Search results for: clinical decision support sytem

Authors: I. Ling Tsai, Shu Fen Wu, Chen-Fuh Lam, Chia Yu Chen, Shu Jiuan Chen, Yen Lin Liu

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Purpose: Following the conduction of the National Health Insurance (NHI) system in Taiwan since 1995, the demand for anesthesia services continues to increase in the operating rooms and other medical units. It has been well recognized that increased work stress not only affects the clinical performance of the medical staff, long-term work load may also result in occupational burnout. Our study aimed to determine the influence of working environment, work stress and job satisfaction on the occupational burnout in nurse anesthetists. The ultimate goal of this research project is to develop a strategy in establishing a friendly, less stressful workplace for the nurse anesthetists to enhance their job satisfaction, thereby reducing occupational burnout and increasing the career life for nurse anesthetists. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator 2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the nurse anesthetists. The relationships between two numeric datasets were analyzed by the Pearson correlation test (SPSS 20.0). Results: A total of 66 completed questionnaires were collected from 75 nurses (response rate 88%). The average scores for the working environment, job satisfaction, and work stress were 69.6%, 61.5%, and 63.9%, respectively. The three perspectives used to assess the occupational burnout, namely emotional exhaustion, depersonalization and sense of personal accomplishment were 26.3, 13.0 and 24.5, suggesting the presence of moderate to high degrees of burnout in our nurse anesthetists. The presence of occupational burnout was closely correlated with the unsatisfactory working environment (r=-0.385, P=0.001) and reduced job satisfaction (r=-0.430, P=0.000). Junior nurse anesthetists (<1-year clinical experience) reported having higher satisfaction in working environment than the seniors (5 to 10-year clinical experience) (P=0.02). Although the average scores for work stress, job satisfaction, and occupational burnout were lower in junior nurses, the differences were not statistically different. The linear regression model, the working environment was the independent factor that predicted occupational burnout in nurse anesthetists up to 19.8%. Conclusions: High occupational burnout is more likely to develop in senior nurse anesthetists who experienced the dissatisfied working environment, work stress and lower job satisfaction. In addition to the regulation of clinical duties, the increased workload in the supervision of the junior nurse anesthetists may result in emotional stress and burnout in senior nurse anesthetists. Therefore, appropriate adjustment of clinical and teaching loading in the senior nurse anesthetists could be helpful to improve the occupational burnout and enhance the retention rate.

Keywords: nurse anesthetists, working environment, work stress, job satisfaction, occupational burnout

Procedia PDF Downloads 278

Authors: Avantika Verma

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In industrialized nations, corneal lacerations are one of the most common reason for hospitalization. This study was designed to study visual and clinical outcome in patients presenting with full thickness corneal lacerations in Indian population and to ascertain the impact of various preoperative and operative factors influencing prognosis after repair of corneal lacerations. Males in third decade with injuries at work with metallic objects were common. Lens damage, hyphema, vitreous hemorrhage, retinal detachment and endophthalmitis were seen. All the patients underwent primary repair within first 24 hours of presentation. At 3 months, 74.3% had a good visual outcome. About 5.7% of patients had no perception of light.In conclusion, various demographic and preoperative factors like age, time of presentation, vision at presentation, length of corneal wound, involvement of visual axis, associated ocular features like hyphaema, lenticular changes, vitreous haemorrhage and retinal detachment are significant prognostic indicators for final visual outcome.

Keywords: corneal laceration, corneal wound repair, injury, visual outcome

Procedia PDF Downloads 357

Authors: J. Tamosaitiene

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The article focuses on the identification and classification of key risk management criteria that represent the most important sustainability aspects of the construction industry. The construction sector is one of the most important sectors in Lithuania. Nowadays, the assessment of the risk level of a construction project is especially important for the quality of construction projects, the growth of enterprises and the sector. To establish the most important criteria for successful growth of the sector, a questionnaire for experts was developed. The analytic hierarchy process (AHP), the expert judgement method and other multicriteria decision making (MCDM) methods were used to develop the hybrid model. The results were used to develop an integrated knowledge system for the measurement of a risk level particular to construction projects. The article presents a practical case that details the developed system, sustainable aspects, and risk assessment.

