Search results for: risk management failure

Authors: Susanne Fridsten, Kristina Hellman, Anders Sundin, Lennart Blomqvist

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Background: Patients diagnosed with locally advanced cervical carcinoma are treated with definitive concomitant chemo-radiotherapy. Treatment failure occurs in 30-50% of patients with very poor prognoses. The treatment is standardized with risk for both over-and undertreatment. Consequently, there is a great need for biomarkers able to predict therapy outcomes to allow for individualized treatment. Aim: To explore the role of T2- and diffusion-weighted magnetic resonance imaging (MRI) for early prediction of therapy outcome and the optimal time point for assessment. Methods: A pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) undergoing definitive chemoradiotherapy. All patients underwent MRI four times, at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment started. Tumour size, size change (∆size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and change of ADC (∆ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis", PP, and the remaining eight patients are referred to "good prognosis", GP. The tumor size was larger at all time points for PP than for GP. The ∆size between any of the four-time points was the same for PP and GP patients. The sensitivity and specificity to predict prognostic group depending on a remaining tumor on DWI were highest at 5 weeks and 83% (5/6) and 63% (5/8), respectively. The combination of tumor size at baseline and remaining tumor on DWI at 5 weeks in ROC analysis reached an area under the curve (AUC) of 0.83. After 12 weeks, no remaining tumor was seen on DWI among patients with GP, as opposed to 2/7 PP patients. Adding ADC to the tumor size measurements did not improve the predictive value at any time point. Conclusion: A large tumor at baseline MRI combined with a remaining tumor on DWI at 5 weeks predicted a poor prognosis.

Keywords: chemoradiotherapy, diffusion-weighted imaging, magnetic resonance imaging, uterine cervical carcinoma

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Authors: Asnawi Mohd Busrah, Au Mau Teng, Tan Chin Hooi, Lau Chee Chong

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This paper describes value based planning (VBP) methodology incorporating risk assessment as an enhanced and more practical approach to evaluate distribution network projects in Peninsular Malaysia. Assessment indicators associated with economics, performance and risks are formulated to evaluate distribution projects to quantify their benefits against investment. The developed methodology is implemented in a web-based software customized to capture investment and network data, compute assessment indicators and rank the proposed projects according to their benefits. Value based planning approach addresses economic factors in the power distribution planning assessment, so as to minimize cost solution to the power utility while at the same time provide maximum benefits to customers.

Keywords: value based planning, distribution network, value of loss load (VoLL), energy not served (ENS)

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Authors: Mehrnoosh Askarizadeh

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In an ever changeable and globalized world with new economic and global competitors competing for the same customers and resources, is increasing the pressure on organizations' competitiveness. In addition, organizations faces additional challenges due to an ever-growing amount of data and the ever-bigger challenge of analyzing that data and keeping the data secure. Successful companies are characterized by exploiting their intellectual capital in an efficient manner. Thus, the most valuable asset an organization has today has become its employees' knowledge. To enable this, there is a tool that supports easier handling and optimizes the use of knowledge, which is knowledge management. Based on the theoretical framework and careful review as well as analysis of interviews and observations resulted in six essential areas: structure, management, compensation, communication, trust and motivation. The analysis showed that the scientific articles and literature have different perspectives, different definitions and are based on different theories but the essence is that they all finally seems to arrive at the same result and conclusion, although with different viewpoints and perspectives. This is regardless of whether the focus is on management style, rewards or communication they all focus on the individual. The conclusion is that organizational culture affects knowledge management and dissemination of information, because of its direct impact on the individual. The largest and most important underlying factor why we choose to participate in improvement work or share knowledge is our motivation. Motivation is the reason for and the reason behind our actions.

