Search results for: multiple rare variants
3289 Artificial Intelligence-Based Detection of Individuals Suffering from Vestibular Disorder
Authors: Dua Hişam, Serhat İkizoğlu
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Identifying the problem behind balance disorder is one of the most interesting topics in the medical literature. This study has considerably enhanced the development of artificial intelligence (AI) algorithms applying multiple machine learning (ML) models to sensory data on gait collected from humans to classify between normal people and those suffering from Vestibular System (VS) problems. Although AI is widely utilized as a diagnostic tool in medicine, AI models have not been used to perform feature extraction and identify VS disorders through training on raw data. In this study, three machine learning (ML) models, the Random Forest Classifier (RF), Extreme Gradient Boosting (XGB), and K-Nearest Neighbor (KNN), have been trained to detect VS disorder, and the performance comparison of the algorithms has been made using accuracy, recall, precision, and f1-score. With an accuracy of 95.28 %, Random Forest Classifier (RF) was the most accurate model.Keywords: vestibular disorder, machine learning, random forest classifier, k-nearest neighbor, extreme gradient boosting
Procedia PDF Downloads 693288 Super Harmonic Nonlinear Lateral Vibration of an Axially Moving Beam with Rotating Prismatic Joint
Authors: M. Najafi, S. Bab, F. Rahimi Dehgolan
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The motion of an axially moving beam with rotating prismatic joint with a tip mass on the end is analyzed to investigate the nonlinear vibration and dynamic stability of the beam. The beam is moving with a harmonic axially and rotating velocity about a constant mean velocity. A time-dependent partial differential equation and boundary conditions with the aid of the Hamilton principle are derived to describe the beam lateral deflection. After the partial differential equation is discretized by the Galerkin method, the method of multiple scales is applied to obtain analytical solutions. Frequency response curves are plotted for the super harmonic resonances of the first and the second modes. The effects of non-linear term and mean velocity are investigated on the steady state response of the axially moving beam. The results are validated with numerical simulations.Keywords: super harmonic resonances, non-linear vibration, axially moving beam, Galerkin method
Procedia PDF Downloads 3923287 Epidemiology of Gestational Choriocarcinoma: A Systematic Review
Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan
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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor
Procedia PDF Downloads 3303286 The Rehabilitation of The Covered Bridge Leclerc (P-00249) Passing Over the Bouchard Stream in LaSarre, Quebec
Authors: Nairy Kechichian
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The original Leclerc Bridge is a covered wooden bridge that is considered a Quebec heritage structure with an index of 60, making it a very important provincial bridge from a historical point of view. It was constructed in 1927 and is in the rural area of Abitibi-Temiscamingue. It is a “town Québécois” type of structure, which is generally rare but common for covered bridges in Abitibi-Temiscamingue. This type of structure is composed of two trusses on both sides formed with diagonals, internal bracings, uprights and top and bottom chords to allow the transmission of loads. This structure is mostly known for its solidity, lightweightness, and ease of construction. It is a single-span bridge with a length of 25.3 meters and allows the passage of one vehicle at a time with a 4.22-meter driving lane. The structure is composed of 2 trusses located at each end of the deck, two gabion foundations at both ends, uprights and top and bottom chords. WSP (Williams Sale Partnership) Canada inc. was mandated by the Transport Minister of Quebec in 2019 to increase the capacity of the bridge from 5 tons to 30.6 tons and rehabilitate it, as it has deteriorated quite significantly over the years. The bridge was damaged due to material deterioration over time, exposure to humidity, high load effects and insect infestation. To allow the passage of 3 axle trucks, as well as to keep the integrity of this heritage structure, the final design chosen to rehabilitate the bridge involved adding a new deck independent from the roof structure of the bridge. Essentially, new steel beams support the deck loads and the desired vehicle loads. The roof of the bridge is linked to the steel deck for lateral support, but it is isolated from the wooden deck. The roof is preserved for aesthetic reasons and remains intact as it is a heritage piece. Due to strict traffic management obstacles, an efficient