznetsov, Anna M. Soldatova, Tatyana N. Enina, Elena A. Gorbatenko, Dmitrii V. Krinochkin

Abstract:

The aim of the study was to evaluate potential parameters related with super-response to CRT. Methods: 60 CRT patients (mean age 54.3 ± 9.8 years; 80% men) with congestive heart failure (CHF) II-IV NYHA functional class, left ventricular ejection fraction < 35% were enrolled. At baseline, 1 month, 3 months and each 6 months after implantation clinical, electrocardiographic and echocardiographic parameters, NT-proBNP level were evaluated. According to the best decrease of left ventricular end-systolic volume (LVESV) (mean follow-up period 33.7 ± 15.1 months) patients were classified as super-responders (SR) (n=28; reduction in LVESV ≥ 30%) and non-SR (n=32; reduction in LVESV < 30%). Results: At baseline groups differed in age (58.1 ± 5.8 years in SR vs 50.8 ± 11.4 years in non-SR; p=0.003), gender (female gender 32.1% vs 9.4% respectively; p=0.028), width of QRS complex (157.6 ± 40.6 ms in SR vs 137.6 ± 33.9 ms in non-SR; p=0.044). Percentage of LBBB was equal between groups (75% in SR vs 59.4% in non-SR; p=0.274). All parameters of mechanical dyssynchrony were higher in SR, but only difference in left ventricular pre-ejection period (LVPEP) was statistically significant (153.0 ± 35.9 ms vs. 129.3 ± 28.7 ms p=0.032). NT-proBNP level was lower in SR (1581 ± 1369 pg/ml vs 3024 ± 2431 pg/ml; p=0.006). The survival rates were 100% in SR and 90.6% in non-SR (log-rank test P=0.002). Multiple logistic regression analysis showed that LVPEP (HR 1.024; 95% CI 1.004–1.044; P = 0.017), baseline NT-proBNP level (HR 0.628; 95% CI 0.414–0.953; P=0.029) and age at baseline (HR 1.094; 95% CI 1.009-1.168; P=0.30) were independent predictors for CRT super-response. ROC curve analysis demonstrated sensitivity 71.9% and specificity 82.1% (AUC=0.827; p < 0.001) of this model in prediction of super-response to CRT. Conclusion: Super-response to CRT is associated with better survival in long-term period. Presence of LBBB was not associated with super-response. LVPEP, NT-proBNP level, and age at baseline can be used as independent predictors of CRT super-response.

Keywords: cardiac resynchronisation therapy, superresponse, congestive heart failure, left bundle branch block

Procedia PDF Downloads 381
9908 Role of Senior Management in Implementing Lean Manufacturing Practices: A Study of Manufacturing Companies of Pakistan

Authors: Saima Yaqoob

Abstract:

Due to advancement in technologies and cutting cost competition, especially in manufacturing business, organizations are now becoming more focused toward achieving exceptional quality standards with low manufacturing cost. In this concern, many process improvement strategies are becoming popular in the way of increasing productivity and output. Lean manufacturing principles are among one of them, increasingly used for improving productivity by reducing wastages. Many success factors are involved in lean implementation. But, the role of senior management is most important in developing the lean culture in an organization. Purpose of this study is to investigate the perception of executive level management related to the successful implementation of lean practices and its comparison with the existing practices in the organization. In order to collect data, survey questionnaire comprised of eight statements rendering the critical success factors were sent to the top management of fifty (50) automotive manufacturing companies of Karachi. After analyzing their feedbacks, the trend of lean manufacturing principles and the commitment of senior management toward its implementation was identified in the manufacturing industries of Karachi, Pakistan.