Keywords: lean, lean production, knowledge management, information management, motivation

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Authors: H. M. Nuralam, Z. Xiao-lan, B. K. Dubey, D. Wen-Chuan

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Healthcare waste (HCW) is one of the major concerns in environmental issues due to its infectious and hazardous nature that is requires specific treatment and systematic management prior to final disposal. This study aimed to assess HCW management system in Dhaka City (DC), Bangladesh, by investigating the present practices implemented by the city. In this study, five different healthcare establishments were selected in DC. Field visits and interviews with health personnel and staff who are concerned with the waste management were conducted. The information was gathered through questionnaire focus on the different aspect of HCW management like, waste segregation and collection, storage and transport, awareness as well. The results showed that a total of 7,215 kg/day (7.2 ton/day) of waste were generated, of which 79.36% (5.6 ton/day) was non-hazardous waste and 20.6% (1.5 ton/day) was hazardous waste. The rate of waste generation in these healthcare establishments (HCEs) was 2.6 kg/bed/day. There was no appropriate and systematic management of HCWs except at few private HCEs that segregate their hazardous waste. All the surveyed HCEs dumped their HCW together with the municipal waste, and some staff members were also found to be engaged in improper handling of the generated waste. Furthermore, the used sharp instruments, saline bags, blood bags and test tubes were collected for resale or reuse. Nevertheless, the lack of awareness, appropriate policy, regulation and willingness to act, were responsible for the improper management of HCW in DC. There was lack of practical training of concerned healthcare to handle the waste properly, while the nurses and staff were found to be aware of the health impacts of HCW.

Keywords: awareness, disposal, Dhaka city, healthcare waste management, waste generation

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Authors: N. S. Achour, M. Hamdaoui, S. Ben Nasrallah, A. Perwuelz

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The main idea of this work is to investigate the effect of knitted fabrics characteristics on moisture management properties. Wetting and transport properties of single jersey, Rib 1&1 and English Rib fabrics made out of cotton and blended Cotton/Polyester yarns were studied. The dynamic water sorption of fabrics was investigated under same isothermal and terrestrial conditions at 20±2°C-65±2% by using the Moisture Management Tester (MMT) which can be used to quantitatively measure liquid moisture transfer in one step in a fabric in multi directions: Absorption rate, moisture absorbing time of the fabric's inner and outer surfaces, one-way transportation capability, the spreading/drying rate, the speed of liquid moisture spreading on fabric's inner and outer surfaces are measured, recorded and discussed. The results show that fabric’s composition and knit’s structure have a significant influence on those phenomena.

Keywords: knitted fabrics characteristics, moisture management properties, multi directions, the moisture management tester

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Authors: Namubiru Zula, Janice Desire Busingue

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Pro-active educational approaches have lately been adapted Globally in the Conservation of Natural Resources. This led to the introduction of the co-management system, which worked for some European Countries on the conservation of sharks and other Natural resources. However, this approach has drastically failed in the Fishery sector on Lake Victoria; and the punitive education approach has been re-instated. Literature is readily available about the punitive educational approaches and scanty with the pro-active one. This article analyses the pro-active approach adopted by the Department of Fisheries for the orientation of BMU leaders in a co-management system. The study is interpreted using the social constructivist lens for co-management of the fishery resource to ensure that fishers are also back to fishing sustainably. It highlights some of the education methods used, methodological challenges that included the power and skills gap of the facilitators and program designers, and some implications to practice.

Keywords: beach management units, fishers, education methods, proactive approach, punitive approach

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Authors: Carl van Walraven, Meltem Tuna

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Background: Network meta-analysis (NMA) quantifies the relative efficacy of 3 or more interventions from studies containing a subgroup of interventions. This study applied the analytical approach of NMA to quantify the relative accuracy of prediction models with distinct inclusion criteria that are evaluated on a common population (‘concurrent external validation’). Methods: We simulated binary events in 5000 patients using a known risk function. We biased the risk function and modified its precision by pre-specified amounts to create 15 prediction models with varying accuracy and distinct patient applicability. Prediction model accuracy was measured using the Scaled Brier Score (SBS). Overall prediction model accuracy was measured using fixed-effects methods that accounted for model applicability patterns. Prediction model accuracy was summarized as the Network Relative Model Accuracy (NeRMA) Score which ranges from -∞ through 0 (accuracy of random guessing) to 1 (accuracy of most accurate model in concurrent external validation). Results: The unbiased prediction model had the highest SBS. The NeRMA score correctly ranked all simulated prediction models by the extent of bias from the known risk function. A SAS macro and R-function was created to implement the NeRMA Score. Conclusions: The NeRMA Score makes it possible to quantify the accuracy of binomial prediction models having distinct inclusion criteria in a concurrent external validation.

