Search results for: clinical decision support system

Authors: Hosein Hamisheh Bahar, Mohammad Hossein Fazel Zarandi, Akbar Esfahanipour

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In this paper, a hybrid expert system is developed by using fuzzy genetic network programming with reinforcement learning (GNP-RL). In this system, the frame-based structure of the system uses the trading rules extracted by GNP. These rules are extracted by using technical indices of the stock prices in the training time period. For developing this system, we applied fuzzy node transition and decision making in both processing and judgment nodes of GNP-RL. Consequently, using these method not only did increase the accuracy of node transition and decision making in GNP's nodes, but also extended the GNP's binary signals to ternary trading signals. In the other words, in our proposed Fuzzy GNP-RL model, a No Trade signal is added to conventional Buy or Sell signals. Finally, the obtained rules are used in a frame-based system implemented in Kappa-PC software. This developed trading system has been used to generate trading signals for ten companies listed in Tehran Stock Exchange (TSE). The simulation results in the testing time period shows that the developed system has more favorable performance in comparison with the Buy and Hold strategy.

Keywords: fuzzy genetic network programming, hybrid expert system, technical trading signal, Tehran stock exchange

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Authors: Assem El-Ansary

Abstract:

This paper illustrates the event-oriented Behavioral Pattern Analysis (BPA) modeling approach in developing an Intelligent Agent Reservation System (IARS). The Event defined in BPA is a real-life conceptual entity that is unrelated to any implementation. The major contributions of this research are developing the Behavioral Pattern Analysis (BPA) modeling methodology, and developing an interactive software tool (DECISION) which is based on a combination of the Analytic Hierarchy Process (AHP) and the ELECTRE Multi-Criteria Decision Making (MCDM) methods.

Keywords: analysis, intelligent agent, reservation system, modeling methodology, software modeling, event-oriented, behavioral pattern, use cases

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Authors: Mette Kjerholt, Thora Grothe Thomsen, Connie Bøttcher Berthelsen, Bibi Hølge Hazelton

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Academic nursing is a relatively new phenomenon in Denmark. Leadership and management training in nursing does not prepare Danish nurse leaders to become leaders for nurses with academic background, and some leaders may feel estranged with including this kind of nursing staff in clinical settings. Currently there is a debate regarding what academic nurses can contribute with in clinical practice, and some managers express concern regarding whether this will lead to less focus on clinical practice and more focus on theoretical issues that may not seem so relevant in a busy everyday clinical setting. The paper will present the experiences of integrating three advanced nurse practitioners with Ph.D. degrees (ANP) in three different clinical departments at a regional hospital in Denmark with no prior experiences with such profiles among its staff.

Keywords: leadership, advanced nurse practitioners, clinical practice, academic nursing

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Authors: Keenoo Bibi Sumera, Alsheikh Mona, Mubarak Jan Beebee Zeba Mahetaab

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Background: Due to the busy schedule of the practicing clinicians at the hospitals, students may not always be attended to, which is to their detriment. The clinicians at the hospitals are also not always acquainted with teaching and/or supervising students on their placements. Additionally, there is a high student-patient ratio. Since they are the prospective clinical doctors under training, they need to reach the competence levels in clinical decision-making skills to be able to serve the healthcare system of the country and to be safe doctors. Aims and Objectives: A reflective portfolio was used to provide a means for students to learn by reflecting on their experiences and obtaining continuous feedback. This practice is an attempt to compensate for the scarcity of lack of resources, that is, clinical placement supervisors and patients. It is also anticipated that it will provide learners with a continuous monitoring and learning gap analysis tool for their clinical skills. Methodology: A hardcopy reflective portfolio was designed and validated. The portfolio incorporated a mini clinical evaluation exercise (mini-CEX), direct observation of procedural skills and reflection sections. Workshops were organized for the stakeholders, that is the management, faculty and students, separately. The rationale of reflection was emphasized. Students were given samples of reflective writing. The portfolio was then implemented amongst the undergraduate medical students of years four, five and six during clinical clerkship. After 16 weeks of implementation of the portfolio, a survey questionnaire was introduced to explore how undergraduate students perceive the educational value of the reflective portfolio and its impact on their deep information processing. Results: The majority of the respondents are in MD Year 5. Out of 52 respondents, 57.7% were doing the internal medicine clinical placement rotation, and 42.3% were in Otorhinolaryngology clinical placement rotation. The respondents believe that the implementation of a reflective portfolio helped them identify their weaknesses, gain professional development in terms of helping them to identify areas where the knowledge is good, increase the learning value if it is used as a formative assessment, try to relate to different courses and in improving their professional skills. However, it is not necessary that the portfolio will improve the self-esteem of respondents or help in developing their critical thinking, The portfolio takes time to complete, and the supervisors are not useful. They had to chase supervisors for feedback. 53.8% of the respondents followed the Gibbs reflective model to write the reflection, whilst the others did not follow any guidelines to write the reflection 48.1% said that the feedback was helpful, 17.3% preferred the use of written feedback, whilst 11.5% preferred oral feedback. Most of them suggested more frequent feedback. 59.6% of respondents found the current portfolio user-friendly, and 28.8% thought it was too bulky. 27.5% have mentioned that for a mobile application. Conclusion: The reflective portfolio, through the reflection of their work and regular feedback from supervisors, has an overall positive impact on the learning process of undergraduate medical students during their clinical clerkship.

