Search results for: intensive case management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19842

Search results for: intensive case management

18522 Mobile Traffic Management in Congested Cells using Fuzzy Logic

Authors: A. A. Balkhi, G. M. Mir, Javid A. Sheikh

Abstract:

To cater the demands of increasing traffic with new applications the cellular mobile networks face new changes in deployment in infrastructure for making cellular networks heterogeneous. To reduce overhead processing the densely deployed cells require smart behavior with self-organizing capabilities with high adaptation to the neighborhood. We propose self-organization of unused resources usually excessive unused channels of neighbouring cells with densely populated cells to reduce handover failure rates. The neighboring cells share unused channels after fulfilling some conditional candidature criterion using threshold values so that they are not suffered themselves for starvation of channels in case of any abrupt change in traffic pattern. The cells are classified as ‘red’, ‘yellow’, or ‘green’, as per the available channels in cell which is governed by traffic pattern and thresholds. To combat the deficiency of channels in red cell, migration of unused channels from under-loaded cells, hierarchically from the qualified candidate neighboring cells is explored. The resources are returned back when the congested cell is capable of self-contained traffic management. In either of the cases conditional sharing of resources is executed for enhanced traffic management so that User Equipment (UE) is provided uninterrupted services with high Quality of Service (QoS). The fuzzy logic-based simulation results show that the proposed algorithm is efficiently in coincidence with improved successful handoffs.

Keywords: candidate cell, channel sharing, fuzzy logic, handover, small cells

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18521 A Study of Emergency Nurses' Knowledge and Attitudes regarding Pain

Authors: Liqun Zou, Ling Wang, Xiaoli Chen

Abstract:

Objective: Through the questionnaire about emergency nurses’ knowledge and attitudes regarding pain management to understand whether they are well mastered and practiced the related knowledge about pain management, providing a reference for continuous improvement of the quality of nursing care in acute pain and for improving the effect of management on emergency pain patients. Method: The Chinese version questionnaire about KASRP (knowledge and attitudes survey regarding pain) was handed out to 132 emergency nurses to do a study about the knowledge and attitude of pain management. Meanwhile, SPSS17.0 was used to do a descriptive analysis and variance analysis on collected data. Results: The emergency nurses’ correct answer rate about KASRP questionnaire is from 25% to 65% and the average correct rate is (44.65 + 7.85)%. In addition, there are 10 to 26 items being given the right answer. Therefore, the average correct items are (17.86 ± 3.14). Moreover, there is no statistical significant on the differences about the correct rate for different age, gender and work experience to answer; however, the difference of the correct rate in different education background and the professional title is significant. Conclusion: There is a remarkable lack of knowledge and attitude towards pain management in emergency nurses, whose basic knowledge of pain is sufficient. Besides, there is a deviation between the knowledge of pain management and clinical practice, which needs to be improved.

Keywords: emergency nurse, pain, KASRP questionnaire, pain management

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18520 A Study on Characteristics of Entrepreneur Spirit-Focus on Ventures

Authors: Do Jaesoo, Kim Kyoung Seok

Abstract:

Under the recent difficult economic conditions, a number of people are increasingly expecting fostering ventures as the breakthrough in economic recovery and thus more attention is socially paid to an entrepreneur spirit. However, even though the role of managers is very important for the success of a venture company, programs to cultivate their qualities and skills are quite insufficient. In recent years, programs to foster entrepreneurs and business men have proliferated, which are led mainly by national agencies, research institutions, and large corporations. However, these programs still remain at a tottering stage, since there is no accumulated knowledge in many aspects, including systemic know-how and education. Therefore, this study attempted to introduce the definition of the entrepreneur (founder’s) spirit and furthermore identify the characteristics required for entrepreneurs as the subject of management. It thus tried to examine how those characteristics have an influence on entrepreneurs as their successful conditions, and presented foreign cases after analyzing the entrepreneur spirit through case studies. The entrepreneur spirit and the venture management emerge as a new field in business administration and scholars have reported various theories. Further research activities and efforts for active exchanges are also needed thereof.