construction method was put into place, which consisted of building a temporary bridge and moving the existing roof onto it to allow the circulation of vehicles on one side of the temporary bridge while providing a working space for the repairs of the roof on the other side to take place simultaneously. In parallel, this method allowed the demolition and reconstruction of the existing foundation, building a new steel deck, and transporting back the roof on the new bridge. One of the main criteria for the rehabilitation of the wooden bridge was to preserve, as much as possible, the existing patrimonial architectural design of the bridge. The project was completed successfully by the end of 2021.Keywords: covered bridge, wood-steel, short span, town Québécois structure
Procedia PDF Downloads 673285 The Effectiveness of Video Modeling Procedures on Request an Item Behavior Children with Autism Spectrum Disorders
Authors: Melih Cattik
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The present study investigate effectiveness of video modeling procedures on request an item behavior of children with ASD. Two male and a female children with ASD participated in the study. A multiple baseline across participant single-subject design was used to evaluate the effects of the video modeling procedures on request an item behavior. During baseline, no prompts were presented to participants. In the intervention phase, the teacher gave video model to the participant and than created opportunity for request an item to him/her. When the first participant reached to criterion, the second participant began intervention. This procedure continued till all participants completed intervention. Finally, all three participants learned to request an item behavior. Based upon findings of this study, it will make suggestions to future researches.Keywords: autism spectrum disorders, video modeling procedures, request an item behavior, single subject design
Procedia PDF Downloads 4093284 An Approach for Multilayered Ecological Networks
Authors: N. F. F. Ebecken, G. C. Pereira
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Although networks provide a powerful approach to the study of a wide variety of ecological systems, their formulation usually does not include various types of interactions, interactions that vary in space and time, and interconnected systems such as networks. The emerging field of 'multilayer networks' provides a natural framework for extending ecological systems analysis to include these multiple layers of complexity as it specifically allows for differentiation and modeling of intralayer and interlayer connectivity. The structure provides a set of concepts and tools that can be adapted and applied to the ecology, facilitating research in high dimensionality, heterogeneous systems in nature. Here, ecological multilayer networks are formally defined based on a review of prior and related approaches, illustrates their application and potential with existing data analyzes, and discusses limitations, challenges, and future applications. The integration of multilayer network theory into ecology offers a largely untapped potential to further address ecological complexity, to finally provide new theoretical and empirical insights into the architecture and dynamics of ecological systems.Keywords: ecological networks, multilayered networks, sea ecology, Brazilian Coastal Area
Procedia PDF Downloads 1553283 Does Supervisory Board Composition Influence Sustainability Reporting Quality?
Authors: Patrick Velte
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Sustainability reporting has become a central element of modern corporate governance practice. This paper is the first to recognize supervisory board independence, sustainable expertise and gender diversity in two European two tier countries and their impact on sustainability reporting quality. For a sample of 188 German and Austrian companies which are listed at the Prime Standard of the Frankfurt and Vienna Stock Exchange for the business years 2012-2013, descriptive findings show that CSR reporting quality is still low in both countries. Furthermore, multiple regressions state that independent and female members in the supervisory board do have a positive impact on CSR reporting quality in Germany and Austria. However, the existence of sustainable experts in the supervisory board both in Germany and Austria shows a positive but insignificant impact. Our findings suggest that the current European corporate governance regulations can be a useful instrument to increase the quality of modern CSR reporting for the stakeholders.Keywords: sustainability reporting, corporate governance, gender diversity, board independence
Procedia PDF Downloads 3973282 Crisis Management and Corporate Political Activism: A Qualitative Analysis of Online Reactions toward Tesla
