Search results for: intensive case management
17865 Revolutionizing Project Management: A Comprehensive Review of Artificial Intelligence and Machine Learning Applications for Smarter Project Execution
Authors: Wenzheng Fu, Yue Fu, Zhijiang Dong, Yujian Fu
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The integration of artificial intelligence (AI) and machine learning (ML) into project management is transforming how engineering projects are executed, monitored, and controlled. This paper provides a comprehensive survey of AI and ML applications in project management, systematically categorizing their use in key areas such as project data analytics, monitoring, tracking, scheduling, and reporting. As project management becomes increasingly data-driven, AI and ML offer powerful tools for improving decision-making, optimizing resource allocation, and predicting risks, leading to enhanced project outcomes. The review highlights recent research that demonstrates the ability of AI and ML to automate routine tasks, provide predictive insights, and support dynamic decision-making, which in turn increases project efficiency and reduces the likelihood of costly delays. This paper also examines the emerging trends and future opportunities in AI-driven project management, such as the growing emphasis on transparency, ethical governance, and data privacy concerns. The research suggests that AI and ML will continue to shape the future of project management by driving further automation and offering intelligent solutions for real-time project control. Additionally, the review underscores the need for ongoing innovation and the development of governance frameworks to ensure responsible AI deployment in project management. The significance of this review lies in its comprehensive analysis of AI and ML’s current contributions to project management, providing valuable insights for both researchers and practitioners. By offering a structured overview of AI applications across various project phases, this paper serves as a guide for the adoption of intelligent systems, helping organizations achieve greater efficiency, adaptability, and resilience in an increasingly complex project management landscape.Keywords: artificial intelligence, decision support systems, machine learning, project management, resource optimization, risk prediction
Procedia PDF Downloads 2117864 Early Onset Neonatal Sepsis Pathogens in Malaysian Hospitals: Determining Empiric Antibiotic
Authors: Nazedah Ain Ibrahim, Mohamed Mansor Manan
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Treatment of suspected early onset neonatal sepsis (EONS) in Neonatal Intensive Care Unit (NICU) is essential. However, information regarding EONS pathogens may vary between regions. Global perspectives showed Group B Streptococcal (GBS) as the most common causative pathogens, but the widespread use of intrapartum antibiotics has changed the pathogens pattern towards gram negative microorganisms, especially E. coli. Objective of this study is to describe the pathogens isolated, to assess current treatment and risk of EONS. Records of 899 neonates born in three General Hospitals between 2009 until 2012 were retrospectively reviewed. The inclusion criteria were neonates with blood culture taken prior to empiric antibiotics administration and within 72 hours of life. Of the study group, a total of 734 (82%) cases had documented blood culture that met the inclusion criteria. Proven EONS (as confirmed by positive blood culture) was found in 22 (3%) neonates. The majority was isolated with gram positive organisms, 17 (2.3%). In addition, other common gram positive organism isolated were Coagulase negative staphylococci (7) followed by Bacillus sp. (5) and Streptococcus pneumonia (2), and only one case isolated with GBS, Streptococcus spp. and Enterococcus sp. Meanwhile, only five cases of gram negative organisms [Stenotropomonas (xantho) maltophi (1), Haemophilus influenza (1), Spingomonas paucimobilis (1), Enterobacter gergoviae (1) and E. coli (1)] were isolated. A total of 286 (39%) cases were exposed to intrapartum antibiotics and of those, 157 (21.4%) were administered prior to delivery. All grams positive and most gram negative organisms showed sensitivity to the tested antibiotics. Only two rare gram negative organisms showed total resistant. Male, surfactant, caesarean delivery and prolonged rapture of membrane >18hours were a possible risk of proven EONS. Although proven EONS remains uncommon in Malaysia, nonetheless, the effect of intrapartum antibiotics still required continuous surveillance. However, by analyzing isolated pathogens it can be used as treatment guidance in managing suspected EONS.Keywords: early onset neonatal sepsis, neonates, pathogens, gram positive, gram negative
Procedia PDF Downloads 31617863 Buffer Zone a Means of Reduction of Deforestation on Protected Area: A Case Study of Gunung Palung National Park in West Kalimantan, Indonesia
Authors: Dhruba Khatri, Uttam Ghimire, Nabin Kumar Thapalia
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Protected area management in Indonesia is based on MAB program and ICDPs have become Indonesia’s main approach to biodiversity conservation since the early 1990s. However, very few ICDPs have realized the importance of biodiversity conservation in Indonesia and significantly enhanced as a result of currently planned project activities. Gunung Palung National Park in West Kalimantan was damaged illegal logging after decentralization. It made clear through the field survey: (1) Agroforestry did not make reduce to deforestation on regional level and (2) local people who engaging illegal logging activities have two characteristics that for their life and for vent of surplus labor in village. From these results, it became clear that a local resident had a bilateral character as an actor of conservation and the deforestation and also it confirmed that a market also was working on both of the conservation and deforestation. Therefore, surplus labor can be the key actors for future program design and at the same time it is necessary corroborative system which central government, local government, and local people are concerned with the process of policy making under the situation that management body of national park and buffer zone was separated.Keywords: buffer zone, decentralization, Gunung Palung National Park, illegal logging, Indonesia