Keywords: risk, system, model, construction

Procedia PDF Downloads 167

Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

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In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: data security, flow cytometry, leukaemia, telematics platform, telemedicine

Procedia PDF Downloads 984

Authors: Armin Khaghani Boroujeni, Leila Dehghani, Parham Talebi Boroujeni, Sahar Rostamian, Ali Asilian

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Background: Hair loss is a common complaint observed in both genders. Androgenetic alopecia is known pattern for hair loss. To assess new regenerative strategies (PRP, A-SC-BT, conditioned media, exosome-based treatments) compared to conventional therapies for hair loss or hair regeneration, an updated review was undertaken. To address this issue, we carried out this systematic review to comprehensively evaluate the efficacy of cell-based therapies on hair loss. Methods: The available online databases, including ISI Web of Science, Scopus, and PubMed, were searched systematically up to February 2022. The quality assessment of included studies was done using the Cochrane Collaboration's tool. Results: As a result, a total of 90 studies involving 2345 participants were included in the present study. The enrolled studies were conducted between 2010 and 2022. The subjects’ mean age ranged from 19 to 55.11 years old. Approaches using platelet rich plasma (PRP) provide a beneficial impact on hair regrowth. However, other cell-based therapies, including stem cell transplant, stem cell-derived conditioned medium, and stem cell-derived exosomes, revealed conflicting evidence. Conclusion: However, cell-based therapies for hair loss are still in their infancy, and more robust clinical studies are needed to better evaluate their mechanisms of action, efficacy, safety, benefits, and limitations. In this review, we provide the resources to the latest clinical studies and a more detailed description of the latest clinical studies concerning cell-based therapies in hair loss.

Keywords: cell-based therapy, exosome, hair restoration, systematic review

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Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

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Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos

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Aims: Atrial fibrillation (AF) remains one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Ablation techniques are becoming more appealing after the latest results of randomized trials showing the overall clinical benefit. On the other hand, imaging techniques and the frontier application of 3D printing are emerging as a valuable ally for cardiac procedures. However, no randomized trial has directly assessed the impact of preprocedural imaging and especially 3D printing guidance for AF ablation. The present study is designed to investigate for the first time the effect of 3D printing of the heart on the safety and effectiveness of the ablation procedure. Methods and design: The 3D-GALA trial is a randomized, open-label, controlled, multicentre clinical trial of 2 parallel groups designed to enroll a total of 100 patients undergoing ablation using cryo-balloon for paroxysmal and persistent AF. Patients will be randomized with a patient allocation ratio of 1: 1 to preprocedural MRI scan of the heart and 3D printing of left atrium and pulmonary veins and cryoablation versus standard cryoablation without imaging. Patients will be followed up to 6 months after the index procedure. The primary outcome measure is the reduction of radiation dose and contrast amount during pulmonary veins isolation. Secondary endpoints will include the percentage of atrial fibrillation relapse at 24h-Holter electrocardiogram monitoring at 6 months after initial treatment. Discussion: To our knowledge, the 3D-GALA trial will be the first study to provide evidence about the clinical impact of preprocedural imaging and 3D printing before cryoablation.

Keywords: atrial fibrillation, cardiac MRI, cryoablation, 3-d printing

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Authors: Suraj Mehrotra

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The stock market is a volatile, bustling marketplace that is a cornerstone of economics. It defines whether companies are successful or in spiral. A thorough understanding of it is important - many companies have whole divisions dedicated to analysis of both their stock and of rivaling companies. Linking the world of finance and artificial intelligence (AI), especially the stock market, has been a relatively recent development. Predicting how stocks will do considering all external factors and previous data has always been a human task. With the help of AI, however, machine learning models can help us make more complete predictions in financial trends. Taking a look at the stock market specifically, predicting the open, closing, high, and low prices for the next day is very hard to do. Machine learning makes this task a lot easier. A model that builds upon itself that takes in external factors as weights can predict trends far into the future. When used effectively, new doors can be opened up in the business and finance world, and companies can make better and more complete decisions. This paper explores the various techniques used in the prediction of stock prices, from traditional statistical methods to deep learning and neural networks based approaches, among other methods. It provides a detailed analysis of the techniques and also explores the challenges in predictive analysis. For the accuracy of the testing set, taking a look at four different models - linear regression, neural network, decision tree, and naïve Bayes - on the different stocks, Apple, Google, Tesla, Amazon, United Healthcare, Exxon Mobil, J.P. Morgan & Chase, and Johnson & Johnson, the naïve Bayes model and linear regression models worked best. For the testing set, the naïve Bayes model had the highest accuracy along with the linear regression model, followed by the neural network model and then the decision tree model. The training set had similar results except for the fact that the decision tree model was perfect with complete accuracy in its predictions, which makes sense. This means that the decision tree model likely overfitted the training set when used for the testing set.