Authors: Roxana D. Maiorescu-Murphy
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In the US, corporations have recently embraced political stances in an attempt to respond to the external pressure exerted by activist groups. To date, research in this area remains in its infancy, and few studies have been conducted on the way stakeholder groups respond to corporate political advocacy in general and in the immediacy of such a corporate announcement in particular. The current study aims to fill in this research void. In addition, the study contributes to an emerging trajectory in the field of crisis management by focusing on the delineation between crises (unexpected events related to products and services) and scandals (crises that spur moral outrage). The present study looked at online reactions in the aftermath of Elon Musk’s endorsement of the Republican party on Twitter. Two data sets were collected from Twitter following two political endorsements made by Elon Musk on May 18, 2022, and June 15, 2022, respectively. The total sample of analysis stemming from the data two sets consisted of N=1,374 user comments written as a response to Musk’s initial tweets. Given the paucity of studies in the preceding research areas, the analysis employed a case study methodology, used in circumstances in which the phenomena to be studied had not been researched before. According to the case study methodology, which answers the questions of how and why a phenomenon occurs, this study responded to the research questions of how online users perceived Tesla and why they did so. The data were analyzed in NVivo by the use of the grounded theory methodology, which implied multiple exposures to the text and the undertaking of an inductive-deductive approach. Through multiple exposures to the data, the researcher ascertained the common themes and subthemes in the online discussion. Each theme and subtheme were later defined and labeled. Additional exposures to the text ensured that these were exhaustive. The results revealed that the CEO’s political endorsements triggered moral outrage, leading to Tesla’s facing a scandal as opposed to a crisis. The moral outrage revolved around the stakeholders’ predominant rejection of a perceived intrusion of an influential figure on a domain reserved for voters. As expected, Musk’s political endorsements led to polarizing opinions, and those who opposed his views engaged in online activism aimed to boycott the Tesla brand. These findings reveal that the moral outrage that characterizes a scandal requires communication practices that differ from those that practitioners currently borrow from the field of crisis management. Specifically, because scandals flourish in online settings, practitioners should regularly monitor stakeholder perceptions and address them in real-time. While promptness is essential when managing crises, it becomes crucial to respond immediately as a scandal is flourishing online. Finally, attempts should be made to distance a brand, its products, and its CEO from the latter’s political views.Keywords: crisis management, communication management, Tesla, corporate political activism, Elon Musk
Procedia PDF Downloads 913281 Qatari Licensure System: Giving Voice to Educators at Government-Funded Schools
Authors: Abdullah Abu-Tineh, Hissa Sadiq, Fatma Al-Mutawah, Youmen Chabaan
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The current study examined the experiences of educators in Qatar with the licensure process currently implemented at government schools. Using a survey study design, a total of 1,669 participants expressed their perceptions on the strengths and weaknesses of the licensure system, the professional standards, and the professional portfolio. Findings included participants’ beliefs on the importance of the licensure system in improving their performance, the necessity of using the professional standards as tools for professional growth and development, the importance of refining the professional portfolio for authenticity and reliability, and the inclusion of multiple sources of evidence, such as classroom observations, interviews, student learning outcomes, and surveys. Documenting teachers’ and school leaders’ voices was fundamental in finding ways to successfully drive future developments of the licensure system. The findings may also provide implications for other countries interested in developing or refining their own appraisal systems.Keywords: licensure system, educator voice, professional standards, professional portfolio
Procedia PDF Downloads 2033280 Designing a Method to Control and Determine the Financial Performance of the Real Cost Sub-System in the Information Management System of Construction Projects
Authors: Alireza Ghaffari, Hassan Saghi