Keywords: venture, entrepreneur, entrepreneur (founder’s) spirit, characteristics of entrepreneur spirit

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18519 Absorptive Capabilities in the Development of Biopharmaceutical Industry: The Case of Bioprocess Development and Research Unit, National Polytechnic Institute

Authors: Ana L. Sánchez Regla, Igor A. Rivera González, María del Pilar Monserrat Pérez Hernández

Abstract:

The ability of an organization to identify and get useful information from external sources, assimilate it, transform and apply to generate products or services with added value is called absorptive capacity. Absorptive capabilities contribute to have market opportunities to firms and get a leader position with respect to others competitors. The Bioprocess Development and Research Unit (UDIBI) is a Research and Development (R&D) laboratory that belongs to the National Polytechnic Institute (IPN), which is a higher education institute in Mexico. The UDIBI was created with the purpose of carrying out R and D activities for the Transferon®, a biopharmaceutical product developed and patented by IPN. The evolution of competence and scientific and technological platform made UDIBI expand its scope by providing technological services (preclínical studies and bio-compatibility evaluation) to the national pharmaceutical industry and biopharmaceutical industry. The relevance of this study is that those industries are classified as high scientific and technological intensity, and yet, after a review of the state of the art, there is only one study of absorption capabilities in biopharmaceutical industry with a similar scope to this research; in the case of Mexico, there is none. In addition to this, UDIBI belongs to a public university and its operation does not depend on the federal budget, but on the income generated by its external technological services. This fact represents a highly remarkable case in Mexico's public higher education context. This current doctoral research (2015-2019) is contextualized within a case study, its main objective is to identify and analyze the absorptive capabilities that characterise the UDIBI that allows it had become in a one of two third authorized laboratory by the sanitary authority in Mexico for developed bio-comparability studies to bio-pharmaceutical products. The development of this work in the field is divided into two phases. In a first phase, 15 interviews were conducted with the UDIBI personnel, covering management levels, heads of services, project leaders and laboratory personnel. These interviews were structured under a questionnaire, which was designed to integrate open questions and to a lesser extent, others, whose answers would be answered on a Likert-type rating scale. From the information obtained in this phase, a scientific article was made (in review and a proposal of presentation was submitted in different academic forums. A second stage will be made from the conduct of an ethnographic study within this organization under study that will last about 3 months. On the other hand, it is intended to carry out interviews with external actors around the UDIBI (suppliers, advisors, IPN officials, including contact with an academic specialized in absorption capacities to express their comments on this thesis. The inicial findings had shown two lines: i) exist institutional, technological and organizational management elements that encourage and/or limit the creation of absorption capacities in this scientific and technological laboratory and, ii) UDIBI has had created a set of multiple transfer technology of knowledge mechanisms which have had permitted to build a huge base of prior knowledge.

Keywords: absorptive capabilities, biopharmaceutical industry, high research and development intensity industries, knowledge management, transfer of knowledge

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18518 Improving Contributions to the Strengthening of the Legislation Regarding Road Infrastructure Safety Management in Romania, Case Study: Comparison Between the Initial Regulations and the Clarity of the Current Regulations - Trends Regarding the Efficiency

Authors: Corneliu-Ioan Dimitriu, Gheorghe Frățilă

Abstract:

Romania and Bulgaria have high rates of road deaths per million inhabitants. Directive (EU) 2019/1936, known as the RISM Directive, has been transposed into national law by each Member State. The research focuses on the amendments made to Romanian legislation through Government Ordinance no. 3/2022, which aims to improve road safety management on infrastructure. The aim of the research is two-fold: to sensitize the Romanian Government and decision-making entities to develop an integrated and competitive management system and to establish a safe and proactive mobility system that ensures efficient and safe roads. The research includes a critical analysis of European and Romanian legislation, as well as subsequent normative acts related to road infrastructure safety management. Public data from European Union and national authorities, as well as data from the Romanian Road Authority-ARR and Traffic Police database, are utilized. The research methodology involves comparative analysis, criterion analysis, SWOT analysis, and the use of GANTT and WBS diagrams. The Excel tool is employed to process the road accident databases of Romania and Bulgaria. Collaboration with Bulgarian specialists is established to identify common road infrastructure safety issues. The research concludes that the legislative changes have resulted in a relaxation of road safety management in Romania, leading to decreased control over certain management procedures. The amendments to primary and secondary legislation do not meet the current safety requirements for road infrastructure. The research highlights the need for legislative changes and strengthened administrative capacity to enhance road safety. Regional cooperation and the exchange of best practices are emphasized for effective road infrastructure safety management. The research contributes to the theoretical understanding of road infrastructure safety management by analyzing legislative changes and their impact on safety measures. It highlights the importance of an integrated and proactive approach in reducing road accidents and achieving the "zero deaths" objective set by the European Union. Data collection involves accessing public data from relevant authorities and using information from the Romanian Road Authority-ARR and Traffic Police database. Analysis procedures include critical analysis of legislation, comparative analysis of transpositions, criterion analysis, and the use of various diagrams and tools such as SWOT, GANTT, WBS, and Excel. The research addresses the effectiveness of legislative changes in road infrastructure safety management in Romania and the impact on control over management procedures. It also explores the need for strengthened administrative capacity and regional cooperation in addressing road safety issues. The research concludes that the legislative changes made in Romania have not strengthened road safety management and emphasize the need for immediate action, legislative amendments, and enhanced administrative capacity. Collaboration with Bulgarian specialists and the exchange of best practices are recommended for effective road infrastructure safety management. The research contributes to the theoretical understanding of road safety management and provides valuable insights for policymakers and decision-makers in Romania.