Keywords: Portfolio, Reflection, Feedback, Clinical Placement, Undergraduate Medical Education

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Authors: Komol Phaisarn, Anuphan Suttimarn, Vitchanan Keawtong, Kittisak Thongyoun, Chaiyos Jamsawang

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This article is intended to analyze insurance information which contains information on the customer decision when purchasing life insurance pay package. The data were analyzed in order to present new customers with Life Insurance Perfect Pay package to meet new customers’ needs as much as possible. The basic data of insurance pay package were collect to get data mining; thus, reducing the scattering of information. The data were then classified in order to get decision model or decision tree using Algorithm C4.5 (J-48). In the classification, WEKA tools are used to form the model and testing datasets are used to test the decision tree for the accurate decision. The validation of this model in classifying showed that the accurate prediction was 68.43% while 31.25% were errors. The same set of data were then tested with other models, i.e. Naive Bayes and Zero R. The results showed that J-48 method could predict more accurately. So, the researcher applied the decision tree in writing the program used to introduce the product to new customers to persuade customers’ decision making in purchasing the insurance package that meets the new customers’ needs as much as possible.

Keywords: decision tree, data mining, customers, life insurance pay package

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Authors: Abadi Berhane, Walelign Worku, Berhanu Abrha, Gebre Hadgu, Tigray

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Sesame is an important oilseed crop in Ethiopia; which is the second most exported agricultural commodity next to coffee. However, there is poor soil fertility management and a research-led farming system for the crop. The AquaCrop model was applied as a decision-support tool; which performs a semi-quantitative approach to simulate the yield of crops under different soil fertility levels. The objective of this experiment was to calibrate and validated the AquaCrop model for simulating the growth and yield of sesame under different nitrogen fertilizer levels and to test the performance of the model as a decision-support tool for improved sesame cultivation in the study area. The experiment was laid out as a randomized complete block design (RCBD) in a factorial arrangement in the 2016, 2017, and 2018 main cropping seasons. In this experiment, four nitrogen fertilizer rates; 0, 23, 46, and 69 Kg/ha nitrogen, and three improved varieties (Setit-1, Setit-2, and Humera-1). In the meantime, growth, yield, and yield components of sesame were collected from each treatment. Coefficient of determination (R2), Root mean square error (RMSE), Normalized root mean square error (N-RMSE), Model efficiency (E), and Degree of agreement (D) were used to test the performance of the model. The results indicated that the AquaCrop model successfully simulated soil water content with R2 varying from 0.92 to 0.98, RMSE 6.5 to 13.9 mm, E 0.78 to 0.94, and D 0.95 to 0.99; and the corresponding values for AB also varied from 0.92 to 0.98, 0.33 to 0.54 tons/ha, 0.74 to 0.93, and 0.9 to 0.98, respectively. The results on the canopy cover of sesame also showed that the model acceptably simulated canopy cover with R2 varying from 0.95 to 0.99, and a RMSE of 5.3 to 8.6%. The AquaCrop model was appropriately calibrated to simulate soil water content, canopy cover, aboveground biomass, and sesame yield; the results indicated that the model adequately simulated the growth and yield of sesame under the different nitrogen fertilizer levels. The AquaCrop model might be an important tool for improved soil fertility management and yield enhancement strategies of sesame. Hence, the model might be applied as a decision-support tool in soil fertility management in sesame production.

Keywords: aquacrop model, sesame, normalized water productivity, nitrogen fertilizer

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Authors: Ying Chuan Wang, Zhang Tao