Keywords: lean manufacturing, process improvement, senior management, perception, involvement, waste reduction

Procedia PDF Downloads 178
9907 An Overview of Structure Based Activity Outcomes of Pyran Derivatives Against Alzheimer’s Disease

Authors: Faisal Almalki

Abstract:

Pyran is a heterocyclic group containing oxygen that possesses a variety of pharmacological effects. Pyran is also one of the most prevalent structural subunits in natural products, such as xanthones, coumarins, flavonoids, benzopyrans, etc. Additionally demonstrating the neuroprotective properties of pyrans is the fact that this heterocycle has recently attracted the attention of scientists worldwide. Alzheimer's Disease (AD) treatment and diagnosis are two of the most critical research objectives worldwide. Increased amounts of extracellular senile plaques, intracellular neurofibrillary tangles, and a progressive shutdown of cholinergic basal forebrain neuron transmission are often related with cognitive impairment. This review highlights the various pyran scaffolds of natural and synthetic origin that are effective in the treatment of AD. For better understanding synthetic compounds are categorized as different types of pyran derivatives like chromene, flavone, xanthone, xanthene, etc. The discussion encompasses both the structure-activity correlations of these compounds as well as their activity against AD. Because of the intriguing actions that were uncovered by these pyran-based scaffolds, there is no question that they are at the forefront of the search for potential medication candidates that could treat Alzheimer's disease.

Keywords: alzheimer’s disease, pyran, coumarin, xanthone

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9906 Architectural Building Safety and Health Performance Model for Stratified Low-Cost Housing: Education and Management Tool for Building Managers

Authors: Zainal Abidin Akasah, Maizam Alias, Azuin Ramli

Abstract:

The safety and health performances aspects of a building are the most challenging aspect of facility management. It requires a deep understanding by the building managers on the factors that contribute to health and safety performances. This study attempted to develop an explanatory architectural safety performance model for stratified low-cost housing in Malaysia. The proposed Building Safety and Health Performance (BSHP) model was tested empirically through a survey on 308 construction practitioners using Partial Least Squares (PLS) and Structural Equation Modelling (SEM) tool. Statistical analysis results supports the conclusion that architecture, building services, external environment, management approaches and maintenance management have positive influence on safety and health performance of stratified low-cost housing in Malaysia. The findings provide valuable insights for construction industry to introduce BSHP model in the future where the model could be used as a guideline for training purposes of managers and better planning and implementation of building management.

Keywords: building management, stratified low-cost housing, safety, health model

Procedia PDF Downloads 543
9905 GIS Based Project Management Information System for Infrastructure Projects

Authors: Riki Panchal, Debasis Sarkar

Abstract:

This paper describes the work done for the GIS-based project management for different infrastructure projects. It is a review paper which gives the idea of the trends in the construction project management and various models adopted for the betterment of the project planning and execution. Traditional scheduling and progress control techniques such as bar charts and the critical path method fail to provide information pertaining to the spatial aspects of a construction project. An integrated system was developed to represent construction progress not only in terms of a CPM schedule but also in terms of a graphical representation of the construction that is synchronized with the work schedule. Hence, it is suggested to work on the common platform from where all the data can be shared and analyzed.

Keywords: GIS, project management, integrated model, infrastructure project

Procedia PDF Downloads 506
9904 Role of Speech Articulation in English Language Learning

Authors: Khadija Rafi, Neha Jamil, Laiba Khalid, Meerub Nawaz, Mahwish Farooq

Abstract:

Speech articulation is a complex process to produce intelligible sounds with the help of precise movements of various structures within the vocal tract. All these structures in the vocal tract are named as articulators, which comprise lips, teeth, tongue, and palate. These articulators work together to produce a range of distinct phonemes, which happen to be the basis of language. It starts with the airstream from the lungs passing through the trachea and into oral and nasal cavities. When the air passes through the mouth, the tongue and the muscles around it form such coordination it creates certain sounds. It can be seen when the tongue is placed in different positions- sometimes near the alveolar ridge, soft palate, roof of the mouth or the back of the teeth which end up creating unique qualities of each phoneme. We can articulate vowels with open vocal tracts, but the height and position of the tongue is different every time depending upon each vowel, while consonants can be pronounced when we create obstructions in the airflow. For instance, the alphabet ‘b’ is a plosive and can be produced only by briefly closing the lips. Articulation disorders can not only affect communication but can also be a hurdle in speech production. To improve articulation skills for such individuals, doctors often recommend speech therapy, which involves various kinds of exercises like jaw exercises and tongue twisters. However, this disorder is more common in children who are going through developmental articulation issues right after birth, but in adults, it can be caused by injury, neurological conditions, or other speech-related disorders. In short, speech articulation is an essential aspect of productive communication, which also includes coordination of the specific articulators to produce different intelligible sounds, which are a vital part of spoken language.

