Search results for: missed appointments

Authors: Arun C. Gulani, Aaishwariya A. Gulani, Amanda Southall

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Background: Laser Corneoplastique™ as a least interventional, visually promising technique for patients with vision disability from corneal scars of varied causes has been retrospectively reviewed and proves to cause a paradigm shift in mindset and approach towards corneal scars as a Refractive surgery aiming for emmetropic, unaided vision of 20;/20 in most cases. Three decades of work on this technique has been compiled in this 15-year study. Subject and Methods: The objective of this study was to determine the success of Laser Corneoplastique™ surgery as a treatment of corneal scar cases. A survey of corneal scar cases caused by various medical histories that had undergone Laser Corneoplastique™ surgery over the past twenty years by a single surgeon Arun C. Gulani, M.D. were retrospectively reviewed. The details of each of the cases were retrieved from their medical records and analyzed. Each patient had been examined thoroughly at their preoperative appointments for stability of refraction and vision, depth of scar, pachymetry, topography, pattern of the scar and uncorrected and best corrected vision potential, which were all taken into account in the patients' treatment plans. Results: 64 eyes of 53 patients were investigated for scar etiology, keratometry, visual acuity, and complications. There were 25 different etiologies seen, with the most common being a Herpetic scar. The average visual acuity post-op was, on average, 20/23.55 (±7.05). Laser parameters used were depth and pulses. Overall, the mean Laser ablation depth was 30.67 (±19.05), ranging from 2 to 73 µm. Number of Laser pulses averaged 191.85 (±112.02). Conclusion: Refractive Laser Corneoplastique™ surgery, when practiced as an art, can address all levels of ametropia while reversing complex corneas and scars from refractive surgery complications back to 20/20 vision.

Keywords: corneal scar, refractive surgery, corneal transplant, laser corneoplastique

Procedia PDF Downloads 149

Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

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The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

Procedia PDF Downloads 305

Authors: Dorothy I. Riddle

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Limited mobility (or an inability to walk more than 15 meters without sitting down to rest) restricts full community participation for 13 percent of Canadian adults or 4.2 million persons), yet Canadian accessibility standards are silent on distance to be walked as an accessibility barrier to be addressed. Instead, they focus on ensuring access for the wheeled mobility devices used regularly by le The Accessible Canada Act mandates that Canada be barrier free by 2040, which will necessitate eliminating distance to be walked as a barrier in federal programs and services. This paper details the results of a multi-year research project funded by Accessibility Standards Canada to document the lived experience of those struggling with limited mobility and make recommendations regarding how to ensure accessibility for those with limited mobility. Over 2,600 Canadians from across Canada participated in an online survey and follow-up focus groups. The results underscored the importance of providing not only mobility supports in public facilities but also the information necessary for planning access to federal programs and services. As numerous participants indicated, if they weren’t sure how far they would have to walk, they simply stayed home and depended on friends and relatives for help with errands or appointments. This included failing to participate in civic activities, such as voting, for fear of having to walk too far and stand unsupported for too long. Types of information that were deemed critical included whether or not mobility aids were available, where seating to rest was located throughout the facility, what alternatives to standing while waiting for service and having to walk to the service provider (rather than the provider coming to the customer) were available, and diagrams of accessible parking and its relationship to elevators and services.

Keywords: accessibility standards, distance to be walked, limited mobility, mobility aids, service to customer

Procedia PDF Downloads 51

Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.

Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine

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Authors: Felipa de Mello-Sampayo

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The aim of this study is to undertake, from patient’s perspective, the timing and probability of using teledermatology, comparing it with a conventional referral system. The dynamic stochastic model’s main value-added consists of the concrete application to patients waiting for dermatology surgical intervention. Patients with low health level uncertainty must use teledermatology treatment as soon as possible, which is precisely when the teledermatology is least valuable. The results of the model were then tested empirically with the teledermatology network covering the area served by the Hospital Garcia da Horta, Portugal, links the primary care centers of 24 health districts with the hospital’s dermatology department via the corporate intranet of the Portuguese healthcare system. Health level volatility can be understood as the hazard of developing skin cancer and the trend of health level as the bias of developing skin lesions. The results of the survival analysis suggest that the theoretical model can explain the use of teledermatology. It depends negatively on the volatility of patients' health, and positively on the trend of health, i.e., the lower the risk of developing skin cancer and the younger the patients, the more presurgical teledermatology one expects to occur. Presurgical teledermatology also depends positively on out-of-pocket expenses and negatively on the opportunity costs of teledermatology, i.e., the lower the benefit missed by using teledermatology, the more presurgical teledermatology one expects to occur.