Procedia PDF Downloads 41417862 The Effect of Internal Auditing Function on the Quality of Financial Reporting: A Theoretical Framework
Authors: Hani Albogami
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The internal audit function is considered as one of the internal corporate governance mechanisms that may have an impact on improving earnings quality by constraining earnings management. The internal audit function is also a unique corporate governance mechanism because internal auditors have more involvement with the day-to-day operations comparing to the audit committee, and also internal auditors audit their companies the whole year compared to the external auditor who audits only a certain time of the year. The relationships between internal audit function and earnings management can be understood by some theories. Therefore, this paper provides a theoretical background of the influence of the quality of internal audit function on earnings management. In particular, the agency theory, institutional theory, singling theory, and resource dependency theory are adapted by this paper to provide some understanding and analyses that can be a basis for future research to contribute to the corporate governance academic studies.Keywords: internal audit, corporate governance, earnings management, accounting
Procedia PDF Downloads 20117861 A Case Study of Meningoencephalitis following Le Fort I Osteotomy
Authors: Ryan Goh, Nicholas Beech
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Introduction: Le Fort I Osteotomies, although are common procedures in Oral and Maxillofacial Surgery, carry a degree of risk of unfavourable propagation of the down-fracture of the maxilla. This may be the first reported case in the literature for meningoencephalitis to occur following a Le Fort I Osteotomy. Case: A 32-year-old female was brought into the Emergency Department four days after a Le Fort I Osteotomy, with a Glasgow Coma Scale (GCS) of 8 (E3V1M4). A Computed Tomography (CT) Head showed a skull base fracture at the right sphenoid sinus. Lumbar puncture was completed, and Klebsiella oxytoca was found in the Cerebrospinal Fluid (CSF). She was treated with Meropenem, and rapidly improved thereafter. CSF rhinorrhoea was identified when she was extubated, which was successfully managed via a continuous lumbar drain. She was discharged on day 14 without any neurological deficits. Conclusion: The most likely aspect of the Le Fort I Osteotomy to obtain a skull base fracture is during the pterygomaxillary disjunction. Care should always be taken to avoid significant risks of skull base fractures, CSF rhinorrhoea, meningitis and encephalitis.Keywords: meningitis, orthognathic surgery, post-operative complication, skull base, rhinorrhea
Procedia PDF Downloads 12517860 The Use of Budgeting as an Effective Management Tool for Small, Medium and Micro Enterprises during COVID-19 Pandemic: A Perspective from South Africa
Authors: Abongile Zweni, Grate Moyo, Ricardo Peters, Bingwen Yan
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Budgets are one of the most important tools that organisations, big or small, need to use as management tools. When organisations, particularly Small, Medium and Micro Enterprises (SMMEs), do not use budgets, they are bound to fail in their infancy stage. The aim of this study was to assess whether or not SMMEs in South Africa used budgets as an effective management tool during the COVID-19 pandemic. For the purposes of this study, data was collected using an online questionnaire (survey). This study used the quantitative research approach. The study used descriptive statistics to analyse the research question. The study found that most SMMEs did not use budgets during the COVID-19 pandemic; one of the reasons, amongst others, was that most of them had to close down during the lockdown, and some of them did not even qualify for government bailout or government grants.Keywords: budget management, SMMEs, COVID-19, South Africa
Procedia PDF Downloads 19217859 Bilateral Retinitis in Q Fever
Authors: Carl Eiselen, Stephen O’Hagan
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Background: Q fever, caused by the obligate intracellular bacterium Coxiella burnetii, is an infectious disease with variable systemic manifestations. Its potential to cause ocular complications has not been reported before in Australia. This case study explores the unusual presentation of asymptomatic acute multifocal retinitis (AMR) in a patient with acute Q fever endocarditis and hepatitis in rural Queensland, Australia. Case Presentation: A 48-year-old male gardener presented with flu-like symptoms, weight loss, and encephalopathy. Despite systemic malaise, he had no ocular symptoms. Laboratory investigations confirmed acute Q fever, and imaging studies identified hepatic involvement and endocarditis. The retinal screening revealed asymptomatic AMR, corroborated by fundus examination and SD-OCT. Following treatment with Doxycycline and hydroxychloroquine, both systemic and ocular manifestations improved. Discussion: This is the first documented case of asymptomatic AMR associated with Q fever. The patient’s lack of autoantibodies challenges the established understanding of Q fever endocarditis and suggests potential alternative mechanisms. Conclusion: This case report expands our understanding of the multi-systemic impact of Q fever, highlighting the need for comprehensive clinical evaluation and including retinal screening in the setting of acute infection. The disease's underlying mechanism for ocular involvement is not yet established.Keywords: Coxiella Burnetti, Q fever, ocular manifestation, acute multifocal retintis, endocarditis