Keywords: linguistics, speech articulation, speech therapy, language learning

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9903 Application of Customer Relationship Management Systems in Business: Challenges and Opportunities

Authors: K. Liagkouras, K. Metaxiotis

Abstract:

Customer relationship management (CRM) systems in business are a reality of the contemporary business world for the last decade or so. Still, there are grey areas regarding the successful implementation and operation of CRM systems in business. This paper, through the systematic study of the CRM implementation paradigm, attempts to identify the most important challenges and opportunities that the CRM systems face in a rapidly changing business world.

Keywords: customer relationship management, CRM, business, literature review

Procedia PDF Downloads 499
9902 Successful Management of a Boy with Mild Persistent Asthma: A Longitudinal Case

Authors: A. Lubis, L. Setiawati, A. R. Setyoningrum, A. Suryawan, Irwanto

Abstract:

Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: asthma, chronic health problems, growth, development

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9901 The Rail Traffic Management with Usage of C-OTDR Monitoring Systems

Authors: Andrey V. Timofeev, Dmitry V. Egorov

Abstract:

This paper presents development results of usage of C-OTDR monitoring systems for rail traffic management. The C-OTDR method is based on vibrosensitive properties of optical fibers. Analysis of Rayleigh backscattering radiation parameters changes which take place due to microscopic seismoacoustic impacts on the optical fiber allows to determine seismoacoustic emission source positions and to identify their types. This approach proved successful for rail traffic management (moving block system, weigh- in-motion system etc).

Keywords: C-OTDR systems, moving block-sections, rail traffic management, Rayleigh backscattering, weigh-in-motion

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9900 An Infrared Inorganic Scintillating Detector Applied in Radiation Therapy

Authors: Sree Bash Chandra Debnath, Didier Tonneau, Carole Fauquet, Agnes Tallet, Julien Darreon

Abstract:

Purpose: Inorganic scintillating dosimetry is the most recent promising technique to solve several dosimetric issues and provide quality assurance in radiation therapy. Despite several advantages, the major issue of using scintillating detectors is the Cerenkov effect, typically induced in the visible emission range. In this context, the purpose of this research work is to evaluate the performance of a novel infrared inorganic scintillator detector (IR-ISD) in the radiation therapy treatment to ensure Cerenkov free signal and the best matches between the delivered and prescribed doses during treatment. Methods: A simple and small-scale infrared inorganic scintillating detector of 100 µm diameter with a sensitive scintillating volume of 2x10-6 mm3 was developed. A prototype of the dose verification system has been introduced based on PTIR1470/F (provided by Phosphor Technology®) material used in the proposed novel IR-ISD. The detector was tested on an Elekta LINAC system tuned at 6 MV/15MV and a brachytherapy source (Ir-192) used in the patient treatment protocol. The associated dose rate was measured in count rate (photons/s) using a highly sensitive photon counter (sensitivity ~20ph/s). Overall measurements were performed in IBATM water tank phantoms by following international Technical Reports series recommendations (TRS 381) for radiotherapy and TG43U1 recommendations for brachytherapy. The performance of the detector was tested through several dosimetric parameters such as PDD, beam profiling, Cerenkov measurement, dose linearity, dose rate linearity repeatability, and scintillator stability. Finally, a comparative study is also shown using a reference microdiamond dosimeter, Monte-Carlo (MC) simulation, and data from recent literature. Results: This study is highlighting the complete removal of the Cerenkov effect especially for small field radiation beam characterization. The detector provides an entire linear response with the dose in the 4cGy to 800 cGy range, independently of the field size selected from 5 x 5 cm² down to 0.5 x 0.5 cm². A perfect repeatability (0.2 % variation from average) with day-to-day reproducibility (0.3% variation) was observed. Measurements demonstrated that ISD has superlinear behavior with dose rate (R2=1) varying from 50 cGy/s to 1000 cGy/s. PDD profiles obtained in water present identical behavior with a build-up maximum depth dose at 15 mm for different small fields irradiation. A low dimension of 0.5 x 0.5 cm² field profiles have been characterized, and the field cross profile presents a Gaussian-like shape. The standard deviation (1σ) of the scintillating signal remains within 0.02% while having a very low convolution effect, thanks to lower sensitive volume. Finally, during brachytherapy, a comparison with MC simulations shows that considering energy dependency, measurement agrees within 0.8% till 0.2 cm source to detector distance. Conclusion: The proposed scintillating detector in this study shows no- Cerenkov radiation and efficient performance for several radiation therapy measurement parameters. Therefore, it is anticipated that the IR-ISD system can be promoted to validate with direct clinical investigations, such as appropriate dose verification and quality control in the Treatment Planning System (TPS).

