Search results for: long term outcome

Authors: Woo-Tai Jung, Sung-Yong Choi, Young-Hwan Park

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The composite pavement system considered in this paper is composed of a functional surface layer, a fiber reinforced asphalt middle layer and a fiber reinforced lean concrete base layer. The mix design of the fiber reinforced lean concrete corresponds to the mix composition of conventional lean concrete but reinforced by fibers. The quasi-absence of research on the durability or long-term performances (fatigue, creep, etc.) of such mix design stresses the necessity to evaluate experimentally the long-term characteristics of this layer composition. This study tests the creep characteristics as one of the long-term characteristics of the fiber reinforced lean concrete layer for composite pavement using a new creep device. The test results reveal that the lean concrete mixed with fiber reinforcement and fly ash develops smaller creep than the conventional lean concrete. The results of the application of the CEB-FIP prediction equation indicate that a modified creep prediction equation should be developed to fit with the new mix design of the layer.

Keywords: creep, lean concrete, pavement, fiber reinforced concrete, base

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Authors: Olga C. Rodrigue

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Long-term care and skilled nursing facilities experience ebbs and flows of nursing staffing, a problem compounded by the perception of the facilities as undesirable workplaces and competition for staff from other healthcare entities. Travel nurses are contracted to fill staffing needs due to increased admissions, increased and unexpected attrition of nurses, or facility expansion of services. Prior to beginning the contracted assignment, the travel nurse must meet industry, company, and regulatory requirements (The Joint Commission and CMS) for skills and knowledge. Travel nurses, however, inconsistently receive the pre-assignment orientation needed to work at the contracted facility, if any information is given at all. When performance expectations are not met, travel nurses may subsequently choose to leave the position without completing the terms of the contract, and some facilities may choose to terminate the contract prior to the expected end date. The overarching goal of the Doctor of Nursing Practice evidence-based practice improvement project is to provide travel nurses with the basic and necessary information to prepare them to begin a long-term and skilled nursing assignment. The project involves the identification of travel nurse learning needs through a survey and the development and provision of web-based learning modules to address those needs prior to arrival for a long-term and skilled nursing assignment.

Keywords: nurse staffing, travel nurse, travel staff, contract staff, contracted assignment, long-term care, skilled nursing, onboarding, orientation, staff development, supplemental staff

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Authors: N. Uaphongsathorn, C. Worawong, S. Thaewpia

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Background and significance: The population is aging in Thai society, the elderly dependent is at great risk of various functional, psychological, and socio-economic problems as well as less access to health care. They may require long term care at home to maximize their functional abilities and activities of daily living and to improve their quality of life during their own age. Therefore, there is a need to develop a home-based long term care to meet the long term care needs of elders dependent. Methods: The research purpose was to develop long term care model among the elderly dependent in Chaiyaphum province in Northeast region of Thailand. Action Research which is composing of planning, action, observation, and reflection phases was used. Research was carried out for 12 months in all sub-districts of 6 districts in Chaiyaphum province. Participants (N = 1,010) participating in the processes of model development were comprised of 3 groups: a) a total of 110 health care professionals, b) a total of 600 health volunteers and family caregivers and c) a total of 300 the elderly dependent with chronically medical illnesses or disabilities. Descriptive statistics and content analysis were used to analyze data. Findings: Results have shown that the most common health problems among elders dependent with physical disabilities to function independently were cardiovascular disease, dementia, and traffic injuries. The development of home-based long term care model among elders dependent in Chaiyaphum province was composed of six key steps. They are: a) initiating policies supporting formal and informal caregivers for the elder dependent in all sub-districts, b) building network and multidisciplinary team, c) developing 3-day care manager training program and 3-day care provider training program d) training case managers and care providers for the elderly dependent through team and action learning, e) assessing, planning and providing care based on care individual’s needs of the elderly dependent, and f) sharing experiences for good practice and innovation for long term care at homes in district urban and rural areas. Among all care managers and care providers, the satisfaction level for training programs was high with a mean score of 3.98 out of 5. The elders dependent and family caregivers addressed that long term care at home could contribute to improving life’s daily activities, family relationship, health status, and quality of life. Family caregivers and volunteers have feeling a sense of personal satisfaction and experiencing providing meaningful care and support for elders dependent. Conclusion: In conclusion, a home-based long term care is important to Thai elders dependent. Care managers and care providers play a large role and responsibility to provide appropriate care to meet the elders’ needs in both urban and rural areas in Thai society. Further research could be rigorously studied with a larger group of populations in similar socio-economic and cultural contexts.