Keywords: machine learning, testing set, artificial intelligence, stock analysis

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Authors: Hend Almaseb

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​The motivational model proposed by Self-Determination Theory provided an explanation for clients’ motivation for therapy. Among a sample of 78 inpatient residents in the Addiction Treatment Center, this study examined the relationship between three types of motivation (Autonomous, Controlled, and Amotivation) and each of the following variables: Age, Marital Status, Educational Level of Participant, and Number of Years of Addiction. In addition, the study investigated whether or not the participants are motivated to receive therapy. The results showed 1) a significant relationship between Controlled Motivation and the following variables: Age, Marital Status, and Number of Years of Addiction; 2) a significant relationship between Autonomous Motivation and Number of Years of Addiction; and a significant relationship between Educational Level and Amotivation. The results also illustrated that the participants of this study were not motivated to seek therapy.

Keywords: addiction, clinical social work, motivation, self-determination

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Authors: Junaid Mahmood Alam, Sana Anwar, Sarah Sughra Asghar

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Chronic hepatitis or Hepatitis C viral (HCV) infection has been identified as one of the factors that could elicit autoimmune disease resulting in the development of auto-antibodies. Furthermore, HCV is implicated in contravening of forbearance to antigens, therefore, inciting auto-reactivity. In this regard, several near and past studies noted the prevalence of thyroid dysfunction and production of anti-thyroid antibodies (ATAb) such as anti-thyroid peroxidase (AntiTPO) and anti-thyroglobulin (AntiTG) in patients with HCV. Likewise, one of the etiologies of augmentation of thyroid disease is basically interferon therapy for HCV infections, for which a number of autoimmune diseases have been noted including Grave’s disease, Hishimoto thyroiditis. A prospectively case-control study was therefore carried out at department of clinical biochemistry lab services and chemical pathology in collaboration with department of clinical microbiology, at Liaquat National Hospital and Medical College, Karachi Pakistan for the period January 2015 to December 2017. Two control groups were inducted for comparison purpose, control group 1 = without HCV infection and with thyroid disorders (n = 20), control group 2 = with HCV infection and without thyroid disorders (n = 20), whereas HCV infected were n = 40 where more than half were noted to be positive for either of HCV IgG and Ag. In HCV group, patients with existing sub-clinical hypothyroidism and clinical hyperthyroidism were less than 5%. Analysis showed the presence of AntiTG in 12 HCV patients (30%), AntiTPO in 15 (37.5%) and both AntiTG and antiTPO in 10 patients (25%). Only 3 patients were found with the history of anti-thyroid auto-antibodies (7.5%) and one with parents and relatives with auto-immune disorders (2.5%). Patients that remained untreated were 12 (30%), under treatment 18 (45%) and with complete-course of treatment 10 (25%). As per review of the literature, meta-analysis of evident data and cross-sectional studies of selective cohorts (as studied in presented research), thyroid connection is designated as one of the most recurrent endocrine ailment associated with chronic HCV infection. Moreover, it also represents an extrahepatic disease in the continuum of HCV syndrome. In conclusion, HCV patients were more likely to encompass thyroid disorders especially related to development of either of ATAb or both antiTG and AntiTPO.

Keywords: Hepatitis C viral (HCV) infection, anti-thyroid antibodies, anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies

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Authors: Hyunchul Ahn, William X. S. Wong

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Corporate credit rating prediction is one of the most important topics, which has been studied by researchers in the last decade. Over the last decade, researchers are pushing the limit to enhance the exactness of the corporate credit rating prediction model by applying several data-driven tools including statistical and artificial intelligence methods. Among them, multiclass support vector machine (MSVM) has been widely applied due to its good predictability. However, heuristics, for example, parameters of a kernel function, appropriate feature and instance subset, has become the main reason for the critics on MSVM, as they have dictate the MSVM architectural variables. This study presents a hybrid MSVM model that is intended to optimize all the parameter such as feature selection, instance selection, and kernel parameter. Our model adopts genetic algorithm (GA) to simultaneously optimize multiple heterogeneous design factors of MSVM.

Keywords: corporate credit rating prediction, Feature selection, genetic algorithms, instance selection, multiclass support vector machines

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Authors: Taner Ersoz, Filiz Ersoz, Seyma Ozbilge

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In this study, the clients who applied to a bank branch for loan were analyzed through data mining. The study was composed of the information such as amounts of loans received by personal and SME clients working with the bank branch, installment numbers, number of delays in loan installments, payments available in other banks and number of banks to which they are in debt between 2010 and 2013. The client risk profile was examined through Classification and Regression Tree (CART) analysis, one of the decision tree classification methods. At the end of the study, 5 different types of customers have been determined on the decision tree. The classification of these types of customers has been created with the rating of those posing a risk for the bank branch and the customers have been classified according to the risk ratings.

