Search results for: model of community management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 27117

Search results for: model of community management

1347 Internal Family Systems Parts-Work: A Revolutionary Approach to Reducing Suicide Lethality

Authors: Bill D. Geis

Abstract:

Even with significantly increased spending, suicide rates continue to climb—with alarming increases among traditionally low-risk groups. This has caused clinicians and researchers to call for a complete rethinking of all assumptions about suicide prevention, assessment, and intervention. A form of therapy--Internal Family Systems Therapy--affords tremendous promise in sustained diminishment of lethal suicide risk. Though a form of therapy that is most familiar to trauma therapists, Internal Family Systems Therapy, involving direct work with suicidal parts, is a promising therapy for meaningful and sustained reduction in suicide deaths. Developed by Richard Schwartz, Internal Family Systems Therapy proposes that we are all influenced greatly by internal parts, frozen by development adversities, and these often-contradictory parts contribute invisibly to mood, distress, and behavior. In making research videos of patients from our database and discussing their suicide attempts, it is clear that many persons who attempt suicide are in altered states at the time of their attempt and influenced by factors other than conscious intent. Suicide intervention using this therapy involves direct work with suicidal parts and other interacting parts that generate distress and despair. Internal Family Systems theory posits that deep experiences of pain, fear, aloneness, and distress are defended by a range of different parts that attempt to contain these experiences of pain through various internal activities that unwittingly push forward inhibition, fear, self-doubt, hopelessness, desires to cut and engage in destructive behavior, addictive behavior, and even suicidal actions. These suicidal parts are often created (and “frozen”) at young ages, and these very young parts do not understand the consequences of this influence. Experience suggests that suicidal parts can create impulsive risk behind the scenes when pain is high and emotional support reduced—with significant crisis potential. This understanding of latent suicide risk is consistent with many of our video accounts of serious suicidal acts—compiled in a database of 1104 subjects. Since 2016, consent has been obtained and records kept of 23 highly suicidal patients, with initial Intention-to-Die ratings (0= no intent, 10 = conviction to die) between 5 and 10. In 67% of these cases using IFST parts-work intervention, these highly suicidal patients’ risk was reduced to 0-1, and 83% of cases were reduced to 4 or lower. There were no suicide deaths. Case illustrations will be offered.

Keywords: suicide, internal family systems therapy, crisis management, suicide prevention

Procedia PDF Downloads 22
1346 Angiomotin Regulates Integrin Beta 1-Mediated Endothelial Cell Migration and Angiogenesis

Authors: Yuanyuan Zhang, Yujuan Zheng, Giuseppina Barutello, Sumako Kameishi, Kungchun Chiu, Katharina Hennig, Martial Balland, Federica Cavallo, Lars Holmgren

Abstract:

Angiogenesis describes that new blood vessels migrate from pre-existing ones to form 3D lumenized structure and remodeling. During directional migration toward the gradient of pro-angiogenic factors, the endothelial cells, especially the tip cells need filopodia to sense the environment and exert the pulling force. Of particular interest are the integrin proteins, which play an essential role in focal adhesion in the connection between migrating cells and extracellular matrix (ECM). Understanding how these biomechanical complexes orchestrate intrinsic and extrinsic forces is important for our understanding of the underlying mechanisms driving angiogenesis. We have previously identified Angiomotin (Amot), a member of Amot scaffold protein family, as a promoter for endothelial cell migration in vitro and zebrafish models. Hence, we established inducible endothelial-specific Amot knock-out mice to study normal retinal angiogenesis as well as tumor angiogenesis. We found that the migration ratio of the blood vessel network to the edge was significantly decreased in Amotec- retinas at postnatal day 6 (P6). While almost all the Amot defect tip cells lost migration advantages at P7. In consistence with the dramatic morphology defect of tip cells, there was a non-autonomous defect in astrocytes, as well as the disorganized fibronectin expression pattern correspondingly in migration front. Furthermore, the growth of transplanted LLC tumor was inhibited in Amot knockout mice due to fewer vasculature involved. By using MMTV-PyMT transgenic mouse model, there was a significantly longer period before tumors arised when Amot was specifically knocked out in blood vessels. In vitro evidence showed that Amot binded to beta-actin, Integrin beta 1 (ITGB1), Fibronectin, FAK, Vinculin, major focal adhesion molecules, and ITGB1 and stress fibers were distinctly induced by Amot transfection. Via traction force microscopy, the total energy (force indicater) was found significantly decreased in Amot knockdown cells. Taken together, we propose that Amot is a novel partner of the ITGB1/Fibronectin protein complex at focal adhesion and required for exerting force transition between endothelial cell and extracellular matrix.

Keywords: angiogenesis, angiomotin, endothelial cell migration, focal adhesion, integrin beta 1

Procedia PDF Downloads 228
1345 Radiomics: Approach to Enable Early Diagnosis of Non-Specific Breast Nodules in Contrast-Enhanced Magnetic Resonance Imaging

Authors: N. D'Amico, E. Grossi, B. Colombo, F. Rigiroli, M. Buscema, D. Fazzini, G. Cornalba, S. Papa

Abstract:

Purpose: To characterize, through a radiomic approach, the nature of nodules considered non-specific by expert radiologists, recognized in magnetic resonance mammography (MRm) with T1-weighted (T1w) sequences with paramagnetic contrast. Material and Methods: 47 cases out of 1200 undergoing MRm, in which the MRm assessment gave uncertain classification (non-specific nodules), were admitted to the study. The clinical outcome of the non-specific nodules was later found through follow-up or further exams (biopsy), finding 35 benign and 12 malignant. All MR Images were acquired at 1.5T, a first basal T1w sequence and then four T1w acquisitions after the paramagnetic contrast injection. After a manual segmentation of the lesions, done by a radiologist, and the extraction of 150 radiomic features (30 features per 5 subsequent times) a machine learning (ML) approach was used. An evolutionary algorithm (TWIST system based on KNN algorithm) was used to subdivide the dataset into training and validation test and to select features yielding the maximal amount of information. After this pre-processing, different machine learning systems were applied to develop a predictive model based on a training-testing crossover procedure. 10 cases with a benign nodule (follow-up older than 5 years) and 18 with an evident malignant tumor (clear malignant histological exam) were added to the dataset in order to allow the ML system to better learn from data. Results: NaiveBayes algorithm working on 79 features selected by a TWIST system, resulted to be the best performing ML system with a sensitivity of 96% and a specificity of 78% and a global accuracy of 87% (average values of two training-testing procedures ab-ba). The results showed that in the subset of 47 non-specific nodules, the algorithm predicted the outcome of 45 nodules which an expert radiologist could not identify. Conclusion: In this pilot study we identified a radiomic approach allowing ML systems to perform well in the diagnosis of a non-specific nodule at MR mammography. This algorithm could be a great support for the early diagnosis of malignant breast tumor, in the event the radiologist is not able to identify the kind of lesion and reduces the necessity for long follow-up. Clinical Relevance: This machine learning algorithm could be essential to support the radiologist in early diagnosis of non-specific nodules, in order to avoid strenuous follow-up and painful biopsy for the patient.