Keywords: teledermatology, wait time, uncertainty, opportunity cost, survival analysis

Procedia PDF Downloads 97

Authors: Sibongiseni Peacock, Denver Naidoo, Sikhalazo Dube

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The study investigates the impact of the National Red Meat Development Programme on household food security in rural areas of uMzimkhulu. Self-administered questionnaires were employed to gather data from 77 smallholder beef farmers participating in the St. Paul feedlot project. Data analysis utilized the Household Food Insecurity Access Scale (HFIAS) developed by USAID to assess the household food security status of St. Paul feedlot beneficiaries, with descriptive statistics employed for result analysis. Findings indicate that the majority (80.50%) of beneficiaries experienced food insecurity, while (19.50%) were classified as food secure, with most participants falling within the category of moderate food insecurity. Food insecurity predominantly stemmed from challenges faced by farmers unable to sell their cattle or whose cattle were not market-ready due to bureaucratic obstacles hindering the programme. Farmers identified feed shortages as the primary constraint, resulting in missed income opportunities. These findings underscore the critical need to address feed challenges and bureaucratic barriers to enhance the efficacy of the National Red Meat Development Programme in promoting household food security in rural areas.

Keywords: National Red Meat Development, household food security, St. Paul feedlot

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Authors: Semra Çörekçi̇

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In this study, a new source on Ottoman Self-narratives, Kulakzâde Mahmud Paşa’s Düşname (Dreambook), will be introduced to illustrate how dreams can provide a ground for historical analysis. The manuscript looks like a private notebook of an Ottoman official, Mahmud Pasha, who lived and operated in Rumelia in the early eighteenth century. It provides insight into the ordinary and daily concerns of a bureaucrat who had the knowledge and tools to record them in writing. On the one side of the notebook, Mahmud Pasha recorded his travels and appointments in 1730-1731. He wrote places that he reached and stayed every day. On the reverse side, the same author kept a record of his dreams and named that part of his notebook, Düşname. He recorded his dreams on a daily basis in writing and therefore they were well-preserved in a dream diary. This study aims at drawing the social, cultural and psychic life of an early modern Ottoman bureaucrat. It will uncover the ways and means whereby he interpreted his environment, as well as how he made meaning of his dreams considering the social milieu and historical context within which he lived. The first part will focus on 'official dreams' uncovering how his official life and ambitions coincide with his spiritual life. Related to this, connection between anxiety and dream narratives will be evaluated as dreams in which the mundane concerns of securing a post occupied the most central place in the construction of his narrative. A further point will be made by questioning Mahmud Pasha’s possible Sufi connections and his familiarity with the tradition of dream interpretation. Also, considering Mahmud Pasha’s inclusion of other’s dreams in his Düşnâme, the issue of dream-telling will be questioned in order to reveal how dreams were interconnected and how they created a space for social gathering.

Keywords: Ottoman self-narratives, dreams, diary, Ottoman cultural history

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Authors: Zhou Yang, Heli Sun, Jianbin Huang, Jizhong Zhao, Shaojie Qiao

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Traffic prediction is essential in a multitude of ways in modern urban life. The researchers of earlier work in this domain carry out the investigation chiefly with two major focuses: (1) the accurate forecast of future values in multiple time series and (2) knowledge extraction from spatial-temporal correlations. However, two key considerations for traffic prediction are often missed: the completeness of raw data and the full context of the prediction timestamp. Concentrating on the two drawbacks of earlier work, we devise an approach that can address these issues in a two-phase framework. First, we utilize the raw trajectories to a greater extent through building a VLA table and data compression. We obtain the intra-trajectory features with graph-based encoding and the intertrajectory ones with a grid-based model and the technique of back projection that restore their surrounding high-resolution spatial-temporal environment. To the best of our knowledge, we are the first to study direct feature extraction from raw trajectories for traffic prediction and attempt the use of raw data with the least degree of reduction. In the prediction phase, we provide a broader context for the prediction timestamp by taking into account the information that are around it in the training dataset. Extensive experiments on several well-known datasets have verified the effectiveness of our solution that combines the strength of raw trajectory data and prediction context. In terms of performance, our approach surpasses several state-of-the-art methods for traffic prediction.