Keywords: elderly people, care manager, care provider, long term care

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Authors: Xinyi Xu

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This study conducts a detailed examination of Asian stock markets over the period from 2008 to 2023, with a focus on the dynamics of cointegration and their relevance for long-term investment strategies. Specifically, we assess the co-movement and potential for pairs trading—a strategy where investors take opposing positions on two stocks, indices, or financial instruments that historically move together. For example, we explore the relationship between the Nikkei 225 (N225), Japan’s benchmark stock index, and the Straits Times Index (STI) of Singapore, as well as the relationship between the Korea Composite Stock Price Index (KS11) and the STI. The methodology includes tests for normality, stationarity, cointegration, and the application of Vector Error Correction Modeling (VECM). Our findings reveal significant long-term relationships between these pairs, indicating opportunities for pairs trading strategies. Furthermore, the research underscores the challenges posed by model instability and the influence of major global incidents, which are identified as structural breaks. These findings pave the way for further exploration into the intricacies of financial market dynamics.

Keywords: normality tests, stationarity, cointegration, VECM, pairs trading

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Authors: Elie Awwad, Bilal Hamad, Mounir Mabsout, Helmi Khatib

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The paper reports test results on the long-term behavior of sustainable hemp-concrete material prepared in research work conducted at the American University of Beirut. The tests results are in terms of compressive and splitting tensile tests conducted on standard 150x300 mm cylinders. A control mix without fibers, one polypropylene-concrete mix, and ten hemp-concrete mixes were prepared with different percentages of industrial hemp fibers and reduced coarse aggregate contents. The objective was to investigate the strength properties of hemp-reinforced concrete at 1.5 years age as compared with control mixes. The results indicated that both the compressive strength and the splitting tensile strength results of all tested cylinders increased as compared with the 28-days values. Also, the difference between the hemp-concrete samples and the control samples at 28 days was maintained at 1.5 years age indicating that hemp fibers did not exhibit any negative effect on the long-term strength properties of concrete.

Keywords: hemp-reinforced concrete, natural fibers, compressive strength, splitting tensile strength

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Authors: Alexander Rych

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Piql Preservation Services (“Piql”) is a turnkey solution designed for secure, migration-free long- term preservation of digital data. Piql sets an open standard for long- term preservation for the future. It consists of equipment and processes needed for writing and retrieving digital data. Exponentially growing amounts of data demand for logistically effective and cost effective processes. Digital storage media (hard disks, magnetic tape) exhibit limited lifetime. Repetitive data migration to overcome rapid obsolescence of hardware and software bears accelerated risk of data loss, data corruption or even manipulation and adds significant repetitive costs for hardware and software investments. Piql stores any kind of data in its digital as well as analog form securely for 500 years. The medium that provides this is a film reel. Using photosensitive film polyester base, a very stable material that is known for its immutability over hundreds of years, secure and cost-effective long- term preservation can be provided. The film reel itself is stored in a packaging capable of protecting the optical storage medium. These components have undergone extensive testing to ensure longevity of up to 500 years. In addition to its durability, film is a true WORM (write once- read many) medium. It therefore is resistant to editing or manipulation. Being able to store any form of data onto the film makes Piql a superior solution for long-term preservation. Paper documents, images, video or audio sequences – all of those file formats and documents can be preserved in its native file structure. In order to restore the encoded digital data, only a film scanner, a digital camera or any appropriate optical reading device will be needed in the future. Every film reel includes an index section describing the data saved on the film. It also contains a content section carrying meta-data, enabling users in the future to rebuild software in order to read and decode the digital information.

Keywords: digital data, long-term preservation, migration-free, photosensitive film

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Authors: Andreas Hirseland, Lukas Kerschbaumer

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In Germany, during the past years there constantly are about one million long term unemployed who did not benefit from the prospering labor market while most short term unemployed did. Instead, they are continuously dependent on welfare and sometimes precarious short-term employment, experiencing work poverty. Long term unemployment thus turns into a main obstacle to regular employment, especially if accompanied by other impediments such as low level education (school/vocational), poor health (especially chronical illness), advanced age (older than fifty), immigrant status, motherhood or engagement in care for other relatives. Almost two thirds of all welfare recipients have multiple impediments which hinder a successful transition from welfare back to sustainable and sufficient employment. Hiring them is often considered as an investment too risky for employers. Therefore formal application schemes based on formal qualification certificates and vocational biographies might reduce employers’ risks but at the same time are not helpful for long-term unemployed and welfare recipients. The panel survey ‘Labor market and social security’ (PASS; ~15,000 respondents in ~10,000 households), carried out by the Institute of Employment Research (the research institute of the German Federal Labor Agency), shows that their chance to get back to work tends to fall to nil. Only 66 cases of such unlikely transitions could be observed. In a sequential explanatory mixed-method study, the very scarce ‘success stories’ of unlikely transitions from long term unemployment to work were explored by qualitative inquiry – in-depth interviews with a focus on biography accompanied by qualitative network techniques in order to get a more detailed insight of relevant actors involved in the processes which promote the transition from being a welfare recipient to work. There is strong evidence that sustainable transitions are influenced by biographical resources like habits of network use, a set of informal skills and particularly a resilient way of dealing with obstacles, combined with contextual factors rather than by job-placement procedures promoted by Job-Centers according to activation rules or by following formal paths of application. On the employer’s side small and medium-sized enterprises are often found to give job opportunities to a wider variety of applicants, often based on a slow but steadily increasing relationship leading to employment. According to these results it is possible to show and discuss some limitations of (German) activation policies targeting welfare dependency and long-term unemployment. Based on these findings, indications for more supportive small scale measures in the field of labor-market policies are suggested to help long-term unemployed with multiple impediments to overcome their situation.