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The aim of this article intends to explore the differences of well-being of employees in casino hotels before and after the Chinese government began to fight corruption. This researcher also attempted to find out the relationship between work pressure and well-being of employees in gambling workplaces before and after the Chinese government crackdowns the corruption. The category of well-being including life well-being, workplace well-being, and psychological well-being was included for analyzing well-being of employees in gaming workplaces. In addition, the psychological pressure classification was applied into this study and the Job Content Questionnaire (JCQ) would be adopted on investigating employees’ work pressure in terms of decision latitude, psychological demands, and workplace support. This study is a quantitative approach research and was conducted in March 2017. A purposive sampling was used in this study. A total of valid 339 responses were collected and the participants were casino hotel employees. The findings showed that decision latitude was significantly different prior to and after Chinese government crackdowns on corruption. Moreover, workplace support was strongly significantly related to employees’ well-being before Chinese government crackdowns. Decision latitude was strongly significantly related to employees’ well-being after Chinese government crackdowns. The findings suggest that employees’ work pressure affects their well being. In particular, because of workplace supports, it may alleviate employees’ work pressure and affect their perceptions of well-being but only prior to fighting the crackdowns. Importantly, decision latitude has become an essential factor affecting their well-being after the crackdown. It is finally hoped that the findings of this study provide suggestion to the managerial levels of hospitality industries. It is important to enhance employees’ decision latitude. Offering training courses to equip employees’ skills could be a possible way to reduce work pressure. In addition, establishing career path for the employees to pursuit is essential for their self-development and the improvement of well being. This would be crucial for casino hotels’ sustainable development and strengthening their competitiveness.

Keywords: well-being, work pressure, Casino hotels’ employees, gaming workplace

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Authors: Shohreh Ghasemi

Abstract:

Introduction: Managing oral and maxillofacial trauma is a multifaceted challenge, as it can have life-threatening consequences and significant functional and aesthetic impact. Navigation techniques have been introduced to improve surgical precision to meet this challenge. A machine learning algorithm was also developed to support clinical decision-making regarding treating oral and maxillofacial trauma. Given these advances, this systematic meta-analysis aims to assess the efficacy of navigational techniques in treating oral and maxillofacial trauma and explore the impact of machine learning on their management. Methods: A detailed and comprehensive analysis of studies published between January 2010 and September 2021 was conducted through a systematic meta-analysis. This included performing a thorough search of Web of Science, Embase, and PubMed databases to identify studies evaluating the efficacy of navigational techniques and the impact of machine learning in managing oral and maxillofacial trauma. Studies that did not meet established entry criteria were excluded. In addition, the overall quality of studies included was evaluated using Cochrane risk of bias tool and the Newcastle-Ottawa scale. Results: Total of 12 studies, including 869 patients with oral and maxillofacial trauma, met the inclusion criteria. An analysis of studies revealed that navigation techniques effectively improve surgical accuracy and minimize the risk of complications. Additionally, machine learning algorithms have proven effective in predicting treatment outcomes and identifying patients at high risk for complications. Conclusion: The introduction of navigational technology has great potential to improve surgical precision in oral and maxillofacial trauma treatment. Furthermore, developing machine learning algorithms offers opportunities to improve clinical decision-making and patient outcomes. Still, further studies are necessary to corroborate these results and establish the optimal use of these technologies in managing oral and maxillofacial trauma

Keywords: trauma, machine learning, navigation, maxillofacial, management

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Authors: Nafe Moradkhani, Frederick Benaben, Benoit Montreuil, Ali Vatankhah Barenji, Dima Nazzal

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In the context of the global pandemic, the practical management of the 2020 presidential election in the USA was a strong concern. To anticipate and prepare for this election accurately, one of the main challenges was to confront (i) forecasts of voter turnout, (ii) capacities of the facilities and, (iii) potential configuration options of resources. The approach chosen to conduct this anticipative study consists of collecting data about forecasts and using simulation models to work simultaneously on resource allocation and facility configuration of polling places in Fulton County, Georgia’s largest county. A polling place is a dedicated facility where voters cast their ballots in elections using different devices. This article presents the results of the simulations of such places facing pre-identified potential risks. These results are oriented towards the efficiency of these places according to different criteria (health, trust, comfort). Then a dynamic framework is introduced to describe risks as physical forces perturbing the efficiency of the observed system. Finally, the main benefits and contributions resulting from this simulation campaign are presented.

Keywords: performance, decision support, simulation, artificial intelligence, risk management, election, pandemics, information system

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Authors: Shizra Waris, Bilal Shoaib, Munib Ahmad

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Background; The using of clinical decision support systems (CDSSs) may recover unceasing disease organization, which requires regular visits to multiple health professionals, treatment monitoring, disease control, and patient behavior modification. The objective of this survey is to determine if these CDSSs improve the processes of unceasing care including diagnosis, treatment, and monitoring of diseases. Though artificial intelligence is not a new idea it has been widely documented as a new technology in computer science. Numerous areas such as education business, medical and developed have made use of artificial intelligence Methods: The survey covers articles extracted from relevant databases. It uses search terms related to information technology and viral hepatitis which are published between 2000 and 2016. Results: Overall, 80% of studies asserted the profit provided by information technology (IT); 75% of learning asserted the benefits concerned with medical domain;25% of studies do not clearly define the added benefits due IT. The CDSS current state requires many improvements to hold up the management of liver diseases such as HCV, liver fibrosis, and cirrhosis. Conclusion: We concluded that the planned model gives earlier and more correct calculation of hepatitis B and it works as promising tool for calculating of custom hepatitis B from the clinical laboratory data.

