Search results for: N rates
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2789

Search results for: N rates

2729 Personalized Email Marketing Strategy: A Reinforcement Learning Approach

Authors: Lei Zhang, Tingting Xu, Jun He, Zhenyu Yan

Abstract:

Email marketing is one of the most important segments of online marketing. It has been proved to be the most effective way to acquire and retain customers. The email content is vital to customers. Different customers may have different familiarity with a product, so a successful marketing strategy must personalize email content based on individual customers’ product affinity. In this study, we build our personalized email marketing strategy with three types of emails: nurture, promotion, and conversion. Each type of email has a different influence on customers. We investigate this difference by analyzing customers’ open rates, click rates and opt-out rates. Feature importance from response models is also analyzed. The goal of the marketing strategy is to improve the click rate on conversion-type emails. To build the personalized strategy, we formulate the problem as a reinforcement learning problem and adopt a Q-learning algorithm with variations. The simulation results show that our model-based strategy outperforms the current marketer’s strategy.

Keywords: email marketing, email content, reinforcement learning, machine learning, Q-learning

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2728 Availability Analysis of Milling System in a Rice Milling Plant

Authors: P. C. Tewari, Parveen Kumar

Abstract:

The paper describes the availability analysis of milling system of a rice milling plant using probabilistic approach. The subsystems under study are special purpose machines. The availability analysis of the system is carried out to determine the effect of failure and repair rates of each subsystem on overall performance (i.e. steady state availability) of system concerned. Further, on the basis of effect of repair rates on the system availability, maintenance repair priorities have been suggested. The problem is formulated using Markov Birth-Death process taking exponential distribution for probable failures and repair rates. The first order differential equations associated with transition diagram are developed by using mnemonic rule. These equations are solved using normalizing conditions and recursive method to drive out the steady state availability expression of the system. The findings of the paper are presented and discussed with the plant personnel to adopt a suitable maintenance policy to increase the productivity of the rice milling plant.

Keywords: availability modeling, Markov process, milling system, rice milling plant

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2727 The Acceptable Roles of Artificial Intelligence in the Judicial Reasoning Process

Authors: Sonia Anand Knowlton

Abstract:

There are some cases where we as a society feel deeply uncomfortable with the use of Artificial Intelligence (AI) tools in the judicial decision-making process, and justifiably so. A perfect example is COMPAS, an algorithmic model that predicts recidivism rates of offenders to assist in the determination of their bail conditions. COMPAS turned out to be extremely racist: it massively overpredicted recidivism rates of Black offenders and underpredicted recidivism rates of white offenders. At the same time, there are certain uses of AI in the judicial decision-making process that many would feel more comfortable with and even support. Take, for example, a “super-breathalyzer,” an (albeit imaginary) tool that uses AI to deliver highly detailed information about the subject of the breathalyzer test to the legal decision-makers analyzing their drunk-driving case. This article evaluates the point at which a judge’s use of AI tools begins to undermine the public’s trust in the administration of justice. It argues that the answer to this question depends on whether the AI tool is in a role in which it must perform a moral evaluation of a human being.

Keywords: artificial intelligence, judicial reasoning, morality, technology, algorithm

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2726 Biomass and Biogas Yield of Maize as Affected by Nitrogen Rates with Varying Harvesting under Semi-Arid Condition of Pakistan

Authors: Athar Mahmood, Asad Ali

Abstract:

Management considerations including harvesting time and nitrogen application considerably influence the biomass yield, quality and biogas production. Therefore, a field study was conducted to determine the effect of various harvesting times and nitrogen rates on the biomass yield, quality and biogas yield of maize crop. This experiment was consisted of various harvesting times i.e., harvesting after 45, 55 and 65 days of sowing (DAS) and nitrogen rates i.e., 0, 100, 150 and 200 kg ha-1 respectively. The data indicated that maximum plant height, leaf area, dry matter (DM) yield, protein, acid detergent fiber, neutral detergent fiber, crude fiber contents and biogas yield were recorded 65 days after sowing while lowest was recorded 45 days after sowing. In contrary to that significantly higher chlorophyll contents were observed at 45 DAS. In case of nitrogen rates maximum plant height, leaf area, and DM yield, protein contents, ash contents, acid detergent fiber, neutral detergent fiber, crude fiber contents and chlorophyll contents were determined with nitrogen at the rate of 200 kg ha-1, while minimum was observed when no N was applied. Therefore, harvesting 65 DAS and N application @ 200 kg ha-1 can be suitable for getting the higher biomass and biogas production.