Keywords: against-all-odds, economic sociology, long-term unemployment, mixed-methods

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Authors: A. B. Benshak, M. G. Yilkangnha, V. Y. Nanle

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Social crises and violent conflict can inflict direct (short-term) impact on the environment like poisoning water bodies, climate change, deforestation, destroying the chemical component of the soil due to the chemical and biological weapons used. It can also impact the environment indirectly (long-term), e.g., the destruction of political and economic infrastructure to manage the environmental resources and breaking down traditional conservation practices, population displacement and refugee flows which puts pressure on the already inadequate resources, infrastructure, facilities, amenities, services etc. This study therefore examines the impact of social crises on the environment in Jos Plateau State with emphasis on the long-term impact, analyze the relationship between crises and the environment and assess the perception of people on social crises because much work have concentrated on other repercussions such as the economy, health etc that are more politically expedient. The data for this research were collected mostly through interviews, questionnaire, dailies and reports on the subject matter. The data and findings were presented in tables and results showed that the environment is directly and indirectly impacted by crises and that these impacts can in turn result to a continuous cycle of violent activities if not addressed because of the inadequacies in the supply of infrastructural facilities, resources and so on caused by the inflow of displaced population. Recommendations were made on providing security to minimize conflict occurrences in Jos and its environs, minimizing the impact of social crises on the environment, provision of adequate infrastructural facilities to carter for population rise, renewal and regeneration schemes, etc. which will go a long way in mitigating the impact of crises on the environment.

Keywords: environment, impact, long-term, social crises

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Authors: Mohammad Moridzadeh, Mohammad Djavid, Barry Doyle

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An assessment of the long-term stability of a cavern in Chagrin shale excavated by the sequential excavation method was performed during and after construction. During the excavation of the cavern, deformations of rock mass were measured at the surface of excavation and within the rock mass by surface and deep measurement instruments. Rock deformations were measured during construction which appeared to result from the as-built excavation sequence that had potentially disturbed the rock and its behavior. Also some additional time dependent rock deformations were observed during and post excavation. Several opinions have been expressed to explain this time dependent deformation including stress changes induced by excavation, strain softening (or creep) in the beddings with and without clay and creep of the shaley rock under compressive stresses. In order to analyze and replicate rock behavior observed during excavation, including current and post excavation elastic, plastic, and time dependent deformation, Finite Element Analysis (FEA) was performed. The analysis was also intended to estimate long term deformation of the rock mass around the excavation. Rock mass behavior including time dependent deformation was measured by means of rock surface convergence points, MPBXs, extended creep testing on the long anchors, and load history data from load cells attached to several long anchors. Direct creep testing of Chagrin Shale was performed on core samples from the wall of the Pump Room. Results of these measurements were used to calibrate the FEA of the excavation. These analyses incorporate time dependent constitutive modeling for the rock to evaluate the potential long term movement in the roof, walls, and invert of the cavern. The modeling was performed due to the concerns regarding the unanticipated behavior of the rock mass as well as the forecast of long term deformation and stability of rock around the excavation.

Keywords: Cavern, Chagrin shale, creep, finite element.

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Authors: Vaidehi Iyer, Konstantin Borozdin

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Time series prediction problems have many important practical applications, but are notoriously difficult for statistical modeling. Recently, machine learning methods have been attracted significant interest as a practical tool applied to a variety of problems, even though developments in this field tend to be semi-empirical. This paper explores application of Long Short Term Memory based Recurrent Neural Networks to the one-step prediction of time series for both trend and stochastic components. Two types of data are analyzed - daily stock prices, that are often considered to be a typical example of a random walk, - and weather patterns dominated by seasonal variations. Results from both analyses are compared, and reinforced learning framework is used to select more efficient between Recurrent Neural Networks and more traditional auto regression methods. It is shown that both methods are able to follow long-term trends and seasonal variations closely, but have difficulties with reproducing day-to-day variability. Future research directions and potential real world applications are briefly discussed.

Keywords: long short term memory, prediction methods, recurrent neural networks, reinforcement learning

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Authors: Athanasios A. Tountas, Geoffrey A. Ozin, Mohini M. Sain

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Renewable hydrogen (H₂) carriers such as methanol (MeOH), dimethyl ether (DME), oxymethylene dimethyl ethers (OMEs), and conceivably ammonia (NH₃) can be reformed back into H₂ and are fundamental chemical conversions for the long-term viability of the H₂ economy due to their higher densities and ease of transportability compared to H₂. MeOH is an especially important carrier as it is a simple C1 chemical that can be produced from green solar-PV-generated H₂ and direct-air-captured CO₂ with a current commercially practical solar-to-fuel efficiency of 10% from renewable solar energy. MeOH steam reforming (MSR) in stationary systems next to H₂ fuel-cell filling stations can eliminate the need for onboard mobile reformers, and the former systems can be more robust in terms of attaining strict H₂ product specifications, and MeOH is a safe, lossless, and compact medium for long-term H₂ storage. Both thermal- and photo-catalysts are viable options for achieving the stable, long-term performance of stationary MSR systems.