Keywords: traffic prediction, raw data utilization, context building, data reduction

Procedia PDF Downloads 98

Authors: Tom Ryan

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This paper investigates the rural mobility and accessibility challenges of a specific target group - Seniors. The target group is those over 66 years of age who are entitled to use the Public Transport (PT) Free Travel Scheme in rural Ireland. The paper explores at a high level some of the projected rural PT challenges and requirements over the next 10-15 years, noting that statistical predictions show that there will be a significant population demographic shift within the Senior's age profile. Using the PESTEL framework, the literature review explored existing research concerning mobility, accessibility challenges, and the opportunities Seniors face. Twenty-seven qualitative in-depth interviews with stakeholders within the ecosystem were undertaken. The stakeholders included: rural PT customers, Local-Link managers, NTA senior management, a Minister of State, and a European parliament policymaker. Tier 1 interviewee feedback spotlights that the PT network system does not exist for rural patients to access hospital facilities. There was no evidence from the Tier 2 research findings to show that health policymakers and transport planners are working to deliver a national solution to support patients getting access to hospital appointments. Several research interviewees discussed the theme of isolation and the perceived stigma of senior males utilising PT. The findings indicated that MaaS is potentially revolutionary in the PT arena. Finally, this paper suggests several short-, medium- and long-term recommendations based on the research findings. These recommendations are a potential springboard to ensure that rural PT is suitable for future Irish generations.

Keywords: accessibility, active ageing, car dependence, isolation, seniors health issues, behavioural changes, environmental challenges, internet of things, demand responsive, mobility as a service

Procedia PDF Downloads 81

Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

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Authors: Jingting Luo, Yong Wang, Ying Wang

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Pedestrian detection in image or video data is a very important and challenging task in security surveillance. The difficulty of this task is to locate and detect pedestrians of different scales in complex scenes accurately. To solve these problems, a deep neural network (RT-YOLOv3) is proposed to realize real-time pedestrian detection at different scales in security monitoring. RT-YOLOv3 improves the traditional YOLOv3 algorithm. Firstly, the deep residual network is added to extract vehicle features. Then six convolutional neural networks with different scales are designed and fused with the corresponding scale feature maps in the residual network to form the final feature pyramid to perform pedestrian detection tasks. This method can better characterize pedestrians. In order to further improve the accuracy and generalization ability of the model, a hybrid pedestrian data set training method is used to extract pedestrian data from the VOC data set and train with the INRIA pedestrian data set. Experiments show that the proposed RT-YOLOv3 method achieves 93.57% accuracy of mAP (mean average precision) and 46.52f/s (number of frames per second). In terms of accuracy, RT-YOLOv3 performs better than Fast R-CNN, Faster R-CNN, YOLO, SSD, YOLOv2, and YOLOv3. This method reduces the missed detection rate and false detection rate, improves the positioning accuracy, and meets the requirements of real-time detection of pedestrian objects.

Keywords: pedestrian detection, feature detection, convolutional neural network, real-time detection, YOLOv3

Procedia PDF Downloads 115

Authors: Elizabeth Snyman-Van Deventer

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Numerous corporate scandals, which included investment scams, corporate malfeasance, unethical conduct and conflicts of interest, contributed to the collapse of WorldCom, Global Crossing, Xerox, Tyco, Enron, Sprint, AbbVie and Imclone and led to alarmed investors abandoning public securities markets and the tumbling of U.S stock markets. These companies suffered significant financial losses due to substantial and fraudulent misstatements and other illegal, corrupt or unethical practices. Executives were convicted of fraud and sentenced to prison. The corporate financial scandals, governance failures, and the ensuing public outcries led to mandatory legislation, e.g. the Sarbanes-Oxley Act in the USA. In European corporate scandals such as Parmalat, Royal Dutch Ahold, Vivendi, Adecco and Elan, the boards missed financial misrepresentations. In South Africa, Steinhoff is the most well-known example of corporate collapse, but now we can also add Tongaat Hulett. It seems as if fraud and corruption may be the major sources of these corporate collapses. In most instances, there is either the active involvement of the directors and managers in these fraudulent or corrupt practices, or there is a negligent or even intentional failure to act by directors to prevent these activities. However, besides directors and managers, auditors and lawyers failed in most of these companies to fulfil their professional duties. In most of these major collapses, the ethics of especially auditors and directors could be questioned. This paper will first provide a brief overview of corporate collapses. Secondly, the reasons for these collapses, with a focus on unethical conduct, will be discussed.