Keywords: prediction model accuracy, scaled brier score, fixed effects methods, concurrent external validation

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Authors: Maniam Kaliannan

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Studies on best practice or “bundles” of human resource management aims at providing a ‘universal solution’ to organizations yet critics challenge this view and place importance on the architecture of human resource processes in response to the dynamic needs of organizations. This paper identifies these best practices and explores how the applications of selected human resource management practices to a case study help solved their human resource problems. The case study includes insights on the problems faced; the approach taken to identify its root causes and explores how selected human resource management practices helped managed the overall predicament. The case study results supports the importance of aligning ‘bundles’ of practices with organizational architecture and ensuring that the architecture of human resource practices evolve with the changing needs of organizations. In addition, a framework based on the events of the case study is proposed to systematically manage their human resources

Keywords: bundles, best practices, human resource management, organizational architecture, framework

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Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

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Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

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Authors: Hieu Nguyen

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Performance management is the concern of any organizations in the context of increasing demand and fierce competition between education institution. This paper draws together the performance management concepts and focuses specifically to Balance Scorecard in the context of education. The study employs semi-structured in-depth interview to explore the measurement items for each of the sub-objectives in the four perspectives. Each of the perspectives’ explored measurement items will then be discussed the role and influence of them towards the perspective and how to improve the measurements to have improved performance management. Finally, the measurements will be put together as a suggested balanced scorecard framework in the case of International University.

Keywords: performance management, education institution, balance scorecard, measurement items, four perspectives, international univeristy

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Authors: Noryani Natasha Yahaya, Anas Ibrahim, Juraidah Ahmad, Azura Ahmad, Mohd Ikmal Fazlan Rosli, Zailan Ramli, Muhd Sidek Muhd Norhasri

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The subgrade formation is an important element of the railway structure which holds overall track stability. Conventional track maintenance involves many substructure component replacements, as well as track re-ballasting on a regular basis is partially contributed to the embankment's long-term settlement problem. For subgrade long-term stability analysis, the geophysical method is commonly being used to diagnose those hidden sources/mechanisms of track deterioration problems that the normal visual method is unable to detect. Electrical resistivity tomography (ERT) is one of the applicable geophysical tools that are helpful in railway subgrade inspection/track monitoring due to its flexibility and reliability of the analysis. The ERT was conducted at KM 23.0 of Pinang Tunggal track to investigate the subgrade of railway track through the characterization/mapping on track formation profiling which was directly generated using 2D analysis of Res2dinv software. The profiles will allow examination of the presence and spatial extent of a significant subgrade layer and screening of any poor contact of soil boundary. Based on the finding, there is a mix/interpretation/intermixing of an interlayer between the sub-ballast and the sand. Although the embankment track considered here is at no immediate risk of settlement effect or any failure, the regular monitoring of track’s location will allow early correction maintenance if necessary. The developed data of track formation clearly shows the similarity of the side view with the assessed track. The data visualization in the 2D section of the track embankment agreed well with the initial assumption based on the main element structure general side view.

Keywords: ground track, assessment, resistivity, geophysical railway, method

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Authors: Said Al Saifi

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This paper proposes a conceptual model for understanding the impact of organisational culture on knowledge management processes and their link with organisational performance. It is suggested that organisational culture should be assessed as a multi-level construct comprising artifacts, espoused beliefs and values, and underlying assumptions. A holistic view of organisational culture and knowledge management processes, and their link with organisational performance, is presented. A comprehensive review of previous literature was undertaken in the development of the conceptual model. Taken together, the literature and the proposed model reveal possible relationships between organisational culture, knowledge management processes, and organisational performance. Potential implications of organisational culture levels for the creation, sharing, and application of knowledge are elaborated. In addition, the paper offers possible new insight into the impact of organisational culture on various knowledge management processes and their link with organisational performance. A number of possible relationships between organisational culture factors, knowledge management processes, and their link with organisational performance were employed to examine such relationships. The research model highlights the multi-level components of organisational culture. These are: the artifacts, the espoused beliefs and values, and the underlying assumptions. Through a conceptualisation of the relationships between organisational culture, knowledge management processes, and organisational performance, the study provides practical guidance for practitioners during the implementation of knowledge management processes. The focus of previous research on knowledge management has been on understanding organisational culture from the limited perspective of promoting knowledge creation and sharing. This paper proposes a more comprehensive approach to understanding organisational culture in that it draws on artifacts, espoused beliefs and values, and underlying assumptions, and reveals their impact on the creation, sharing, and application of knowledge which can affect overall organisational performance.