Keywords: fuel-cell vehicle filling stations, methanol steam reforming, hydrogen transport and storage, stationary reformer, liquid hydrogen carriers

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Authors: Chih-Hsiang Chang, Chia-Ching Tsai

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The aim of this study is to examine the stock price effect of the enterprises being classified as socially responsible. We explore the stock price response to the announcement that an enterprise is selected for the Taiwan Corporate Sustainability Awards. Empirical results indicate that the announcements of the Taiwan Corporate Sustainability Awards provide useful informational content to stock market. We find the evidence of insignificantly positive short-term and significantly positive long-term price reaction to the enterprises being classified as socially responsible. This study concludes that investors in the Taiwan stock market tend to view an enterprise being selected for the Taiwan Corporate Sustainability Awards as one with superior quality and long-term price potential.

Keywords: corporate social responsibility, stock price effect, Taiwan stock market, investments

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Authors: Farshad Ghazalian, Laleh Hakemi, Lotfali Pourkazemi, Maryam Ameri, Seyed Hossein Alavi

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Background: The use of whole body vibration (WBV) as an exercise method has rapidly increased over the last decade. The aim of this study was to evaluate long term effects of different amplitudes of whole body vibration training with progressive frequencies on lipid profile of young healthy men. Materials and methods: Thirty three healthy male students were divided randomly in three groups: high amplitude vibration group (n=11), low amplitude vibration group (n=11), and control group (n=11). The vibration training consisted of 5 week whole-body vibration 3 times a week with amplitudes 4 and 2 mm and progressive frequencies from 25 Hz with increments of 5 Hz weekly. Concentrations TG, HDL, LDL, cholesterol, and VLDL before and after 5 weeks of training were measured in plasma samples. Statistical analysis was done using one way analysis of variance. P<0.05 was considered statistically significant. Results: The most important result of the present study is finding no favorable changes of 5-week vibration training with different amplitudes on blood lipid profiles. Discussion and conclusions: It was emphasized that in vibration training there should be a relationship between intensity and volume of exercise and lipid responses in order to improve blood lipoprotein profiles.

Keywords: long term, body, vibration training, lipid

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Authors: Damanhur Munardi, Muhammad Hafiz, Dina Nurmalita Sari, Syarifah Ridani Alifa

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Purpose: This research aims to analyze the Benefits, Opportunity, Cost, and Risk aspects of applying the Green Finance concept and to obtain the right Green Finance financing strategy to be implemented within a long-term and short-term strategic framework.Methodology: This research method uses a qualitative-descriptive analysis approach. The analysis technique uses Analytical Network Process (ANP) with a BOCR network structure approach.Findings: The research results show that the most priority long-term strategic alternative based on the long-term BOCR analysis is increasing awareness among the public and industry by 52% and the importance of coordination between related institutions by 50%. Meanwhile, the most priority short-term strategic alternatives are the importance of coordination between related institutions 29%, increasing awareness among the public and industry 28%, the banking industry proactively funding environmentally friendly companies and technology 23%, the existence of Green Finance POS (Standard Operating Procedures) 20%.Implications: This research can be used as a reference for regulators and policymakers in making strategic decisions that can increase green finance financing. The novelty of this research is identifying problems that occur in green finance financing in Aceh province by analyzing opinions from experts in related fields and financial regulators in Aceh to create a strategy that can be implemented to increase green finance financing in Aceh province through BPD in Aceh, namely Bank Aceh.

Keywords: green financing, banking, sharia, islamic

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Authors: Chen-Yuan Hsu

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Introduction Elderly is growing and results to live in the long-term care (LTC) and then due to the routine of the facilities in Taiwan, also resulted to losing of those people with environment interaction, so, the self-reliance support (SRS) for those people to experience environment interaction is an essential. Methods This study was recruited samples of a LTC in the central of Taiwan. There was a following research on the SRS group with 20 samples collected and routine care group with 20 samples. A structured questionnaire as the Environment Interaction Dimension, as data collection included demographic information and the dimensions of environment interaction. Data analysis used SPSS 22.0 for Window 2000 to report the finding. Results The Environment Interaction Dimension for Taiwanese is a Chinese version of the containing 8 items. The result of t-test analysis found that environment interaction showed a significant difference between groups (p＜.05), the result recommended that there was a higher score of environment interaction dimension on the SRS group (29.90±5.56) comparing with the routine care group (22.1±5.53). Conclusion This study showed that the SRS group was higher than the routine care group on the environment interaction dimension for Taiwanese elderly living in the LTC. The results can also provide the reference for LTC, to encourage those people to participate in SRS in LTC, and therefore also improving their environment interaction.