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Project management is more complex than managing the day-to-day affairs of an organization. When the project dimensions are broad and multiple projects have to be monitored in different locations, the integrated management becomes even more complicated. One of the main concerns of project managers is the integrated project management, which is mainly rooted in the lack of accurate and accessible information from different projects in various locations. The collection of dispersed information from various parts of the network, their integration and finally the selective reporting of this information is among the goals of integrated information systems. It can help resolve the main problem, which is bridging the information gap between executives and senior managers in the organization. Therefore, the main objective of this study is to design and implement an important subset of a project management information system in order to successfully control the cost of construction projects so that its results can be used to design raw software forms and proposed relationships between different project units for the collection of necessary information.Keywords: financial performance, cost subsystem, PMIS, project management
Procedia PDF Downloads 1093279 The Effectiveness of ICT-Assisted PBL on College-Level Nano Knowledge and Learning Skills
Authors: Ya-Ting Carolyn Yang, Ping-Han Cheng, Shi-Hui Gilbert Chang, Terry Yuan-Fang Chen, Chih-Chieh Li
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Nanotechnology is widely applied in various areas so professionals in the related fields have to know more than nano knowledge. In the study, we focus on adopting ICT-assisted PBL in college general education to foster professionals who possess multiple abilities. The research adopted a pretest and posttest quasi-experimental design. The control group received traditional instruction, and the experimental group received ICT-assisted PBL instruction. Descriptive statistics will be used to describe the means, standard deviations, and adjusted means for the tests between the two groups. Next, analysis of covariance (ANCOVA) will be used to compare the final results of the two research groups after 6 weeks of instruction. Statistics gathered in the end of the research can be used to make contrasts. Therefore, we will see how different teaching strategies can improve students’ understanding about nanotechnology and learning skills.Keywords: nanotechnology, science education, project-based learning, information and communication technology
Procedia PDF Downloads 3753278 Study of Treatment Plant of The City Chlef Study of Environmental Impact
Authors: Houmame Benbouali, Aboubakr Gribi
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The risks, in general, exist in any project, one can hardly carry out a project without taking risks. The hydraulic works are rather complex projects in their design, realization and exploitation and are often subjected at the multiple risks being able to influence with their good performance and can have a negative impact on their environment. The present study was carried out to quote the impacts caused by purification plant STEP Chlef on the environment, it aims has studied the environmental impacts during construction and when designing this STEP, it is divided into two parts: The first part results from a research task bibliographer which contain three chapters (- cleansing of water-worn- general information on water worn-proceed of purification of waste water). The second part is an experimental part which is divided into four chapters (detailed state initial description of the station of purification-evaluation of the impacts of the project analyzes measurements and recommendations).Keywords: treatment plant, waste water, waste water treatment, Chlef
Procedia PDF Downloads 3343277 Detecting Cyberbullying, Spam and Bot Behavior and Fake News in Social Media Accounts Using Machine Learning
Authors: M. D. D. Chathurangi, M. G. K. Nayanathara, K. M. H. M. M. Gunapala, G. M. R. G. Dayananda, Kavinga Yapa Abeywardena, Deemantha Siriwardana
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Due to the growing popularity of social media platforms at present, there are various concerns, mostly cyberbullying, spam, bot accounts, and the spread of incorrect information. To develop a risk score calculation system as a thorough method for deciphering and exposing unethical social media profiles, this research explores the most suitable algorithms to our best knowledge in detecting the mentioned concerns. Various multiple models, such as Naïve Bayes, CNN, KNN, Stochastic Gradient Descent, Gradient Boosting Classifier, etc., were examined, and the best results were taken into the development of the risk score system. For cyberbullying, the Logistic Regression algorithm achieved an accuracy of 84.9%, while the spam-detecting MLP model gained 98.02% accuracy. The bot accounts identifying the Random Forest algorithm obtained 91.06% accuracy, and 84% accuracy was acquired for fake news detection using SVM.Keywords: cyberbullying, spam behavior, bot accounts, fake news, machine learning