Procedia PDF Downloads 5617858 Integrated Risk Management in The Supply Chain of Essential Medicines in Zambia
Authors: Mario M. J. Musonda
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Access to health care is a human right, which includes having timely access to affordable and quality essential medicines at the right place and in sufficient quantity. However, inefficient public sector supply chain management contributes to constant shortages of essential medicines at health facilities. Literature review involved a desktop study of published research studies and reports on risk management, supply chain management of essential medicines and their integration to increase the efficiency of the latter. The research was conducted on a sample population of offices under Ministry of Health Headquarters, Lusaka Provincial and District Offices, selected health facilities in Lusaka, Medical Stores Limited, Zambia Medicines Regulatory Authority and Cooperating Partners. Individuals involved in study were selected judgmentally by their functions under selection and quantification, regulation, procurement, storage, distribution, quality assurance, and dispensing of essential medicines. Structured interviews and discussions were held with selected experts and self-administered questionnaires were distributed. Collected and analysed data of 35 returned and usable questionnaires from the 50 distributed. The highest prioritised risks were; inadequate and inconsistent fund disbursements, weak information management systems, weak quality management systems and insufficient resources (HR and infrastructure) among others. The results for this research can be used to increase the efficiency of the public sector supply chain of essential medicines and other pharmaceuticals. The results of the study showed that there is need to implement effective risk management systems by participating institutions and organisations to increase the efficiency of the entire supply chain in order to avoid and/or reduce shortages of essential medicines at health facilities.Keywords: essential medicine, risk assessment, risk management, supply chain, supply chain risk management
Procedia PDF Downloads 44317857 A Conceptual E-Business Model and the Effect of Strategic Planning Parameters on E-Business Strategy Management and Performance
Authors: Alexandra Lipitakis, Evangelia A. E. C. Lipitakis
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In this article, a class of e-business strategy planning parameters are introduced and their effect on financial and non-financial performance of e-businesses and organizations is investigated. The relationships between these strategic planning parameters, i.e. Formality, Participation, Sophistication, Thoroughness, Synergy and Cooperation, Entropic Factor, Adaptivity, Uncertainty and Financial and Non-Financial Performance are examined and the directions of these relationships are given. A conceptual model has been constructed and quantitative research methods can be used to test the considered eight hypotheses. In the framework of e-business strategy planning this research study clearly demonstrates how strategic planning components have positive relationships with e-business strategy management and performance.Keywords: e-business management, e-business model, e-business performance assessments, strategy management methodologies, strategy planning, quantitative methods
Procedia PDF Downloads 39017856 Aeration of Fish Pond Aquaculture Using Wind Power
Authors: Fatima Hassan Mohamed Ahmed
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This study discusses the possibility techniques of using wind energy to operate the aeration devices which are used in the intensive fish farm for Nile Tilapia. The main objective is to show at what expense this renewable energy source can increase the production. The study was done for the oxygen consumption by 1 kg fishes of tilapia put in 1 m3. The theoretical study shows that the fishes consume around 0.5 gO2/hour when using paddle wheels with average oxygen transfer rate 2.6 kgO2/kW.h comparing this with dissolved oxygen consumed by fishes it was found that 1 kW will aerate 5200 m3 and the same power will aerate 1800 m3 when using air diffuser system with average oxygen transfer rate 0.9 kgO2/kW.h, this power can be supplied by the wind turbine with dimension with a tower 6 m high and diameter 2.7 m.Keywords: aeration, fish pond, wind, power
Procedia PDF Downloads 63817855 Analysis of Histogram Asymmetry for Waste Recognition
Authors: Janusz Bobulski, Kamila Pasternak
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Despite many years of effort and research, the problem of waste management is still current. So far, no fully effective waste management system has been developed. Many programs and projects improve statistics on the percentage of waste recycled every year. In these efforts, it is worth using modern Computer Vision techniques supported by artificial intelligence. In the article, we present a method of identifying plastic waste based on the asymmetry analysis of the histogram of the image containing the waste. The method is simple but effective (94%), which allows it to be implemented on devices with low computing power, in particular on microcomputers. Such de-vices will be used both at home and in waste sorting plants.Keywords: waste management, environmental protection, image processing, computer vision
Procedia PDF Downloads 11917854 How Does Improving the Existing DSL Infrastructure Influences the Expansion of Fiber Technology?