Keywords: self-reliance support, environment interaction, long-term care, elderly

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Authors: Stephan Printz, Kristina Lahl, René Vossen, Sabina Jeschke

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Strategic investment decisions are characterized by high innovation potential and long-term effects on the competitiveness of enterprises. Due to the uncertainty and risks involved in this complex decision making process, the need arises for well-structured support activities. A method that considers cost and the long-term added value is the cost-benefit effectiveness estimation. One of those methods is the “profitability estimation focused on benefits – PEFB”-method developed at the Institute of Management Cybernetics at RWTH Aachen University. The method copes with the challenges associated with strategic investment decisions by integrating long-term non-monetary aspects whilst also mapping the chronological sequence of an investment within the organization’s target system. Thus, this method is characterized as a holistic approach for the evaluation of costs and benefits of an investment. This participation-oriented method was applied to business environments in many workshops. The results of the workshops are a library of more than 96 cost aspects, as well as 122 benefit aspects. These aspects are preprocessed and comparatively analyzed with regards to their alignment to a series of risk levels. For the first time, an accumulation and a distribution of cost and benefit aspects regarding their impact and probability of occurrence are given. The results give evidence that the PEFB-method combines precise measures of financial accounting with the incorporation of benefits. Finally, the results constitute the basics for using information technology and data science for decision support when applying within the PEFB-method.

Keywords: cost-benefit analysis, multi-criteria decision, profitability estimation focused on benefits, risk and uncertainty analysis

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Authors: Mehrnaz Alibeikloo, Hadi Khabbaz, Behzad Fatahi

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The spectral random field method is one of the widely used methods to obtain more reliable and accurate results in geotechnical problems involving material variability. Karhunen-Loeve (K-L) expansion method was applied to perform random field discretization of cross-correlated creep parameters. Karhunen-Loeve expansion method is based on eigenfunctions and eigenvalues of covariance function adopting Kernel integral solution. In this paper, the accuracy of Karhunen-Loeve expansion was investigated to predict long-term settlement of soft soils adopting elastic visco-plastic creep model. For this purpose, a parametric study was carried to evaluate the effect of K-L expansion terms and spatial correlation length on the reliability of results. The results indicate that small values of spatial correlation length require more K-L expansion terms. Moreover, by increasing spatial correlation length, the coefficient of variation (COV) of creep settlement increases, confirming more conservative and safer prediction.

Keywords: Karhunen-Loeve expansion, long-term settlement, reliability analysis, spatial correlation length

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.

Keywords: community-based, disability, health outcomes, quality of life, soldiers

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Authors: Mahmut Yildirim

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This paper proposed the bidirectional long short-term memory (Bi-LSTM) network-aided deep learning (DL)-based signal detection for Orthogonal frequency division multiplexing with all index modulation (OFDM-AIM), namely Bi-DeepAIM. OFDM-AIM is developed to increase the spectral efficiency of OFDM with index modulation (OFDM-IM), a promising multi-carrier technique for communication systems beyond 5G. In this paper, due to its strong classification ability, Bi-LSTM is considered an alternative to the maximum likelihood (ML) algorithm, which is used for signal detection in the classical OFDM-AIM scheme. The performance of the Bi-DeepAIM is compared with LSTM network-aided DL-based OFDM-AIM (DeepAIM) and classic OFDM-AIM that uses (ML)-based signal detection via BER performance and computational time criteria. Simulation results show that Bi-DeepAIM obtains better bit error rate (BER) performance than DeepAIM and lower computation time in signal detection than ML-AIM.

Keywords: bidirectional long short-term memory, deep learning, maximum likelihood, OFDM with all index modulation, signal detection

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Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

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Authors: R. Deju, M. Mincu, D. Gurau

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During the interim storage or final disposal of low level waste, migration/diffusion of radionuclides can occur when the waste comes in contact with water. The long-term leaching behaviour into surrounding fluid (demineralized water) of ¹³⁷Cs, ⁶⁰Co and ¹⁵²Eu radionuclides, artificially incorporated in mortar matrices made from natural aggregates (river sand) and recycled radioactive concrete was studied. Results presented in this work are obtained in two years of mortar testing and will be used for the safety increasing in the storage of low level radioactive waste. The study involved the influence of curing time, type and size distribution of the aggregates on leaching behaviour. The mortar samples were immersed in distilled water for 30 days. The leached activity of the mortar samples was measured on samples from the immersing water and analyzed through a gamma-ray spectrometry method using an HPGe detector with a GESPECOR code for efficiency evaluation. The long-term leaching behaviour of the radionuclides was evaluated from the leaching data calculating the apparent diffusion coefficient.