Keywords: IR-Scintillating detector, dose measurement, micro-scintillators, Cerenkov effect

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9899 The Use of Sustainable Tourism, Decrease Performance Levels, and Change Management for Image Branding as a Contemporary Tool of Foreign Policy

Authors: Mehtab Alam

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Sustainable tourism practices require to improve the decreased performance levels in phases of change management for image branding. This paper addresses the innovative approach of using sustainable tourism for image branding as a contemporary tool of foreign policy. The sustainable tourism-based foreign policy promotes cultural values, green tourism, economy, and image management for the avoidance of rising global conflict. The mixed-method approach (quantitative 382 surveys, qualitative 11 interviews at saturation point) implied for the data analysis. The research finding provides the potential of using sustainable tourism by implying skills and knowledge, capacity, and personal factors of change management in improving tourism-based performance levels. It includes the valuable tourism performance role for the success of a foreign policy through sustainable tourism. Change management in tourism-based foreign policy provides the destination readiness for international engagement and curbing of climate issues through green tourism. The research recommends the impact of change management in improving the tourism-based performance levels of image branding for a coercive foreign policy. The paper’s future direction for the immediate implementation of tourism-based foreign policy is to overcome the contemporary issues of travel marketing management, green infrastructure, and cross-border regulation.

Keywords: decrease performance levels, change management, sustainable tourism, image branding, foreign policy

Procedia PDF Downloads 111
9898 Development of Web Application for Warehouse Management System: A Case Study of Ceramics Factory

Authors: Thanaphat Suwanaklang, Supaporn Suwannarongsri

Abstract:

Presently, there are many industries in Thailand producing various products for both domestic distribution and export to foreign countries. Warehouse is one of the most important areas of business needing to store their products. Such businesses need to have a suitable warehouse management system for reducing the storage time and using the space as much as possible. This paper proposes the development of a web application for a warehouse management system. One of the ceramics factories in Thailand is conducted as a case study. By applying the ABC analysis, fixed location, commodity system, ECRS, and 7-waste theories and principles, the web application for the warehouse management system of the selected ceramics factory is developed to design the optimal storage area for groups of products and design the optimal routes of forklifts. From experimental results, it was found that the warehouse management system developed via the web application can reduce the travel distance of forklifts and the time of searching for storage area by 100% once compared with the conventional method. In addition, the entire storage area can be on-line and real-time monitored.

Keywords: warehouse management system, warehouse design method, logistics system, web application

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9897 Prevalence, Median Time, and Associated Factors with the Likelihood of Initial Antidepressant Change: A Cross-Sectional Study

Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

Abstract:

Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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9896 Designing AI-Enabled Smart Maintenance Scheduler: Enhancing Object Reliability through Automated Management

Authors: Arun Prasad Jaganathan

Abstract:

In today's rapidly evolving technological landscape, the need for efficient and proactive maintenance management solutions has become increasingly evident across various industries. Traditional approaches often suffer from drawbacks such as reactive strategies, leading to potential downtime, increased costs, and decreased operational efficiency. In response to these challenges, this paper proposes an AI-enabled approach to object-based maintenance management aimed at enhancing reliability and efficiency. The paper contributes to the growing body of research on AI-driven maintenance management systems, highlighting the transformative impact of intelligent technologies on enhancing object reliability and operational efficiency.