Keywords: breast, machine learning, MRI, radiomics

Procedia PDF Downloads 262
1344 The Effects of Geographical and Functional Diversity of Collaborators on Quality of Knowledge Generated

Authors: Ajay Das, Sandip Basu

Abstract:

Introduction: There is increasing recognition that diverse streams of knowledge can often be recombined in novel ways to generate new knowledge. However, knowledge recombination theory has not been applied to examine the effects of collaborator diversity on the quality of knowledge such collaborators produce. This is surprising because one would expect that a collaborative team with certain aspects of diversity should be able to recombine process elements related to knowledge development, which are relatively tacit, but also complementary because of the collaborator’s varying backgrounds. Theory and Hypotheses: We propose to examine two aspects of diversity in the environments of collaborative teams to try and capture such potential recombinations of relatively tacit, process knowledge. The first aspect of diversity in team members’ environments is geographical. Collaborators with more geographical distance between them (perhaps working in different countries) often have more autonomy in the processes they adopt for knowledge development. In the absence of overt monitoring, such collaborators are likely to adopt differing approaches to knowledge development. The sharing of such varying approaches among collaborators is likely to result in greater quality of the common collaborative pursuit. The second aspect is diversity in the work backgrounds of team members. Such diversity can also increase the potential for knowledge recombination. For example, if one or more members are from a manufacturing center (versus all of them being from a purely R&D center), such members will provide unique perspectives on the implementation of innovative ideas. Again, knowledge that has been evaluated from these diverse perspectives is likely to be of a higher quality. In addition to the above aspects of environmental diversity among team members, we also plan to examine the extent to which individual collaborators are in different environments from the primary innovation center of their employing firms. Proposed Methods: We will test our model on a sample of firms in the semiconductor industry. Our level of analysis will be individual patents generated by these firms and the teams involved in the generation of these. Information on manufacturing activities of our sample firms will be obtained from SEMI, a proprietary database of the semiconductor industry, as well as company 10-K reports. Conclusion: We believe that our results will represent a preliminary attempt to understand how various forms of diversity in collaborative teams impact the knowledge development process. Our dependent variable of knowledge quality is important to study since higher values of this variable can not only drive firm performance but the broader development of regions and societies through spillover impacts on future innovation. The results of this study will, therefore, inform future research and practice in innovation, geographical location, and vertical integration.

Keywords: innovation, manufacturing strategy, knowledge, diversity

Procedia PDF Downloads 347
1343 Understanding the Qualitative Nature of Product Reviews by Integrating Text Processing Algorithm and Usability Feature Extraction

Authors: Cherry Yieng Siang Ling, Joong Hee Lee, Myung Hwan Yun

Abstract:

The quality of a product to be usable has become the basic requirement in consumer’s perspective while failing the requirement ends up the customer from not using the product. Identifying usability issues from analyzing quantitative and qualitative data collected from usability testing and evaluation activities aids in the process of product design, yet the lack of studies and researches regarding analysis methodologies in qualitative text data of usability field inhibits the potential of these data for more useful applications. While the possibility of analyzing qualitative text data found with the rapid development of data analysis studies such as natural language processing field in understanding human language in computer, and machine learning field in providing predictive model and clustering tool. Therefore, this research aims to study the application capability of text processing algorithm in analysis of qualitative text data collected from usability activities. This research utilized datasets collected from LG neckband headset usability experiment in which the datasets consist of headset survey text data, subject’s data and product physical data. In the analysis procedure, which integrated with the text-processing algorithm, the process includes training of comments onto vector space, labeling them with the subject and product physical feature data, and clustering to validate the result of comment vector clustering. The result shows 'volume and music control button' as the usability feature that matches best with the cluster of comment vectors where centroid comments of a cluster emphasized more on button positions, while centroid comments of the other cluster emphasized more on button interface issues. When volume and music control buttons are designed separately, the participant experienced less confusion, and thus, the comments mentioned only about the buttons' positions. While in the situation where the volume and music control buttons are designed as a single button, the participants experienced interface issues regarding the buttons such as operating methods of functions and confusion of functions' buttons. The relevance of the cluster centroid comments with the extracted feature explained the capability of text processing algorithms in analyzing qualitative text data from usability testing and evaluations.

Keywords: usability, qualitative data, text-processing algorithm, natural language processing

Procedia PDF Downloads 279
1342 The Role of High-Intensity Focused Ultrasound (HIFU) in the Treatment of Fibroadenomas: A Systematic Review

Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

Abstract:

Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

Procedia PDF Downloads 213
1341 3d Gis Participatory Mapping And Conflict Ladm: Comparative Analysis Of Land Policies And Survey Procedures Applied By The Igorots, Ncip, And Denr To Itogon Ancestral Domain Boundaries

Authors: Deniz A. Apostol, Denyl A. Apostol, Oliver T. Macapinlac, George S. Katigbak

Abstract:

Ang lupa ay buhay at ang buhay ay lupa (land is life and life is land). Based on the 2015 census, the Indigenous Peoples (IPs) population in the Philippines is estimated to be 11.3-20.2 million. They hail from various regions, possess distinct cultures, but encounter shared struggles in territorial disputes. Itogon, the largest Benguet municipality, is home to the Ibaloi, Kankanaey, and other Igorot tribes. Despite having three (3) Ancestral Domains (ADs), Itogon is predominantly labeled as timberland or forest. These overlapping land classifications highlight the presence of inconsistencies in national laws and jurisdictions. This study aims to analyze surveying procedures used by the Igorots, NCIP, and DENR in mapping the Itogon AD Boundaries, show land boundary delineation conflicts, propose surveying guidelines, and recommend 3D Participatory Mapping as geomatics solution for updated AD reference maps. Interpretative Phenomenological Analysis (IPA), Comparative Legal Analysis (CLA), and Map Overlay Analysis (MOA) were utilized to examine the interviews, compare land policies and surveying procedures, and identify differences and overlaps in conflicting land boundaries. In the IPA, master themes identified were AD Definition (rights, responsibilities, restrictions), AD Overlaps (land classifications, political boundaries, ancestral domains, land laws/policies), and Other Conflicts (with other agencies, misinterpretations, suggestions), as considerations for mapping ADs. CLA focused on conflicting surveying procedures: AD Definitions, Surveying Equipment, Surveying Methods, Map Projections, Order of Accuracy, Monuments, Survey Parties, Pre-survey, Survey Proper, and Post-survey procedures. MOA emphasized the land area percentage of conflicting areas, showcasing the impact of misaligned surveying procedures. The findings are summarized through a Land Administration Domain Model (LADM) Conflict, for AD versus AD and Political Boundaries. The products of this study are identification of land conflict factors, survey guidelines recommendations, and contested land area computations. These can serve as references for revising survey manuals, updating AD Sustainable Development and Protection Plans, and making amendments to laws.