Keywords: management, road infrastructure safety, legislation, amendments, collaboration

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18517 Integrated Management of Diseases of Vegetables and Flower Crops Grown in Protected Condition under Organic Production System

Authors: Shripad Kulkarni

Abstract:

Plant disease is an impairment of the normal state of a plant that interrupts or modifies its vital functions. Disease occurs on different parts of plants and cause heavy losses. Diagnosis of Problem is very important before planning any management practice and this can be done based on appearance of the crop, examination of the root and examination of the soil. There are various types of diseases such as biotic (transmissible) which accounts for ~30% whereas , abiotic (not transmissible) diseases are the major one with ~70% incidence. Plant diseases caused by different groups of organism’s belonging fungi, bacteria, viruses, nematodes and few others have remained important in causing significant losses in different crops indicating the urgent need of their integrated management. Various factors favor disease development and different steps and methods are involved in management of diseases under protected condition. Management of diseases through botanicals and bioagents by modifying root and aerial environment, vector management along with care to be taken while managing the disease are analysed.

Keywords: organic production system, diseases, bioagents and polyhouse, agriculture

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18516 Optical Fiber Data Throughput in a Quantum Communication System

Authors: Arash Kosari, Ali Araghi

Abstract:

A mathematical model for an optical-fiber communication channel is developed which results in an expression that calculates the throughput and loss of the corresponding link. The data are assumed to be transmitted by using of separate photons with different polarizations. The derived model also shows the dependency of data throughput with length of the channel and depolarization factor. It is observed that absorption of photons affects the throughput in a more intensive way in comparison with that of depolarization. Apart from that, the probability of depolarization and the absorption of radiated photons are obtained.

Keywords: absorption, data throughput, depolarization, optical fiber

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18515 Dengue Death Review: A Tool to Adjudge the Cause of Dengue Mortality and Use of the Tool for Prevention of Dengue Deaths

Authors: Gagandeep Singh Grover, Vini Mahajan, Bhagmal, Priti Thaware, Jaspreet Takkar

Abstract:

Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated a review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have a longer stay in the hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be a major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

Keywords: dengue, death, morbidities, DHF, DSS

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18514 Setting Ground for Improvement of Knowledge Managament System in the Educational Organization

Authors: Mladen Djuric, Ivan Janicijevic, Sasa Lazarevic

Abstract:

One of the organizational issues is how to develop and shape decision making and knowledge management systems which will continually avoid traps of both paralyses by analyses“ and extinction by instinct“, the concepts that are a kind of tolerant limits anti-patterns which define what we can call decision making and knowledge management patterns control zone. This paper discusses potentials for development of a core base for recognizing, capturing, and analyzing anti-patterns in the educational organization, thus creating a space for improving decision making and knowledge management processes in education.

Keywords: anti-patterns, decision making, education, knowledge management

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18513 Knowledge Management Efficiency of Personnel in Rajamangala University of Technology Srivijaya Songkhla, Thailand

Authors: Nongyao Intasaso, Atchara Rattanama, Navarat Pewnual

Abstract:

This research is survey research purposed to study the factor affected to knowledge management efficiency of personnel in Rajamangala University of Technology Srivijaya, and study the problem of knowledge management affected to knowledge development of personnel in the university. The tool used in this study is structures questioner standardize rating scale in 5 levels. The sample selected by purposive sampling and there are 137 participation calculated in 25% of population. The result found that factor affected to knowledge management efficiency in the university included (1) result from the organization factor found that the university provided project or activity that according to strategy and mission of knowledge management affected to knowledge management efficiency in highest level (x̅ = 4.30) (2) result from personnel factor found that the personnel are eager for knowledge and active to learning to develop themselves and work (Personal Mastery) affected to knowledge management efficiency in high level (x̅ = 3.75) (3) result from technological factor found that the organization brought multimedia learning aid to facilitate learning process affected to knowledge management efficiency in high level (x̅ = 3.70) and (4) the result from learning factor found that the personnel communicated and sharing knowledge and opinion based on acceptance to each other affected to knowledge management efficiency in high level (x̅ = 3.78). The problem of knowledge management in the university included the personnel do not change their work behavior, insufficient of collaboration, lack of acceptance in knowledge and experience to each other, and limited budget. The solutions to solve these problems are the university should be support sufficient budget, the university should follow up and evaluate organization development based on knowledge using, the university should provide the activity emphasize to personnel development and assign the committee to process and report knowledge management procedure.