Keywords: AI, machine learning, predictive maintenance, object-based maintenance, expert team scheduling

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9895 Secure Intelligent Information Management by Using a Framework of Virtual Phones-On Cloud Computation

Authors: Mohammad Hadi Khorashadi Zadeh

Abstract:

Many new applications and internet services have been emerged since the innovation of mobile networks and devices. However, these applications have problems of security, management, and performance in business environments. Cloud systems provide information transfer, management facilities, and security for virtual environments. Therefore, an innovative internet service and a business model are proposed in the present study for creating a secure and consolidated environment for managing the mobile information of organizations based on cloud virtual phones (CVP) infrastructures. Using this method, users can run Android and web applications in the cloud which enhance performance by connecting to other CVP users and increases privacy. It is possible to combine the CVP with distributed protocols and central control which mimics the behavior of human societies. This mix helps in dealing with sensitive data in mobile devices and facilitates data management with less application overhead.

Keywords: BYOD, mobile cloud computing, mobile security, information management

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9894 A Review on Applications of Evolutionary Algorithms to Reservoir Operation for Hydropower Production

Authors: Nkechi Neboh, Josiah Adeyemo, Abimbola Enitan, Oludayo Olugbara

Abstract:

Evolutionary algorithms are techniques extensively used in the planning and management of water resources and systems. It is useful in finding optimal solutions to water resources problems considering the complexities involved in the analysis. River basin management is an essential area that involves the management of upstream, river inflow and outflow including downstream aspects of a reservoir. Water as a scarce resource is needed by human and the environment for survival and its management involve a lot of complexities. Management of this scarce resource is necessary for proper distribution to competing users in a river basin. This presents a lot of complexities involving many constraints and conflicting objectives. Evolutionary algorithms are very useful in solving this kind of complex problems with ease. Evolutionary algorithms are easy to use, fast and robust with many other advantages. Many applications of evolutionary algorithms, which are population based search algorithm, are discussed. Different methodologies involved in the modeling and simulation of water management problems in river basins are explained. It was found from this work that different evolutionary algorithms are suitable for different problems. Therefore, appropriate algorithms are suggested for different methodologies and applications based on results of previous studies reviewed. It is concluded that evolutionary algorithms, with wide applications in water resources management, are viable and easy algorithms for most of the applications. The results suggested that evolutionary algorithms, applied in the right application areas, can suggest superior solutions for river basin management especially in reservoir operations, irrigation planning and management, stream flow forecasting and real-time applications. The future directions in this work are suggested. This study will assist decision makers and stakeholders on the best evolutionary algorithm to use in varied optimization issues in water resources management.

Keywords: evolutionary algorithm, multi-objective, reservoir operation, river basin management

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9893 A Case Study on the Effect of a Mobility Focused Exercise Training in Rehabilitation of an Elite Weightlifter with Shoulder Pain and Weakness

Authors: Lingling Li, Peng Zhao, Runze Guan, Alice Jones, Tao Yu

Abstract:

Background: Shoulder pain and weakness are associated with complex pathologies and often precludes weightlifters from participation in training. The role and mode of exercise training in weightlifters with shoulder pathology remains unclear. Objectives: This case report described an exercise program in management of an elite weightlifter with primary complaint of right shoulder pain and weakness. Methods: A 22-year-old weightlifter presented with 2-year duration of right shoulder pain and weakness which was worsened by routine weightlifting training, and symptoms were not relieved with steroid injection, manual therapy nor usual physiotherapy. There was a limitation in all active range of motion especially horizontal extension (13ᵒ) and external rotation (41ᵒ) with pain intensity at 4/10 and 10/10 (numeric pain rating score) respectively. Muscle weakness was most significant at supraspinatus and teres minor, 38% and 27% respectively compared to his left shoulder (hand-held dynamometry, Micro FET2). An exercise training program focusing on improving mobility was designed for this athlete following a comprehensive physical assessment. Exercises included specific stretching, muscle activating and scapular stability training; once per day, and for 60 minutes each session. All exercises were completed under instruction as pain allowed. Quantitative assessment was conducted at the end of each week for 3 weeks. Outcomes: After the program, the athlete was pain-free in all movements except the O’Brien active compression internal rotation test, the pain was however reduced from 10/10 to 3/10. The horizontal extension and external rotation range increased to 79ᵒ to 120ᵒ respectively, and strength of all rotator cuff muscles returned to normal. At 1-month follow up, the athlete was totally pain-free and had returned to normal function and weightlifting training activities. The outcomes sustained through 6-month and one year. Conclusion: This case report supports the use of a mobility-focused exercise program for management of shoulder pain and weakness in an elite weightlifter athlete.