Keywords: chemical composition, fiber contents, biogas, nitrogen, harvesting time

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2725 Spatial Distribution of Certified Mental Disabilities in China

Authors: Jiayue Yang

Abstract:

Based on an analysis of China's database of certified disabled persons in 2021, this study reveals several key findings. Firstly, the proportion of certified mentally disabled persons among China's certified disabled population (Certification rate 1) shows a decreasing distribution from the East to the West and from the South to the North. Secondly, the spatial distribution of the number of mentally disabled persons per 1,000 people holding certificates (certification rate 2) shows a relatively scattered pattern, with significant variations observed between cities in the eastern region. However, on an overall scale, a south-north gradient can still be observed, with higher rates in the North and lower rates in the west, while the central region demonstrates higher rates compared to the western region. The variation in the rate of mentally handicapped certificates among regions is influenced not only by traditional culture and welfare level but also exhibits a certain correlation with the level of economic development.

Keywords: certified disabled persons, mentally disabled persons, spatial distribution, China

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2724 Unreliable Production Lines with Simultaneously Unbalanced Operation Time Means, Breakdown, and Repair Rates

Authors: Sabry Shaaban, Tom McNamara, Sarah Hudson

Abstract:

This paper investigates the benefits of deliberately unbalancing both operation time means (MTs) and unreliability (failure and repair rates) for non-automated production lines.The lines were simulated with various line lengths, buffer capacities, degrees of imbalance and patterns of MT and unreliability imbalance. Data on two performance measures, namely throughput (TR) and average buffer level (ABL) were gathered, analyzed and compared to a balanced line counterpart. A number of conclusions were made with respect to the ranking of configurations, as well as to the relationships among the independent design parameters and the dependent variables. It was found that the best configurations are a balanced line arrangement and a monotone decreasing MT order, coupled with either a decreasing or a bowl unreliability configuration, with the first generally resulting in a reduced TR and the second leading to a lower ABL than those of a balanced line.

Keywords: unreliable production lines, unequal mean operation times, unbalanced failure and repair rates, throughput, average buffer level

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2723 Maternal Request: A Minor but Important Contributor to the Rising Rates of Caesarean Section: A Retrospective Observational Study

Authors: Katherine Russell

Abstract:

Background: Over recent decades the number of caesarean sections performed in the UK has continued to rise. The cause of the rising caesarean rate (CSR) is not well understood. However, one of the most heavily cited reasons is an increase in maternal request for caesarean section. Maternal request for caesarean section (CDMR) refers to a caesarean section performed on maternal request with no medical indication. The true rate of caesarean delivery on maternal request in the UK and its contribution to the caesarean section rate is not known. Methods: To elucidate current understanding of the cause of the rising caesarean section rate and the role of CDMR we conducted a systematic review of the literature. To determine the role of CDMR in the CSR at the PRH we conducted a retrospective observational study of the caesarean section rates and CDMR from 2009-2015. Results: We demonstrated a negative correlation between rates of elective sections and CDMR over the study period (-0.123). On average, there were more elective sections performed after 2011 (15.10% of all deliveries) than before 2011 (12.41% of all deliveries); this difference was statistically significant (p = < 0.001). There were more cases of CDMR after 2011 (1.39% of all deliveries) than before 2011 (0.85% of all deliveries). The difference in average rates of CDMR before and after 2011 was statistically significant (p ≤ 0.001). Conclusions: CDMR is only a minor contributor to the CSR at the PRH. However, it remains an important factor because it represents a target for the reduction of the CSR that is more manageable than other, more complex and ubiquitous causes of the rising CSR.