Keywords: knowledge application, knowledge creation, knowledge management, knowledge sharing, organisational culture, organisational performance

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Authors: Kolesnik Nadezda A.

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The research aims to elaborate inter-organizational network relationships management model to maximize value co-creation. We propose a network management framework that requires evaluation of network partners with respect to their position and role in network; and elaboration of appropriate relationship development strategy with partners in network. Empirical research and approval is based on the case study method, including structured in-depth interviews with the companies from b2b market.

Keywords: inter-organizational networks, value co-creation, model, B2B market

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Authors: Thouraya Eshami

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The aim of this study is to understand, interpret and describe the dynamics of the management and leadership practices with its diverse constituents within the middle management cadre in two selected post-1992 UK universities. The information will be gleaned from interviews conducted with academics who became middle-managers (an AD, SGL and TL) in two selected case Higher Education Institutes. The term middle management is used to describe personnel occupying positions at the level of assistant deans, dean (which also referred to as associate deans), and team leaders.

Keywords: academic manager, associate dean, higher education, middle manager, post 1992 universities

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Authors: Si Jack Chong, Chew Theng Yap, Wan Loong James Mok

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Introduction: Regional burn centres face the spectra of introduced multi-drug resistant organisms (MDRO) from transfer patients resident in MDRO endemic countries. MDRO can cause severe nosocomial infection, which in massive burn patients, will lead to greater morbidity and mortality and strain the institution financially. We aim to highlight 4 key measures that have effectively prevented transmission of imported MDRO. Methods: A case of Candida auris (C. auris) from a massive burn patient transferred from an MDRO endemic country is used to illustrate the measures. C. auris is a globally emerging multi-drug resistant fungal pathogen causing nosocomial transmission. Results: Infection control measures used to mitigate the risk of outbreak from transfer cases are: (1) Multidisciplinary team approach involving Infection Control and Infectious Disease specialists early to ensure appropriate antibiotics use and implementation of barrier measures, (2) aseptic procedures for dressing change with strict isolation and donning of personal protective equipment in the ward, (3) early screening of massive burn patient from MDRO endemic region, (4) hydrogen peroxide vaporization terminal cleaning for operating theatres and rooms. Conclusion: The prevalence of air travel and international transfer to regional burn centres will need effective infection control measures to reduce the risk of transmission from imported massive burn patients. In our centre, we have effectively implemented 4 measures which have reduced the risks of local contamination. We share a recent case report to illustrate successful management of a potential MDRO outbreak resulting from transfer of massive burn patient resident in an MDRO endemic area.

Keywords: burns, burn unit, cross infection, infection control

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Authors: Audrius Dedele, Aukse Miskinyte

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Air pollution is a major problem, especially in large cities, causing a variety of environmental issues and a risk to human health effects. In order to observe air quality, to reduce and control air pollution in the city, municipalities are responsible for the creation of air quality management plans, air quality monitoring and emission inventories. Atmospheric dispersion modelling systems, along with monitoring, are powerful tools, which can be used not only for air quality management, but for the assessment of human exposure to air pollution. These models are widely used in epidemiological studies, which try to determine the associations between exposure to air pollution and the adverse health effects. The purpose of this study was to determine the concentration of particulate matter smaller than 10 μm (PM10) in different districts of Kaunas city during winter season. ADMS-Urban dispersion model was used for the simulation of PM10 pollution. The inputs of the model were the characteristics of stationary, traffic and domestic sources, emission data, meteorology and background concentrations were entered in the model. To assess the modelled concentrations of PM10 in Kaunas districts, geographic information system (GIS) was used. More detailed analysis was made using Spatial Analyst tools. The modelling results showed that the average concentration of PM10 during winter season in Kaunas city was 24.8 µg/m3. The highest PM10 levels were determined in Zaliakalnis and Aleksotas districts with are the highest number of individual residential properties, 32.0±5.2 and 28.7±8.2 µg/m3, respectively. The lowest pollution of PM10 was modelled in Petrasiunai district (18.4 µg/m3), which is characterized as commercial and industrial neighbourhood.