Keywords: detection, hapataties, observation, disesese

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Authors: Kristina Rosengren, Petra Brannefors, Eric Carlstrom

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Background: Implementation and use of person-centered care (PCC) is increasing worldwide, and why the current study intends to increase knowledge regarding how PCC is used in different European countries. Purpose: To describe the extent of person-centred care in 23 European countries in relation to use specific countries healthcare system (Beveridge, Bismarck, Mixed/OOP). Methods: The study was conducted by literature review inspired by Spice, both scientific empirical studies (Cinahl, Medline, Scopus) as well as grey literature (Google) were used. Totally 1194 documents were included divided into Cinahl n=139, Medline n=245, Scopus n=493 and Google n=317. Data were analysed with descriptive (percentage, range) regarding content and scope of PCC/country according to content and scope of PCC in each country, grouped into the healthcare system (Beveridge, Bismarck, Mixed/OOP) and geographic placement. Results: PCC were most common in UK (England, Scotland, Wales, North Ireland), n=481, 40.3%, Sweden (n=231, 19.3%), The Netherlands (n=80, 6.7%), Ireland (n=79, 6.6%) and Norway (n=61, 5.1%); and less common in Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Beveridge healthcare system (12/23=0.5217, 52.2%) show 85 percent of documents with advantage of scientific literature valued 2.92 (n=999, 0.55-4.07), compare to advantage of grey literature in Bismarck (10/23=0.4347, 43.5%) with 15 percentage valued 2.35 (n=190, 0-3.27) followed by Mixed/OOP (1/23=4%) with 0.4 valued 2.25. Conclusions: Seven out of 10 countries with Beveridge health system used PCC compare to less-used PCC in countries with the Bismarck system. Research, as well as national regulations regarding PCC, are important tools to motivate the advantage of PCC in clinical practice. Moreover, implementation of PCC needs a systematic approach, from national (politicians), regional (guideline) and local (specific healthcare settings) levels visualized by decision-making as law, mission, policies, and routines in clinical practice to establish a well-integrated phenomenon in Europe.

Keywords: Beveridge, Bismarck, Europe, evidence-based, literature review, person-centered care

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Authors: Fatema Akram, Mohammad G. Rasul, M. Masud K. Khan, M. Sharif I. I. Amir

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Australia is a country of some 7,700 million square kilometres with a population of about 22.6 million. At present water security is a major challenge for Australia. In some areas the use of water resources is approaching and in some parts it is exceeding the limits of sustainability. A focal point of proposed national water conservation programs is the recycling of both urban storm-water and treated wastewater. But till now it is not widely practiced in Australia, and particularly storm-water is neglected. In Australia, only 4% of storm-water and rainwater is recycled, whereas less than 1% of reclaimed wastewater is reused within urban areas. Therefore, accurately monitoring, assessing and predicting the availability, quality and use of this precious resource are required for better management. As storm-water is usually of better quality than untreated sewage or industrial discharge, it has better public acceptance for recycling and reuse, particularly for non-potable use such as irrigation, watering lawns, gardens, etc. Existing storm-water recycling practice is far behind of research and no robust technologies developed for this purpose. Therefore, there is a clear need for using modern technologies for assessing feasibility of storm-water harvesting and reuse. Numerical modelling has, in recent times, become a popular tool for doing this job. It includes complex hydrological and hydraulic processes of the study area. The hydrologic model computes storm-water quantity to design the system components, and the hydraulic model helps to route the flow through storm-water infrastructures. Nowadays water quality module is incorporated with these models. Integration of Geographic Information System (GIS) with these models provides extra advantage of managing spatial information. However for the overall management of a storm-water harvesting project, Decision Support System (DSS) plays an important role incorporating database with model and GIS for the proper management of temporal information. Additionally DSS includes evaluation tools and Graphical user interface. This research aims to critically review and discuss all the aspects of storm-water harvesting and reuse such as available guidelines of storm-water harvesting and reuse, public acceptance of water reuse, the scopes and recommendation for future studies. In addition to these, this paper identifies, understand and address the importance of modern technologies capable of proper management of storm-water harvesting and reuse.