Keywords: professional duties, corporate collapses, ethical conduct, legal ethics, directors, auditors

Procedia PDF Downloads 37

Authors: Salma Krafessi

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The financial markets have a multifaceted, intricate environment, and enormous volumes of data are produced every day. To find investment possibilities, possible fraudulent activity, and market oddities, accurate anomaly identification in this data is essential. Conventional methods for detecting anomalies frequently fail to capture the complex organization of financial data. In order to improve the identification of abnormalities in financial time series data, this study presents Tucker Decomposition as a reliable multi-way analysis approach. We start by gathering closing prices for the S&P 500 index across a number of decades. The information is converted to a three-dimensional tensor format, which contains internal characteristics and temporal sequences in a sliding window structure. The tensor is then broken down using Tucker Decomposition into a core tensor and matching factor matrices, allowing latent patterns and relationships in the data to be captured. A possible sign of abnormalities is the reconstruction error from Tucker's Decomposition. We are able to identify large deviations that indicate unusual behavior by setting a statistical threshold. A thorough examination that contrasts the Tucker-based method with traditional anomaly detection approaches validates our methodology. The outcomes demonstrate the superiority of Tucker's Decomposition in identifying intricate and subtle abnormalities that are otherwise missed. This work opens the door for more research into multi-way data analysis approaches across a range of disciplines and emphasizes the value of tensor-based methods in financial analysis.

Keywords: tucker decomposition, financial markets, financial engineering, artificial intelligence, decomposition models

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Authors: Shirin jalili, Hadi Shirzad, Samaneh Nabavi, Somayeh Khanjani

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Biosensors in forensic analysis are ideal biological tools that can be used for rapid and sensitive initial screening and testing to detect of suspicious components like biological and chemical agent in crime scenes. The wide use of different biomolecules such as proteins, nucleic acids, microorganisms, antibodies and enzymes makes it possible. These biosensors have great advantages such as rapidity, little sample manipulation and high sensitivity, also Because of their stability, specificity and low cost they have become a very important tool to Forensic analysis and detection of crime. In crime scenes different substances such as rape samples, Semen, saliva fingerprints and blood samples, act as a detecting elements for biosensors. On the other hand, successful fluid recovery via biosensor has the propensity to yield a highly valuable source of genetic material, which is important in finding the suspect. Although current biological fluid testing techniques are impaired for identification of body fluids. But these methods have disadvantages. For example if they are to be used simultaneously, Often give false positive result. These limitations can negatively result the output of a case through missed or misinterpreted evidence. The use of biosensor enable criminal researchers the highly sensitive and non-destructive detection of biological fluid through interaction with several fluid-endogenous and other biological and chemical contamination at the crime scene. For this reason, using of the biosensors for detecting the biological fluid found at the crime scenes which play an important role in identifying the suspect and solving the criminal.

Keywords: biosensors, forensic analysis, biological fluid, crime detection

Procedia PDF Downloads 1072

Authors: Nadya Patel, Jawn Lim

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Foresight 3.0 is a synergistic methodology that encompasses systems analysis, future studies, capacity building, and forward planning. These components are interconnected, fostering a collective anticipatory intelligence that promotes societal resilience (Ravetz, 2020). However, traditional applications of these strands can often fall short, leading to missed opportunities and narrow perspectives. Therefore, Foresight 3.0 champions a holistic approach to tackling complex issues, focusing on systemic transformations and power dynamics. Businesses are pivotal in preparing the workforce for an increasingly uncertain and complex world. This necessitates the adoption of innovative tools and methodologies, such as Foresight 3.0, that can better equip young employees to anticipate and navigate future challenges. Firstly, the incorporation of its methodology into workplace training can foster a holistic perspective among employees. This approach encourages employees to think beyond the present and consider wider social, economic, and environmental contexts, thereby enhancing their problem-solving skills and resilience. This paper discusses our research on integrating Foresight 3.0's transformative principles with a newly developed Critical Design Futures (CDF) framework to equip organisations with the ability to innovate for the world's most complex social problems. This approach is grounded in 'collective forward intelligence,' enabling mutual learning, co-innovation, and co-production among a diverse stakeholder community, where business transformation and innovation are achieved.