Keywords: exercise training, mobility, rehabilitation, shoulder pain, weightlifting

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9892 Strategic Development of Urban Environmental Management Base on Good Governance - Case study of (Waste Management of Tehran)

Authors: A. Farhad Sadri, B. Ali Farhadi, C. Nasim Shalamzari

Abstract:

Waste management is a principle of urban and environmental governance. Waste management in Tehran metropolitan requires good strategies for better governance. Using of good urban governance principles together with eight main indexes can be an appropriate base for this aim. One of the reasonable tools in this field is usage of SWOT methods which provides possibility of comparing the opportunities, threats, weaknesses, and strengths by using IFE and EFE matrixes. The results of the above matrixes, respectively 2.533 and 2.403, show that management system of Tehran metropolitan wastes has performed weak regarding to internal factors and has not have good performance regarding using the opportunities and dealing with threats. In this research, prioritizing and describing the real value of each 24 strategies in waste management in Tehran metropolitan have been surveyed considering good governance derived from Quantitative Strategic Planning Management (QSPM) by using Kolomogrof-Smirnoff by 1.549 and significance level of 0.073 in order to define normalization of final values and all of the strategies utilities and Variance Analysis of ANOVA has been calculated for all SWOT strategies. Duncan’s test results regarding four WT, ST, WO, and SO strategies show no significant difference. In addition to mean comparison by Duncan method in this research, LSD (Lowest Significant Difference test) has been used by probability of 5% and finally, 7 strategies and final model of Tehran metropolitan waste management strategy have been defined. Increasing the confidence of people with transparency of budget, developing and improving the legal structure (rule-oriented and law governance, more responsibility about requirements of private sectors, increasing recycling rates and real effective participation of people and NGOs to improve waste management (contribution) and etc, are main available strategies which have been achieved based on good urban governance management principles.

Keywords: waste, strategy, environmental management, urban good governance, SWOT

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9891 Performance Evaluation of Construction Projects by Earned Value Management Method, Using Primavera P6 – A Case Study in Istanbul, Turkey

Authors: Mohammad Lemar Zalmai, Osman Hurol Turkakin, Cemil Akcay, Ekrem Manisali

Abstract:

Most of the construction projects are exposed to time and cost overruns due to various factors and this is a major problem. As a solution to this, the Earned Value Management (EVM) method is considered. EVM is a powerful and well-known method used in monitoring and controlling the project. EVM is a technique that project managers use to track the performance of their project against project baselines. EVM gives an early indication that either project is delayed or not, and the project is either over budget or under budget at any particular day by tracking it. Thus, it helps to improve the management control system of a construction project, to detect and control the problems in potential risk areas and to suggest the importance and purpose of monitoring the construction work. This paper explains the main parameters of the EVM system involved in the calculation of time and cost for construction projects. In this study, the project management software Primavera P6 is used to deals with the project monitoring process of a seven-storeyed (G+6) faculty building whose construction is in progress at Istanbul, Turkey. A comparison between the planned progress of construction activities and actual progress is performed, and the analysis results are interpreted. This case study justifies the benefits of using EVM for project cash flow analysis and forecasting.

Keywords: earned value management (EVM), construction cost management, construction planning, primavera P6, project management, project scheduling

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9890 Motivation and Efficiency of Quality Management Systems Implementation: A Study of Kosovo Organizations

Authors: Naim Ismajli, Ilir Rexhepi

Abstract:

The article presents the results of the study about the motives and efficiency of quality management system (Quality System, QS) implementation in Kosovo companies. The main purpose of the study was to find out why Kosovo companies seek the implementation and certification of QS in accordance with the requirements of the ISO 9001 series of the standards and what has changed after the QS implementation. Furthermore, the results of the research were compared with similar performed in the other European countries. The performed research revealed that the implementation of QS mostly results in the benefits of an intangible nature that are internal to the company. In addition, although the main reasons to start implementing QS are the expectations of the external advantages, the implementation results mostly in the increase of the internal benefits such as an improvement in the definition of the responsibilities and obligations of the employees, a decrease in the nonconformities, better communication among the employees, and increased efficiency.