Keywords: ancestral domain, gis, indigenous people, land policies, participatory mapping, surveying, survey procedures

Procedia PDF Downloads 81
1340 Analysis of the Strategic Value at the Usage of Green IT Application for the Organizational Product or Service in Order to Gain the Competitive Advantage; Case: E-Money of a Telecommunication Firm in Indonesia

Authors: I Putu Deny Arthawan Sugih Prabowo, Eko Nugroho, Rudy Hartanto

Abstract:

Known, Green IT is a concept about how to use the technology (IT) wisely, efficiently, and environmentally. However, it exists as the consequence of the rapid-growth of the technology (especially IT) currently. Not only for the environments, the usage of Green IT applications, e.g. Cloud Computing (Cloud Storage) and E-Money (E-Cash), also gives its benefits for the organizational business strategy (especially the organizational product/service strategy) in order to gain the organizational competitive advantage (to be the market leader). This paper takes the case at E-Money as a Value-Added Services (VAS) of a telecommunication firm (company) in Indonesia which it also competes with the competitors’ similar product (service). Although it has been a popular telecommunication firm’s product/service, but its strategic values for the organization (firm) is still unknown, and therefore, the aim of this paper is for analyzing its strategic values for gaining the organizational competitive advantage. However, in this paper, its strategic value analysis is viewed by how to assess (consider) its strategic benefits and also manage the challenges or risks of its implementation at the organization as an organizational product/service. Then the paper uses a research model for investigating the influences of both perceived risks and the organizational cultures to the usage of Green IT Application at the organization and also both the usage of Green IT Application at the organization and the threats-challenges of the organizational products/services to the competitive advantage of the organizational products/services. However, the paper uses the quantitative research method (collecting the information from the field respondents by using the research questionnaires) and then, the primary data is analyzed by both descriptive and inferential statistics. Also in this paper, SmartPLS is used for analyzing the primary data by the quantitative research method. Besides using the quantitative research method, the paper also uses the qualitative research method, such as interviewing the field respondent and/or directly field observation, for deeply confirming the quantitative research method’s analysis results at the certain domain, e.g. both organizational cultures and internal processes that support the usage of Green IT applications for the organizational product/service (E-Money in this paper case). However, the paper is still at an infant stage of in-progress research. Then the paper’s results may be used as a reference for the organization (firm or company) in developing the organizational business strategies, especially about the organizational product/service that relates to Green IT applications. Besides it, the paper may also be the future study, e.g. the influence of knowledge transfer about E-Money and/or other Green IT application-based products/services to the organizational service performance that relates to the product (service) in order to gain the competitive advantage.

Keywords: Green IT, competitive advantage, strategic value, organization (firm or company), organizational product (service)

Procedia PDF Downloads 300
1339 Cluster-Based Exploration of System Readiness Levels: Mathematical Properties of Interfaces

Authors: Justin Fu, Thomas Mazzuchi, Shahram Sarkani

Abstract:

A key factor in technological immaturity in defense weapons acquisition is lack of understanding critical integrations at the subsystem and component level. To address this shortfall, recent research in integration readiness level (IRL) combines with technology readiness level (TRL) to form a system readiness level (SRL). SRL can be enriched with more robust quantitative methods to provide the program manager a useful tool prior to committing to major weapons acquisition programs. This research harnesses previous mathematical models based on graph theory, Petri nets, and tropical algebra and proposes a modification of the desirable SRL mathematical properties such that a tightly integrated (multitude of interfaces) subsystem can display a lower SRL than an inherently less coupled subsystem. The synthesis of these methods informs an improved decision tool for the program manager to commit to expensive technology development. This research ties the separately developed manufacturing readiness level (MRL) into the network representation of the system and addresses shortfalls in previous frameworks, including the lack of integration weighting and the over-importance of a single extremely immature component. Tropical algebra (based on the minimum of a set of TRLs or IRLs) allows one low IRL or TRL value to diminish the SRL of the entire system, which may not be reflective of actuality if that component is not critical or tightly coupled. Integration connections can be weighted according to importance and readiness levels are modified to be a cardinal scale (based on an analytic hierarchy process). Integration arcs’ importance are dependent on the connected nodes and the additional integrations arcs connected to those nodes. Lack of integration is not represented by zero, but by a perfect integration maturity value. Naturally, the importance (or weight) of such an arc would be zero. To further explore the impact of grouping subsystems, a multi-objective genetic algorithm is then used to find various clusters or communities that can be optimized for the most representative subsystem SRL. This novel calculation is then benchmarked through simulation and using past defense acquisition program data, focusing on the newly introduced Middle Tier of Acquisition (rapidly field prototypes). The model remains a relatively simple, accessible tool, but at higher fidelity and validated with past data for the program manager to decide major defense acquisition program milestones.

Keywords: readiness, maturity, system, integration

Procedia PDF Downloads 85
1338 Enhancement of Mass Transport and Separations of Species in a Electroosmotic Flow by Distinct Oscillatory Signals

Authors: Carlos Teodoro, Oscar Bautista

Abstract:

In this work, we analyze theoretically the mass transport in a time-periodic electroosmotic flow through a parallel flat plate microchannel under different periodic functions of the applied external electric field. The microchannel connects two reservoirs having different constant concentrations of an electro-neutral solute, and the zeta potential of the microchannel walls are assumed to be uniform. The governing equations that allow determining the mass transport in the microchannel are given by the Poisson-Boltzmann equation, the modified Navier-Stokes equations, where the Debye-Hückel approximation is considered (the zeta potential is less than 25 mV), and the species conservation. These equations are nondimensionalized and four dimensionless parameters appear which control the mass transport phenomenon. In this sense, these parameters are an angular Reynolds, the Schmidt and the Péclet numbers, and an electrokinetic parameter representing the ratio of the half-height of the microchannel to the Debye length. To solve the mathematical model, first, the electric potential is determined from the Poisson-Boltzmann equation, which allows determining the electric force for various periodic functions of the external electric field expressed as Fourier series. In particular, three different excitation wave forms of the external electric field are assumed, a) sawteeth, b) step, and c) a periodic irregular functions. The periodic electric forces are substituted in the modified Navier-Stokes equations, and the hydrodynamic field is derived for each case of the electric force. From the obtained velocity fields, the species conservation equation is solved and the concentration fields are found. Numerical calculations were done by considering several binary systems where two dilute species are transported in the presence of a carrier. It is observed that there are different angular frequencies of the imposed external electric signal where the total mass transport of each species is the same, independently of the molecular diffusion coefficient. These frequencies are called crossover frequencies and are obtained graphically at the intersection when the total mass transport is plotted against the imposed frequency. The crossover frequencies are different depending on the Schmidt number, the electrokinetic parameter, the angular Reynolds number, and on the type of signal of the external electric field. It is demonstrated that the mass transport through the microchannel is strongly dependent on the modulation frequency of the applied particular alternating electric field. Possible extensions of the analysis to more complicated pulsation profiles are also outlined.