Authors: Peter Winzer, Erik Massarczyk
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Experts, enterprises and operators expect that the bandwidth request will increase up to rates of 100 to 1,000 Mbps within several years. Therefore the most important question is, which technology shall satisfy the future consumer broadband demands. Currently the consensus is, that the fiber technology has the best technical characteristics to achieve such the high bandwidth rates. But fiber technology is so far very cost-intensive and resource consuming. To avoid these investments, operators are concentrating to upgrade the existing copper and hybrid fiber coax infrastructures. This work presents a comparison of the copper and fiber technologies including an overview about the current German broadband market. Both technologies are reviewed in the terms of demand, willingness to pay and economic efficiency in connection with the technical characteristics.Keywords: broadband customer demand, fiber development, g.fast, vectoring, willingness to pay for broadband services
Procedia PDF Downloads 46917853 A Case Study on the Census of Technological Capacities in Health Care in Rural Sanitary Institutions in South Cameroon
Authors: Doriane Micaela Andeme Bikoro, Samuel Fosso Wamba, Jean Robert Kala Kamdjoug
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Currently one of the leading fields in the market of technological innovation is digital health. In developed countries, this booming innovation is experiencing an exponential speed. We understand that in developed countries, e-health could also revolutionize the practice of medicine and therefore fill the many failures observed in medical care. Everything leads to believe that future technology is oriented towards the medical sector. The aim of this work is to explore at the same time the technological resources and the potential of health care based on new technologies; it is a case study in a rural area of Southern Cameroon. Among other things, we will make a census of the shortcomings and problems encountered, and we will propose various appropriate solutions. The work methodology used here is essentially qualitative. We used two qualitative data collection techniques, direct observation, and interviews. In fact, we spent two weeks in the field observing and conducting some semi-directive interviews with some of those responsible for these health structures. This study was conducted in three health facilities in the south of the country; including two health centers and a rural hospital. Many technological failures have been identified in the day-to-day management of these health facilities and especially in the administration of health care to patients. We note major problems such as the digital divide, the lack of qualified personnel, the state of isolation of this area. This is why various proposals are made to improve the health sector in Cameroon both technologically and medically.Keywords: Cameroon, capacities, census, digital health, qualitative method, rural area
Procedia PDF Downloads 14417852 Management of H. Armigera by Using Various Techniques
Authors: Ajmal Khan Kassi, Humayun Javed, Syed Abdul Qadeem
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The study was conducted to find out the best management practices against American bollworm on Okra variety Arka Anamika during 2016. The three different management practices viz. Release of Trichogramma chilonis, hoeing and weeding, clipping and lufenuron insect growth regulator (IGR) which were tested individually and with all possible combinations for the controlling of American bollworm at 3 diverse areas viz. University Research Farm Koont, NARC and Farmer Field Taxila. All the treatment combinations regarding damage of fruit showed significant results. The minimum fruit infestation i.e. 3.20% and 3.58% was recorded with combined treatment (i.e. T. chilonis + hoeing + weeding + lufenuron) in two different localities. This combined treatment also resulted in maximum yield at NARC and Taxila i.e. 57.67 and 62.66 q/ha respectively. This treatment gave the best results to manage H. armigera. On the basis of different integrated pest management techniques, Arka Anamika variety proved to be comparatively resistant against H. armigera in different localities. So this variety is recommended for the cultivation in Pothwar region to get maximum yield.Keywords: management, american bollworm, arka anamika, okra
Procedia PDF Downloads 5517851 Performance Analysis of Proprietary and Non-Proprietary Tools for Regression Testing Using Genetic Algorithm
Authors: K. Hema Shankari, R. Thirumalaiselvi, N. V. Balasubramanian
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The present paper addresses to the research in the area of regression testing with emphasis on automated tools as well as prioritization of test cases. The uniqueness of regression testing and its cyclic nature is pointed out. The difference in approach between industry, with business model as basis, and academia, with focus on data mining, is highlighted. Test Metrics are discussed as a prelude to our formula for prioritization; a case study is further discussed to illustrate this methodology. An industrial case study is also described in the paper, where the number of test cases is so large that they have to be grouped as Test Suites. In such situations, a genetic algorithm proposed by us can be used to reconfigure these Test Suites in each cycle of regression testing. The comparison is made between a proprietary tool and an open source tool using the above-mentioned metrics. Our approach is clarified through several tables.Keywords: APFD metric, genetic algorithm, regression testing, RFT tool, test case prioritization, selenium tool
Procedia PDF Downloads 43617850 Power Management in Wireless Combustible Gas Sensors
Authors: Denis Spirjakin, Alexander Baranov, Saba Akbari, Natalia Kalenova, Vladimir Sleptsov