Keywords: cesarean section, maternal request for cesarean section, obstetrics, pre-natal health

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2722 Single Stage “Fix and Flap” Orthoplastic Approach to Severe Open Tibial Fractures: A Systematic Review of the Outcomes

Authors: Taylor Harris

Abstract:

Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.

Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review

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2721 Evaluation of Dynamic Log Files for Different Dose Rates in IMRT Plans

Authors: Saad Bin Saeed, Fayzan Ahmed, Shahbaz Ahmed, Amjad Hussain

Abstract:

The aim of this study is to evaluate dynamic log files (Dynalogs) at different dose rates by dose-volume histograms (DVH) and used as a (QA) procedure of IMRT. Seven patients of phase one head and neck cancer with similar OAR`s are selected randomly. Reference plans of dose rate 300 and 600 MU/Min with prescribed dose of 50Gy in 25 fractions for each patient is made. Dynalogs produced by delivery of reference plans processed by in-house MATLAB program which produces new field files contain actual positions of multi-leaf collimators (MLC`s) instead of planned positions in reference plans. Copies of reference plans are used to import new field files generated by MATLAB program and renamed as Dyn.plan. After dose calculations of Dyn.plans for different dose rates, DVH, and multiple linear regression tools are used to evaluate reference and Dyn.plans. The results indicate good agreement of correlation between different dose rate plans. The maximum dose difference among PTV and OAR`s are found to be less than 5% and 9% respectively. The study indicates the potential of dynalogs to be used as patient-specific QA of IMRT at different dose rate.

Keywords: IMRT, dynalogs, dose rate, DVH

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2720 Data Rate Based Grouping Scheme for Cooperative Communications in Wireless LANs

Authors: Sunmyeng Kim

Abstract:

IEEE 802.11a/b/g standards provide multiple transmission rates, which can be changed dynamically according to the channel condition.Cooperative communications we reintroduced to improve the overallperformance of wireless LANs with the help of relay nodes with higher transmission rates. The cooperative communications are based on the fact that the transmission is much faster when sending data packets to a destination node through a relay node with higher transmission rate, rather than sending data directly to the destination node at low transmission rate. To apply the cooperative communications in wireless LAN, several MAC protocols have been proposed. Some of them can result in collisions among relay nodes in a dense network. In order to solve this problem, we propose a new protocol. Relay nodes are grouped based on their transmission rates. And then, relay nodes only in the highest group try to get channel access. Performance evaluation is conducted using simulation, and shows that the proposed protocol significantly outperforms the previous protocol in terms of throughput and collision probability.

Keywords: cooperative communications, MAC protocol, relay node, WLAN

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2719 Effect of Salicylic Acid and Nitrogen Fertilizer on Wheat Growth and Yield

Authors: Omar Ibrahim, Aly A. Gaafar, K. A. Ratib

Abstract:

Two field experiments in micro plots were carried out during the winter seasons of 2012/2013 and 2013/2014, Soil Salinity Laboratory, Alexandria, Egypt, to study the effect of three levels of salicylic acid (SA) as a growth regulator (0, 50, 100 ppm) and three rates of nitrogen fertilizer (75, 100, 125 kg N/feddan) on growth and yield of a spring wheat (Giza 168). The experimental design was a split plot with the main plots in randomized complete block design (RCBD) and four replicates. The results indicated that increasing nitrogen fertilizer rates resulted in insignificant effect on both plant height (cm) and grain weight/spike only. However, a significant effect was observed in all the other studied characters due to the increase in nitrogen fertilizer. On the other hand, increasing salicylic acid rates resulted in insignificant effect in all the studied characters except for chlorophyll a, chlorophyll b, number of grain/spike, and grain yield (gm/ plot). The highest effects on grain yield in wheat were obtained by the rate of 125 kg/feddan of nitrogen fertilizer and 100 ppm of salicylic acid. In conclusion, the data indicated that a high grain yield could be obtained by adding 100 kg/feddan of nitrogen fertilizer and spraying of 50 ppm of salicylic acid with no significant difference with the highest rates. Finally, the interaction had no significant effect on all the studied characters.