Keywords: business transformation, innovation, foresight, critical design

Procedia PDF Downloads 48

Authors: Usama Shahid, Muhammad Zunnurain Hussain

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This research paper presents a comprehensive analysis of a sentiment analysis approach that employs valence and arousal as its foundational pillars, in comparison to traditional techniques. Sentiment analysis is an indispensable task in natural language processing that involves the extraction of opinions and emotions from textual data. The valence and arousal dimensions, representing the intensity and positivity/negativity of emotions, respectively, enable the creation of four quadrants, each representing a specific emotional state. The study seeks to determine the impact of utilizing these quadrants to identify distinct emotional states on the accuracy and efficiency of sentiment analysis, in comparison to traditional techniques. The results reveal that the valence and arousal-based approach outperforms other approaches, particularly in identifying nuanced emotions that may be missed by conventional methods. The study's findings are crucial for applications such as social media monitoring and market research, where the accurate classification of emotions and opinions is paramount. Overall, this research highlights the potential of using valence and arousal as a framework for sentiment analysis and offers invaluable insights into the benefits of incorporating specific types of emotions into the analysis. These findings have significant implications for researchers and practitioners in the field of natural language processing, as they provide a basis for the development of more accurate and effective sentiment analysis tools.

Keywords: sentiment analysis, valence and arousal, emotional states, natural language processing, machine learning, text analysis, sentiment classification, opinion mining

Procedia PDF Downloads 57

Authors: Gholamhossein Hosseini

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Two earliness cotton genotypes I and II, which had been developed by hybridization and backcross methods between sindise-80 as an early maturing gene parent and two other lines i.e. Red leaf and Bulgare-557 as a second parent, are subjected to different environmental conditions. The early maturing genotypes with coded names of I and II were compared with four native cotton cultivars in randomized complete block design (RCBD) with four replications in three ecological regions of Iran from 2016-2017. Two early maturing genotypes along with four native cultivars viz. Varamin, Oltan, Sahel and Arya were planted in Agricultural Research Station of Varamin, Moghan and Kashmar for evaluation. Earliness data were collected for six treatments during two years in the three regions except missing data for the second year of Kashmar. Therefore, missed data were estimated and imputed. For testing the homogeneity of error variances, each experiment at a given location or year is analyzed separately using Hartley and Bartlett’s Chi-square tests and both tests confirmed homogeneity of variance. Combined analysis of variance showed that genotypes I and II were superior in Varamin, Moghan and Kashmar regions. Earliness means and their interaction effects were compared with Duncan’s multiple range tests. Finally combined analysis of variance showed that genotypes I and II were superior in Varamin, Moghan and Kashmar regions. Earliness means and their interaction effects are compared with Duncan’s multiple range tests.

Keywords: cotton, combined, analysis, earliness

Procedia PDF Downloads 112

Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

Procedia PDF Downloads 103

Authors: Rahul Thakur, Onkar Chandel

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Red Hat is the world leader in providing open source software and solutions. A global enterprise, like Red Hat, has unique issues of connecting employees with content because of distributed offices, multiple teams spread across geographies, multiple languages, and different cultures. Employees, of a global company, create content that is distributed across departments, teams, regions, and countries. This makes finding the best content difficult since owners keep iterating on the existing content. When employees are unable to find the content, they end up creating it once again and in the process duplicating existing material and effort. Also, employees may not find the relevant content and spend time reviewing obsolete duplicate, or irrelevant content. On an average, a person spends 15 minutes/day in failed searches that might result in missed business opportunities, employee frustration, and substandard deliverables. Red Hat Knowledge Management Office (KMO) applied 'open source strategy' to solve the above problems. Under the Open Source Strategy, decisions are taken collectively. The strategy aims at accomplishing common goals with the help of communities. The objectives of this initiative were to save employees' time, get them authentic content, improve their content search experience, avoid duplicate content creation, provide context based search, improve analytics, improve content management workflows, automate content classification, and automate content upload. This session will describe open source strategy, its applicability in content management, challenges, recommended solutions, and outcome.