Keywords: gamma spectrometry, leaching behavior, reuse and recycling of radioactive concrete, waste management

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Authors: Dalia Feiziene, Virginijus Feiza, Agne Putramentaite, Jonas Volungevicius, Kristina Amaleviciute, Sarunas Antanaitis

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The investigations on soil conservation are one of the most important topics in modern agronomy. Soil management practices have great influence on soil physico-chemical quality and GHG emission. Research objective: To reveal the sensitivity and vitality of soils with different texture to long-term antropogenisation on Cambisol in Central Lithuania and to compare them with not antropogenised soil resources. Methods: Two long-term field experiments (loam on loam; sandy loam on loam) with different management intensity were estimated. Disturbed and undisturbed soil samples were collected from 5-10, 15-20 and 30-35 cm depths. Soil available P and K contents were determined by ammonium lactate extraction, total N by the dry combustion method, SOC content by Tyurin titrimetric (classical) method, texture by pipette method. In undisturbed core samples soil pore volume distribution, plant available water (PAW) content were determined. A closed chamber method was applied to quantify soil respiration (SR). Results: Long-term resources management changed soil quality. In soil with loam texture, within 0-10, 10-20 and 30-35 cm soil layers, significantly higher PAW, SOC and mesoporosity (MsP) were under no-tillage (NT) than under conventional tillage (CT). However, total porosity (TP) under NT was significantly higher only in 0-10 cm layer. MsP acted as dominant factor for N, P and K accumulation in adequate layers. P content in all soil layers was higher under NT than in CT. N and K contents were significantly higher than under CT only in 0-10 cm layer. In soil with sandy loam texture, significant increase in SOC, PAW, MsP, N, P and K under NT was only in 0-10 cm layer. TP under NT was significantly lower in all layers. PAW acted as strong dominant factor for N, P, K accumulation. The higher PAW the higher NPK contents were determined. NT did not secure chemical quality within deeper layers than CT. Long-term application of mineral fertilisers significantly increased SOC and soil NPK contents primarily in top-soil. Enlarged fertilization determined the significantly higher leaching of nutrients to deeper soil layers (CT) and increased hazards of top-soil pollution. Straw returning significantly increased SOC and NPK accumulation in top-soil. The SR on sandy loam was significantly higher than on loam. At dry weather conditions, on loam SR was higher in NT than in CT, on sandy loam SR was higher in CT than in NT. NPK fertilizers promoted significantly higher SR in both dry and wet year, but suppressed SR on sandy loam during usual year. Not antropogenised soil had similar SOC and NPK distribution within 0-35 cm layer and depended on genesis of soil profile horizons.

Keywords: fertilizers, long-term experiments, soil texture, soil tillage, straw

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Authors: I. Martinez-Conesa, E. Garcia-Meca, M. Barradas-Quiroz

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The objective of this study is to assess the impact on earnings management of latest two Hofstede cultural dimensions: long-term orientation and indulgence. Long-term orientation represents the alignment of a society towards the future and indulgence expresses the extent to which a society exhibits willingness, or restrain, to realise their impulses. Additionally, this paper tests if there are relevant differences by testing the moderating role of the legal tradition, Continental versus Anglo-Saxon. Our sample comprises 15 countries: Belgium, Canada, Germany, Spain, France, Great Britain, Hong Kong, India, Japan, Korea, Netherlands, Philippines, Portugal, Sweden, and Thailand, with a total of 12,936 observations from 2003 to 2013. Our results show that managers in countries with high levels of long-term orientation reduce their levels of discretionary accruals. The findings do not confirm the effect of indulgence on earnings management. In addition, our results confirm previous literature regarding the effect of individualism, noting that firms in countries with high levels of collectivism might be more inclined to use earnings discretion to protect the welfare of the collective group of firm stakeholders. Uncertainty avoidance results in downwards earnings management as well as high disclosure, suggesting that less manipulation takes place when transparency is higher. Indulgence is the cultural dimension that confronts wellbeing versus survival; dimension is formulated including happiness, the perception of live control and the importance of leisure. Indulgence shows a weak negative correlation with power distance indicating a slight tendency for more hierarchical societies to be less indulgent. Anglo-Saxon countries are a positive effect of individualism and a negative effect of masculinity, uncertainty avoidance, and disclosure. With respect to continental countries, we can see a significant and positive effect of individualism and a significant and negative effect of masculinity, long-term orientation, and indulgence. Therefore, we observe the negative effect on earnings management provoked by higher disclosure and uncertainty avoidance only happens in Anglo-Saxon countries. Meanwhile, the improvement in reporting quality motivated by higher long-term orientation and higher indulgence is dominant in Continental countries. Our results confirm that there is a moderating effect of the legal system in the association between culture and earnings management. This effect is especially relevant in the dimensions related to uncertainty avoidance, long term orientation, indulgence, and disclosure. The negative effect of long-term orientation on earnings management only happens in those countries set in continental legal systems because of the Anglo-Saxon legal systems is supported by the decisions of the courts and the traditions, so it already has long-term orientation. That does not occur in continental systems, depending mainly of contend of the law. Sensitivity analysis used with Jones modified CP model, Jones Standard model and Jones Standard CP model confirm the robustness of these results. This paper collaborates towards a better understanding on how earnings management, culture and legal systems relate to each other, and contribute to previous literature by examining the influence of the two latest Hofstede’s dimensions not previously studied in papers.