Keywords: client classification, loan suitability, risk rating, CART analysis

Procedia PDF Downloads 338

Authors: Jiajia Peng, Danni Cheng, Jianqing Qiu, Yufang Rao, Minzi Mao, Ke Qiu, Junhong Li, Fei Chen, Feng Liu, Jun Liu, Xiaosong Mu, Wenxin Yu, Wei Zhang, Wei Xu, Yu Zhao, Jianjun Ren

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Background: Currently, primary B-cell non-Hodgkin lymphoma (B-NHL) and T/NK-cell non-Hodgkin lymphoma (NKT-NHL) originated from the nasal cavity (NC), nasopharynx (NP) and nasal sinus (NS) distinguished unclearly in the clinic. Objective: We sought to compare the clinical and survival differences of B-NHL and NKT-NHL that occurred in NC, NP, and NS, respectively. Methods: Retrospective data of patients diagnosed with nasal cavity lymphoma (NCL), nasopharyngeal lymphoma (NPL), and nasal sinus lymphoma (NSL) between 1975 and 2017 from the Surveillance, Epidemiology, and End Results (SEER) database were collected. We identified the B/NKT-NHL patients based on the histological type and performed univariate, multivariate, and Kaplan-Meier analyses to investigate the survival rates. Results: Of the identified 3,101 B-NHL and 738 NKT-NHL patients, those with B-NHL in NP were the majority (43%) and had better cancer-specific survival than those in NC and NS from 2010 to 2017 (5-year-CSS, NC vs. NP vs. NS: 81% vs. 83% vs. 82%). In contrast, most of the NKT-NHL originated from NC (68%) and had the highest CSS rate in the recent seven years (2010-2017, 5-year-CSS: 63%). Additionally, the survival outcomes of patients with NKT-NHL-NP (HR: 1.34, 95% CI: 0.62-2.89, P=0.460) who had received surgery were much worse than those of patients with NKT-NHL-NC (HR: 1.07, 95% CI: 0.75-1.52, P=0.710) and NKT-NHL-NS (HR: 1.11, 95% CI: 0.59-2.07, P=0.740). NKT-NHL-NS patients who had radiation performed (HR: 0.38, 95% CI: 0.19-0.73, P=0.004) showed the highest survival rates, while chemotherapy performed (HR: 1.01, 95% CI: 0.43-2.37, P=0.980) presented opposite results. Conclusions: Although B-NHL and NKT-NHL originating from NC, NP and NS had similar anatomical locations, their clinical characteristics, treatment therapies, and prognoses were different in this study. Our findings may suggest that B-NHL and NKT-NHL in NC, NP, and NS should be treated as different diseases in the clinic.

Keywords: nasopharyngeal lymphoma, nasal cavity lymphoma, nasal sinus lymphoma, B-cell non-Hodgkin lymphoma, T/NK-cell non-Hodgkin lymphoma

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Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya

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Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.

Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia

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Authors: Wipanee Maen-In

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The objectives of the research are i) to study the motivations of european and scandinavian tourists who select Ranong province as their destinations ii) to study their perception towards the Ranong Province and iii) to study the visitors’ decision making while visiting Ranong Province. The samples of the study are 220 European and Scandinavian tourists’ visitors at the Ranong by accidental sampling and in clouding online questionnaires for 53 sampling. The data analysis includes Percentage, Frequency and One-way ANOVA. The findings from the research are the motivation level of the visitors is considered prominent, the average score of the motivational factors ranks higher than the average of the pull factors to visit the Ranong province when considering the factors analysis, the research shows that the reason that most tourists visit the Ranong is for relaxation while the purity of the natural mineral hot springs is the most important pull factor.

Keywords: European and Scandinavian, Ranong province, tourists’ perceptions, visitors’ decision making

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Authors: Tai-Yue Wang, Yi-Ho Chen

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In this study, we investigate a two-echelon supply chain with two suppliers and three retailers among which one retailer dominates other retailers. A price competition demand function is used to model this dominant retailer, which is leading market. The promotion strategies and negotiation schemes are integrated to form decision-making models under different scenarios. These models are then formulated into different mathematical programming models. The decision variables such as promotional costs, retailer prices, wholesale price, and order quantity are included in these models. At last, the distributions of promotion costs under different cost allocation strategies are discussed. Finally, an empirical example used to validate our models. The results from this empirical example show that the profit model will create the largest profit for the supply chain but with different profit-sharing results. At the same time, the more risk a member can take, the more profits are distributed to that member in the utility model.