Keywords: content classification, content management, knowledge management, open source

Procedia PDF Downloads 184

Authors: Kassa Endalamaw Rewnu

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The variability properties of a quasar sample, spectroscopically complete to magnitude J = 22.0, are investigated on a time baseline of 2 years using three different photometric bands (U, J and F). The original sample was obtained using a combination of different selection criteria: colors, slitless spectroscopy and variability, based on a time baseline of 1 yr. The main goals of this work are two-fold: first, to derive the percentage of variable quasars on a relatively short time baseline; secondly, to search for new quasar candidates missed by the other selection criteria; and, thus, to estimate the completeness of the spectroscopic sample. In order to achieve these goals, we have extracted all the candidate variable objects from a sample of about 1800 stellar or quasi-stellar objects with limiting magnitude J = 22.50 over an area of about 0.50 deg2. We find that > 65% of all the objects selected as possible variables are either confirmed quasars or quasar candidates on the basis of their colors. This percentage increases even further if we exclude from our lists of variable candidates a number of objects equal to that expected on the basis of `contamination' induced by our photometric errors. The percentage of variable quasars in the spectroscopic sample is also high, reaching about 50%. On the basis of these results, we can estimate that the incompleteness of the original spectroscopic sample is < 12%. We conclude that variability analysis of data with small photometric errors can be successfully used as an efficient and independent (or at least auxiliary) selection method in quasar surveys, even when the time baseline is relatively short. Finally, when corrected for the different intrinsic time lags corresponding to a fixed observed time baseline, our data do not show a statistically significant correlation between variability and either absolute luminosity or redshift.

Keywords: nuclear activity, galaxies, active quasars, variability

Procedia PDF Downloads 46

Authors: Nadine Abuqtaish

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Females’ participation in athletic sports events has increased in the last decades, and the discovery of eating disorders and menstrual dysfunction has been evident since the early 1980s. The term “Female athlete triad” was initially defined by the Task Force on Women’s Issues of the American College of Sports Medicine (ACSM) in 1992. Menstrual irregularities have been prevalent in competitive female athletes, especially in their adolescence and early adulthood age. Nutritional restrictions to maintain a certain physique and lean look are sought to be advantageous in female athletes such as gymnastics, cheerleading, or weight-sensitive sports such as endurance sports (cycling and marathoners). This stress places the female at risk of irregularities in their menstrual cycle which can lead them to lose their circadian estrogen levels. Estrogen is an important female reproductive hormone that plays a role in maintaining bone mass. Bone mineral density peaks by the age 25. Inadequate estrogen due to missed menstrual cycle or amenorrhea has been estimated to cause a yearly loss of 2% of bone mass, increasing the risk of osteoporosis in the postmenopausal phase. This paper is intended to have a better depth understanding of whether female athletes are being monitored by their official entities or coaches. A qualitative research method through online search engines and keywords “females, athletes, triad, amenorrhea, anorexia, osteoporosis” were used to collect the available primary sources from official public library databases. The latest consensus was published in 2014 by the Female Athlete Triad Coalition and the need for further research and emphasis on this issue is still lacking.

Keywords: female, athlete, triad, amenorrhea, anorexia, bone loss

Procedia PDF Downloads 31

Authors: Cyrillus Prabandana

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Supply chain optimisation requires multiple factors as consideration or constraints. These factors are including but not limited to demand forecasting, raw material fulfilment, production capacity, inventory level, facilities locations, transportation means, and manpower availability. By knowing all manageable factors involved and assuming the uncertainty with pre-defined percentage factors, an integrated supply chain model could be developed to manage various business scenarios. This paper analyse the utilisation of geographical point of view to develop an integrated supply chain network model to optimise the distribution of finished product appropriately according to forecasted demand and available supply. The supply chain optimisation model shows that small change in one supply chain constraint is possible to largely impact other constraints, and the new information from the model should be able to support the decision making process. The model was focused on three areas, i.e. raw material fulfilment, production capacity and finished products transportation. To validate the model suitability, it was implemented in a project aimed to optimise the concrete supply chain in a mining location. The high level of operations complexity and involvement of multiple stakeholders in the concrete supply chain is believed to be sufficient to give the illustration of the larger scope. The implementation of this geographical supply chain network modeling resulted an optimised concrete supply chain from raw material fulfilment until finished products distribution to each customer, which indicated by lower percentage of missed concrete order fulfilment to customer.