Keywords: air pollution, dispersion model, GIS, Particulate matter

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Authors: A. Maruf Aytekin

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We present our approach on using continuous delivery pattern for release management. One of the key practices of agile and lean teams is the continuous delivery of new features to stakeholders. The main benefits of this approach lie in the ability to release new applications rapidly which has real strategic impact on the competitive advantage of an organization. Organizations that successfully implement Continuous Delivery have the ability to evolve rapidly to support innovation, provide stable and reliable software in more efficient ways, decrease the amount of resources need for maintenance, and lower the software delivery time and costs. One of the objectives of this paper is to elaborate a case study where IT division of Central Securities Depository Institution (MKK) of Turkey apply Continuous Delivery pattern to improve release management process.

Keywords: automation, continuous delivery, deployment, release management

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Authors: Janaína F. Guidolini, Jean P. H. B. Ometto, Angélica Giarolla, Peter M. Toledo, Carlos A. Valera

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The water crisis, a major problem of the 21^st century, occurs mainly due to poor management. The central issue that should govern the management is the integration of the various aspects that interfere with the use of water resources and their protection, supported by legal basis. A watershed is a unit of water interacting with the physical, biotic, social, economic and cultural variables. The Brazilian law recognized river basin as the territorial management unit. Based on the diagnosis of the current situation of the water resources of the Rio Grande Basin, a discussion informed in the Brazilian legal basis was made to propose measures to fight or mitigate damages and environmental degradation in the Basin. To manage water resources more efficiently, conserve water and optimize their multiple uses, the integration of acquired scientific knowledge and management is essential. Moreover, it is necessary to monitor compliance with environmental legislation.

Keywords: conservation of soil and water, environmental laws, river basin, sustainability

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Authors: Palash Bandyopadhyay

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Background and significance of the study: Crude oil and natural gas is of crucial importance due to its increasing demand in India. The demand has been increased because of change of lifestyle overtime. Since India has poor utilization of oil production capacity, constantly the import of it has been increased progressively day by day. This ultimately hit the foreign exchange reserves of India, however it negatively affect the Indian economy as well. The financial performance of crude oil and natural gas companies in India has been trimmed down year after year because of underutilization of production capacity, enhancement of demand, change in life style, and change in import bill and outflows of foreign currencies. In this background, the current study seeks to measure the financial performance of crude oil and natural gas companies of India in the post liberalization period. Keeping in view of this, this study assesses the financial performance in terms of liquidity management, solvency, efficiency, financial stability, and profitability of the companies under study. Methodology: This research work is encircled on yearly ratio data collected from Centre for Monitoring Indian Economy (CMIE) Prowess database for the periods between 1993-94 and 2012-13 with 20 observations using liquidity, solvency and efficiency indicators, profitability indicators and financial stability indicators of all the major crude oil and natural gas companies in India. In the course of analysis, descriptive statistics, correlation statistics, and linear regression test have been utilized. Major findings: Descriptive statistics indicate that liquidity position is satisfactory in case of three crude oil and natural gas companies (Oil and Natural Gas Companies Videsh Limited, Oil India Limited and Selan exploration and transportation Limited) out of selected companies under study but solvency position is satisfactory only for one company (Oil and Natural Gas Companies Videsh Limited). However, efficiency analysis points out that Oil and Natural Gas Companies Videsh Limited performs effectively the management of inventory, receivables, and payables, but the overall liquidity management is not well. Profitability position is very much satisfactory in case of all the companies except Tata Petrodyne Limited, but profitability management is not satisfactory for all the companies under study. Financial stability analysis shows that all the companies are more dependent on debt capital, which bears a financial risk. Correlation and regression test results illustrates that profitability is positively and negatively associated with liquidity, solvency, efficiency, and financial stability indicators. Concluding statement: Management of liquidity and profitability of crude oil and natural gas companies in India should have been improved through controlling unnecessary imports in spite of the heavy demand of crude oil and natural gas in India and proper utilization of domestic oil reserves. At the same time, Indian government has to concern about rupee depreciation and interest rates.