Procedia PDF Downloads 363276 Decision Support Tool for Green Roofs Selection: A Multicriteria Analysis
Authors: I. Teotónio, C.O. Cruz, C.M. Silva, M. Manso
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Diverse stakeholders show different concerns when choosing green roof systems. Also, green roof solutions vary in their cost and performance. Therefore, decision-makers continually face the difficult task of balancing benefits against green roofs costs. Decision analysis methods, as multicriteria analysis, can be used when the decision‑making process includes different perspectives, multiple objectives, and uncertainty. The present study adopts a multicriteria decision model to evaluate the installation of green roofs in buildings, determining the solution with the best trade-off between costs and benefits in agreement with the preferences of the users/investors. This methodology was applied to a real decision problem, assessing the preferences between different green roof systems in an existing building in Lisbon. This approach supports the decision-making process on green roofs and enables robust and informed decisions on urban planning while optimizing buildings retrofitting.Keywords: decision making, green roofs, investors preferences, multicriteria analysis, sustainable development
Procedia PDF Downloads 1843275 An Audit on the Role of Sentinel Node Biopsy in High-Risk Ductal Carcinoma in Situ and Intracystic Papillary Carcinoma
Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew
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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease
Procedia PDF Downloads 1113274 Characterization and Design of a Crumb Rubber Modified Asphalt Mix Formulation
Authors: H. Al-Baghli
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Laboratory trial results of mixing crumb rubber produced from discarded tires with 60/70 pen grade Kuwaiti bitumen are presented on this paper. PG grading and multiple stress creep recovery tests were conducted on Kuwaiti bitumen blended with 15% and 18% crumb rubber at temperatures ranging from 40 to 70 °C. The results from elastic recovery and non-recoverable creep presented optimum performance at 18% rubber content. The optimum rubberized-bitumen mix was next transformed into a pelletized form (PelletPave®), and was used as a partial replacement to the conventional bitumen in the manufacture of continuously graded hot mix asphalts at a number of binder contents. The trialed PelletPave® contents were at 2.5%, 3.0%, and 3.5% by mass of asphalt mix. In this investigation, it was not possible to utilize the results of standard Marshall method of mix design (i.e. volumetric, stability and flow tests) and subsequently additional assessment of mix compactability was carried out using gyratory compactor in order to determine the optimum PelletPave® and total binder contents.Keywords: crumb rubber, Marshall mix design, PG grading, rubberized-bitumen
Procedia PDF Downloads 2183273 Evaluation of Longitudinal Relaxation Time (T1) of Bone Marrow in Lumbar Vertebrae of Leukaemia Patients Undergoing Magnetic Resonance Imaging
Authors: M. G. R. S. Perera, B. S. Weerakoon, L. P. G. Sherminie, M. L. Jayatilake, R. D. Jayasinghe, W. Huang
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The aim of this study was to measure and evaluate the Longitudinal Relaxation Times (T1) in bone marrow of an Acute Myeloid Leukaemia (AML) patient in order to explore the potential for a prognostic biomarker using Magnetic Resonance Imaging (MRI) which will be a non-invasive prognostic approach to AML. MR image data were collected in the DICOM format and MATLAB Simulink software was used in the image processing and data analysis. For quantitative MRI data analysis, Region of Interests (ROI) on multiple image slices were drawn encompassing vertebral bodies of L3, L4, and L5. T1 was evaluated using the T1 maps obtained. The estimated bone marrow mean value of T1 was 790.1 (ms) at 3T. However, the reported T1 value of healthy subjects is significantly (946.0 ms) higher than the present finding. This suggests that the T1 for bone marrow can be considered as a potential prognostic biomarker for AML patients.Keywords: acute myeloid leukaemia, longitudinal relaxation time, magnetic resonance imaging, prognostic biomarker.
Procedia PDF Downloads 5313272 The Moderating Effects of Attachment Style on the Relationship between the Psychological Symptoms and Well-Being of Mental Health Practitioners in Rehabilitation Centers: A Preliminary Study
Authors: Amaba, Marinela C., Espino, Gianne Ericka S. J. Valencia, Zeia Beatriz C.