Keywords: decision making, geographical supply chain modeling, supply chain optimisation, supply chain

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Authors: Policarpio Jr. Joves

Abstract:

Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Noha Mohammed Ismael Awad Eladal, Aala Shoukry Emara

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Background: Wound healing after dental implant surgery is critical to the procedure's success. The aim of this study was to explore the effects of rutin+vitamin C supplementation in wound healing following the placement of dental implants. Methodology: There were 20 participants in this randomized controlled clinical trial who needed dental implants to replace missing teeth. Patients were divided into two groups, and group A received dental implants. Group B received dental implants with vitamin C administration. Follow-up appointments were performed on day 3, day 7, and day 14 post-surgery, during which soft tissue healing and pain response scores were evaluated using the visual analog scale. Postoperative digital panoramas were taken immediately after surgery, 3 months and 6 months postoperatively. Changes in bone density along with the bone-implant interface at the mesial, distal and apical sides were assessed using the digora software. Results: An independent t-test was used to compare the means of variables between the two groups. At the same time, repeated measures were employed to compare the means of variables between two groups. ANOVA was used to compare bone density for the same group at different dates. Significant increased differences were observed at the mesial, distal and apical sides Surrounding the implants of both groups per time. However, the rate of increase was significantly higher in group B The mean difference at the mesial side after 6 months was 21.99 ± 5.48 in the group B and 14.21 ± 4.95 in group A, while it read 21.74 ± 3.56 in the group B and 10.78 ± 3.90 in group A at the distal side and was 18.90 ± 5.91 in the group B and 10.39 ± 3.49 group A at the apical side. Significance was recorded at P = 0.004, P = 0.0001, and 0.001 at the mesial, distal and apical sides respectively. The mean pain score and wound healing were significantly higher in group A as compared to group B, respectively. Conclusion: The rutin c + vitamin c group significantly promoted bone healing and speeded up the osseointegration process and improved soft tissue healing.

Keywords: osseointegration, soft tissue, rutin c, dental implant

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Authors: Shreesh Sinha, Alexander B. Barker, Megan Parkin, Emma Wilson, Rachael L. Murray

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Background and Objectives: Exposure to HFSS imagery is associated with the consumption of foods high in fat, sugar or salt (HFSS), and subsequently obesity, among young people. We report and compare the results of two content analyses, one of two popular terrestrial children's television channels in the UK and the other of a selection of children's programmes available on video-on-demand (VOD) streaming sites. Methods: Content analysis of three days' worth of programmes (including advertisements) on two popular children's television channels broadcast on UK television (CBeebies and Milkshake) as well as a sample of 40 highest-rated children's programmes available on the VOD platforms, Netflix and Amazon Prime, using 1-minute interval coding. Results: HFSS content was seen in 181 broadcasts (36%) and in 417 intervals (13%) on terrestrial television, 'Milkshake' had a significantly higher proportion of programmes/adverts which contained HFSS content than 'CBeebies'. In VOD platforms, HFSS content was seen in 82 episodes (72% of the total number of episodes), across 459 intervals (19% of the total number of intervals), with no significant difference in the proportion of programmes containing HFSS content between Netflix and Amazon Prime. Conclusions: This study demonstrates that HFSS content is common in both popular UK children's television channels and children's programmes on VOD services. Since previous research has shown that HFSS content in the media has an effect on HFSS consumption, children's television programmes broadcast either on TV or VOD services are likely to have an effect on HFSS consumption in children, and legislative opportunities to prevent this exposure are being missed.

Keywords: public health, junk food, children's TV, HFSS

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Authors: Kinga Zebrowska, Maria Falis, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Olga Plaza, Katarzyna Kwiatkowska