Keywords: knowledge management, efficiency, personnel, learning process

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18512 Build Information Systems Environment Clean Through the Sms Gateway

Authors: Lutpi Ginanjar

Abstract:

Environmental hygiene is indispensable for people to live healthy, safe and peaceful. In a small environment, the cleanliness of the environment is very easy to overcome, but on the larger environment requires a more complicated management and considerable investments. In general environmental hygiene are managed by the Department of Hygiene and Landscaper. Found a good management, but much less good management. The difficulties that are often encountered on waste management also caused public awareness itself. In addition, communities have difficulty in making a report about the rubbish because not dibangunnyasistem good information. Essai aims to build information systems environment clean especially the handling of waste in the city of Bandung, West Java province. The system was built with PHP software. Expected results obtained after the construction of the information system of environmental hygiene can be demonstrated to the community will be the health of the environment.

Keywords: information systems, SMS gateway, management, software, PHP

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18511 Plural Perspectives in Conservation Conflicts: The Role of Iconic Species

Authors: Jean Hugé, Francisco Benitez-Capistros, Giorgia Camperio-Ciani

Abstract:

Addressing conservation conflicts requires the consideration of multiple stakeholders' perspectives and knowledge claims, in order to inform complex and possibly contentious decision-making dilemmas. Hence, a better understanding of why people in particular contexts act in a particular way in a conservation conflict is needed. First, this contribution aims at providing and applying an approach to map and interpret the diversity of subjective viewpoints with regard to iconic species in conservation conflicts. Secondly, this contribution aims to feed the reflection on the possible consequences of the diversity of perspectives for the future management of wildlife (in particular iconic species), based on case studies in Galapagos and Malaysia. The use of the semi-quantitative Q methodology allowed us to identify various perspectives on conservation in different social-ecological contexts. While the presence of iconic species may lead to a more passionate and emotional debate, it may also provide more opportunities for finding common ground and for jointly developing acceptable management solutions that will depolarize emergent, long-lasting or latent conservation conflicts. Based on the research team’s experience in the field, and on the integration of ecological and social knowledge, methodological and management recommendations are made with regard to conservation conflicts involving iconic wildlife. The mere presence of iconic wildlife does not guarantee its centrality in conservation conflicts, and comparisons will be drawn between the cases of the giant tortoises (Chelonoidis spec.) in Galapagos, Ecuador and the Milky Stork (Mycteria cinerea) in western peninsular Malaysia. Acknowledging the diversity of viewpoints, reflecting how different stakeholders see, act and talk about wildlife management, highlights the need to develop pro-active and resilient strategies to deal with these issues.

Keywords: conservation conflicts, Q methodology, Galapagos, Malaysia, giant tortoise, milky stork

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18510 Inhibitions in Implementing Green Supply Chain Management at Hospitals

Authors: M. Aruna, Uma Gunasilan

Abstract:

Hospitals play an ample role in securing the health of a country. Nevertheless, they also have an unhealthy side. Ecological issues strengthen ill-health throughout the domain which subsequently puts pressure on hospital supply chains. Medical waste indeed is hazardous for environment and subsequently for human. The hospital waste management is of immense prominence due to its infectious and hazardous nature that can source many effects on human health and the environment. Government regulations and public cognizance regarding hospital waste issues have imposed hospital units to admit these strategies. The innovative technologies and instruments have been developed to handle hospital wastes. Green supply chain management practices are common in the United States. In India, Green Supply Chain management (GSCM) has just started to be recognized and practiced. GSCM are green, integrated and ecologically optimized. In Green supply chain management environmental sustainability is found to be an important driver. Eleven barriers are identified in this work. Interpretive Structural Modeling (ISM) technique is used for ranking the obstructions.