Keywords: storm-water management, storm-water harvesting and reuse, numerical modelling, geographic information system, decision support system, database

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Authors: Abadi Berhane, Walelign Worku, Berhanu Abrha, Gebre Hadgu

Abstract:

Sesame is an important oilseed crop in Ethiopia, which is the second most exported agricultural commodity next to coffee. However, there is poor soil fertility management and a research-led farming system for the crop. The AquaCrop model was applied as a decision-support tool, which performs a semi-quantitative approach to simulate the yield of crops under different soil fertility levels. The objective of this experiment was to calibrate and validate the AquaCrop model for simulating the growth and yield of sesame under different nitrogen fertilizer levels and to test the performance of the model as a decision-support tool for improved sesame cultivation in the study area. The experiment was laid out as a randomized complete block design (RCBD) in a factorial arrangement in the 2016, 2017, and 2018 main cropping seasons. In this experiment, four nitrogen fertilizer rates, 0, 23, 46, and 69 Kg/ha nitrogen, and three improved varieties (Setit-1, Setit-2, and Humera-1). In the meantime, growth, yield, and yield components of sesame were collected from each treatment. Coefficient of determination (R2), Root mean square error (RMSE), Normalized root mean square error (N-RMSE), Model efficiency (E), and Degree of agreement (D) were used to test the performance of the model. The results indicated that the AquaCrop model successfully simulated soil water content with R2 varying from 0.92 to 0.98, RMSE 6.5 to 13.9 mm, E 0.78 to 0.94, and D 0.95 to 0.99, and the corresponding values for AB also varied from 0.92 to 0.98, 0.33 to 0.54 tons/ha, 0.74 to 0.93, and 0.9 to 0.98, respectively. The results on the canopy cover of sesame also showed that the model acceptably simulated canopy cover with R2 varying from 0.95 to 0.99 and a RMSE of 5.3 to 8.6%. The AquaCrop model was appropriately calibrated to simulate soil water content, canopy cover, aboveground biomass, and sesame yield; the results indicated that the model adequately simulated the growth and yield of sesame under the different nitrogen fertilizer levels. The AquaCrop model might be an important tool for improved soil fertility management and yield enhancement strategies of sesame. Hence, the model might be applied as a decision-support tool in soil fertility management in sesame production.

Keywords: aquacrop model, normalized water productivity, nitrogen fertilizer, canopy cover, sesame

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Authors: Rhenan D. Estacio

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This research presents the career decision making difficulty and emotional quotient of one hundred fifty (150) college students of City College of Angeles, Academic Year 2016-2017. Independent sample T-test and Pearson r correlation were done to shifter and non-shifter in terms of their career decision making difficulty and emotional quotient. A significant positive correlation revealed (r=.302) on career decision making difficulty and emotional quotient. Also, a significant negative correlation revealed (r=-.329) on career decision making difficulty and a moderating variable which is age. The finding significantly shows that emotional quotient was associated and adds a significant incremental variance with career decision making difficulty. Moreover, age shows a moderating effect on career decision making difficulty by having a significant decline and increment on variables. Furthermore, categorization of career decision making difficulty and emotional quotient of said participants are described in this study. In addition, career guidance interventions were suggested based on the results of this study.

Keywords: career, decision-making, difficulty, emotional, quotient

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Vasoontara Yiengprugsawan, Sam-ang Seubsman

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As Thais live longer, caregivers will become even more important to social and healthcare systems. Commonly reported in many low and middle‐income countries in Asia, formal social welfare services to support caregivers are lacking and informal family support will be required for all levels of care. In 2005, 87,151 open‐university adults were recruited to the Thai Cohort Study, with the majority aged between 25 and 39 years, and residing nationwide. At the 4‐year follow up in 2009 (n=60569) and the 8‐year follow‐up in 2013 (n=42785), prospective cohort participants were asked if they provide care for chronically ill, disabled, or frail family members. Among Thai cohort members reporting between 2009 and 2013, approximately 56% were not caregivers in either year, 24.5% reported providing care in 2009 only, 8.6% in 2013 only, and 10.6% reported providing care at both time points. Caregivers in the cohort reported providing financial support, help with shopping, emotional support, and assist with daily activities. Kessler 6 psychological distress scale, measured in both 2009 and 2013, was used as the primary outcome of a relationship between caregiving status and mental health. Using multivariate logistic regression, our 4‐year longitudinal findings revealed that cohort members who reported providing care at both time points were 1.4 to 1.6 times more likely to report high psychological distress than non‐caregivers, after accounting for potential covariates. With increasing needs for informal care provided by family members, the future health and social welfare system will need to provide adequate support to caregivers (e.g., respite care, clinical support and information for the family, and awareness of mental health among caregivers).