Keywords: growth regulator, nitrogen fertilizer, spring wheat, salicylic acid

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2718 Evaluation of the Safety and Performance of Blood Culture Practices Using BD Safety-Lokᵀᴹ Blood Collection Sets in the Emergency Room

Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

Abstract:

Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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2717 Investigating the Effects of Cylinder Disablement on Diesel Engine Fuel Economy and Exhaust Temperature Management

Authors: Hasan Ustun Basaran

Abstract:

Diesel engines are widely used in transportation sector due to their high thermal efficiency. However, they also release high rates of NOₓ and PM (particulate matter) emissions into the environment which have hazardous effects on human health. Therefore, environmental protection agencies have issued strict emission regulations on automotive diesel engines. Recently, these regulations are even increasingly strengthened. Engine producers search novel on-engine methods such as advanced combustion techniques, utilization of renewable fuels, exhaust gas recirculation, advanced fuel injection methods or use exhaust after-treatment (EAT) systems in order to reduce emission rates on diesel engines. Although those aforementioned on-engine methods are effective to curb emission rates, they result in inefficiency or cannot decrease emission rates satisfactorily at all operating conditions. Therefore, engine manufacturers apply both on-engine techniques and EAT systems to meet the stringent emission norms. EAT systems are highly effective to diminish emission rates, however, they perform inefficiently at low loads due to low exhaust gas temperatures (below 250°C). Therefore, the objective of this study is to demonstrate that engine-out temperatures can be elevated above 250°C at low-loaded cases via cylinder disablement. The engine studied and modeled via Lotus Engine Simulation (LES) software is a six-cylinder turbocharged and intercooled diesel engine. Exhaust temperatures and mass flow rates are predicted at 1200 rpm engine speed and several low loaded conditions using LES program. It is seen that cylinder deactivation results in a considerable exhaust temperature rise (up to 100°C) at low loads which ensures effective EAT management. The method also improves fuel efficiency through reduced total pumping loss. Decreased total air induction due to inactive cylinders is thought to be responsible for improved engine pumping loss. The technique reduces exhaust gas flow rate as air flow is cut off on disabled cylinders. Still, heat transfer rates to the after-treatment catalyst bed do not decrease that much since exhaust temperatures are increased sufficiently. Simulation results are promising; however, further experimental studies are needed to identify the true potential of the method on fuel consumption and EAT improvement.

Keywords: cylinder disablement, diesel engines, exhaust after-treatment, exhaust temperature, fuel efficiency

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2716 Apollo Clinical Excellence Scorecard (ACE@25): An Initiative to Drive Quality Improvement in Hospitals

Authors: Anupam Sibal

Abstract:

Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

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2715 Systematic Review and Meta-Analysis of Mid-Term Survival, and Recurrent Mitral Regurgitation for Robotic-Assisted Mitral Valve Repair

Authors: Ramanen Sugunesegran, Michael L. Williams

Abstract:

Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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2714 Environmental, Climate Change, and Health Outcomes in the World

Authors: Felix Aberu

Abstract:

The high rate of greenhouse gas (CO₂) emission and increased concentration of Carbon Dioxide in the atmosphere are not unconnected to both human and natural activities. This has caused climate change and global warming in the world. The adverse effect of these climatic changes has no doubt threatened human existence. Hence, this study examined the effects of environmental and climate influence on mortality and morbidity rates, with particular reference to the world’s leading CO₂ emission countries, using both the pre-estimation, estimation, and post-estimation techniques for more dependable outcomes. Hence, the System Generalized Method of Moments (SGMM) was adopted as the main estimation technique for the data analysis from 1996 to 2023. The coefficient of carbon emissions confirmed a positive and significant relationship among CO₂ emission, mortality, and morbidity rates in the world’s leading CO₂ emissions countries, which implies that carbon emission has contributed to mortality and morbidity rates in the world. Therefore, significant action should be taken to facilitate the expansion of environmental protection and sustainability initiatives in any CO₂ emissions nations of the world.