Keywords: electroosmotic flow, mass transport, oscillatory flow, species separation

Procedia PDF Downloads 211
1337 Linking Soil Spectral Behavior and Moisture Content for Soil Moisture Content Retrieval at Field Scale

Authors: Yonwaba Atyosi, Moses Cho, Abel Ramoelo, Nobuhle Majozi, Cecilia Masemola, Yoliswa Mkhize

Abstract:

Spectroscopy has been widely used to understand the hyperspectral remote sensing of soils. Accurate and efficient measurement of soil moisture is essential for precision agriculture. The aim of this study was to understand the spectral behavior of soil at different soil water content levels and identify the significant spectral bands for soil moisture content retrieval at field-scale. The study consisted of 60 soil samples from a maize farm, divided into four different treatments representing different moisture levels. Spectral signatures were measured for each sample in laboratory under artificial light using an Analytical Spectral Device (ASD) spectrometer, covering a wavelength range from 350 nm to 2500 nm, with a spectral resolution of 1 nm. The results showed that the absorption features at 1450 nm, 1900 nm, and 2200 nm were particularly sensitive to soil moisture content and exhibited strong correlations with the water content levels. Continuum removal was developed in the R programming language to enhance the absorption features of soil moisture and to precisely understand its spectral behavior at different water content levels. Statistical analysis using partial least squares regression (PLSR) models were performed to quantify the correlation between the spectral bands and soil moisture content. This study provides insights into the spectral behavior of soil at different water content levels and identifies the significant spectral bands for soil moisture content retrieval. The findings highlight the potential of spectroscopy for non-destructive and rapid soil moisture measurement, which can be applied to various fields such as precision agriculture, hydrology, and environmental monitoring. However, it is important to note that the spectral behavior of soil can be influenced by various factors such as soil type, texture, and organic matter content, and caution should be taken when applying the results to other soil systems. The results of this study showed a good agreement between measured and predicted values of Soil Moisture Content with high R2 and low root mean square error (RMSE) values. Model validation using independent data was satisfactory for all the studied soil samples. The results has significant implications for developing high-resolution and precise field-scale soil moisture retrieval models. These models can be used to understand the spatial and temporal variation of soil moisture content in agricultural fields, which is essential for managing irrigation and optimizing crop yield.

Keywords: soil moisture content retrieval, precision agriculture, continuum removal, remote sensing, machine learning, spectroscopy

Procedia PDF Downloads 93
1336 Nimart-trained Nurses' Perspectives Regarding Virally Unsuppressed Children HIV-positive on Antiretroviral Therapy and Missing Scheduled Clinic Visits: Mopani District, Limpopo Province

Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba

Abstract:

Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.

Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments

Procedia PDF Downloads 94
1335 Land Use Influence on the 2014 Catastrophic Flood in the Northeast of Peninsular Malaysia

Authors: Zulkifli Yusop

Abstract:

The severity of December 2014 flood on the east coast of Peninsular Malaysia has raised concern over the adequacy of existing land use practices and policies. This article assesses flood responses to selective logging, plantation establishment (oil palm and rubber) and their subsequent management regimes. The hydrological impacts were evaluated on two levels: on-site (mostly in the upstream) and off-site to reflect the cumulative impact at downstream. Results of experimental catchment studies suggest that on-site impact of flood could be kept to a minimum when selecting logging strictly adhere to the existing guidelines. However, increases in flood potential and sedimentation rate were observed with logging intensity and slope steepness. Forest conversion to plantation show the highest impacts. Except on the heavily compacted surfaces, the ground revegetation is usually rapid within two years upon the cessation of the logging operation. The hydrological impacts of plantation opening and replanting could be significantly reduced once the cover crop has fully established which normally takes between three to six months after sowing. However, as oil palms become taller and the canopy gets closer, the cover crop tends to die off due to light competition, and its protecting function gradually diminishes. The exposed soil is further compacted by harvesting machinery which subsequently leads to greater overland flow and erosion rates. As such, the hydrological properties of matured oil palm plantations are generally poorer than in young plantation. In hilly area, the undergrowth in rubber plantation is usually denser compared to under oil palm. The soil under rubber trees is also less compacted as latex collection is done manually. By considering the cumulative effects of land-use over space and time, selective logging seems to pose the least impact on flood potential, followed by planting rubber for latex, oil palm and Latex Timber Clone (LTC). The cumulative hydrological impact of LTC plantation is the most severe because of its shortest replanting rotation (12 to 15 years) compared to oil palm (25 years) and rubber for latex (35 years). Furthermore, the areas gazetted for LTC are mostly located on steeper slopes which are more susceptible to landslide and erosion. Forest has limited capability to store excess rainfall and is only effective in attenuating regular floods. Once the hydrologic storage is exceeded, the excess rainfall will appear as flood water. Therefore, for big floods, rainfall regime has a much bigger influence than land use.

Keywords: selective logging, plantation, extreme rainfall, debris flow

Procedia PDF Downloads 343
1334 The Influence of Absorptive Capacity on Process Innovation: An Exploratory Study in Seven Leading and Emerging Countries

Authors: Raphael M. Rettig, Tessa C. Flatten

Abstract:

This empirical study answer calls for research on Absorptive Capacity and Process Innovation. Due to the fourth industrial revolution, manufacturing companies face the biggest disruption of their production processes since the rise of advanced manufacturing technologies in the last century. Therefore, process innovation will become a critical task to master in the future for many manufacturing firms around the world. The general ability of organizations to acquire, assimilate, transform, and exploit external knowledge, known as Absorptive Capacity, was proven to positively influence product innovation and is already conceptually associated with process innovation. The presented research provides empirical evidence for this influence. The findings are based on an empirical analysis of 732 companies from seven leading and emerging countries: Brazil, China, France, Germany, India, Japan, and the United States of America. The answers to the survey were collected in February and March 2018 and addressed senior- and top-level management with a focus on operations departments. The statistical analysis reveals the positive influence of potential and Realized Absorptive Capacity on successful process innovation taking the implementation of new digital manufacturing processes as an example. Potential Absorptive Capacity covering the acquisition and assimilation capabilities of an organization showed a significant positive influence (β = .304, p < .05) on digital manufacturing implementation success and therefore on process innovation. Realized Absorptive Capacity proved to have significant positive influence on process innovation as well (β = .461, p < .01). The presented study builds on prior conceptual work in the field of Absorptive Capacity and process innovation and contributes theoretically to ongoing research in two dimensions. First, the already conceptually associated influence of Absorptive Capacity on process innovation is backed by empirical evidence in a broad international context. Second, since Absorptive Capacity was measured with a focus on new product development, prior empirical research on Absorptive Capacity was tailored to the research and development departments of organizations. The results of this study highlight the importance of Absorptive Capacity as a capability in mechanical engineering and operations departments of organizations. The findings give managers an indication of the importance of implementing new innovative processes into their production system and fostering the right mindset of employees to identify new external knowledge. Through the ability to transform and exploit external knowledge, own production processes can be innovated successfully and therefore have a positive influence on firm performance and the competitive position of their organizations.

Keywords: absorptive capacity, digital manufacturing, dynamic capabilities, process innovation

Procedia PDF Downloads 138
1333 Enhancing Intra-Organizational Supply Chain Relationships in Manufacturing Companies: A Case Study in Tigray, Ethiopia

Authors: Weldeabrha Kiros Kidanemaryam

Abstract:

The investigation is to examine intra-organizational supply chain relationships of firms, which will help to look at and give an emphasis on internal processes and operations strength and achievements to make an influence even for external relationship management and outstanding performances of organizations. The purpose of the study is to scrutinize the internal supply chain relationships within manufacturing companies located in Tigray. The qualitative and quantitative data analysis methods were employed during the study by applying the primary data sources (questionnaires & interviews) and secondary data sources (organizational reports and documents) with the purposive sampling method. Thus, a descriptive research design was also applied in the research project in line with the cross-sectional research design which portrays simply the magnitude of the issues and problems by collecting the required and necessary data once from the sample respondents. This is because the study variables don’t have any cause-and-effect relationship in the research project that requires other types of research design than a descriptive research design; it already needs to be assessed and analyzed with a detailed description of the results after quantifying the outcomes and degree of the issues and problems based on the data gathered from respondents. The collected data was also analyzed by using the statistical package for social sciences (SPSS Version 20). The intra-organizational relationships of the companies are moderately accomplished, which requires an improvement for enhancing the performances of each unit or department within the firms so as to upgrade and ensure the progress of the companies’ effectiveness and efficiency. Moreover, the manufacturing companies have low industrial discipline and working culture, weak supervision of manpower, delayed delivery in the process within the companies, unsatisfactory quality of products, underutilization of capacity, and low productivity and profitability, which in turn results in minimizing the performance of intra-organizational supply chain relationships and to reduce the companies’ organizational efficiency, effectiveness and sustainability. Hence, the companies should have to give emphasize building and managing the intra-organizational supply chain relationships effectively because nothing can be done without creating successful and progressive relationships with internal units or functional areas and individuals for the production and provision of the required and qualified products that permits to meet the intended customers’ desires. The study contributes to improving the practical applications and gives an emphasis on the policy measurements and implications of the manufacturing companies with regard to intra-organizational supply chain relationships.

Keywords: supply chain, supply chain relationships, intra-organizational relationships, manufacturing companies

Procedia PDF Downloads 16
1332 Application of Improved Semantic Communication Technology in Remote Sensing Data Transmission

Authors: Tingwei Shu, Dong Zhou, Chengjun Guo

Abstract:

Semantic communication is an emerging form of communication that realize intelligent communication by extracting semantic information of data at the source and transmitting it, and recovering the data at the receiving end. It can effectively solve the problem of data transmission under the situation of large data volume, low SNR and restricted bandwidth. With the development of Deep Learning, semantic communication further matures and is gradually applied in the fields of the Internet of Things, Uumanned Air Vehicle cluster communication, remote sensing scenarios, etc. We propose an improved semantic communication system for the situation where the data volume is huge and the spectrum resources are limited during the transmission of remote sensing images. At the transmitting, we need to extract the semantic information of remote sensing images, but there are some problems. The traditional semantic communication system based on Convolutional Neural Network cannot take into account the global semantic information and local semantic information of the image, which results in less-than-ideal image recovery at the receiving end. Therefore, we adopt the improved vision-Transformer-based structure as the semantic encoder instead of the mainstream one using CNN to extract the image semantic features. In this paper, we first perform pre-processing operations on remote sensing images to improve the resolution of the images in order to obtain images with more semantic information. We use wavelet transform to decompose the image into high-frequency and low-frequency components, perform bilinear interpolation on the high-frequency components and bicubic interpolation on the low-frequency components, and finally perform wavelet inverse transform to obtain the preprocessed image. We adopt the improved Vision-Transformer structure as the semantic coder to extract and transmit the semantic information of remote sensing images. The Vision-Transformer structure can better train the huge data volume and extract better image semantic features, and adopt the multi-layer self-attention mechanism to better capture the correlation between semantic features and reduce redundant features. Secondly, to improve the coding efficiency, we reduce the quadratic complexity of the self-attentive mechanism itself to linear so as to improve the image data processing speed of the model. We conducted experimental simulations on the RSOD dataset and compared the designed system with a semantic communication system based on CNN and image coding methods such as BGP and JPEG to verify that the method can effectively alleviate the problem of excessive data volume and improve the performance of image data communication.

Keywords: semantic communication, transformer, wavelet transform, data processing

Procedia PDF Downloads 72
1331 The Psychological Specification of Motivation of Managerial Activity

Authors: Laura Petrosyan

Abstract:

The high and persistent working results are possible when people are interested in the results of the work. Motivation of working may be present as a psychological complicated phenomena, which determines person's behavior in working process. Researchers point out that working motivation is displayed in three correlated conditions. These are interest in outcomes of work, satisfaction with the work, and the third, is the level of devotion of employee. Solution of the problem of effective staff management depends on the development of workers' skills. Despite, above mentioned problem could be solved by the process of finding methods to induce the employees to the effective work. Motivation of the managerial activity aroused not only during the working process, but also before it starts. During education the future manager obtains many professional skills. However, the experience shows, that only professional skills are not enough for the effective work. Presently, one of the global educational problems is the development of motivation in professions. In psychological literature the fact is mentioned, that the motivation can be inside and outside. Outside motivation is active only at short time. Instead, inside motivation can be active during all process of the professional development. Hence, the motivation of managerial activity might be developed during the education. The future manager choose the profession being under some impression of personal qualities. Detection of future manager’s motivation will influence on the development of syllabuses. Moreover, use of the psychological methods could be evolved for preparing motivated managers. Conducted research has been done in the Public Administration Academy of the RA. The aim of research was to discover students' motivation of profession. 102 master students took part in the research from Public Administration Academy. In the research were used the following methods: method of identifying a person's motivation to succeed (T. Elers) and method of studying students’ motivation (T.E. Ilyin). First of the methods designed to explore a person's motivational orientation to get success represented by Hackhausen. The method gives the opportunity to reveal the level of motivation to success. In the second method separated three scales: i) Knowledge achievements, ii) Knowledge of the profession, iii) Get a diploma. The data obtained from these tests gave quantitative data. Aanalyses of our survey results exposes that within master students the high level have the average rates of knowledge achievements. The average rates of knowledge of the profession and geting a diploma not in high level. Furthermore, there are almost equal to each other. In the educational process The student acquiring skills not synthesize with the wield profession. Results show that specialists really view about profession not formulated yet.

Keywords: managerial activity, motivation, psychological complicated phenomena, working process, education the future manager

Procedia PDF Downloads 444
1330 Applicable Law to Intellectual and Industrial Property Agreements According to Turkish Private International Law and Rome I Regulation

Authors: Sema Cortoglu Koca

Abstract:

Intellectual and industrial property rules, have a substantial effect on the sustainable development. Intellectual and industrial property rights, as temporary privileges over the products of intellectual activity, determine the supervision of information and technology. The level and scope of intellectual property protection thus influence the flow of technology between developed and developing countries. In addition, intellectual and industrial property rights are based on the notion of balance. Since they are time-limited rights, they reconcile private and public benefits. That is, intellectual and industrial property rights respond to both private interests and public interests by rewarding innovators and by promoting the dissemination of ideas, respectively. Intellectual and industrial property rights can, therefore, be a tool for sustainable development. If countries can balance their private and public interests according to their particular context and circumstances, they can ensure the intellectual and industrial property which promotes innovation and technology transfer relevant for them. People, enterprises and countries who need technology, can transfer developed technology which is acquired by people, enterprises and countries so as to decrease their technological necessity and improve their technology. Because of the significance of intellectual and industrial property rights on the technology transfer law as mentioned above, this paper is confined to intellectual and industrial property agreements especially technology transfer contracts. These are license contract, know-how contract, franchise agreement, joint venture agreement, management agreement, research and development agreement. In Turkey, technology transfer law is still a developing subject. For developing countries, technology transfer regulations are very important for their private international law because these countries do not know which technology transfer law is applicable when conflicts arise. In most technology transfer contracts having international elements, the parties choose a law to govern their contracts. Where the parties do not choose a law, either expressly or impliedly, and matters which is not excluded in party autonomy, the court has to determine the applicable law to contracts in a matter of capacity, material, the formal and essential validity of contracts. For determining the proper law of technology transfer contracts, it is tried to build a rule for applying all technology transfer contracts. This paper is confined to the applicable law to intellectual and industrial property agreements according to ‘5718 Turkish Act on Private International Law and Civil Procedure’ and ‘Regulation (EC) No 593/2008 of the European Parliament and of the Council of 17 June 2008 on the law applicable to contractual obligations (Rome I)’. Like these complex contracts, to find a rule can be really difficult. We can arrange technology transfer contracts in groups, and we can determine the rule and connecting factors to these groups. For the contracts which are not included in these groups, we can determine a special rule considering the characteristics of the contract.