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In this paper we propose the approach to power management in wireless combustible gas sensors. This approach makes possible drastically prolong sensor nodes autonomous lifetime. That is necessary to tie battery replacement to every year technical service procedures which are claimed by safety standards. Using this approach the current consumption of the wireless combustible gas sensor node was decreased from 80 mA to less than 2 mA and the power consumption from more than 220 mW to 4.6 mW. These values provide autonomous lifetime of the node more than one year.Keywords: Gas sensors, power management, wireless sensor network
Procedia PDF Downloads 72417849 Bilateral Choroidal Metastases as the Presenting Manifestation of Lung Adenocarcinoma in a Young, Non-smoking Female: A Case Report
Authors: Paras Agarwal
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Background: Initially believed to be rare, metastases to the eye are the most common ocular malignancy. The choroid’s high perfusion rate not only makes it the most susceptible ocular site for tumour seeding, but also promotes its growth. The cancers most frequently responsible for choroidal metastases originate from the breast and lung, although a significant proportion have unidentified primaries at the time of presentation. Case Presentation: This case report describes a 34 year old female presenting to the ophthalmology department with a one month history of painless distorted vision. On fundus examination, she was noted to have bilateral choroidal lesionsand subsequently underwent a comprehensive diagnostic work-up. The patient was diagnosed with metastatic pulmonary adenocarcinoma, despite lacking conventional risk factors. As she was found to have a mutation in EGFR, the patient was commenced on tyrosine-kinase inhibition with afatinib. The choroidal lesions regressed with a significant improvement in visual acuity and a dramatic anatomical reduction of the choroidal masses. Conclusions: Our case demonstrates the importance of considering metastases as a differential diagnosis for choroidal lesions. Appropriate and thorough history-taking, examination and investigations may be required in order to deduce the underlying cause. Our case is unusual in view of the choroidal lesion being the primary manifestation of metastatic lung cancer in a young patient with no known risk factors. Early recognition of choroidal metastases is important as it is often the first sign of tumour dissemination and will prompt earlier treatment with systemic medications such as chemotherapy, immunotherapy, targeted therapy or hormonal therapy. Our case report also demonstrates the efficacy of afatinib for the treatment of choroidal metastases, with morphological and functional improvements observed with regard to the choroidal metastatic tumour.Keywords: choroidal neoplasm, choroidal naevus, pulmonary adenocarcinoma, metastases, lung cancer
Procedia PDF Downloads 13617848 Contemporary Materialities
Authors: Fabian Saptouw
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In the past decade there was a resurgence of interest in the value of ‘process’ and ‘craft’ within the social and artistic community. Theorist like Barbara Bolt and Paul Carter have eloquently argued for the importance of ‘theorizing out of practice’ and ‘material thinking’ in response to this trend. Time and labour intensive artistic production processes are however not generally included in this bracket and often labelled as either obsessive or absurd. Neither of these terms adequately conveys the conceptual importance of labour in relation to ‘process’ as manifested through this production method. This issue will be addressed by critically assessing the work of eight South African artists through the lens of contemporary process-based production. This will result in a more integrated view of the art-object, its art-historical trajectory, its materialisation as well as its production process. This paper will conclude by tying the characteristics of these artworks to international trends and provide a platform for the overall reconsideration of unalienated artistic labour.Keywords: materiality, process art, practice-led research, unalienated labour
Procedia PDF Downloads 34117847 Cuban's Supply Chains Development Model: Qualitative and Quantitative Impact on Final Consumers
Authors: Teresita Lopez Joy, Jose A. Acevedo Suarez, Martha I. Gomez Acosta, Ana Julia Acevedo Urquiaga
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Current trends in business competitiveness indicate the need to manage businesses as supply chains and not in isolation. The use of strategies aimed at maximum satisfaction of customers in a network and based on inter-company cooperation; contribute to obtaining successful joint results. In the Cuban economic context, the development of productive linkages to achieve integrated management of supply chains is considering a key aspect. In order to achieve this jump, it is necessary to develop acting capabilities in the entities that make up the chains through a systematic procedure that allows arriving at a management model in consonance with the environment. The objective of the research focuses on: designing a model and procedure for the development of integrated management of supply chains in economic entities. The results obtained are: the Model and the Procedure for the Development of the Supply Chains Integrated Management (MP-SCIM). The Model is based on the development of logistics in the network actors, the joint work between companies, collaborative planning and the monitoring of a main indicator according to the end customers. The application Procedure starts from the well-founded need for development in a supply chain and focuses on training entrepreneurs as doers. The characterization and diagnosis is done to later define the design of the network and the relationships between the companies. It takes into account the feedback as a method of updating the conditions and way to focus the objectives according to the final customers. The MP-SCIM is the result of systematic work with a supply chain approach in companies that have consolidated as coordinators of their network. The cases of the edible oil chain and explosives for construction sector reflect results of more remarkable advances since