Keywords: environmental, mortality, morbidity, health outcomes, carbon emissions

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2713 Influence of Moringa Leaves Extract on the Response of Hb Molecule to Dose Rates’ Changes: II. Relaxation Time and Its Thermodynamic Driven State Functions

Authors: Mohamed M. M. Elnasharty, Azhar M. Elwan

Abstract:

Irradiation deposits energy through ionisation changing the bio-system’s net dipole, allowing the use of dielectric parameters and thermodynamic state functions related to these parameters as biophysical detectors to electrical inhomogeneity within the biosystem. This part is concerned with the effect of Moringa leaves extract, natural supplement, on the response of the biosystem to two different dose rates of irradiation. Having Hb molecule as a representative to the biosystem to be least invasive to the biosystem, dielectric measurements were used to extract the relaxation time of certain process found in the Hb spectrum within the indicated frequency window and the interrelated thermodynamic state functions were calculated from the deduced relaxation time. The results showed that relaxation time was decreased for both dose rates indicating a strong influence of Moringa on the response of biosystem and consequently Hb molecule. This influence was presented in the relaxation time and other parameters as well.

Keywords: activation energy, DC conductivity, dielectric relaxation, enthalpy change, Moringa leaves extract, relaxation time

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2712 Improving Patient Outcomes for Aspiration Pneumonia

Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

Abstract:

Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

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2711 Observational Study Reveals Inverse Relationship: Rising PM₂.₅ Concentrations Linked to Decreasing Muon Flux

Authors: Yashas Mattur, Jensen Coonradt

Abstract:

Muon flux, the rate of muons reaching Earth from the atmosphere, is impacted by various factors such as air pressure, temperature, and humidity. However, the influence of concentrations of PM₂.₅ (particulate matter with diameters 2.5 mm or smaller) on muon detection rates remains unexplored. During the summer of 2023, smoke from Canadian wildfires (containing significant amounts of particulate matter) blew over regions in the Northern US, introducing huge fluctuations in PM₂.₅ concentrations, thus inspiring our experiment to investigate the correlation of PM₂.₅ concentrations and muon rates. To investigate this correlation, muon collision rates were measured and analyzed alongside PM₂.₅ concentration data over the periods of both light and heavy smoke. Other confounding variables, including temperature, humidity, and atmospheric pressure, were also considered. The results reveal a statistically significant inverse correlation between muon flux and PM₂.₅ concentrations, indicating that particulate matter has an impact on the rate of muons reaching the earth’s surface.

Keywords: Muon Flux, atmospheric effects on muons, PM₂.₅, airborne particulate matter

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2710 Four-Electron Auger Process for Hollow Ions

Authors: Shahin A. Abdel-Naby, James P. Colgan, Michael S. Pindzola

Abstract:

A time-dependent close-coupling method is developed to calculate a total, double and triple autoionization rates for hollow atomic ions of four-electron systems. This work was motivated by recent observations of the four-electron Auger process in near K-edge photoionization of C+ ions. The time-dependent close-coupled equations are solved using lattice techniques to obtain a discrete representation of radial wave functions and all operators on a four-dimensional grid with uniform spacing. Initial excited states are obtained by relaxation of the Schrodinger equation in imaginary time using a Schmidt orthogonalization method involving interior subshells. The radial wave function grids are partitioned over the cores on a massively parallel computer, which is essential due to the large memory requirements needed to store the coupled-wave functions and the long run times needed to reach the convergence of the ionization process. Total, double, and triple autoionization rates are obtained by the propagation of the time-dependent close-coupled equations in real-time using integration over bound and continuum single-particle states. These states are generated by matrix diagonalization of one-electron Hamiltonians. The total autoionization rates for each L excited state is found to be slightly above the single autoionization rate for the excited configuration using configuration-average distorted-wave theory. As expected, we find the double and triple autoionization rates to be much smaller than the total autoionization rates. Future work can be extended to study electron-impact triple ionization of atoms or ions. The work was supported in part by grants from the American University of Sharjah and the US Department of Energy. Computational work was carried out at the National Energy Research Scientific Computing Center (NERSC) in Berkeley, California, USA.