Keywords: intellectual and industrial property agreements, Rome I regulation, technology transfer, Turkish act on private international law and civil procedure

Procedia PDF Downloads 150
1329 Considerations for Effectively Using Probability of Failure as a Means of Slope Design Appraisal for Homogeneous and Heterogeneous Rock Masses

Authors: Neil Bar, Andrew Heweston

Abstract:

Probability of failure (PF) often appears alongside factor of safety (FS) in design acceptance criteria for rock slope, underground excavation and open pit mine designs. However, the design acceptance criteria generally provide no guidance relating to how PF should be calculated for homogeneous and heterogeneous rock masses, or what qualifies a ‘reasonable’ PF assessment for a given slope design. Observational and kinematic methods were widely used in the 1990s until advances in computing permitted the routine use of numerical modelling. In the 2000s and early 2010s, PF in numerical models was generally calculated using the point estimate method. More recently, some limit equilibrium analysis software offer statistical parameter inputs along with Monte-Carlo or Latin-Hypercube sampling methods to automatically calculate PF. Factors including rock type and density, weathering and alteration, intact rock strength, rock mass quality and shear strength, the location and orientation of geologic structure, shear strength of geologic structure and groundwater pore pressure influence the stability of rock slopes. Significant engineering and geological judgment, interpretation and data interpolation is usually applied in determining these factors and amalgamating them into a geotechnical model which can then be analysed. Most factors are estimated ‘approximately’ or with allowances for some variability rather than ‘exactly’. When it comes to numerical modelling, some of these factors are then treated deterministically (i.e. as exact values), while others have probabilistic inputs based on the user’s discretion and understanding of the problem being analysed. This paper discusses the importance of understanding the key aspects of slope design for homogeneous and heterogeneous rock masses and how they can be translated into reasonable PF assessments where the data permits. A case study from a large open pit gold mine in a complex geological setting in Western Australia is presented to illustrate how PF can be calculated using different methods and obtain markedly different results. Ultimately sound engineering judgement and logic is often required to decipher the true meaning and significance (if any) of some PF results.

Keywords: probability of failure, point estimate method, Monte-Carlo simulations, sensitivity analysis, slope stability

Procedia PDF Downloads 205
1328 Implementing a Structured, yet Flexible Tool for Critical Information Handover

Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

Abstract:

An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

Procedia PDF Downloads 243
1327 Computational and Experimental Determination of Acoustic Impedance of Internal Combustion Engine Exhaust

Authors: A. O. Glazkov, A. S. Krylova, G. G. Nadareishvili, A. S. Terenchenko, S. I. Yudin

Abstract:

The topic of the presented materials concerns the design of the exhaust system for a certain internal combustion engine. The exhaust system can be divided into two parts. The first is the engine exhaust manifold, turbocharger, and catalytic converters, which are called “hot part.” The second part is the gas exhaust system, which contains elements exclusively for reducing exhaust noise (mufflers, resonators), the accepted designation of which is the "cold part." The design of the exhaust system from the point of view of acoustics, that is, reducing the exhaust noise to a predetermined level, consists of working on the second part. Modern computer technology and software make it possible to design "cold part" with high accuracy in a given frequency range but with the condition of accurately specifying the input parameters, namely, the amplitude spectrum of the input noise and the acoustic impedance of the noise source in the form of an engine with a "hot part". Getting this data is a difficult problem: high temperatures, high exhaust gas velocities (turbulent flows), and high sound pressure levels (non-linearity mode) do not allow the calculated results to be applied with sufficient accuracy. The aim of this work is to obtain the most reliable acoustic output parameters of an engine with a "hot part" based on a complex of computational and experimental studies. The presented methodology includes several parts. The first part is a finite element simulation of the "cold part" of the exhaust system (taking into account the acoustic impedance of radiation of outlet pipe into open space) with the result in the form of the input impedance of "cold part". The second part is a finite element simulation of the "hot part" of the exhaust system (taking into account acoustic characteristics of catalytic units and geometry of turbocharger) with the result in the form of the input impedance of the "hot part". The next third part of the technique consists of the mathematical processing of the results according to the proposed formula for the convergence of the mathematical series of summation of multiple reflections of the acoustic signal "cold part" - "hot part". This is followed by conducting a set of tests on an engine stand with two high-temperature pressure sensors measuring pulsations in the nozzle between "hot part" and "cold part" of the exhaust system and subsequent processing of test results according to a well-known technique in order to separate the "incident" and "reflected" waves. The final stage consists of the mathematical processing of all calculated and experimental data to obtain a result in the form of a spectrum of the amplitude of the engine noise and its acoustic impedance.

Keywords: acoustic impedance, engine exhaust system, FEM model, test stand

Procedia PDF Downloads 50
1326 Defining and Measuring the Success of the Hospitality-Based Social Enterprise Ringelblum Café

Authors: Nitzan Winograd, Nada Kakabadse

Abstract:

This study examines whether the hospitality-based social enterprise Ringelblum Café is achieving its stated social goals of developing a sense of self-efficacy among at-risk youth who work in this enterprise and raising levels of recruitment to the Israel Defence Forces (IDF) and National Service (NS) among these young adults. Ringelblum Café was founded in 2009 in Be'er-Sheva in order to provide employment solutions for at-risk youth in the southern district of Israel. Each year, 10 at-risk young adults aged 16–18 are referred to the programme by various welfare agencies. The training programme is approximately a year in duration and includes professional training in the art of cooking. Each young adult is also supported by a social worker. This study is based on the participation of 31 youths who graduated from the Ringelblum Café’s training programme. A convenience sampling model was used with the assistance of the programme's social worker. This study is quantitative in its approach. Data was collected by means of three separate self-reported questionnaires: a personal information questionnaire collected general demographics data; a self-efficacy questionnaire consisted of two parts: general self-efficacy and social self-efficacy; and an IDS/NS recruitment questionnaire. The study uses the theory of change in order to find out whether at-risk youth in the Ringelblum Café programme are taught a profession with future prospects, as well as whether they develop a sense of self-efficacy and raise their chances of recruitment into the IDF/NS. The study found that the sense of self-efficacy of the graduates is relatively high. In addition, there was a significant difference between the importance of recruitment to the IDF/NS among these youth prior to the beginning of the programme and after its completion, indicating that the training programme had a positive effect on motivation for recruitment to the IDF/NS. The study also found that the percentage of recruits to the IDF/NS among youth who graduated from the training programme were not significantly higher than the general recruitment figures in Israel. In conclusion, Ringelblum Café is making sound progress towards achieving its social goals regarding recruitment to the IDF/NS. Moreover, the sense of self-efficacy among the graduates is relatively high, and it can be assumed that the training programme has a positive effect on these young adults, although there is no clear connection between the two. This study is among a few that have been conducted in the field of hospitality-based social enterprises in Israel and can serve as a basis for further research. Moreover, the study results may help improve the perception of at-risk youth and their contribution to society and could increase awareness of the growing trend of social enterprises promoting social goals.