Keywords: financial performance, crude oil and natural gas companies, India, linear regression

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Authors: Hala M. El-hanbuli, Mohammed F. Darweesh

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The incidence rates of any tumor vary hugely with geographical location. Basal Cell Carcinoma (BCC) is one of the most common skin cancer that has many histopathologic subtypes. Objective: The aim was to study the histopathological features of BCC cases that were received in the Pathology Department, Kasr El-Aini hospital, Cairo University, Egypt during the period from Jan 2004 to Dec 2013 and to evaluate the clinical characters through the patient data available in the request sheets. Methods: Slides and data of BCC cases were collected from the archives of the pathology department, Kasr El-Aini hospital. Revision of all available slides and histological classification of BCC according to WHO (2006) was done. Results: A total number of 310 cases of BCC representing about 65% from the total number of malignant skin tumors examined during the 10-years duration in the department. The age ranged from 8 to 84 years, the mean age was (55.7 ± 15.5). Most of the patients (85%) were above the age of 40 years. There was a slight male predominance (55%). Ulcerated BCC was the most common gross picture (60%), followed by nodular lesion (30%) and finally the ulcerated nodule (10%). Most of the lesions situated in the high-risk sites (77%) where the nose was the most common site (35%) followed by the periocular area (22%), then periauricular (15%) and finally perioral (5%). No lesion was reported outside the head. The tumor size was less than 2 centimeters in 65% of cases, and from 2-5 centimeters in the lesions' greatest dimension in the rest of cases. Histopathological reclassification revealed that the nodular BCC was the most common (68%) followed by the pigmented nodular (18.75%). The histologic high-risk groups represented (7.5%) about half of them (3.75%) being basosquamous carcinoma. The total incidence for multiple BCC and 2nd primary was 12%. Recurrent BCC represented 8%. All of the recurrent lesions of BCC belonged to the histologic high-risk group. Conclusion: Basal Cell Carcinoma is the most common skin cancer in the 10-year survey. Histopathological diagnosis and classification of BCC cases are essential for the determination of the tumor type and its biological behavior.

Keywords: basal cell carcinoma, high risk, histopathological features, statistical analysis

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Authors: Pulak Swain, A. K. Ojha

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Portfolio optimization is based on dealing with the problems of efficient asset allocation. Risk and Expected return are two conflicting criteria in such problems, where the investor prefers the return to be high and the risk to be low. Using multi-objective approach we can solve those type of problems. However the information which we have for the input parameters are generally ambiguous and the input values can fluctuate around some nominal values. We can not ignore the uncertainty in input values, as they can affect the asset allocation drastically. So we use Robust Optimization approach to the problems where the input parameters comes under box uncertainty. In this paper, we solve the multi criteria robust problem with the help of  E- constraint method.

Keywords: portfolio optimization, multi-objective optimization, ϵ - constraint method, box uncertainty, robust optimization

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Authors: Karla N. Penna, Eloise J. Hoffman, Tonya R. Carter

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This paper suggests that effective cultural landscape management plans in an Indigenous context should be undertaken using multidisciplinary approach taken into consideration context-related social and cultural aspects. In relation to working in Indigenous and mining contexts, we draw upon and contribute to International policies on human rights that promote the development of management plans on that are co-designed through genuine engagement processes. We suggest that the production of management plans that are built upon culturally relevant frameworks, lead to more inclusive economic development, a greater sense of trust, and shared managerial responsibilities. In this paper, three issues related to Indigenous engagement and cultural landscape management plans will be addressed: (1) the need for effective communication channels between proponents and Traditional Owners (Australian original Aboriginal peoples who inhabited specific regions), (2) the use of a culturally sensitive approach to engage local representatives in the decision making processes, and (3) how design of new management plans can help in establishing shared management.