Keywords: supply chain, price promotion, mathematical models, dominant retailer

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Authors: Soressa Tolcha Jarra

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Looking into firm-level internationalization strategies and their effects on firms' productivity is needed in order to understand the role of firms’ participation in trading activities on the one hand and the effects of firms’ internalization strategies on firm-level productivity on the other. Thus, this study aims to investigate firms' imports of intermediates and export strategies and their impact on firm productivity using an establishment-level panel dataset from Ethiopian manufacturing firms over the period 2011–2020. Methodologically, the joint firm’s decision to import intermediates and estimate exports is undertaken by system GMM using Wooldridge's approach. The translog-production function is used to estimate firm-level productivity by considering a general Markov process. The size of the firm is used in a mediating role. The result indicates evidence of the self-selection of more productive firms into exporting and importing intermediates, which is indicative of sizable export and import market entry costs. Furthermore, there is evidence in favor of learning by exporting (LBE) and learning by importing (LBI) hypotheses for smaller and medium Ethiopian manufacturing firms. However, for large firms, there is only evidence in support of the learning by exporting (LBE) hypothesis.

Keywords: Ethiopia, export, firm productivity, intermediate imports

Procedia PDF Downloads 37

Authors: Mykah W. Sumoldao, Maria Erissa C. Susa, Triny Cate M. Telan, Christian Arvin M. Torres, Jasmine I. Udasco, Franceis Jeramil M. Walis, Shellyn S. Wandagan, Janine May M. Warding, Queenie Diana Rose P. Zalun Hope Lulet A. Lomioan

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This descriptive phenomenological study explored the lived experiences of the primary caregiver of schizophrenia patients at the Acute Crisis Intervention Service in Cagayan Valley Medical Center. The research aimed to understand the emotional, physical, and financial challenges these primary caregivers face. Data was gathered through interviews with nine (9) primary caregivers and analyzed using Colaizzi’s seven-step method. Two main themes emerged: Experience/ Challenges (Emotional, Physical, and Financial Challenges) and Managing Mechanisms (Support Systems and Resilience and Commitment). The study found that primary caregivers deal with a complex mix of difficulties, often with limited resources. They rely heavily on personal strength, faith, family, friends and community support to manage their roles. The findings highlighted the need for better support systems to ease primary caregivers' burdens. Financial aid, respite care, and mental health support are crucial for improving primary caregivers' quality of life and the care they provide. Additionally, raising awareness about primary caregivers' challenges can foster a supportive community, with more help from local organizations and government entities. Thus, this study provided insights into the caregiving experiences of those supporting schizophrenia patients. It emphasized the importance of practical support and emotional resilience. By addressing these needs, a more supportive environment can be created, benefiting both primary caregivers and their patients.

Keywords: primary caregiver burden, mental health, primary caregiver well-being, primary caregiver

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Authors: Filiz Ersoz, Taner Ersoz, Erkin Guler

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This paper addresses the issues and technique for textile industry using data mining techniques. Data mining has been applied to the stitching of garments products that were obtained from a textile company. Data mining techniques were applied to the data obtained from the CHAID algorithm, CART algorithm, Regression Analysis and, Artificial Neural Networks. Classification technique based analyses were used while data mining and decision model about the production per person and variables affecting about production were found by this method. In the study, the results show that as the daily working time increases, the production per person also decreases. In addition, the relationship between total daily working and production per person shows a negative result and the production per person show the highest and negative relationship.

Keywords: data mining, textile production, decision trees, classification

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Authors: D. Bąk-Grabowska, K. Grzesik, A. Iwanicka, A. Jagoda

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The process of human resources management in the structures of corporate groups demonstrates certain specificity, resulting from the division of decision-making and executive competencies, which occurs within these structures between a parent company and its subsidiaries. The subprocess of employee assessment is considered crucial, since it provides information for the implementation of personnel function. The empirical studies conducted in corporate groups, within which at least one company is located in Poland, confirmed the critical significance of employee assessment systems in the process of human resources management in corporate groups. Parent companies, most often, retain their decision-making authority within the framework of the discussed process and introduce uniform employee assessment and personnel controlling systems to subsidiary companies. However, the instruments for employee assessment applied in corporate groups do not present such specificity.