Keywords: at-risk youth, Israel Defence Forces (IDF), national service, recruitment, self-efficacy, social enterprise

Procedia PDF Downloads 209
1325 Emergency Surgery in the Elderly, What Particularities

Authors: Mekroud Amel

Abstract:

Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

Procedia PDF Downloads 74
1324 Osseointegration Outcomes Following Amputee Lengthening

Authors: Jason Hoellwarth, Atiya Oomatia, Anuj Chavan, Kevin Tetsworth, Munjed Al Muderis

Abstract:

Introduction: Percutaneous EndoProsthetic Osseointegration for Limbs (PEPOL) facilitates improved quality of life (QOL) and objective mobility for most amputees discontent with their traditional socket prosthesis (TSP) experience. Some amputees desiring PEPOL have residual bone much shorter than the currently marketed press-fit implant lengths of 14-16 cm, potentially a risk for failure to integrate. We report on the techniques used, complications experienced, the management of those complications, and the overall mobility outcomes of seven patients who had femur distraction osteogenesis (DO) with a Freedom nail followed by PEPOL. Method: Retrospective evaluation of a prospectively maintained database identified nine patients (5 females) who had transfemoral DO in preparation for PEPOL with two years of follow-up after PEPOL. Six patients had traumatic causes of amputation, one had perinatal complications, one was performed to manage necrotizing fasciitis and one was performed as a result of osteosarcoma. Result: The average age at which DO commenced was 39.4±15.9 years, and seven patients had their amputation more than ten years prior (average 25.5±18.8 years). The residual femurs, on average, started at 102.2±39.7 mm and were lengthened 58.1±20.7 mm, 98±45% of the goal (99±161% of the original bone length). Five patients (56%) had a complication requiring additional surgery: four events of inadequate regeneration were managed with continued lengthening to the desired goal followed by autograft placement harvested from contralateral femur reaming; one patient had the cerclage wires break, which required operative replacement. All patients had osseointegration performed at 355±123 days after the initial lengthening nail surgery. One patient had K-level >2 before DO, at a mean of 3.4±0.6 (2.6-4.4) years following osseointegration. Six patients had K-level >2. The 6-Minute Walk Test remained unchanged (267±56 vs. 308 ± 117 meters). Patient self-rating of prosthesis function, problems, and amputee situation did not significantly change from before DO to after osseointegration. Six patients required additional surgery following osseointegration: six to remove fixation plates placed to maintain distraction osteogenesis length at osseointegration; two required irritation and debridement for infection. Conclusion: Extremely short residual femurs, which make TSP use troublesome, can be lengthened with externally controlled telescoping nails and successfully achieve osseointegration. However, it is imperative to counsel patients that additional surgery to address inadequate regeneration or to remove painful hardware used to maintain fixation may be necessary. This may improve the amputee’s expectations before beginning a potentially arduous process.

Keywords: osseointegration, limb lengthening, quality of life, amputation

Procedia PDF Downloads 66
1323 Patient Agitation and Violence in Medical-Surgical Settings at BronxCare Hospital, Before and During COVID-19 Pandemic; A Retrospective Chart Review

Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

Abstract:

Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

Procedia PDF Downloads 140
1322 Nonlinear Interaction of Free Surface Sloshing of Gaussian Hump with Its Container

Authors: Mohammad R. Jalali

Abstract:

Movement of liquid with a free surface in a container is known as slosh. For instance, slosh occurs when water in a closed tank is set in motion by a free surface displacement, or when liquid natural gas in a container is vibrated by an external driving force, such as an earthquake or movement induced by transport. Slosh is also derived from resonant switching of a natural basin. During sloshing, different types of motion are produced by energy exchange between the liquid and its container. In present study, a numerical model is developed to simulate the nonlinear even harmonic oscillations of free surface sloshing of an initial disturbance to the free surface of a liquid in a closed square basin. The response of the liquid free surface is affected by amplitude and motion frequencies of its container; therefore, sloshing involves complex fluid-structure interactions. In the present study, nonlinear interaction of free surface sloshing of an initial Gaussian hump with its uneven container is predicted numerically. For this purpose, Green-Naghdi (GN) equations are applied as governing equation of fluid field to produce nonlinear second-order and higher-order wave interactions. These equations reduce the dimensions from three to two, yielding equations that can be solved efficiently. The GN approach assumes a particular flow kinematic structure in the vertical direction for shallow and deep-water problems. The fluid velocity profile is finite sum of coefficients depending on space and time multiplied by a weighting function. It should be noted that in GN theory, the flow is rotational. In this study, GN numerical simulations of initial Gaussian hump are compared with Fourier series semi-analytical solutions of the linearized shallow water equations. The comparison reveals that satisfactory agreement exists between the numerical simulation and the analytical solution of the overall free surface sloshing patterns. The resonant free surface motions driven by an initial Gaussian disturbance are obtained by Fast Fourier Transform (FFT) of the free surface elevation time history components. Numerically predicted velocity vectors and magnitude contours for the free surface patterns indicate that interaction of Gaussian hump with its container has localized effect. The result of this sloshing is applicable to the design of stable liquefied oil containers in tankers and offshore platforms.

Keywords: fluid-structure interactions, free surface sloshing, Gaussian hump, Green-Naghdi equations, numerical predictions

Procedia PDF Downloads 394
1321 Startup Ecosystem in India: Development and Impact

Authors: Soham Chakraborty

Abstract:

This article examines the development of start-up culture in India, its development as well as related impact on the Indian society. Another vibrant synonym of start-up in the present century can be starting afresh. Startups have become the new flavor of this decade. A startup ecosystem is formed by mainly the new generation in the making. A startup ecosystem involves a variety of elements without which a startup can never prosper, they are—ideas, inventions, innovations as well as authentic research in the field into which one is interested, mentors, advisors, funding bodies, service provider organizations, angel, venture and so on. The culture of startup is quiet nascent but rampant in India. This is largely due to the widespread of media as a medium through which the newfangled entrepreneurs can spread their word of mouth far and wide. Different kinds of media such as Television, Radio, Internet, Print media and so on, act as the weapon to any startup company in India. The article explores how there is a sudden shift in the growing Indian economy due to the rise of startup ecosystem. There are various reasons, which are the result of the growing success of startup in India, firstly, entrepreneurs are building up startup ideas on the basis of various international startup but giving them a pinch of Indian flavor; secondly, business models are framed based on the current problems that people face in the modern century; thirdly, balance between social and technological entrepreneurs and lastly, quality of mentorship. The Government of India boasts startup as a flagship initiative. Bunch full of benefits and assistance was declared in an event named as 'Start Up India, Stand Up India' on 16th January 2016 by the current Prime Minister of India Mr. Narendra Modi. One of the biggest boon that increasing startups are creating in the society is the proliferation of self-employment. Noted Startups which are thriving in India are like OYO, Where’s The Food (WTF), TVF Pitchers, Flipkart and so on are examples of India is getting covered up by various innovative startups. The deep impact can be felt by each Indian after a few years as various governmental and non-governmental policies and agendas are helping in the sprawling up of startups and have mushroom growth in India. The impact of startup uprising in India is also possible due to increasing globalization which is leading to the eradication of national borders, thereby creating the environment to enlarge one’s business model. To conclude, this article points out on the correlation between rising startup in Indian market and its increasing developmental benefits for the people at large. Internationally, various business portals are tagging India to be the world’s fastest growing startup ecosystem.