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This study aims to determine the moderating role of attachment style on the relationship between psychological symptoms and well-being of mental health practitioners in rehabilitation centers that are accredited of the Department of Health in Pampanga. Using the data gathered from 46 mental health practitioners, multiple regression models were conducted to test the main and moderating effects of attachment styles. The findings show that all three psychological symptoms namely depression, anxiety, and stress have main effects on their general well-being on a negative direction. However, attachment style did not moderate the relationship between the psychological symptoms and general well-being. On one hand, results about the relationship of psychological symptoms and well-being are consistent to previous findings of other studies while on the other hand, results in moderation were contradicting.Keywords: attachment style, psychological symptoms, well-being, mental health practitioners, rehabilitation centers
Procedia PDF Downloads 5533271 The Development of an Anaesthetic Crisis Manual for Acute Critical Events: A Pilot Study
Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong
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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids
Procedia PDF Downloads 1273270 A Digital Health Approach: Using Electronic Health Records to Evaluate the Cost Benefit of Early Diagnosis of Alpha-1 Antitrypsin Deficiency in the UK
Authors: Sneha Shankar, Orlando Buendia, Will Evans
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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis
Procedia PDF Downloads 1673269 Effectiveness of a Peer-Mediated Intervention on Writing Skills in Students with Autism Spectrum Disorder in the Inclusive Classroom
Authors: Siddiq Ahmed
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The current study aimed to investigate the effectiveness of a Peer-Mediated Intervention (PMI) on writing skills for a student with autism spectrum disorders in inclusive classrooms. The participants in this study were two students, one as a tutor and another as a tutee who was diagnosed with autism spectrum disorder (ASD). The target participant struggled with writing skills and was paired with a student with high academic outcomes. The Tutor had a readiness to act as a tutor for his peer and was trained on how to assist his peer and how to identify and guide his peer’s writing mistakes. Multiple baseline design across behaviors was implemented to monitor the student’s progress in writing skills. The results of the present study showed that PMI yielded significant improvements in academic achievements for the target student. This study suggests that further studies should replicate the current study with an intensive focus on other academic skills such as reading comprehension, writing social stories, and math.Keywords: peer tutoring, writing skills, autism, inclusion
Procedia PDF Downloads 1083268 Factors Affecting the Climate Change Adaptation in Agriculture in Central and Western Nepal
Authors: Maharjan Shree Kumar
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Climate change impacts are observed in all livelihood sectors primarily in agriculture and forestry. Multiple factors have influenced the climate vulnerabilities and adaptations in agricultural at the household level. This study focused on the factors affecting adaptation in agriculture in Madi and Deukhuri valleys of Central and Western Nepal. The systematic random sampling technique was applied to select 154 households in Madi and 150 households in Deukhuri. The main purpose of the study was to analyze the socio-economic factors that either influence or restrain the farmers’ adaptation to climate change at the household level by applying the linear probability model. Based on the analysis, it is revealed that crop diversity, education, training and total land holding (acre) were positively significant for adaptation choices the study sites. Rest of the variables were not significant though indicated positive as expected except age, occupation, ethnicity, family size, and access to credit.Keywords: adaptation, agriculture, climate, factors, Nepal
Procedia PDF Downloads 1523267 Ambiguity in Anti-conversion Laws in the Indian States – A Limitation to the Freedom of Religion Guaranteed under the Constitution of India
Authors: Roy Alex, Dr. Shampa I Dev
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Abstract Nine out of twenty-eight states in India have enacted anti-conversion laws to regulate religious conversions by use of force, allurement, inducement, or fraudulent means. The vagueness of the definitions of the terms used in these laws makes them inconsistent with the provisions of the right to freedom of religion guaranteed by the Constitution. It is a critical question whether these laws protect the religious freedom of groups that are “vulnerable” to missionary inducements, or are they restricting the freedom of citizens to propagate their religion to others or change their religious identity? This article looks into the constitutionality of the anti-conversion laws passed in the Indian States and argues that these laws limit the freedom of religion guaranteed under Article 25 of the Constitution of India. The ambiguity in the anti-conversion laws passed in various states of India is brought out by critically analyzing multiple cases charged under anti-conversion laws.Keywords: Freedom of Religion, Anti-conversion Laws, allurement, inducement, and fraudulent means.