Keywords: hollow atoms, autoionization, auger rates, time-dependent close-coupling method

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2709 Variability in Contraception Choices and Abortion Rates among Female Garment Factory Workers in Urban and Rural Cambodia

Authors: Olalekan Olaluwoye, Joanne Williams, Elizabeth Hoban

Abstract:

Background: Modern contraceptives are effective in preventing unwanted pregnancies and therefore the potential to reduce abortion rates. There is a need for information about how rates of contraceptive use and abortion vary across Cambodia and the relationship between the prevalence of modern contraception use and abortion rates. This study compares the use of contraception and abortion among female garment factory workers in rural and urban areas of Cambodia. Method: Cross-sectional surveys were conducted with 1701 women working in eleven garment factories in rural and urban areas of Cambodia. Sexual and reproductive health data were collected using Audio-Assisted Survey Interviews and analysed using STATA 14 software. Findings: Over 70% of the respondents were less than 30 years of age across both rural and urban settings and over 50% have only primary education, thus the study population was largely young women with limited education. A significantly higher proportion of the rural women earned over $200 in the previous month compared with their urban counterparts. The majority of the urban women (51.5%) were married, while single women (46.9%) made up the largest group working in the rural factories. A significantly larger proportion of women in the rural areas (83.9%) were sexually active compared to the urban women (50.9%). More women from the rural areas (41.4%) had been pregnant at some time compared with the urban population (37.7%). The use of any contraceptive method among sexually active women was significantly higher in the rural areas (80.1%) compared to the urban areas (65.7%) with p-value=0.000. However, among those women who used contraception, the prevalence of modern contraception use was slightly higher in the urban population (68.8% urban, 63.4% rural, p-value=0.1). For women who had a history of pregnancy the abortion prevalence was higher among rural women (43.8%) compared to their urban counterparts (37.7%). Regression analysis showed that after adjustment for the demographic variables (age, relationship status, income, education) only age and relationship status had a significant influence on the use of modern contraception.Single females who were sexually active and older women, who had potentially completed their families, were more likely to choose modern contraception. Conclusion: Although overall the use of contraception was higher among rural women, the use of modern contraception was higher among urban women.This finding may partly explain the higher rates of abortion among women in the rural areas as traditional contraception methods have higher failure rates and are more likely to result in an unplanned pregnancy.Despite the regional variation, the high rates of abortion across the country suggest there is a need for improve education on family planning among female garment factory workers in Cambodia.

Keywords: abortion, Cambodia, contraception, garment factory

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2708 Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome: Postoperative Complications in Patients with Diabetes Mellitus

Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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2707 Integrating Technology in Teaching and Learning Mathematics

Authors: Larry Wang

Abstract:

The aim of this paper is to demonstrate how an online homework system is integrated in teaching and learning mathematics and how it improves the student success rates in some gateway mathematics courses. WeBWork provided by the Mathematical Association of America is adopted as the online homework system. During the period of 2010-2015, the system was implemented in classes of precalculus, calculus, probability and statistics, discrete mathematics, linear algebra, and differential equations. As a result, the passing rates of the sections with WeBWork are well above other sections without WeBWork (about 7-10% higher). The paper also shows how the WeBWork system was used.

Keywords: gateway mathematics, online grading, pass rate, WeBWorK

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2706 Rates of Hematophagous Ectoparasite Consumption during Grooming by an Endemic Madagascar Fruit Bat

Authors: Riana V. Ramanantsalama, Aristide Andrianarimisa, Achille P. Raselimanana, Steven M. Goodman

Abstract:

Few details are available on the consumption of ectoparasites, specifically bat flies (Diptera: Nycteribiidae and Streblidae), by their chiropteran hosts while grooming. Such details could provide information on the dynamics of host-parasite interactions. This study presents data on ectoparasite ingestion rates for an endemic Malagasy fruit bat (Pteropodidae: Rousettus madagascariensis) occupying a cave day roost colony in northern Madagascar. Using quantified behavioral analyses, grooming and associated ingestion rates were measured from infrared videos taken in close proximity to day-roosting bats. The recorded individual bats could be visually identified to age (adult, juvenile) and sex (male, female), allowing analyses of the proportion of time these different classes allocated to consuming ectoparasites via auto-grooming (self) or allo-grooming (intraspecific) per 10 min video recording session. These figures could then be extrapolated to estimates of individual daily consumption rates. Based on video recordings, adults spent significantly more time auto-grooming and allo-grooming than juveniles. The latter group was not observed consuming ectoparasites. Grooming rates and the average number of ectoparasites consumed per day did not differ between adult males and females. The mean extrapolated number consumed on a daily basis for individual adults was 37 ectoparasites. When these figures are overlaid on the estimated number of adult Rousettus occurring at the roost site during the dry season, the projected daily consumption rate was 57,905 ectoparasites. To the best knowledge of the authors of this study, the details presented here represent the first quantified data on bat consumption rates of their ectoparasites, specifically dipterans. These results provide new insights into host-parasite predation dynamics. More research is needed to explore the mechanism zoonotic diseases isolated from bat flies might be transmitted to their bat hosts, specifically those pathogens that can be communicated via an oral route.

Keywords: diptera, host-parasite interactions, Madagascar, nycteribiidae, pteropodidae, Rousettus madagascariensis

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2705 Kinetic Analysis of Wood Pellets by Isothermal Calorimetry for Evaluating its Self-heating Potential

Authors: Can Yao, Chang Dong Sheng

Abstract:

The heat released by wood pellets during storage will cause self-heating and even self-ignition. In this work, the heat release rates of pine, fir wood and mahogany pellets at 30–70℃ were measured by TAM air isothermal calorimeter, and the kinetic analysis was performed by iso-conversion ratio and non-steady-state methods to evaluate its self-heating potential. The results show that the reaction temperature can significantly affect the heat release rate. The higher the temperature, the greater the heat release rate. The heat release rates of different kinds of wood pellets are obviously different, and the order of the heat release rates for the three pellets at 70℃ is pine > fir wood > mahogany. The kinetic analysis of the iso-conversion ratio method indicates that the distribution of activation energy for pine, fir wood and mahogany pellets under the release of 0.1–1.0 J/g specific heat are 58–102 kJ/mol, 59–108 kJ/mol and 59–112 kJ/mol, respectively. Their activation energies obtained from the non-steady-state kinetic analysis are 13.43 kJ/mol, 19.19 kJ/mol and 21.09 kJ/mol, respectively. Both kinetic analyses show that the magnitude of self-heating risk for the three pellet fuels is pine pellets > fir wood pellets > mahogany pellets.

Keywords: isothermal calorimeter, kinetics, self-heating, wood pellets

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2704 Regional Treatment Trends in Canada Derived from Pharmacy Records

Authors: John Chau, Tzvi Aviv

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Cardiometabolic conditions (hypertension, diabetes, and hyperlipidemia) are major public health concerns. Analysis of all prescription records from about 10 million patients at the largest network of pharmacies in Canada reveals small year-over-year increases in the treatment prevalence of cardiometabolic diseases prior to the COVID-19 pandemic. Cardiometabolic treatment rates increase with age and are higher in males than females. Hypertension treatment rates were 24% in males and 19% in females in 2021. Diabetes treatment rates were 10% in males and 7% in females in 2021. Geospatial analysis using patient addresses reveals interesting differences among provinces and neighborhoods in Canada. Using digital surveys distributed among 8,504 Canadian adults, an increase in hypertension awareness with age and female gender was observed. However, 7% of seniors and 6% of middle-aged Canadians reported uncontrolled blood pressure (>140/90 mmHg). In addition, elevated blood pressure (130-139/80-89 mmHg) was reported by 20% of seniors and 14% of middle-aged Canadians.

Keywords: cardiometabolic conditions, diabetes, hypertension, precision public health

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2703 Identification and Antibiotic Resistance Rates of Acinetobacter baumannii Strains Isolated from the Respiratory Tract Samples, Obtained from the Different Intensive Care Units

Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.

Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit

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2702 A Soft Error Rates (SER) Evaluation Method of Combinational Logic Circuit Based on Linear Energy Transfers

Authors: Man Li, Wanting Zhou, Lei Li

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Communication stability is the primary concern of communication satellites. Communication satellites are easily affected by particle radiation to generate single event effects (SEE), which leads to soft errors (SE) of the combinational logic circuit. The existing research on soft error rates (SER) of the combined logic circuit is mostly based on the assumption that the logic gates being bombarded have the same pulse width. However, in the actual radiation environment, the pulse widths of the logic gates being bombarded are different due to different linear energy transfers (LET). In order to improve the accuracy of SER evaluation model, this paper proposes a soft error rate evaluation method based on LET. In this paper, the authors analyze the influence of LET on the pulse width of combinational logic and establish the pulse width model based on the LET. Based on this model, the error rate of test circuit ISCAS'85 is calculated. The effectiveness of the model is proved by comparing it with previous experiments.

Keywords: communication satellite, pulse width, soft error rates, LET

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2701 Modeling Drying and Pyrolysis of Moist Wood Particles at Slow Heating Rates

Authors: Avdhesh K. Sharma

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Formulation for drying and pyrolysis process in packed beds at slow heating rates is presented. Drying of biomass particles bed is described by mass diffusion equation and local moisture-vapour-equilibrium relations. In gasifiers, volatilization rate during pyrolysis of biomass is modeled by using apparent kinetic rate expression, while product compositions at slow heating rates is modeled using empirical fitted mass ratios (i.e., CO/CO2, ME/CO2, H2O/CO2) in terms of pyrolysis temperature. The drying module is validated fairly with available chemical kinetics scheme and found that the testing zone in gasifier bed constituted of relatively smaller particles having high airflow with high isothermal temperature expedite the drying process. Further, volatile releases more quickly within the shorter zone height at high temperatures (isothermal). Both, moisture loss and volatile release profiles are found to be sensitive to temperature, although the influence of initial moisture content on volatile release profile is not so sensitive.

Keywords: modeling downdraft gasifier, drying, pyrolysis, moist woody biomass

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2700 Low Influenza Vaccine Coverage Rates among Polish Nurses

Authors: Aneta Nitsch-Osuch, Katarzyna Zycinska, Ewa Gyrczuk, Agnieszka Topczewska-Cabanek, Kazimierz Wardyn

Abstract:

Introduction: Influenza is an important clinical and epidemiological problem and should be considered as a possible nosocomial infection. The aim of the study was to determine the influenza vaccine coverage rates among Polish nurses and to find out drivers and barriers for influenza vaccination among this group of health care workers (HCWs). Material and methods: The self- fulfilled survey with 26 questions about the knowledge, perception, and influenza coverage rates was distributed among 461 nurses. Results: Only 15% of nurses were vaccinated against influenza in the consecutive seasons. The majority (75%) of the regularly vaccinated nurses were ambulatory careworkers. The difference between the number of vaccinated hospitals and ambulatory care nurses was statistically significant (p < 0.05). The main motivating factors for an influenza vaccination were: a fear of the illness and its complications (97%) and a free of charge vaccine available at the workplace (87%). Ambulatory care nurses more often declared that they were vaccinated mainly to protect themselves while hospital care nurses more often declared the will to protect their patients, these differences in the perception and attitudes to an influenza vaccination among hospital and ambulatory care nurses were statistically significant (p < 0.05). The main barriers for an influenza vaccination among the nursing staff were: a lack of reimbursement of the vaccine (95%), a lack of insufficient knowledge about the effectiveness, and safety of the influenza vaccine (54%). The ambulatory care nurses more often found influenza vaccination as the ethical duty compared to hospital care nurses (p < 0.05). Conclusions: The influenza vaccine coverage rates among the Polish nurses are low and must be improved in the future. More educational activities dedicated to HCWs may result in the increased awareness of influenza vaccination benefits for both medical professionals and patients.

Keywords: influenza, vaccination, nurses, ambulatory careworkers

Procedia PDF Downloads 267