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Introduction: According to the ministerial decree of 16 August 2018, each woman in Poland during childbirth has the right to the pharmacological and non-pharmacological labour pain management (LPM). Aim: The aim of the study was to assess the knowledge of Polish mothers about pharmacological and non-pharmacological LPM, to investigate which methods they chose and their satisfaction with chosen ones. Material And Methods: A prospective cross-sectional study was performed among women who gave birth between 2015 and 2018. The self-composed questionnaire was distributed via the Internet in October 2018. Results: 13.727 women participated in the study. 75% have learned about LPM from the Internet. 68% of them did not gain any information on LPM from doctors during their prenatal appointments Safety of the newborn (46%), midwife’s advice (40%) and the chance of the immediate pain relief (39%) were the most important issues while choosing LPM. Respondents used a wide range of non-pharmacological methods, such as the assistance of partner during labour (81%), physical activity (58%), immersion in water (37%), relaxation techniques (15%) and others. 11% of mothers did not use any of the LPM methods. 52% of women declared that they wanted to use the pharmacological anaesthesia, while 49% had it performed (28% epidural, 16% inhaled anaesthesia, 5% parenteral opioids). Pharmacological methods were unavailable due to lack of anaesthesiologist in the maternity ward (41%) or inaccessibility of the chosen methods in the hospital (31%) and too advanced labour (43%). 48% of respondents did not decide to use pharmacological methods, because the pain was bearable (29%), anxiety of child’s health (17%), or belief that the pain is natural and it should not be avoided (16%). 83% of respondents believed that epidural analgesia has no influence on the time needed to gain a full cervix dilatation and 81% of them claimed that serious spinal cord injury is a common side effect of epidural. 51% believed that epidural increases the risk of caesarean section. Conclusions: The knowledge about the methods of LPM is not satisfactory. We should focus on well- maintained education guided by doctors, midwives, and media.

Keywords: childbirth, labour pain management, maternity experiences, obstetrics

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Authors: Maria Ghorbanian, Mohammad Ghahramani, Mahmood Abolghasemi

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Universities and institutions of higher education in Iran, like other higher education institutions in the world, have a heavy mission and task to educate students based on the needs of the country. Taking on such a serious responsibility requires having a good governance system for planning, formulating executive plans, evaluating, and finally modifying them in accordance with the current conditions and challenges ahead. In this regard, the present study was conducted with the aim of identifying the components of good governance in the Iranian higher education system by survey method and with a quantitative approach. In order to collect data, a researcher-made questionnaire was used, which includes two parts: personal and professional characteristics (5 questions) and the three components of good governance in the Iranian higher education system, including good management and leadership (8 items), continuous evaluation and effective (university performance, finance, and university appointments) (8 items) and civic responsibility and sustainable development (7 items). These variables were measured and coded in the form of a five-level Likert scale from "Very Low = 1" to "Very High = 5". First, the validity and reliability of the research model were examined. In order to calculate the reliability of the questionnaire, two methods of Cronbach's alpha and combined reliability were used. Fornell-Larker interaction and criterion were also used to determine the degree of diagnostic validity. The statistical population of this study included all faculty members of public universities in Tehran (N = 4429). The sample size was estimated to be 340 using the Cochran's formula. These numbers were studied using a randomized method with a proportional assignment. The data were analyzed by the structural equation method with the least-squares approach. The results showed that the component of civil responsibility and sustainable development with a factor load of 0.827 is the most important element of good governance.

Keywords: good governance, higher education, sustainable, development

Procedia PDF Downloads 133

Authors: Alexander B. Barker, Megan Parkin, Shreesh Sinha, Emma Wilson, Rachael L. Murray

Abstract:

Objectives: Exposure to HFSS imagery is associated with consumption of foods high in fat, sugar, or salt (HFSS), and subsequently obesity, among young people. We report and compare the results of two content analyses, one of two popular terrestrial children’s television channels in the UK and the other of a selection of children’s programs available on video-on-demand (VOD) streaming sites. Design: Content analysis of three days’ worth of programs (including advertisements) on two popular children’s television channels broadcast on UK television (CBeebies and Milkshake) as well as a sample of 40 highest-rated children’s programs available on the VOD platforms, Netflix and Amazon Prime, using 1-minute interval coding. Setting: United Kingdom, Participants: None. Results: HFSS content was seen in 181 broadcasts (36%) and in 417 intervals (13%) on terrestrial television, ‘Milkshake’ had a significantly higher proportion of programs/adverts which contained HFSS content than ‘CBeebies’. In VOD platforms, HFSS content was seen in 82 episodes (72% of the total number of episodes), across 459 intervals (19% of the total number of intervals), with no significant difference in the proportion of programs containing HFSS content between Netflix and Amazon Prime. Conclusions: This study demonstrates that HFSS content is common in both popular UK children’s television channels and children's programs on VOD services. Since previous research has shown that HFSS content in the media has an effect on HFSS consumption, children’s television programs broadcast either on TV or VOD services are likely having an effect on HFSS consumption in children and legislative opportunities to prevent this exposure are being missed.

Keywords: public health, epidemiology, obesity, content analysis

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Authors: Gauri Shankar Shah

Abstract:

Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

Abstract:

It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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