Procedia PDF Downloads 1063266 The Effects of Infographics as a Supplementary Tool in Promoting Academic Reading Skill in an EFL Class
Authors: Niracha Chompurach, Dararat Khampusaen
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EFL students have to be able to synthesize the texts they are reading critically to compose and connect the information. This study focuses on the effects of the application of Infographics as a supplementary tool to improve Thai EFL students’ Academic reading skills. Infographics are graphic visual representations of information, data, and knowledge offering students to work on gathering multiple types of information, such as pictures, texts, graphs, mapping, and charts. The study aims to investigate if the Infographics as a supplementary tool in academic reading lessons can make a difference in students’ reading skills, and the students’ opinions toward the application of infographics as a reading tool. The participants of this study were 3rd year Thai EFL Khon Kaen University students who took English Academic Reading course. This study employed Infographics assignments, Infographics rubric, and Gucus group interview. This study would advantage for both EFL teachers and students as a means to engage the students to handle the larger load of and represents the complex information in visible and comprehensible way.Keywords: EFL, e-learning, infographics, language education
Procedia PDF Downloads 1633265 The Organizational Behavior that Affect to the Work Motivation in the Dusit Workplace
Authors: Suvimon Wajeetongratana, Prateep Wajeetongratana
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The purpose of this research will study the organizational behavior including self-efficacy, hope, optimism, and resiliency that affect to the work motivation in the Dusit workplace and the sample consisted of the production workers in a private company in Dusit area for four hundred workers with approximately 10,000 employees and in this study will provide the multiple regression analysis was used to analyze the questionnaire survey data. The results of the analysis indicate the latent core confidence factor derived from the four components of self-efficacy, hope, optimism, and resiliency provided a significant positive impact on performance. The impact of the integrated latent core confidence factor was, in fact, more effective than derived from any one individual component, as well as any core trait-like self-evaluations such as self-esteem, general efficacy, internal locus of control, and emotional stability.Keywords: firm performance effectiveness, organizational behavior, work motivation, Dusit workplace
Procedia PDF Downloads 3713264 Oncogenic Role of MicroRNA-346 in Human Non-Small Cell Lung Cancer by Regulation of XPC/ERK/Snail/E-Cadherin Pathway
Authors: Cheng-Cao Sun, Shu-Jun Li, De-Jia Li
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Determinants of growth and metastasis in cancer remain of great interest to define. MicroRNAs (miRNAs) have frequently emerged as tumor metastatic regulator by acting on multiple signaling pathways. Here, we report the definition of miR-346 as an oncogenic microRNA that facilitates non-small cell lung cancer (NSCLC) cell growth and metastasis. XPC, an important DNA damage recognition factor in nucleotide excision repair was defined as a target for down-regulation by miR-346, functioning through direct interaction with the 3'-UTR of XPC mRNA. Blocking miR-346 by an antagomiR was sufficient to inhibit NSCLC cell growth and metastasis, an effect that could be phenol-copied by RNAi-mediated silencing of XPC. In vivo studies established that miR-346 overexpression was sufficient to promote tumor growth by A549 cells in xenografts mice, relative to control cells. Overall, our results defined miR-346 as an oncogenic miRNA in NSCLC, the levels of which contributed to tumor growth and invasive aggressiveness.Keywords: microRNA-346, miR-346, XPC, non-small cell lung cancer, oncogenesis
Procedia PDF Downloads 3123263 People’s Perception towards the ASEAN Economic Community (AEC)
Authors: Nopadol Burananuth