Keywords: corporate groups, employee periodical assessment system, holding, human resources management

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Authors: Arne Koschel

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This article discusses event monitoring options for heterogeneous event sources as they are given in nowadays heterogeneous distributed information systems. It follows the central assumption, that a fully generic event monitoring solution cannot provide complete support for event monitoring; instead, event source specific semantics such as certain event types or support for certain event monitoring techniques have to be taken into account. Following from this, the core result of the work presented here is the extension of a configurable event monitoring (Web) service for a variety of event sources. A service approach allows us to trade genericity for the exploitation of source specific characteristics. It thus delivers results for the areas of SOA, Web services, CEP and EDA.

Keywords: event monitoring, ECA, CEP, SOA, web services

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Authors: Werner Roux Uys

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The Commissioner for the South African Revenue Service (SARS) holds a high position of trust in South African society and a lack of trust by taxpayers in the Commissioner’s actions or conduct could compromise SARS’ management of public finances. Tax morality – which is implicit in the social contract between taxpayers and the state – includes distinct phenomena that can cause a breakdown if there is a perceived lack of action on the part of the Commissioner to ensure public finances are kept safe. To promote tax morality, the Commissioner must support the judiciary in the exercise of its discretion to punish fraudulent tax activities and corrupt tax practices. For several years the political meddling in the Commissioner’s actions and conduct have caused perceived abuse of power at SARS, and taxpayers believed their hard-earned income paid over to SARS would be fruitless and wasteful expenditure. The purpose of this article is to identify and analyse previous decisions held by the South African judiciary regarding the Commissioner’s actions and conduct in tax matters, as well as consider important political statements and newspaper bulletins for the purpose of this research. The study applies a qualitative research approach and exploratory case study technique. Keywords were selected and inserted in the LexisNexis electronic database to systematically identify applicable case law where the ratio decidendi of the court referred to the actions and/or conduct of the Commissioner. Specific real-life statements, including political statements and newspaper bulletins, were selected to support the topic at hand. The purpose of the study is to educate the public about the perceptions that have transformed taxpayers’ behaviour towards the Commissioner for SARS since South Africa’s fledgling constitutional democracy was inaugurated in 1994. The study adds to the literature by identifying key characteristics or distinct phenomena regarding the actions and conduct of the Commissioner affecting taxpayers’ behaviour, including discretionary decision-making. From the findings, it emerged that SARS must abide by its (own) laws and that there is a need to educate not only South African taxpayers about tax morality, but also the public in general.

Keywords: commissioner, SARS, action and conduct, judiciary, discretionry, decsion-making

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Authors: S. Shafiee Ardestani, A. Najafi, N. Valizadeh, E. Payani, H. Karimian

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Objectives: Treatment of mild traumatic brain injury in emergency ward patients with any type of traumatic intracranial hemorrhage is flexible. The aim of this study is to assess the clinical outcomes of mild traumatic brain injury patients who had acute traumatic intracranial hemorrhage on initial emergency ward neuroimaging. Materials-Methods: From March 2011 to November 2012 in a retrospective cohort study we enrolled emergency ward patients with mild traumatic brain injury with Glasgow Coma Scale (GCS) scores of 14 or 15 and who had stable vital signs. Patients who had any type of intracranial hemorrhage on first head CT and repeat head CT within 24 hours were included. Patients with initial GCS < 14, injury > 24 hours old, pregnancy, concomitant non-minor injuries, and coagulopathy were excluded. Primary endpoints were neurosurgical procedures and/or death and for discharged patients, return to the emergency ward during one week. Results: Among 755 patients who were referred to the emergency ward and underwent two head CTs during first 24 hours, 302 (40%) were included. The median interval between CT scans was 6 hours (ranging 4 to 8 hours). Consequently, 135 (45%) patients had subarachnoid hemorrhage, 124 (41%) patients had subdural hemorrhage, 15 (5%) patients had epidural hemorrhage, 28 (9%) patients had cerebral contusions, and 54 (18%) patients had intra-parenchymal hemorrhage. Six of 302 patients died within 15 days of injury. 200 patients (66%) have been discharged from the emergency ward, 25 (12%) of whom returned to the emergency ward after one week. Conclusion: Discharge of the head trauma patients after a repeat head CT and brief period of observation in the emergency ward lead to early discharge of mild traumatic brain injury patients with traumatic ICH without adverse events.