Keywords: culture-centred approach, Holons’ hierarchy, inclusive economic development, indigenous engagement

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Authors: Mohamed Mouloud Haddak, Bouthayna Hayou

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Road accidents in French overseas territories have been understudied, with relevant data often collected late and incompletely. Although these territories account for only 3% to 4% of road traffic injuries in France, their unique characteristics merit closer attention. Despite lower mobility and, consequently, lower exposure to road risks, the actual road risk in Overseas France is as high or even higher than in Metropolitan France. Significant disparities exist not only between Metropolitan France and Overseas territories but also among the overseas territories themselves. The varying population densities in these regions do not fully explain these differences, as each territory has its own distinct vulnerabilities and road safety challenges. This analysis, based on BAAC data files from 2005 to 2018 for both Metropolitan France and the overseas departments and regions, examines key variables such as gender, age, type of road user, type of obstacle hit, type of trip, road category, traffic conditions, weather, and location of accidents. Logistic regression models were built for each region to investigate the risk factors associated with fatal road accidents, focusing on the probability of being killed versus injured. Due to insufficient data, Mayotte and the Overseas Communities (French Polynesia and New Caledonia) were not included in the models. The findings reveal that road safety is worse in the overseas territories compared to Metropolitan France, particularly for vulnerable road users such as pedestrians and motorized two-wheelers. These territories present an accident profile that sits between that of Metropolitan France and middle-income countries. A pressing need exists to standardize accident data collection between Metropolitan and Overseas France to allow for more detailed comparative analyses. Further epidemiological studies could help identify the specific road safety issues unique to each territory, particularly with regards to socio-economic factors such as social cohesion, which may influence road safety outcomes. Moreover, the lack of data on new modes of travel, such as electric scooters, and the absence of socio-economic details of accident victims complicate the evaluation of emerging risk factors. Additional research, including sociological and psychosocial studies, is essential for understanding road users' behavior and perceptions of road risk, which could also provide valuable insights into accident trends in peri-urban areas in France.

Keywords: multivariate logistic regression, french overseas regions, road safety, road traffic accidents, territorial inequalities

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Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

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Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Narong Anurak

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The objectives of this research were to investigate the knowledge and understanding of public relations principles for public relations officials of the office of the faculty of management science in Ratjabhat Suan Sunandha University and to determine the approach of public relations for the Office of Faculty of Management Science.  The questionnaire was utilized as a tool to collect data. Statistics utilized included frequency, percentage, mean, standard deviation, and regression analysis. The results of the research showed that the public relations officials misunderstood on public relations principles. The lack of the perception in media of the target groups both in-house and outside caused the misunderstanding on the roles, mission, and responsibilities. It would be beneficial to public relations division and other divisions of the office of the faculty of management science to be trained and obtained more knowledge and skills on the public relations to support the public relations work for the organization.

Keywords: faculty of management science, preparation in media, public relations, Suan Sunandha Rajabhat University

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Authors: Lukas Kober, Vladimir Littva, Vladimir Siska

Abstract:

The pandemic has had a significant impact on our lives. One of the most affected professions is the nursing profession. Nurses are closest to the patient, spend the most time with him, support him, often replace the closest family members, and of course, are part of the whole treatment process. Current nurses have more competencies and roles than in the past. The healthcare system has reached a turning point, also in connection with the spreading Delta variant and the risk of the arrival of the third wave. The lack of nurses is a long-term problem, but it did not arise by itself. The reasons for the departure of nurses from the health care system are not only due to the increasing average age of nurses and midwives in Slovakia and their retirement. Thousands of nurses are leaving due to poor working conditions, low wages, and poor management of individual workplaces. We need to keep older nurses in the health care system, otherwise, we risk their early departure. The pandemic only exacerbates this situation, and the associated risks, such as occupational infections or enormous overload and exhaustion, only accelerate the exit from the profession. According to current data from the register of nurses and midwives, we canceled 772 registrations from January to September 2021, and 584 nurses requested the suspension of registration due to non-performance of the profession. During the same period, we registered only 240 new nurses graduate. We have had this significant disparity here for a long time. For the whole of 2020, we canceled 911 registrations and suspended 973 registrations. We registered a total of 389 graduates. Our system loses hundreds of graduates a year and loses experienced nurses with decades of experience who leave due to poor working conditions, wages and suffer from burnout. Such compensation should also be awarded to the families of health professionals who have lost their lives due to work and to COVID-19. These options can also be motivating for promising people interested in studying nursing, who can gradually replace the missing workforce. This purchase is supported by the KEGA project no. 015KU-4/2019.