they have applied this approach for more than 5 years and maintain it as a general strategy of successful development. The edible oil trading company experienced a jump in sales. In 2006, the company started the analysis in order to define the supply chain, apply diagnosis techniques, define problems and implement solutions. The involvement of the management and the progressive formation of performance capacities in the personnel allowed the application of tools according to the context. The company that coordinates the explosives chain for construction sector shows adequate training with independence and opportunity in the face of different situations and variations of their business environment. The appropriation of tools and techniques for the analysis and implementation of proposals is a characteristic feature of this case. The coordinating entity applies integrated supply chain management to its decisions based on the timely training of the necessary action capabilities for each situation. Other cases of study and application that validate these tools are also detailed in this paper, and they highlight the results of generalization in the quantitative and qualitative improvement according to the final clients. These cases are: teaching literature in universities, agricultural products of local scope and medicine supply chains.Keywords: integrated management, logistic system, supply chain management, tactical-operative planning
Procedia PDF Downloads 15317846 Review of Studies on Agility in Knowledge Management
Authors: Ferdi Sönmez, Başak Buluz
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Agility in Knowledge Management (AKM) tries to capture agility requirements and their respective answers within the framework of knowledge and learning for organizations. Since it is rather a new construct, it is difficult to claim that it has been sufficiently discussed and analyzed in practical and theoretical realms. Like the term ‘agile learning’, it is also commonly addressed in the software development and information technology fields and across the related areas where those technologies can be applied. The organizational perspective towards AKM, seems to need some more time to become scholarly mature. Nevertheless, in the literature one can come across some implicit usages of this term occasionally. This research is aimed to explore the conceptual background of agility in KM, re-conceptualize it and extend it to business applications with a special focus on e-business.Keywords: knowledge management, agility requirements, agility, knowledge
Procedia PDF Downloads 26417845 A Study to Identify Resistant Hypertension and Role of Spironolactone in its Management
Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal
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Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.Keywords: resistant, hypertension, spironolactone, blood pressure
Procedia PDF Downloads 27817844 Development of Intervention Policy Options for Sustainable Fisheries Management of Lake Hawassa, Ethiopia
Authors: Mekonen Hailu, Gashaw Tesfaye, Adamneh Dagne, Hiwot Teshome
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Lake Hawassa is one of the most important lakes for Ethiopian fishery. It serves as a source of food and nutrition, income and livelihood for many inhabitants. However, the fishery in Lake Hawassa shows a declining trend, especially for the most valuable species, such as the Nile tilapia (Oreochromis niloticus L.), indicating that the existing management systems are either not fully enforced or inadequate. The aim of this study was therefore to develop management policy options for the sustainable utilization and management of fishery resources in Lake Hawassa. A blend of primary and secondary data was used for the study. Primary data were collected using Participatory Rural Appraisal (PRA) techniques such as focus group discussions with members of fishing co-operatives, co-operative leaders and key informant discussion to understand the current state of the fisheries resources. Then literatures were reviewed to obtain secondary data and develop alternative management policy options. It has been realized that Lake Hawassa is not very species-rich in terms of fish diversity. It contains only six species belonging to four families, of which only three are commercially important, including the Nile tilapia (90 % of catches), the African catfish Clarias gariepinus B. (7 % of catches) and the African large barb Labeobarbus intermedius R. (only 3 % of catches). The production has been declining since 2007. The top six challenges that could be responsible for this decline, identified by about two-thirds of respondents and supported by the literature review, are directly linked to fisheries and fisheries management, with overfishing, irregular monitoring, control, and surveillance (MCS) system and the lack of a fishing licensing system ranking first, second and third respectively. It is, therefore, important to address these and other problems identified in the study. Of the management options analyzed, we suggest adapting the management approach to sustain the fishery in Lake Hawaasa and its socio-economic benefits. We also present important conditions for successfully implementing co-management in this and other lakes in Ethiopia.Keywords: comanagement, community-based management, fishery, overfishing, participatory approach, top-down management
Procedia PDF Downloads 1017843 A Paradigm Shift towards Personalized and Scalable Product Development and Lifecycle Management Systems in the Aerospace Industry
Authors: David E. Culler, Noah D. Anderson