Keywords: clinical outcomes, emergency ward, mild traumatic intracranial hemorrhage, Glasgow Coma Scale (GCS)

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Authors: Masoumeh Khailghi Sikaroudi, Mohsen Masoodi, Fazad Shidfar, Meghdad Sedaghat

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Background: The hypertonicity of internal anal sphincter resting pressure is one of the main reasons for chronic anal fissures. The aim of this study is to assess the effect of oral administration of L-arginine on anal fissure symptom improvement by relaxation of the internal anal sphincter. Method: Seventy-six chronic anal fissure patients (age: 18-65 years) took part in this randomized, double-blind, placebo-controlled trial study from February 2019 to October 2020 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were allocated into treatment (L-arginine) or placebo groups. They took a 1000 mg capsule three times a day for one month and were followed up at the end of the first and third months after receiving the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. Result: The analysis of data was shown significant improvement in bleeding, fissure size, and pain within each group; however, this effect was more seen in the arginine group compared to the control group at the end of the study (P-values<0.001). Following that, a significant increase in QoL was seen just in patients who were treated with arginine (P-value=0.006). Also, the comparison of anal pressures to baseline and between groups at the end of the study showed a significant reduction in sphincter pressure in treated patients (P-value<0.001, =0.049; respectively). Conclusion: Oral administration of 3000 mg L-arginine can heal chronic anal fissures by reducing anal internal sphincter pressure with fewer side effects. However, a long-term study with more follow-up is recommended.

Keywords: L-arginine, anal fissure, sphincter pressure, clinical symptoms, quality of life

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Authors: Zarah M. Bello, Nathan Baddoo, Mariana Lilley, Paul Wernick

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In this paper, we present findings from a multi-part study to evaluate candidate elements reflecting the level of digital capability maturity (DCM) in higher education and the relationship between these elements. We will use these findings to propose a model of DCM for educational institutions. We suggest that the success of learning in higher education is dependent in part on the level of maturity of digital capabilities of institutions as well as the abilities of learners and those who support the learning process. It is therefore important to have a good understanding of the elements that underpin this maturity as well as their impact and interactions in order to better exploit the benefits that technology presents to the modern learning environment and support its continued improvement. Having identified ten candidate elements of digital capability that we believe support the level of a University’s maturity in this area as well as a number of relevant stakeholder roles, we conducted two studies utilizing both quantitative and qualitative research methods. In the first of these studies, 85 electronic questionnaires were completed by various stakeholders in a UK university, with a 100% response rate. We also undertook five in-depth interviews with management stakeholders in the same university. We then utilized statistical analysis to process the survey data and conducted a textual analysis of the interview transcripts. Our findings support our initial identification of candidate elements and support our contention that these elements interact in a multidimensional manner. This multidimensional dynamic suggests that any proposal for improvement in digital capability must reflect the interdependency and cross-sectional relationship of the elements that contribute to DCM. Our results also indicate that the notion of DCM is strongly data-centric and that any proposed maturity model must reflect the role of data in driving maturity and improvement. We present these findings as a key step towards the design of an operationalisable DCM maturity model for universities.

Keywords: digital capability, elements, maturity, maturity framework, university

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Authors: Abdullah Abu-Tineh, Hissa Sadiq, Fatma Al-Mutawah, Youmen Chaaban

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The past 20 years have seen a proliferation of empirical research into various licensure systems. Extensive quantitative work investigates these systems of appraisal from different countries, but there is far less research on the implementation of the Qatari licensure system and the adoption of professional standards. In this paper, we provided a quantitatively and qualitatively descriptive look at the process that moves educators from their point of entry into the profession through their certification as accomplished professionals. Specifically, we focused on the perceptions of teachers and school leaders on the licensure system currently adopted by Ministry of Education and Higher Education in Qatar. The paper aims to inform progress towards a system of reliable, valid, and nationally appropriate teacher and school leader evaluation procedures. Such a system can support decision-making based on a common, comprehensive set of standards that ensures the placement of only the most effective educators in Qatari schools. This paper was made possible by NPRP grant # (NPRP7-1224-5-178) from the Qatar national research fund (a member of Qatar foundation) to Abdullah M. Abu-Tineh. The statements made herein are solely the responsibility of the author.

Keywords: licensure system, professional standards, professional portfolio, educator voice

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Authors: Felix Darko-Amoah, Daniel Acquah