Keywords: pandemic, COVID-19, nursing, nursing workforce, lack of nurses

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Authors: C. Nathanailides, S. Anastasiou, A. Dimitroglou, P. Logothetis, G. Kanlis

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In the present work we reviewed historical data of the Greek Marine aquaculture industry including adoption of new methods and technological innovation. The results indicate that the industry exhibited a rapid rise in production efficiency, employment and adoption of new technologies which reduced outbreaks of diseases, reduced production risk and the price of the farmed fish. The improvements of total quality practices and technological input on the Greek Aquaculture industry include improved survival, growth and body shape of farmed fish, which resulted from development of new aquaculture feeds and the genetic selection of the bloodstock. Also improvements in the quality of the final product were achieved via technological input in the methods and technology applied during harvesting, packaging, and transportation-preservation of farmed fish ensuring high quality of the product from the fish farm to the plate of the consumers. These parameters (health management, nutrition, genetics, harvesting and post-harvesting methods and technology) changed significantly over the last twenty years and the results of these improvements are reflected in the production efficiency of the Aquaculture industry and the quality of the final product. It is concluded that the Greek aquaculture industry exhibited a rapid growth, adoption of technologies and supply was stabilized after the global financial crisis, nevertheless, the development of the Greek aquaculture industry is currently limited by international trade sanctions, credit crunch, and increased taxation and not by limited technology or resources.

Keywords: innovation, aquaculture, total quality, management

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Authors: Chitra Rajagopal, Indra Deo Kumar, Ila Chauhan, Ruchi Joshi, Binoy Bhargavan

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Reliability and safety are essential for the success of mission-critical and safety-critical defense systems. Humans are part of the entire life cycle of defense systems development and deployment. The majority of industrial accidents or disasters are attributed to human errors. Therefore, considerations of human performance and human reliability are critical in all complex systems, including defense systems. Defense systems are operating from the ground, naval and aerial platforms in diverse conditions impose unique physical and psychological challenges to the human operators. Some of the safety and mission-critical defense systems with human-machine interactions are fighter planes, submarines, warships, combat vehicles, aerial and naval platforms based missiles, etc. Human roles and responsibilities are also going through a transition due to the infusion of artificial intelligence and cyber technologies. Human operators, not accustomed to such challenges, are more likely to commit errors, which may lead to accidents or loss events. In such a scenario, it is imperative to understand the human factors in defense systems for better systems performance, safety, and cost-effectiveness. A case study using Task Analysis (TA) based methodology for assessment and reduction of human errors in the Air and Missile Defense System in the context of emerging technologies were presented. Action-oriented task analysis techniques such as Hierarchical Task Analysis (HTA) and Operator Action Event Tree (OAET) along with Critical Action and Decision Event Tree (CADET) for cognitive task analysis was used. Human factors assessment based on the task analysis helps in realizing safe and reliable defense systems. These techniques helped in the identification of human errors during different phases of Air and Missile Defence operations, leading to meet the requirement of a safe, reliable and cost-effective mission.

Keywords: defence systems, reliability, risk, safety

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

Abstract:

Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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Authors: Kawinphat Lertpongmanee

Abstract:

The purpose of this research is to examine the relationships among business collaboration effectiveness, modern management excellence, proactive operational management, and firm performance to bring competitive advantage to the firm. Furthermore, the population and sample selected are exporters on textile businesses in Thailand in total of 566 companies. The data were collected by questionnaire survey and sent direct to the directors or managerial managers of each company which is appropriate as the key informant of this research. Moreover, the statistic to test hypothesis uses the hierarchical multiple regression analysis and provides those five hypotheses to testing. The results show direct effect that the business collaboration effectiveness has a significantly positive influence on firm performance, meaning that, the collaboration is an important factor in global business both internal and external of firms that reflect the linkage of business to create competitive advantage and gain benefits simultaneously of the firms efficiently also.

Keywords: business collaboration effectiveness, firm performance, modern management excellence, strategic management

Procedia PDF Downloads 280