Keywords: green supply chain management (GSCM), hospital waste management (HWM), interpretive structural modeling (ISM), medical waste (MW)

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18509 Bullous Pyoderma Gangrenosum in a Patient with Anti-Phospholipid Syndrome: A Case Report and Literature Review

Authors: Yousef Alwashahi, Ahmed Almoqbali, Mayar Albahrani, Asma Alajmi

Abstract:

We report a rare case of a 49-year-old Omani woman who is a known case of primary anti-phospholipid syndrome, glucose-6-phosphate dehydrogenase deficiency, and iron deficiency anaemia. During cannulation, she was found to develop bulla that progressed to ulcerations. With chronicity and recurrent abscess formation that usually increase after surgical intervention, a pathergy phenomenon was postulated. High suspicion of pyoderma gangrenosum was considered. Fortunately, the rapid progression of the disease was slowed down with corticosteroids, cyclosporin, and biological agents.

Keywords: anti-phospholipid syndrome, pyoderma gangrenosum, bullous pyoderma gangrenosum, pathergy, pathergy phenomenon

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18508 Information Technology and Communications in Management of the Imperial Citadel of Thang Long-A World Heritage Site

Authors: Ngo the Bach

Abstract:

Information technology and communications are growing strongly and penetrated almost the entire Vietnamese economy and society. The article presents an overview of information technology and application communications in the management the Central Sector of the Imperial Citadel of Thang Long (Hanoi, Vietnam) - A World Heritage Site. The author also points out the opportunities and challenges of the information technology and communications in the sectors of culture and heritage; the use of information technology as an effective tool to develop mass and interactive communications. The article emphasizes on the advantage of information technology and communications in supporting effectively the management reform with respect to the Imperial Citadel of Thang Long in particular and the management of world heritage sites in Vietnam in general.

Keywords: information technology, communications, management, culture, heritage

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18507 Towards Establishing a Universal Theory of Project Management

Authors: Divine Kwaku Ahadzie

Abstract:

Project management (PM) as a concept has evolved from the early 20th Century into a recognized academic and professional discipline, and indications are that it has come to stay in the 21st Century as a world-wide paradigm shift for managing successful construction projects. However, notwithstanding the strong inroads that PM has made in legitimizing its academic and professional status in construction management practice, the underlining philosophies are still based on cases and conventional practices. An important theoretical issue yet to be addressed is the lack of a universal theory that offers philosophical legitimacy for the PM concept as a uniquely specialized management concept. Here, it is hypothesized that the law of entropy, the theory of uncertainties and the theory of risk management offer plausible explanations for addressing the lacuna of what constitute PM theory. The theoretical bases of these plausible underlying theories are argued and attempts made to establish the functional relationships that exist between these theories and the PM concept. The paper then draws on data related to the success and/or failure of a number of construction projects to validate the theory.

Keywords: concepts, construction, project management, universal theory

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18506 Some Factors Affecting Reproductive Traits in Nigerian Indigenous Chickens under Intensive Management System

Authors: J. Aliyu, A. O. Raji, A. A. Ibrahim

Abstract:

The study was carried out to assess the fertility, early and late embryonic mortalities as well as hatchability by strain, season and hen’s weight in Nigerian indigenous chickens reared on deep litter. Four strains (normal feathered, naked neck, frizzle and dwarf) of hens maintained at a mating ratio of 1 cock to 4 hens, fed breeders mash and water ad libitum were used in a three year experiment. The data generated were subjected to analysis of variance using the SAS package and the means, where significant, were separated using the least significant difference (LSD). There were significant effects (P < 0.05) of strain on all the traits studied. Fertility was generally high (84.29 %) in all the strains. Early embryonic mortality was significantly lowest (P < 0.01) in naked neck which had the highest late embryonic mortality (P < 0.001). Hatchability was significantly highest (P < 0.01) in normal feathered (80.23 %) and slightly depressed in frizzle (74.95 %) and dwarf (72.27 %) while naked neck had the lowest (60.80 %). Season of the year had significant effects on early embryonic mortality. Dry hot season significantly (P < 0.05) depressed fertility while early embryonic mortality was depressed in the wet season (15.33 %). Early and late embryonic mortalities significantly increased (P < 0.05) with increasing weight of hen. Dwarf, frizzle and normal feathered hens could be used to improve hatchability as well as reduce early and late embryonic mortalities in Nigerian indigenous chickens.