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In contemporary ecosystems for developing countries like Ghana, the need to explore innovative solutions for sustainable livelihoods of farmers is more important than ever. With Ghana’s population growing steadily and the demand for food, fiber and shelter increasing, it is imperative that the construction industry and agriculture come together to address the challenges faced by farmers in the country. In order to enhance the livelihoods of cocoa farmers in Ghana, this paper provides an innovative strategy that aims to integrate the areas of civil engineering and cash crop agriculture. This study focuses on cocoa cultivation in poorer nations, where farmers confront a variety of difficulties include restricted access to financing, subpar infrastructure, and insufficient support services. We seek to improve farmers' access to financing, improve infrastructure, and provide support services that are essential to their success by combining the fields of building engineering and cocoa production. The findings of the study are beneficial to cocoa producers, community extension agents, and construction engineers. In order to accomplish our objectives, we conducted 307 of field investigations in particular cocoa growing communities in the Western Region of Ghana. Several studies have shown that there is a lack of adequate infrastructure and financing, leading to low yields, subpar beans, and low farmer profitability in developing nations like Ghana. Our goal is to give farmers access to better infrastructure, better financing, and support services that are crucial to their success through the fusion of construction engineering and cocoa production. Based on data gathered from the field investigations, the results show that the employment of appropriate technology and methods for developing structures, roads, and other infrastructure in rural regions is one of the essential components of this strategy. For instance, we find that using affordable, environmentally friendly materials like bamboo, rammed earth, and mud bricks can assist to cut expenditures while also protecting the environment. By applying simple relational techniques to the data gathered, the results also show that construction engineers are crucial in planning and building infrastructure that is appropriate for the local environment and circumstances and resilient to natural disasters like floods. Thus, the convergence of construction engineering and cash crop cultivation is another crucial component of the agriculture-construction interplay. For instance, farmers can receive financial assistance to buy essential inputs, such as seeds, fertilizer, and tools, as well as training in proper farming methods. Moreover, extension services can be offered to assist farmers in marketing their crops and enhancing their livelihoods and revenue. In conclusion, our analysis of responses from the 307 participants depicts that the combination of construction engineering and cash crop agriculture offers an innovative approach to improving farmers' livelihoods in cocoa farming communities in Ghana. In conclusion, by inculcating the findings of this study into core decision-making, policymakers can help farmers build sustainable and profitable livelihoods by addressing challenges such as limited access to financing, poor infrastructure, and inadequate support services.

Keywords: cocoa agriculture, construction engineering, farm buildings and equipment, improved livelihoods of farmers

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Authors: Edward Guillén, Jeisson Sánchez, Carlos Omar Ramos

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In recent years, a wide variety of applications are developed with Support Vector Machines -SVM- methods and Artificial Neural Networks -ANN-. In general, these methods depend on intrusion knowledge databases such as KDD99, ISCX, and CAIDA among others. New classes of detectors are generated by machine learning techniques, trained and tested over network databases. Thereafter, detectors are employed to detect anomalies in network communication scenarios according to user’s connections behavior. The first detector based on training dataset is deployed in different real-world networks with mobile and non-mobile devices to analyze the performance and accuracy over static detection. The vulnerabilities are based on previous work in telemedicine apps that were developed on the research group. This paper presents the differences on detections results between some network scenarios by applying traditional detectors deployed with artificial neural networks and support vector machines.

Keywords: anomaly detection, back-propagation neural networks, network intrusion detection systems, support vector machines

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Authors: Carla Van De Sande, Jana Vandenberg

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Just like physical skills, cognitive skills grow rusty over time unless they are regularly used and practiced, so academic breaks can have negative consequences on student learning and success. The Keeping in School Shape (KiSS) program is an engaging, accessible, and cost-effective intervention that harnesses the benefits of retrieval practice by using technology to help students maintain proficiency over breaks from school by delivering a daily review problem via text message or email. A growth mindset is promoted through feedback messages encouraging students to try again if they get a problem wrong and to take on a challenging problem if they get a problem correct. This paper reports on the relationship between confidence, accuracy, and decision-making during the implementation of the KiSS Program at a large university during winter break for students enrolled in an engineering introductory Calculus course sequence.

Keywords: growth mindset, learning loss, on-the-go learning, retrieval practice

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Authors: Hyeon-Kyo Lim, Sang-Hun Byun

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Risk assessment is carried out in most industrial plants for accident prevention, but there exists insufficient data for statistical decision making. It is commonly said that risk can be expressed as a product of consequence and likelihood of a corresponding hazard factor. Eventually, therefore, risk assessment involves human decision making which cannot be objective per se. This study was carried out to comprehend perceptive characteristics of human beings in industrial plants. Subjects were shown a set of illustrations describing scenes of industrial plants, and were asked to assess the risk of each scene with not only linguistic variables but also numeric scores in the aspect of consequence and likelihood. After that, their responses were formulated as fuzzy membership functions, and compared with those of university students who had no experience of industrial works. The results showed that risk level of industrial workers were lower than those of any other groups, which implied that the workers might generally have a tendency to neglect more hazard factors in their work fields.

Keywords: fuzzy, hazard, linguistic variable, risk assessment

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