Keywords: family caregivers, psychological distress, prospective cohort, longitudinal study, Thailand

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Authors: Boris Djartov, Sanaz Mostaghim

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This paper presents a number-based dominance method. The main idea is how to fragment the many attributes of the problem into subsets suitable for the well-established concept of Pareto dominance. Although other similar methods can be found in the literature, they focus on comparing the solutions one objective at a time, while the focus of this method is to compare entire subsets of the objective vector. Given the nature of the method, it is computationally costlier than other methods and thus, it is geared more towards selecting an option from a finite set of alternatives, where each solution is defined by multiple objectives. The need for this method was motivated by dynamic alternate airport selection (DAAS). In DAAS, pilots, while en route to their destination, can find themselves in a situation where they need to select a new landing airport. In such a predicament, they need to consider multiple alternatives with many different characteristics, such as wind conditions, available landing distance, the fuel needed to reach it, etc. Hence, this method is primarily aimed at human decision-makers. Many methods within the field of multi-objective and many-objective decision-making rely on the decision maker to initially provide the algorithm with preference points and weight vectors; however, this method aims to omit this very difficult step, especially when the number of objectives is so large. The proposed method will be compared to Favour (1 − k)-Dom and L-dominance (LD) methods. The test will be conducted using well-established test problems from the literature, such as the DTLZ problems. The proposed method is expected to outperform the currently available methods in the literature and hopefully provide future decision-makers and pilots with support when dealing with many-objective optimization problems.

Keywords: multi-objective decision-making, many-objective decision-making, multi-objective optimization, many-objective optimization

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Authors: Amira Ben Rabeh, Faouzi Benzarti, Hamid Amiri, Mouna Bouaziz

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Alzheimer is a disease that affects the brain. It causes degeneration of nerve cells (neurons) and in particular cells involved in memory and intellectual functions. Early diagnosis of Alzheimer Diseases (AD) raises ethical questions, since there is, at present, no cure to offer to patients and medicines from therapeutic trials appear to slow the progression of the disease as moderate, accompanying side effects sometimes severe. In this context, analysis of medical images became, for clinical applications, an essential tool because it provides effective assistance both at diagnosis therapeutic follow-up. Computer Assisted Diagnostic systems (CAD) is one of the possible solutions to efficiently manage these images. In our work; we proposed an application to detect Alzheimer’s diseases. For detecting the disease in early stage we used the three sections: frontal to extract the Hippocampus (H), Sagittal to analysis the Corpus Callosum (CC) and axial to work with the variation features of the Cortex(C). Our method of classification is based on Support Vector Machine (SVM). The proposed system yields a 90.66% accuracy in the early diagnosis of the AD.

Keywords: Alzheimer Diseases (AD), Computer Assisted Diagnostic(CAD), hippocampus, Corpus Callosum (CC), cortex, Support Vector Machine (SVM)

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Authors: Emmanuel Chibuogu Asogwa, Tochukwu Sunday Belonwu

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An urgent demand for creative solutions has been created by the rapid expansion of medical knowledge, the complexity of patient care, and the requirement for more precise decision-making. As a solution to this problem, the creation of a Medical Intelligent Process Model (MIPM) utilizing ontology-based appears as a promising way to overcome this obstacle and unleash the full potential of healthcare systems. The development of a Medical Intelligent Process Model (MIPM) using ontology-based techniques is motivated by a lack of quick access to relevant medical information and advanced tools for treatment planning and clinical decision-making, which ontology-based techniques can provide. The aim of this work is to develop a structured and knowledge-driven framework that leverages ontology, a formal representation of domain knowledge, to enhance various aspects of healthcare. Object-Oriented Analysis and Design Methodology (OOADM) were adopted in the design of the system as we desired to build a usable and evolvable application. For effective implementation of this work, we used the following materials/methods/tools: the medical dataset for the test of our model in this work was obtained from Kaggle. The ontology-based technique was used with Confusion Matrix, MySQL, Python, Hypertext Markup Language (HTML), Hypertext Preprocessor (PHP), Cascaded Style Sheet (CSS), JavaScript, Dreamweaver, and Fireworks. According to test results on the new system using Confusion Matrix, both the accuracy and overall effectiveness of the medical intelligent process significantly improved by 20% compared to the previous system. Therefore, using the model is recommended for healthcare professionals.

Keywords: ontology-based, model, database, OOADM, healthcare

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Authors: Raymond K. Jonkers

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The present study investigated approaches and techniques to enhance strategic management governance and decision making within the framework of a performance-based balanced scorecard. The review of best practices from strategic, program, process, and systems engineering management provided for a holistic approach toward effective outcome-based capability management. One technique, based on factorial experimental design methods, was used to develop an empirical model. This model predicted the degree of capability effectiveness and is dependent on controlled system input variables and their weightings. These variables represent business performance measures, captured within a strategic balanced scorecard. The weighting of these measures enhances the ability to quantify causal relationships within balanced scorecard strategy maps. The focus in this study was on the performance of tangible assets within the scorecard rather than the traditional approach of assessing performance of intangible assets such as knowledge and technology. Tangible assets are represented in this study as physical systems, which may be thought of as being aboard a ship or within a production facility. The measures assigned to these systems include project funding for upgrades against demand, system certifications achieved against those required, preventive maintenance to corrective maintenance ratios, and material support personnel capacity against that required for supporting respective systems. The resultant scorecard is viewed as complimentary to the traditional balanced scorecard for program and performance management. The benefits from these scorecards are realized through the quantified state of operational capabilities or outcomes. These capabilities are also weighted in terms of priority for each distinct system measure and aggregated and visualized in terms of overall state of capabilities achieved. This study proposes the use of interactive controls within the scorecard as a technique to enhance development of alternative solutions in decision making. These interactive controls include those for assigning capability priorities and for adjusting system performance measures, thus providing for what-if scenarios and options in strategic decision-making. In this holistic approach to capability management, several cross functional processes were highlighted as relevant amongst the different management disciplines. In terms of assessing an organization’s ability to adopt this approach, consideration was given to the P3M3 management maturity model.