Keywords: chicken, fertility, hatchability, indigenous, strain

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18505 Efficacy of Knowledge Management Practices in Selected Public Libraries in the Province of Kwazulu-Natal, South Africa

Authors: Petros Dlamini, Bethiweli Malambo, Maggie Masenya

Abstract:

Knowledge management practices are very important in public libraries, especial in the era of the information society. The success of public libraries depends on the recognition and application of knowledge management practices. The study investigates the value and challenges of knowledge management practices in public libraries. Three research objectives informed the study: to identify knowledge management practices in public libraries, understand the value of knowledge management practices in public libraries, and determine the factors hampering knowledge management practices in public libraries. The study was informed by the interpretivism research paradigm, which is associated with qualitative studies. In that light, the study collected data from eight librarians and or library heads, who were purposively selected from public libraries. The study adopted a social anthropological approach, which thoroughly evaluated each participant's response. Data was collected from the respondents through telephonic semi-structured interviews and assessed accordingly. Furthermore, the study used the latest content concept for data interpretation. The chosen data analysis method allowed the study to achieve its main purpose with concrete and valid information. The study's findings showed that all six (100%) selected public libraries apply knowledge management practices. The findings of the study revealed that public libraries have knowledge sharing as the main knowledge management practice. It was noted that public libraries employ many practices, but each library employed its practices of choice depending on their knowledge management practices structure. The findings further showed that knowledge management practices in public libraries are employed through meetings, training, information sessions, and awareness, to mention a few. The findings revealed that knowledge management practices make the libraries usable. Furthermore, it has been asserted that knowledge management practices in public libraries meet users’ needs and expectations and equip them with skills. It was discovered that all participating public libraries from Umkhanyakude district municipality valued their knowledge management practices as the pillar and foundation of services. Noticeably, knowledge management practices improve users ‘standard of living and build an information society. The findings of the study showed that librarians should be responsible for the value of knowledge management practices as they are qualified personnel. The results also showed that 83.35% of public libraries had factors hampering knowledge management practices. The factors are not limited to shortage of funds, resources and space, and political interference. Several suggestions were made to improve knowledge management practices in public libraries. These suggestions include improving the library budget, increasing libraries’ building sizes, and conducting more staff training.

Keywords: knowledge management, knowledge management practices, storage, dissemination

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18504 A Case of Bilateral Vulval Abscess with Pelvic Fistula in an Immunocompromised Patient with Colostomy: A Diagnostic Challenge

Authors: Paul Feyi Waboso

Abstract:

This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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18503 Households’ Willingness to Pay for Watershed Management Practices in Lake Hawassa Watershed, Southern Ethiopia

Authors: Mulugeta Fola, Mengistu Ketema, Kumilachew Alamerie

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Watershed provides vast economic benefits within and beyond the management area of interest. But most watersheds in Ethiopia are increasingly facing the threats of degradation due to both natural and man-made causes. To reverse these problems, communities’ participation in sustainable management programs is among the necessary measures. Hence, this study assessed the households’ willingness to pay for watershed management practices through a contingent valuation study approach. Double bounded dichotomous choice with open-ended follow-up format was used to elicit the households’ willingness to pay. Based on data collected from 275 randomly selected households, descriptive statistics results indicated that most households (79.64%) were willing to pay for watershed management practices. A bivariate Probit model was employed to identify determinants of households’ willingness to pay and estimate mean willingness to pay. Its result shows that age, gender, income, livestock size, perception of watershed degradation, social position, and offered bids were important variables affecting willingness to pay for watershed management practices. The study also revealed that the mean willingness to pay for watershed management practices was calculated to be 58.41 Birr and 47.27 Birr per year from the double bounded and open-ended format, respectively. The study revealed that the aggregate welfare gains from watershed management practices were calculated to be 931581.09 Birr and 753909.23 Birr per year from double bounded dichotomous choice and open-ended format, respectively. Therefore, the policymakers should make households to pay for the services of watershed management practices in the study area.

Keywords: bivariate probit model, contingent valuation, watershed management practices, willingness to pay

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18502 The Role of Risk Management Practices in the Relationship between Risks Factors and Construction Project Performance

Authors: Ali Abdullah Albezaghi

Abstract:

This article aims to introduce a conceptual framework that can facilitate investigations concerning the role of risk management practices in the relationship between construction risks and the construction project's performance. This article is structured based on the extant literature; it reviews theoretical perspectives, highlights the gaps, and illustrates the significance of developing a framework of suggested relationships. Despite growing interest in the role of risks in construction project performance, previous studies have paid little attention to investigating the moderating role of risk management practices on the risk-performance link. This has left researchers and construction project managers with minimal information to explain the conditions under which risk management practices can reduce the impact of project-related risks and improve performance. In this context, this article suggests a viable research model with propositions that assess risk-performance relationships and discusses the potential moderating effects on the domain relationship. This paper adds to the risk management literature by focusing on risk variables that directly impact performance. Further, it also considers the moderating role of risk management practices in such relationships.