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The purposes of this research paper were to study the relationship between the economic factor and political factor, the relationship between political and economic factor and social factor, and the effects of economic factor, political factor, and social factor to the people’s perception about ASEAN Economic Community (AEC). A total of 400 samples were selected from four sub-districts from Arunyaprathet District, Srakaow Province. Data analysis method included multiple regression analysis. The findings revealed that political factor depended on trade cooperation, transportation cooperation, and communication cooperation. Social factor was depended on disaster protection, terrorism protection, and international relations. In addition, the people’s perception of the AEC depended on disaster perception, terrorism protection, international relations, transportation cooperation, communication cooperation, interdependence, and labor movement.Keywords: economic factors, perception, political factors, social factors
Procedia PDF Downloads 5913262 Computed Tomography Brain and Inpatient Falls: An Audit Evaluating the Indications and Outcomes
Authors: Zain Khan, Steve Ahn, Kathy Monypenny, James Fink
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In Australian public hospitals, there were approximately 34,000 reported inpatient falls between 2015 to 2016. The gold standard for diagnosing intracranial injury is non-contrast enhanced brain computed tomography (CTB). Over a three-month timeframe, a total of one hundred and eighty (180) falls were documented between the hours of 4pm and 8am at a large metro hospital. Only three (3) of these scans demonstrated a positive intra-cranial finding. The rationale for scanning varied. The common indications included a fall with head strike, the presence of blood thinning medication, loss of consciousness, reduced Glasgow Coma Scale (GCS), vomiting and new neurological findings. There are several validated tools to aid in decision-making around ordering CTB scans in the acute setting, but no such accepted tool exists for the inpatient space. With further data collection, spanning a greater length of time and through involving multiple centres, work can be done towards generating such a tool that can be utilized for inpatient falls.Keywords: computed tomography, falls, inpatient, intracranial hemorrhage
Procedia PDF Downloads 1713261 Gestational Diabetes Mellitus (GDM) Increasing Postpartum Screening to Prevent T2D
Authors: Boma Nellie S, Nambiar Ritu, K. Kanchanmala, T. Rashida, Israell Imelda, Moul Khusnud, Michael Marina
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Gestational diabetes (GDM) imparts an increased life long risk of developing Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease in women. Once diagnosed with GDM women have up to 74% increased cumulative risk developing T2DM in 10-15 years. Identifying women at increased risk of developing T2DM and offering them pharmacological and lifestyle management interventions will delay or eliminate the development of diabetes in this population. While ADA recommends that all gestational diabetics be offered postnatal screening, worldwide the screening rates from 35-75% and Al Rahba Hospital with a robust universal antenatal screening program for GDM was at a dismal 9% in 2011. A multidisciplinary team was put together involving OB/Gyn Physicians, Midwives, Nurses (ward and OPD) Diabetic Educators, Dietitians, Medical Records, Laboratory & IT with the implementation of multiple strategies to increase the uptake of postpartum screening of the gestational diabetic.Keywords: GDM, postnatal screening, preventing type 2 diabetes, lifestyle management
Procedia PDF Downloads 5213260 Customers’ Intention to Use Electronic Payment System for Purchasing
Authors: Wanida Suwunniponth
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The purpose of this research was to study the factors of characteristic of business, website quality and trust affected intention to use electronic payment systems for online purchasing. This survey research used questionnaire as a tool to collect the data of 300 customers who purchased online products and used an electronic payment system. The descriptive statistics and multiple regression analysis were used to analyze data. The results revealed that customers had a good opinion towards the characteristic of the business and website quality. However, they have a moderate opinion towards trust and intention to repurchase. In addition, the characteristics of the business affected the purchase intention the most, followed by website quality and the trust with statistical significance at 0.05 level. For particular, the terms of reputation, communication, information quality, perceived risk and word of mouth affected the intention to use the electronic payment system. In contrast, the terms of size, system quality and service quality did not affect intention to use an electronic payment system.Keywords: electronic payment, intention, online purchasing, trust
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