Keywords: management, systems, performance, scorecard

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Authors: Khaled M. Alhawiti

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This paper investigates the future of medicine and the use of Natural language processing. The importance of having correct clinical information available online is remarkable; improving patient care at affordable costs could be achieved using automated applications to use the online clinical information. The major challenge towards the retrieval of such vital information is to have it appropriately coded. Majority of the online patient reports are not found to be coded and not accessible as its recorded in natural language text. The use of Natural Language processing provides a feasible solution by retrieving and organizing clinical information, available in text and transforming clinical data that is available for use. Systems used in NLP are rather complex to construct, as they entail considerable knowledge, however significant development has been made. Newly formed NLP systems have been tested and have established performance that is promising and considered as practical clinical applications.

Keywords: clinical information, information retrieval, natural language processing, automated applications

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Authors: Sau Kam Adeline Chan

Abstract:

World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.

Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error

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Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman

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For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.

Keywords: acute medicine, clinical governance, intensive care, patient centered decision making

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Authors: Kate Parkinson

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A Family Group Conference (FGC) is a family-led decision-making process through which a family/kinship group, rather than the professionals involved, is asked to develop a plan for the care or the protection of children in the family. In England and Wales, FGCs are used in 76% of local authorities and in recent years, have tended to be used in cases where the local authority are considering the court process to remove children from their immediate family, to explore kinship alternatives to local authority care. Some local authorities offer the service much earlier, when families first come to the attention of children's social care, in line with research that suggests the earlier an FGC is held, the more likely they are to be successful. Family plans that result from FGCs are different from professional plans in that they are unique to a family and, as a result, reflect the diversity of families. Despite the fact that FGCs are arguable the most researched area of social work globally, there is a dearth of research that examines the nature of family plans and their substance. This paper presents the findings of a documentary analysis of 42 Early Help FGC plans from local authorities in England, with the aim of exploring the level and type of support that family members offer at a FGC. A thematic analysis identified 5 broad areas of support: Practical Support, Building Relationships, Child-care Support, Emotional Support and Social Support. In the majority of cases, family members did not want or ask for any formal support from the local authority or other agencies. Rather, the families came together to agree a plan of support, which was within the parameters of the resources that they as a family could provide. Perhaps then the role of the Early Help professional should be one of a facilitating and enabling role, to support families to develop plans that address their own specific difficulties, rather than the current default option, which is to either close the case because the family do not meet service thresholds or refer to formal support if they do, which may offer very specific support, have rigid referral criteria, long waiting lists and may not reflect the diverse and unique nature of families. FGCs are argued to be culturally appropriate social work practices in that they are appropriate for families from a range of cultural backgrounds and can be adapted to meet particular cultural needs. Furthermore, research on the efficacy of FGCs at an Early Help Level has demonstrated that Early Help FGCs have the potential to address difficulties in family life and prevent the need for formal support services, which are potentially stigmatising and do not reflect the uniqueness and diversity of families. The paper concludes with a recommendation for the use of FGCs across Early Help Services in England and Wales.

Keywords: family group conferences, family led decision making, early help, prevention

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Authors: Assem I. El-Ansary

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This paper illustrates the event-oriented Behavioral Pattern Analysis (BPA) modeling approach in developing an Multi-Agent Railway Control System (MARCS). The Event defined in BPA is a real-life conceptual entity that is unrelated to any implementation. The major contributions of this research are the Behavioral Pattern Analysis (BPA) modeling methodology, and the development of an interactive software tool (DECISION), which is based on a combination of the Analytic Hierarchy Process (AHP) and the ELECTRE Multi-Criteria Decision Making (MCDM) methods.

Keywords: analysis, multi-agent, railway control, modeling methodology, software modeling, event-oriented, behavioral pattern, use cases

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Authors: Langa Hendrick Musawenkosi, Twala Bhekisipho

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The success or failure of students is a concern for every academic institution, college, university, governments and students themselves. Several approaches have been researched to address this concern. In this paper, a view is held that when a student enters a university or college or an academic institution, he or she enters an academic environment. The academic environment is unique concept used to develop the solution for making predictions effectively. This paper presents a model to determine the propensity of a student to succeed or fail in the French South African Schneider Electric Education Center (FSASEC) at the Vaal University of Technology (VUT). The Decision Tree algorithm is used to implement the model at FSASEC.