Keywords: risk management practices, external risks, internal risks, project risks, project performance

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18501 The Perceptions of Parents Regarding the Appropriateness of the Early Childhood Financial Literacy Program for Children 3 to 6 Years of Age Presented at an Early Childhood Facility in South Africa: A Case Study

Authors: M. Naude, R. Joubert, A. du Plessis, S. Pelser, M. Trollip

Abstract:

Context: The study focuses on the perceptions of South African parents and teachers regarding a play-based financial literacy program for children aged 3 to 6 years at an early childhood facility. It emphasizes the importance of early interventions in financial education to reduce poverty and inequality. Research Aim: To explore how parental involvement in teaching money management concepts to young children can support financial literacy education both at school and at home. Methodology: A qualitative deductive case study was conducted at a South African early childhood facility involving 90 children, their teachers and their families. Thematic content analysis of online survey responses and focus group discussions with teachers were used to identify patterns and themes related to participants’ perceptions of the financial literacy program. Validity: The study's validity and reproducibility are ensured by the depth and honesty of the data, participant involvement, and the inquirer's objectivity. Reliability aligns with the interpretive paradigm of this study, while transparency in data gathering and analysis enhances its trustworthiness. Credibility is further supported by using two triangulation methods: focus group interviews with teachers and open-ended questionnaires from parents. Findings: Parents reported overall satisfaction with the program and highlighted the development of essential money management skills in their children. They emphasized the collaborative role of home and school environments in fostering financial literacy in early childhood. Teachers reported that communication and interaction with the parents increased and grew. Healthy and positive relationships were established between the teachers and the parents which contributed to the success of the classroom financial literacy program. Theoretical Importance: The study underscores the significance of play-based financial literacy education in early childhood and the critical role of parental involvement in reinforcing money management concepts. It contributes to laying a solid foundation for children's future financial well-being. Data Collection: Data was collected through an online survey administered to parents of children participating in the financial literacy program over a period of 10 weeks. Focus group discussions were utilized with the teachers of each class after the conclusion of the program. Analysis Procedures: Thematic content analysis was applied to the survey responses to identify patterns, themes, and insights related to the participants’ perceptions of the program's effectiveness in teaching money management concepts to young children. Question Addressed: How does parental involvement in teaching money management concepts to young children support financial literacy education in early childhood? Conclusion: The study highlights the positive impact of a play-based financial literacy program for children aged 3 to 6 years and underscores the importance of collaboration between home and school environments in fostering financial literacy skills.

Keywords: early childhood, financial literacy, money management, parent involvement, play-based learning, South Africa

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18500 Information Technology Impacts on the Supply Chain Performance: Case Study Approach

Authors: Kajal Zarei

Abstract:

Supply chain management is becoming an increasingly important issue in many businesses today. In such circumstances, a number of reasons such as management deficiency in different segments of the supply chain, lack of streamlined processes, resistance to change the current systems and technologies, and lack of advanced information system have paved the ground to ask for innovative research studies. To this end, information technology (IT) is becoming a major driver to overcome the supply chain limitations and deficiencies. The emergence of IT has provided an excellent opportunity for redefining the supply chain to be more effective and competitive. This paper has investigated the IT impact on two-digit industry codes in the International Standard Industrial Classification (ISIC) that are operating in four groups of the supply chains. Firstly, the primary fields of the supply chain were investigated, and then paired comparisons of different industry parts were accomplished. Using experts' ideas and Analytical Hierarchy Process (AHP), the status of industrial activities in Kurdistan Province in Iran was determined. The results revealed that manufacturing and inventory fields have been more important compared to other fields of the supply chain. In addition, IT has had greater impact on food and beverage industry, chemical industry, wood industry, wood products, and production of basic metals. The results indicated the need to IT awareness in supply chain management; in other words, IT applications needed to be developed for the identified industries.