Keywords: quality management systems, ISO 9001, total quality management, environmental management system, ISO 14000, competitiveness, efciency

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9889 Risk Management in Islamic Banks: A Case Study of the Faisal Islamic Bank of Egypt

Authors: Mohamed Saad Ahmed Hussien

Abstract:

This paper discusses the risk management in Islamic banks and aims to determine the difference in the practices and methods of risk management in those banks compared to the conventional banks, and to make a case study of the biggest Islamic bank in Egypt (Faisal Islamic Bank of Egypt) to identify the most important financial risks faced and how to manage those risks. It was found that Islamic banks face two types of risks. The first type is similar to the risks in conventional banks; the second type is the additional risks which facing the Islamic banks only as a result of some Islamic modes of financing. With regard to the risk management, Islamic banks such as conventional banks applied the regulatory rules issued by the Central Banks and the Basel Committee; Islamic banks also applied the instructions and procedures issued by the Islamic Financial Services Board (IFSB). Also, Islamic banks are similar to the conventional banks in the practices and methods which they use to manage the risks. And there are some factors that may affect the risk management in Islamic banks, such as the size of the bank and the efficiency of the administration and the staff of the bank.

Keywords: conventional banks, Faisal Islamic Bank of Egypt, Islamic banks, risk management

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9888 Comparing Bestseller Books in Japanese Public Libraries Managed by Outsourcing and by Local Governments

Authors: Yuhiro Mizunuma, Keita Tsuji

Abstract:

In Japan, local governments have long managed public libraries; however, organizations including private enterprises took over their management with the introduction of an outsourcing system in 2003. Now, whether local governments should apply this system to public libraries is under discussion, and many argue that it is inappropriate for public libraries. In this study, to provide basic data for such discussions, the differences between public libraries managed by outsourcing (henceforth, 'outsourcing libraries') and those managed directly by local governments (henceforth 'direct management libraries') were examined, focusing on bestsellers. We chose the 435 books on the top-20 bestseller lists published from 1996 to 2015 inclusive, as our sample bestseller books; and 413 outsourcing libraries' and 2,619 direct management libraries' holdings of them were investigated using the Calil API (a free Web service that can perform cross-library searches on libraries in Japan). Results show that outsourcing libraries tend to hold fewer bestsellers than direct management libraries. It was also found that direct management libraries tend to hold many duplicates of bestsellers, and that, in many cases, many of those were not being borrowed in direct management libraries.

Keywords: bestseller books, book collection, Japanese public libraries, outsourcing

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9887 Exploiting the Tumour Microenvironment in Order to Optimise Sonodynamic Therapy for Cancer

Authors: Maryam Mohammad Hadi, Heather Nesbitt, Hamzah Masood, Hashim Ahmed, Mark Emberton, John Callan, Alexander MacRobert, Anthony McHale, Nikolitsa Nomikou

Abstract:

Sonodynamic therapy (SDT) utilises ultrasound in combination with sensitizers, such as porphyrins, for the production of cytotoxic reactive oxygen species (ROS) and the confined ablation of tumours. Ultrasound can be applied locally, and the acoustic waves, at frequencies between 0.5-2 MHz, are transmitted efficiently through tissue. SDT does not require highly toxic agents, and the cytotoxic effect only occurs upon ultrasound exposure at the site of the lesion. Therefore, this approach is not associated with adverse side effects. Further highlighting the benefits of SDT, no cancer cell population has shown resistance to therapy-triggered ROS production or their cytotoxic effects. This is particularly important, given the as yet unresolved issues of radiation and chemo-resistance, to the authors’ best knowledge. Another potential future benefit of this approach – considering its non-thermal mechanism of action – is its possible role as an adjuvant to immunotherapy. Substantial pre-clinical studies have demonstrated the efficacy and targeting capability of this therapeutic approach. However, SDT has yet to be fully characterised and appropriately exploited for the treatment of cancer. In this study, a formulation based on multistimulus-responsive sensitizer-containing nanoparticles that can accumulate in advanced prostate tumours and increase the therapeutic efficacy of SDT has been developed. The formulation is based on a polyglutamate-tyrosine (PGATyr) co-polymer carrying hematoporphyrin. The efficacy of SDT in this study was demonstrated using prostate cancer as the translational exemplar. The formulation was designed to respond to the microenvironment of advanced prostate tumours, such as the overexpression of the proteolytic enzymes, cathepsin-B and prostate-specific membrane antigen (PSMA), that can degrade the nanoparticles, reduce their size, improving both diffusions throughout the tumour mass and cellular uptake. The therapeutic modality was initially tested in vitro using LNCaP and PC3 cells as target cell lines. The SDT efficacy was also examined in vivo, using male SCID mice bearing LNCaP subcutaneous tumours. We have demonstrated that the PGATyr co-polymer is digested by cathepsin B and that digestion of the formulation by cathepsin-B, at tumour-mimicking conditions (acidic pH), leads to decreased nanoparticle size and subsequent increased cellular uptake. Sonodynamic treatment, at both normoxic and hypoxic conditions, demonstrated ultrasound-induced cytotoxic effects only for the nanoparticle-treated prostate cancer cells, while the toxicity of the formulation in the absence of ultrasound was minimal. Our in vivo studies in immunodeficient mice, using the hematoporphyrin-containing PGATyr nanoparticles for SDT, showed a 50% decrease in LNCaP tumour volumes within 24h, following IV administration of a single dose. No adverse effects were recorded, and body weight was stable. The results described in this study clearly demonstrate the promise of SDT to revolutionize cancer treatment. It emphasizes the potential of this therapeutic modality as a fist line treatment or in combination treatment for the elimination or downstaging of difficult to treat cancers, such as prostate, pancreatic, and advanced colorectal cancer.

Keywords: sonodynamic therapy, nanoparticles, tumour ablation, ultrasound

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9886 An Overview of Risk Types and Risk Management Strategies to Improve Financial Performance

Authors: Azar Baghtaghi

Abstract:

Financial risk management is critically important as it enables companies to maintain stability and profitability amidst market fluctuations and unexpected events. It involves the precise identification of risks that could impact investments, assets, and potential revenues. By implementing effective risk management strategies, companies can insure themselves against adverse market changes and prevent potential losses. In today's era, where markets are highly complex and influenced by various factors such as macroeconomic policies, exchange rate fluctuations, and natural disasters, the need for meticulous planning to cope with these uncertainties is more pronounced. Ultimately, financial risk management means being prepared for the future and the ability to sustain business in changing environments. A company capable of managing its risks not only achieves sustainable profitability but also gains the confidence of shareholders, investors, and business partners, enhancing its competitive position in the market. In this article, the types of financial risk and risk management strategies for improving financial performance were investigated. By identifying the risks stated in this article and their evaluation techniques, it is possible to improve the organization's financial performance.

Keywords: strategy, risk, risk management, financial performance

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9885 Determinants of Effective Food Waste Management in an Urban Area in Pakistan

Authors: Nazia Jabeen, Denis Hyams-Ssekasi

Abstract:

The study focuses on the determinants of food waste management (FWM) in one of the urban areas of Pakistan. One hundred and two households from the urban areas of Pakistan took part in the study via self-completed questionnaires, and data were analyzed. The research findings indicate that food waste management is a recurring issue, and households must do more to minimize or create business opportunities. Most households agree that food waste has significant implications for the community if not utilized and managed correctly. The value creation deriving from this zero-value resource provides a platform where householders see the benefit of food waste management. Based on the findings, this study acknowledges that food waste has significant economic and social impacts on the community. It concludes that minimization and optimum utilization of food waste create a pathway to business opportunities in urban areas.

Keywords: economic, social, food waste management, business opportunities, value creation

Procedia PDF Downloads 76