Keywords: FSASEC, academic environment model, decision trees, k-nearest neighbor, machine learning, popularity index, support vector machine

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Authors: Mohammadreza Mohebbi, Masoumeh Sanagou

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The ability to predict clinical outcomes is of great importance to physicians and clinicians. A number of different methods have been used in an effort to accurately predict these outcomes. These methods include the development of scoring systems based on multivariate statistical modelling, and models involving the use of classification and regression trees. The process usually consists of two consecutive phases, namely model development and external validation. The model development phase consists of building a multivariate model and evaluating its predictive performance by examining calibration and discrimination, and internal validation. External validation tests the predictive performance of a model by assessing its calibration and discrimination in different but plausibly related patients. A motivate example focuses on prediction modeling using a sample of patients undergone coronary artery bypass graft (CABG) has been used for illustrative purpose and a set of primary considerations for evaluating prediction model studies using specific quality indicators as criteria to help stakeholders evaluate the quality of a prediction model study has been proposed.

Keywords: clinical prediction models, clinical decision rule, prognosis, external validation, model calibration, biostatistics

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Authors: Ashok Kalagura

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This paper presents a data-mining model for fault-zone identification of flexible AC transmission systems (FACTS)-based transmission line including a thyristor-controlled series compensator (TCSC) and unified power-flow controller (UPFC), using ensemble decision trees. Given the randomness in the ensemble of decision trees stacked inside the random forests model, it provides an effective decision on the fault-zone identification. Half-cycle post-fault current and voltage samples from the fault inception are used as an input vector against target output ‘1’ for the fault after TCSC/UPFC and ‘1’ for the fault before TCSC/UPFC for fault-zone identification. The algorithm is tested on simulated fault data with wide variations in operating parameters of the power system network, including noisy environment providing a reliability measure of 99% with faster response time (3/4th cycle from fault inception). The results of the presented approach using the RF model indicate the reliable identification of the fault zone in FACTS-based transmission lines.

Keywords: distance relaying, fault-zone identification, random forests, RFs, support vector machine, SVM, thyristor-controlled series compensator, TCSC, unified power-flow controller, UPFC

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Authors: Kathryn Norgang, Sarah Howrath, Auni Idi Muhire, Pacifique Umubyeyi

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Description : A group of nurses address the shortage of trained staff to respond to critical patients at Rwanda Military Hospital (RMH) by developing a training program and a resuscitation response team. Members of the group who received the training when it first launched are now trainer of trainers; all components of the training program are organized and delivered by RMH staff-the clinical mentor only provides adjunct support. This two day training is held quarterly at RMH; basic life support and exposure to interventions for advanced care are included in the test and skills sign off. Seventy staff members have received the training this year alone. An increased number of admission/transfer to ICU due to successful resuscitation attempts is noted. Lessons learned: -Number of staff trained 2012-2014 (to be verified). -Staff who train together practice with greater collaboration during actual resuscitation events. -Staff more likely to initiate BLS if peer support is present-more staff trained equals more support. -More access to Advanced Cardiac Life Support training is necessary now that the cadre of BLS trained staff is growing. Conclusions: Increased access to training, peer support, and collaborative practice are effective strategies to strengthening resuscitation capacity within a hospital.

Keywords: resuscitation, basic life support, capacity building, resuscitation response teams, nurse trainer of trainers

Procedia PDF Downloads 281

Authors: M. Graus, K. Westhoff, X. Xu

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The climate change causes a change in all aspects of society. While the expansion of renewable energies proceeds, industry could not be convinced based on general studies about the potential of demand side management to reinforce smart grid considerations in their operational business. In this article, a procedure model for a case-specific data-driven decision support for industrial energy management based on a holistic data analytics approach is presented. The model is executed on the example of the strategic decision problem, to integrate the aspect of renewable energies into industrial energy management. This question is induced due to considerations of changing the electricity contract model from a standard rate to volatile energy prices corresponding to the energy spot market which is increasingly more affected by renewable energies. The procedure model corresponds to a data analytics process consisting on a data model, analysis, simulation and optimization step. This procedure will help to quantify the potentials of sustainable production concepts based on the data from a factory. The model is validated with data from a printer in analogy to a simple production machine. The overall goal is to establish smart grid principles for industry via the transformation from knowledge-driven to data-driven decisions within manufacturing companies.

Keywords: data analytics, green production, industrial energy management, optimization, renewable energies, simulation

Procedia PDF Downloads 414