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Integrated systems for product design, manufacturing, and lifecycle management are difficult to implement and customize. Commercial software vendors, including CAD/CAM and third party PDM/PLM developers, create user interfaces and functionality that allow their products to be applied across many industries. The result is that systems become overloaded with functionality, difficult to navigate, and use terminology that is unfamiliar to engineers and production personnel. For example, manufacturers of automotive, aeronautical, electronics, and household products use similar but distinct methods and processes. Furthermore, each company tends to have their own preferred tools and programs for controlling work and information flow and that connect design, planning, and manufacturing processes to business applications. This paper presents a methodology and a case study that addresses these issues and suggests that in the future more companies will develop personalized applications that fit to the natural way that their business operates. A functioning system has been implemented at a highly competitive U.S. aerospace tooling and component supplier that works with many prominent airline manufacturers around the world including The Boeing Company, Airbus, Embraer, and Bombardier Aerospace. During the last three years, the program has produced significant benefits such as the automatic creation and management of component and assembly designs (parametric models and drawings), the extensive use of lightweight 3D data, and changes to the way projects are executed from beginning to end. CATIA (CAD/CAE/CAM) and a variety of programs developed in C#, VB.Net, HTML, and SQL make up the current system. The web-based platform is facilitating collaborative work across multiple sites around the world and improving communications with customers and suppliers. This work demonstrates that the creative use of Application Programming Interface (API) utilities, libraries, and methods is a key to automating many time-consuming tasks and linking applications together.Keywords: PDM, PLM, collaboration, CAD/CAM, scalable systems
Procedia PDF Downloads 17417842 Factors Affecting Employee Performance: A Case Study in Marketing and Trading Directorate, Pertamina Ltd.
Authors: Saptiadi Nugroho, A. Nur Muhamad Afif
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Understanding factors that influence employee performance is very important. By finding the significant factors, organization could intervene to improve the employee performance that simultaneously will affect organization itself. In this research, four aspects consist of PCCD training, education level, corrective action, and work location were tested to identify their influence on employee performance. By using correlation analysis and T-Test, it was found that employee performance significantly influenced by PCCD training, work location, and corrective action. Meanwhile the education level did not influence employee performance.Keywords: employee development, employee performance, performance management system, organization
Procedia PDF Downloads 39017841 Thermoplastic-Intensive Battery Trays for Optimum Electric Vehicle Battery Pack Performance
Authors: Dinesh Munjurulimana, Anil Tiwari, Tingwen Li, Carlos Pereira, Sreekanth Pannala, John Waters
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With the rapid transition to electric vehicles (EVs) across the globe, car manufacturers are in need of integrated and lightweight solutions for the battery packs of these vehicles. An integral part of a battery pack is the battery tray, which constitutes a significant portion of the pack’s overall weight. Based on the functional requirements, cost targets, and packaging space available, a range of materials –from metals, composites, and plastics– are often used to develop these battery trays. This paper considers the design and development of integrated thermoplastic-intensive battery trays, using the available packaging space from a representative EV battery pack. Presented as a proposed alternative are multiple concepts to integrate several connected systems such as cooling plates and underbody impact protection parts of a multi-piece incumbent battery pack. The resulting digital prototype was evaluated for several mechanical performance measures such as mechanical shock, drop, crush resistance, modal analysis, and torsional stiffness. The performance of this alternative design is then compared with the incumbent solution. In addition, insights are gleaned into how these novel approaches can be optimized to meet or exceed the performance of incumbent designs. Preliminary manufacturing feasibility of the optimal solution using injection molding and other commonly used manufacturing methods for thermoplastics is briefly explained. Then numerical and analytical evaluations are performed to show a representative Pareto front of cost vs. volume of the production parts. The proposed solution is observed to offer weight savings of up to 40% on a component level and part elimination of up to two systems in the battery pack of a typical battery EV while offering the potential to meet the required performance measures highlighted above. These conceptual solutions are also observed to potentially offer secondary benefits such as improved thermal and electrical isolations and be able to achieve complex geometrical features, thus demonstrating the ability to use the complete packaging space available in the vehicle platform considered. The detailed study presented in this paper serves as a valuable reference for researches across the globe working on the development of EV battery packs – especially those with an interest in the potential of employing alternate solutions as part of a mixed-material system to help capture untapped opportunities to optimize performance and meet critical application requirements.Keywords: thermoplastics, lightweighting, part integration, electric vehicle battery packs
Procedia PDF Downloads 20517840 The Impact of Corporate Governance Mechanisms on Earnings Management Practices: Evidence from Jordan
Authors: Lara Al-Haddad, Mark Whittington