Keywords: Hofstede, long-term-orientation, earnings management, indulgence

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Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

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Authors: Mrinalini Ranjan, Sudheesh Chethil

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Epilepsy is a common neurological disorder characterised by the recurrence of seizures. Electroencephalogram (EEG) signals are complex biomedical signals which exhibit nonlinear and nonstationary behavior. We use two methods 1) Detrended Fluctuation Analysis (DFA) and 2) Recurrence Plots (RP) to capture this complex behavior of EEG signals. DFA considers fluctuation from local linear trends. Scale invariance of these signals is well captured in the multifractal characterisation using detrended fluctuation analysis (DFA). Analysis of long-range correlations is vital for understanding the dynamics of EEG signals. Correlation properties in the EEG signal are quantified by the calculation of a scaling exponent. We report the existence of two scaling behaviours in the epileptic EEG signals which quantify short and long-range correlations. To illustrate this, we perform DFA on extant ictal (seizure) and interictal (seizure free) datasets of different patients in different channels. We compute the short term and long scaling exponents and report a decrease in short range scaling exponent during seizure as compared to pre-seizure and a subsequent increase during post-seizure period, while the long-term scaling exponent shows an increase during seizure activity. Our calculation of long-term scaling exponent yields a value between 0.5 and 1, thus pointing to power law behaviour of long-range temporal correlations (LRTC). We perform this analysis for multiple channels and report similar behaviour. We find an increase in the long-term scaling exponent during seizure in all channels, which we attribute to an increase in persistent LRTC during seizure. The magnitude of the scaling exponent and its distribution in different channels can help in better identification of areas in brain most affected during seizure activity. The nature of epileptic seizures varies from patient-to-patient. To illustrate this, we report an increase in long-term scaling exponent for some patients which is also complemented by the recurrence plots (RP). RP is a graph that shows the time index of recurrence of a dynamical state. We perform Recurrence Quantitative analysis (RQA) and calculate RQA parameters like diagonal length, entropy, recurrence, determinism, etc. for ictal and interictal datasets. We find that the RQA parameters increase during seizure activity, indicating a transition. We observe that RQA parameters are higher during seizure period as compared to post seizure values, whereas for some patients post seizure values exceeded those during seizure. We attribute this to varying nature of seizure in different patients indicating a different route or mechanism during the transition. Our results can help in better understanding of the characterisation of epileptic EEG signals from a nonlinear analysis.

Keywords: detrended fluctuation, epilepsy, long range correlations, recurrence plots

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Authors: Ying Shi, June Zhang, Lu Shao, Xiyan Xie, Aidi Lao, Zhangan Wang

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Background: Low levels of physical activity are associated with poorer health outcomes, and this situation is more critical in older adults living in long‐term care facilities. Objectives: To systematically identify, appraise, and synthesize current qualitative research evidence regarding the barriers and facilitators to physical activity as reported by older adults and care staff in long‐term care facilities. Design: This is a systematic review with qualitative evidence synthesis adhering to PRISMA guidelines. Methods: We conducted a systematic search on PubMed, Science Citation Index Expanded, Social Sciences Citation Index, EMBASE, CINAHL, and PsychInfo databases from inception until 30 June 2023. Thematic synthesis was undertaken to identify the barriers and facilitators relating to physical activity. Then, we mapped them onto the Capability, Opportunity, Motivation, and Behavior model and Theoretical Domains Framework. Methodological quality was assessed using the CASP Qualitative Studies Checklist, and confidence in review findings was assessed using the GRADE-CERQual approach. Results: We included 32 studies after screening 10496 citations and 177 full texts. Seven themes and 17 subthemes were identified relating to barriers and facilitators influencing physical activity in elderly residents. The main themes were mapped onto COM-B) model-Capability (physical activity knowledge gaps and individual health issues), Opportunity (social support and macro-level resources) and Motivation (health beliefs, fear of falling or injury, and personal and social incentives to physical activity). Most subthemes were graded as high (n = 9) or moderate (n = 3) confidence. Conclusions and Implications: Our comprehensive synthesis of 32 studies provides a wealth of knowledge of barriers and facilitators to physical activity from both residents and care staff’s perspectives. Intervention components were also suggested within the context of long‐term care facilities. End users such as older residents, care staff, and researchers can have confidence in our findings when formulating policies and guidance on promoting physical activity among elderly residents in long‐term care facilities.