Keywords: business, ecosystem, entrepreneurs, media, globalization, startup

Procedia PDF Downloads 262
1320 Assessment of Environmental Risk Factors of Railway Using Integrated ANP-DEMATEL Approach in Fuzzy Conditions

Authors: Mehrdad Abkenari, Mehmet Kunt, Mahdi Nourollahi

Abstract:

Evaluating the environmental risk factors is a combination of analysis of transportation effects. Various definitions for risk can be found in different scientific sources. Each definition depends on a specific and particular perspective or dimension. The effects of potential risks present along the new proposed routes and existing infrastructures of large transportation projects like railways should be studied under comprehensive engineering frameworks. Despite various definitions provided for ‘risk’, all include a uniform concept. Two obvious aspects, loss and unreliability, have always been pointed in all definitions of this term. But, selection as the third aspect is usually implied and means how one notices it. Currently, conducting engineering studies on the environmental effects of railway projects have become obligatory according to the Environmental Assessment Act in developing countries. Considering the longitudinal nature of these projects and probable passage of railways through various ecosystems, scientific research on the environmental risk of these projects have become of great interest. Although many areas of expertise such as road construction in developing countries have not seriously committed to these studies yet, attention to these subjects in establishment or implementation of different systems have become an inseparable part of this wave of research. The present study used environmental risks identified and existing in previous studies and stations to use in next step. The second step proposes a new hybrid approach of analytical network process (ANP) and DEMATEL in fuzzy conditions for assessment of determined risks. Since evaluation of identified risks was not an easy touch, mesh structure was an appropriate approach for analyzing complex systems which were accordingly employed for problem description and modeling. Researchers faced the shortage of real space data and also due to the ambiguity of experts’ opinions and judgments, they were declared in language variables instead of numerical ones. Since fuzzy logic is appropriate for ambiguity and uncertainty, formulation of experts’ opinions in the form of fuzzy numbers seemed an appropriate approach. Fuzzy DEMATEL method was used to extract the relations between major and minor risk factors. Considering the internal relations of risk major factors and its sub-factors in the analysis of fuzzy network, the weight of risk’s main factors and sub-factors were determined. In general, findings of the present study, in which effective railway environmental risk indicators were theoretically identified and rated through the first usage of combined model of DEMATEL and fuzzy network analysis, indicate that environmental risks can be evaluated more accurately and also employed in railway projects.

Keywords: DEMATEL, ANP, fuzzy, risk

Procedia PDF Downloads 404
1319 Discrete PID and Discrete State Feedback Control of a Brushed DC Motor

Authors: I. Valdez, J. Perdomo, M. Colindres, N. Castro

Abstract:

Today, digital servo systems are extensively used in industrial manufacturing processes, robotic applications, vehicles and other areas. In such control systems, control action is provided by digital controllers with different compensation algorithms, which are designed to meet specific requirements for a given application. Due to the constant search for optimization in industrial processes, it is of interest to design digital controllers that offer ease of realization, improved computational efficiency, affordable return rates, and ease of tuning that ultimately improve the performance of the controlled actuators. There is a vast range of options of compensation algorithms that could be used, although in the industry, most controllers used are based on a PID structure. This research article compares different types of digital compensators implemented in a servo system for DC motor position control. PID compensation is evaluated on its two most common architectures: PID position form (1 DOF), and PID speed form (2 DOF). State feedback algorithms are also evaluated, testing two modern control theory techniques: discrete state observer for non-measurable variables tracking, and a linear quadratic method which allows a compromise between the theoretical optimal control and the realization that most closely matches it. The compared control systems’ performance is evaluated through simulations in the Simulink platform, in which it is attempted to model accurately each of the system’s hardware components. The criteria by which the control systems are compared are reference tracking and disturbance rejection. In this investigation, it is considered that the accurate tracking of the reference signal for a position control system is particularly important because of the frequency and the suddenness in which the control signal could change in position control applications, while disturbance rejection is considered essential because the torque applied to the motor shaft due to sudden load changes can be modeled as a disturbance that must be rejected, ensuring reference tracking. Results show that 2 DOF PID controllers exhibit high performance in terms of the benchmarks mentioned, as long as they are properly tuned. As for controllers based on state feedback, due to the nature and the advantage which state space provides for modelling MIMO, it is expected that such controllers evince ease of tuning for disturbance rejection, assuming that the designer of such controllers is experienced. An in-depth multi-dimensional analysis of preliminary research results indicate that state feedback control method is more satisfactory, but PID control method exhibits easier implementation in most control applications.

Keywords: control, DC motor, discrete PID, discrete state feedback

Procedia PDF Downloads 262
1318 Risk Assessment of Lead Element in Red Peppers Collected from Marketplaces in Antalya, Southern Turkey

Authors: Serpil Kilic, Ihsan Burak Cam, Murat Kilic, Timur Tongur

Abstract:

Interest in the lead (Pb) has considerably increased due to knowledge about the potential toxic effects of this element, recently. Exposure to heavy metals above the acceptable limit affects human health. Indeed, Pb is accumulated through food chains up to toxic concentrations; therefore, it can pose an adverse potential threat to human health. A sensitive and reliable method for determination of Pb element in red pepper were improved in the present study. Samples (33 red pepper products having different brands) were purchased from different markets in Turkey. The selected method validation criteria (linearity, Limit of Detection, Limit of Quantification, recovery, and trueness) demonstrated. Recovery values close to 100% showed adequate precision and accuracy for analysis. According to the results of red pepper analysis, all of the tested lead element in the samples was determined at various concentrations. A Perkin- Elmer ELAN DRC-e model ICP-MS system was used for detection of Pb. Organic red pepper was used to obtain a matrix for all method validation studies. The certified reference material, Fapas chili powder, was digested and analyzed, together with the different sample batches. Three replicates from each sample were digested and analyzed. The results of the exposure levels of the elements were discussed considering the scientific opinions of the European Food Safety Authority (EFSA), which is the European Union’s (EU) risk assessment source associated with food safety. The Target Hazard Quotient (THQ) was described by the United States Environmental Protection Agency (USEPA) for the calculation of potential health risks associated with long-term exposure to chemical pollutants. THQ value contains intake of elements, exposure frequency and duration, body weight and the oral reference dose (RfD). If the THQ value is lower than one, it means that the exposed population is assumed to be safe and 1 < THQ < 5 means that the exposed population is in a level of concern interval. In this study, the THQ of Pb was obtained as < 1. The results of THQ calculations showed that the values were below one for all the tested, meaning the samples did not pose a health risk to the local population. This work was supported by The Scientific Research Projects Coordination Unit of Akdeniz University. Project Number: FBA-2017-2494.

Keywords: lead analyses, red pepper, risk assessment, daily exposure

Procedia PDF Downloads 165