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This paper aims to examine the impact of two influential internal corporate governance mechanisms, namely board characteristics and ownership structure on the use of real activities-based and accrual-based earnings management by Jordanian public firms. Using panel data from Jordanian public firms after the introduction of the Jordanian Corporate Governance Code (JCGC) in 2009, the study finds both institutional ownership and managerial ownership constrain the use of real and accrual earnings manipulations. On the other side, both independent directors and largest shareholders are found to exaggerate the incidence of using real and accrual earnings management. The study also examines the trade-off between real and accrual earnings management and found that Jordanian firms use a combination of real and accrual-based earnings management to obtain the greatest effect on earnings reporting strategies. For the purpose of this study, three types of real earnings management are considered: sales manipulation, overproduction, and the abnormal reduction of discretionary expenditures. The abnormal discretionary accrual is considered for accruals management. While for the internal corporate governance mechanisms; board characteristics are examined by using board independence, board size, and CEO-duality; and ownership structure is examined by using managerial ownership, institutional ownership, foreign ownership and largest shareholder ownership. To the best knowledge of the researchers, this study is the first to examine the relationship between board characteristics and real earnings management in Jordan. Further, it is the first to examine the relationship between corporate governance mechanisms and discretionary accruals after the introduction of the Jordanian Corporate Governance Code in 2009. Thus, the findings of this study have important policy implications for policymakers, regulators, standard setters, audit professional, and investors in their attempts to constrain the practice of earnings management, whether real or accrual, and to improve the financial reporting quality in Jordan.Keywords: board characteristics, Jordan, ownership structure, real earnings management
Procedia PDF Downloads 34617839 Performance in Police Organizations: Approaches from the Literature Review
Authors: Felipe Haleyson Ribeiro dos Santos, Edson Ronaldo Guarido Filho
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This article aims to review the literature on performance in police organizations. For that, the inOrdinatio method was adopted, which defines the form of selection and classification of articles. The search was carried out in databases, which resulted in a total of 619 documents that were cataloged and classified with the support of the Mendeley software. The theoretical scope intended here is to identify how performance in police organizations has been studied. After deepening the analysis and focusing on management, it was possible to classify the articles into three levels: individual, organizational, and institutional. However, to our best knowledge, no studies were found that addressed the performance relationship between the levels, which can be seen as a suggestion for further research.Keywords: police management, performance, management, multi-level
Procedia PDF Downloads 10817838 Effects of Molybdenum Treatments on Maize and Sunflower Seedlings
Authors: Eva Bodi, Szilvia Veres, Farzaneh Garousi, Szilvia Varallay, Bela Kovacs
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The aim of the present study was to examine whether increasing molybdenum (Mo) concentration affects on the growth and Mo concentration of maize and sunflower (Helianthus annuus L. cv Arena PR) seedlings within laboratory conditions. In this experiment calcareous chernozem soil was used and Mo was supplemented into the soil as ammonium molybdate [(NH4)6Mo7O24.4H2O] in four different concentrations as follow: 0 (control), 30, 90 and 270 mg/kg. In this study we found that molybdenum in small amount (30 mg/kg) affects positively on growth of maize and sunflower seedlings, however, higher concentration of Mo reduces the dry weights of shoots and roots. In the case of maize the highest Mo treatment (270 mg/kg) and in sunflower 90 mg/kg treatment caused significant reduction in plant growth. In addition, we observed that molybdenum contents in the roots and shoots were very low in case of control soil but were significantly elevated with increasing concentration of Mo treatment. Only in case of sunflower the highest 270 mg/kg Mo treatment caused decrease in Mo concentration.Keywords: dry weight, maize, molybdenum, sunflower
Procedia PDF Downloads 41417837 Unpacking Public Value Destruction through Solid Waste Management in Developing Countries: A Critical Study of Pakistan
Authors: Zubair Ahmad, Paolo Esposito
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The management of solid waste from its collection to disposal is a widespread issue all around the world. This is a stinging issue in the rural and urban areas of the developing and developed states of the world. The mismanagement in Pakistan in the context of solid waste is required to be recognized because it is not only affecting the health of the public but also affecting the health of the environment. Therefore, this study conducts qualitative research methodology and conducted interviews in Lahore, Karachi, Quetta, Peshawar and Islamabad’s solid waste management’s officials and waste pickers, for analyzing uses Grounded theory for the lens of thematic analysis to highlight how public value is being destroyed by the mismanagement of solid waste in Pakistan. This study critically examines the effects of corruption, mismanagement, lawlessness, lack of accountability, budgetary issues, and improper methods for the disposal of solid waste as the major factors that are destroying public value. Recognizing and addressing these factors is essential to improving the system of solid waste management in developing countriesKeywords: solid waste management, public value destruction, health, environment, accountability, grounded theory
Procedia PDF Downloads 3017836 Effects of Self-Management Programs on Blood Pressure Control, Self-Efficacy, Medication Adherence, and Body Mass Index among Older Adult Patients with Hypertension: Meta-Analysis of Randomized Controlled Trials
Authors: Van Truong Pham
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Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index
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