Keywords: long‐term care, older adults, physical activity, qualitative, systematic review

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Authors: John Rothrock

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Background: The role of transthoracic echocardiography (TTE) in the diagnosis and management of patients with acute ischemic stroke remains controversial. While many stroke subspecialist reserve TTE for selected patients, others consider the procedure obligatory for most or all acute stroke patients. This study was undertaken to assess the cost vs. benefit of 'routine' TTE. Methods: We examined a consecutive series of patients who were admitted to a single institution in 2019 for acute ischemic stroke and underwent TTE. We sought to determine the frequency with which the results of TTE led to a new diagnosis of cardioembolism, redirected therapeutic cerebrovascular management, and at least potentially influenced the short or long-term clinical outcome. We recorded the direct cost associated with TTE. Results: There were 1076 patients in the study group, all of whom underwent TTE. TTE identified an unsuspected source of possible/probable cardioembolism in 62 patients (6%), confirmed an initially suspected source (primarily endocarditis) in an additional 13 (1%) and produced findings that stimulated subsequent testing diagnostic of possible/probable cardioembolism in 7 patients ( < 1%). TTE results potentially influenced the clinical outcome in a total of 48 patients (4%). With a total direct cost of $1.51 million, the mean cost per case wherein TTE results potentially influenced the clinical outcome in a positive manner was $31,375. Diagnostically and therapeutically, TTE was most beneficial in 67 patients under the age of 55 who presented with 'cryptogenic' stroke, identifying patent foramen ovale in 21 (31%); closure was performed in 19. Conclusions: The utility of TTE in the setting of acute ischemic stroke is modest, with its yield greatest in younger patients with cryptogenic stroke. Given the greater sensitivity of transesophageal echocardiography in detecting PFO and evaluating the aortic arch, TTE’s role in stroke diagnosis would appear to be limited.

Keywords: cardioembolic, cost-benefit, stroke, TTE

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Authors: Henrique Veras De Paiva Fonseca

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This paper investigates the long-term relationship between early life exposure to malaria and adult socioeconomic outcomes in Brazil. The identification strategy relies on exogenous variation in the risk of malaria outbreaks in different states and seasons of the year to identify early life exposure according to the timing and location of birth. Furthermore, Brazil has undergone a successful campaign of malaria eradication during the late 1950s, which allows for comparing outcomes of birth cohorts born just prior to and just after eradication to identify the extent of in utero exposure. Instrumental variables estimates find consistent negative treatment effects of in utero exposure to malaria on socioeconomic outcomes, such as educational attainment and health status. The effects are stronger for exposure during the first trimester of pregnancy than during other periods of gestation. Additionally, consistent with previous findings, men are more likely to exhibit larger long-term effects.

Keywords: malaria, exposure, eradication, instrumental variables, education, health

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Authors: Mahdi Motahari, Mojtaba Farzaneh, Ebrahim Sepidbar

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Tracking of moving and flying targets is one of the most important issues in image processing topic. Estimating of trajectory of desired object in short-term and long-term scale is more important than tracking of moving and flying targets. In this paper, a new way of identifying and estimating of future trajectory of a moving ball in long-term scale is estimated by using synthesis and interaction of image processing algorithms including noise removal and image segmentation, Kalman filter algorithm in order to estimating of trajectory of ball in football game in short-term scale and intelligent adaptive neuro-fuzzy algorithm based on time series of traverse distance. The proposed system attain more than 96% identify accuracy by using aforesaid methods and relaying on aforesaid algorithms and data base video in format of synthesis and interaction. Although the present method has high precision, it is time consuming. By comparing this method with other methods we realize the accuracy and efficiency of that.

Keywords: tracking, signal processing, moving targets and flying, artificial intelligent systems, estimating of trajectory, Kalman filter

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Authors: Puneet Goyal, Aarti Agarwal

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Background and Objective: Nutritional support is an integral part of palliative care of advanced non-resectable abdominal malignancy patients, though is frequently neglected aspect. Non-Healing high output Entero-cutaneous fistulas sometimes require long term parenteral nutrition, to take care of catabolism and replacement of nutrients. We present a case of inoperable pancreatic malignancy with high output entero-cutaneous fistula, which was provided parenteral nutritional support with the use of Totally Implantable Venous Access Device (TIVAD). Method and Results: 55 year old man diagnosed with carcinoma pancreas had developed high entero-cutaneous fistula. His tumor was found to be inoperable and was on total parenteral nutrition through routine central line. This line was difficult to maintain as he required it for a long term TPN. He was planned to undergo Totally Implantable Venous Access Device (TIVAD) implantation. 8Fr single lumen catheter with Groshong non-return Valve (Bard Access Systems, Inc. USA) was inserted through right internal jugular vein, under fluoroscopic guidance. The catheter was tunneled subcutaneously and brought towards infraclavicular pocket, cut at appropriate length and connected to port and locked. Port was sutured in floor of pocket. Free flow of blood aspirated, flushed with heparinized saline. There was no kink observed in entire length of catheter under fluoroscopy. Skin over infraclavicular pocket was sutured. Long term catheter care and associated risks were explained to patient and relatives. Patient continued to receive total parenteral nutrition as well as other supportive therapy though TIVAD for next 6 weeks, till his demise. Conclusion: TIVADs are standard of care for long term venous access solutions in cancer patients requiring chemotherapy. In this case, we extended its use for providing parenteral nutrition and other supportive therapy. TIVADs can be implanted in advanced cancer patients for providing venous access solution required for various palliative treatments and medications. This will help in improving quality of life and satisfaction amongst terminally ill cancer patients.

Keywords: parenteral nutrition, totally implantable venous access device, long term venous access, interventions in anesthesiology

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