Keywords: supply chain, information technology, analytical hierarchy process, two-digit codes, international standard industrial classification

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18499 The Artificial Intelligence (AI) Impact on Project Management: A Destructive or Transformative Agent

Authors: Kwame Amoah

Abstract:

Artificial intelligence (AI) has the prospect of transforming project management, significantly improving efficiency and accuracy. By automating specific tasks with defined guidelines, AI can assist project managers in making better decisions and allocating resources efficiently, with possible risk mitigation. This study explores how AI is already impacting project management and likely future AI's impact on the field. The AI's reaction has been a divided opinion; while others picture it as a destroyer of jobs, some welcome it as an innovation advocate. Both sides agree that AI will be disruptive and revolutionize PM's functions. If current research is to go by, AI or some form will replace one-third of all learning graduate PM jobs by as early as 2030. A recent survey indicates AI spending will reach $97.9 billion by the end of 2023. Considering such a profound impact, the project management profession will also see a paradigm shift driven by AI. The study examines what the project management profession will look like in the next 5-10 years after this technological disruption. The research methods incorporate existing literature, develop trend analysis, and conduct structured interviews with project management stakeholders from North America to gauge the trend. PM professionals can harness the power of AI, ensuring a smooth transition and positive outcomes. AI adoption will maximize benefits, minimize adverse consequences, and uphold ethical standards, leading to improved project performance.

Keywords: project management, disruptive teacnologies, project management function, AL applications, artificial intelligence

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18498 Case Report on Anaesthesia for Ruptured Ectopic with Severe Pulmonary Hypertension in a Mute Patient

Authors: Pamela Chia, Tay Yoong Chuan

Abstract:

Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

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18497 Reverse Logistics in Clothing Recycling: A Case Study in Chengdu

Authors: Guo Yan

Abstract:

Clothing recycling bin is a traditional way to collect textile waste in many areas. In the clothing recycling business, the transportation cost normally takes over 50% of total costs. This case gives a good way to reduce transportation cost by reverse logistics system. In this reverse logistics system, there are offline strategic alliance partners, such as transport firms, convenience stores, laundries, and post office which are integrated onto the mobile APP. Offline strategic alliance partners provide the service of textile waste collection, and transportation by their vacant vehicles return journey from convenience stores, laundries and post offices to sorting centers. The results of the case study provide the strategic alliance with a valuable and light - asset business model by using the logistics of offline memberships. The company in this case just focuses on textile waste sorting, reuse, recycling etc. The research method of this paper is a case study of a clothing recycling company in Chengdu by field research and interview; the analysis is based on the theory of the reverse logistics system.

Keywords: closed-loop recycles system, clothing recycling, end-of-life clothing, sharing economy, strategic alliance, reverse logistics.

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18496 Scoring System for the Prognosis of Sepsis Patients in Intensive Care Units

Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz

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Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.

Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting

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18495 Case Study: Optimization of Contractor’s Financing through Allocation of Subcontractors

Authors: Helen S. Ghali, Engy Serag, A. Samer Ezeldin

Abstract:

In many countries, the construction industry relies heavily on outsourcing models in executing their projects and expanding their businesses to fit in the diverse market. Such extensive integration of subcontractors is becoming an influential factor in contractor’s cash flow management. Accordingly, subcontractors’ financial terms are important phenomena and pivotal components for the well-being of the contractor’s cash flow. The aim of this research is to study the contractor’s cash flow with respect to the owner and subcontractor’s payment management plans, considering variable advance payment, payment frequency, and lag and retention policies. The model is developed to provide contractors with a decision support tool that can assist in selecting the optimum subcontracting plan to minimize the contractor’s financing limits and optimize the profit values. The model is built using Microsoft Excel VBA coding, and the genetic algorithm is utilized as the optimization tool. Three objective functions are investigated, which are minimizing the highest negative overdraft value, minimizing the net present worth of overdraft, and maximizing the project net profit. The model is validated on a full-scale project which includes both self-performed and subcontracted work packages. The results show potential outputs in optimizing the contractor’s negative cash flow values and, in the meantime, assisting contractors in selecting suitable subcontractors to achieve the objective function.

Keywords: cash flow optimization, payment plan, procurement management, subcontracting plan

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18494 Case Report: A Rare Case of Popliteal Artery Aneurysm Presenting with Foot Drop

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Popliteal artery aneurysms (PAAs) are the most common arterial aneurysm of the periphery. It is defined as focal dilation of the artery more than 50% of the normal vessel diameter which usually varies between 7 mm to 11 mm. The most common presentation for PAAs is claudication due to luminal stenosis secondary to mural thrombus or acute limb ischaemia due to occlusive thrombosis or distal thromboembolism. It is less common for patients to present with non-ischaemic symptoms secondary to mass effect and compression of adjacent structures, and of these, presentation with common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female patient presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA of 22 mm by 21mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option taken in our case.

Keywords: aneurysm, foot drop, peroneal nerve, popliteal

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18493 Comparison of Peri- and Post-Operative Outcomes of Three Left Atrial Incisions: Conventional Direct, Transseptal and Superior Septal Left Atriotomy

Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

Abstract:

Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

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