Search results for: predictive controller
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1634

Search results for: predictive controller

344 COVID_ICU_BERT: A Fine-Tuned Language Model for COVID-19 Intensive Care Unit Clinical Notes

Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

Abstract:

Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation

Procedia PDF Downloads 168
343 Cognitive Rehabilitation in Schizophrenia: A Review of the Indian Scenario

Authors: Garima Joshi, Pratap Sharan, V. Sreenivas, Nand Kumar, Kameshwar Prasad, Ashima N. Wadhawan

Abstract:

Schizophrenia is a debilitating disorder and is marked by cognitive impairment, which deleteriously impacts the social and professional functioning along with the quality of life of the patients and the caregivers. Often the cognitive symptoms are in their prodromal state and worsen as the illness progresses; they have proven to have a good predictive value for the prognosis of the illness. It has been shown that intensive cognitive rehabilitation (CR) leads to improvements in the healthy as well as cognitively-impaired subjects. As the majority of population in India falls in the lower to middle socio-economic status and have low education levels, using the existing packages, a majority of which are developed in the West, for cognitive rehabilitation becomes difficult. The use of technology is also restricted due to the high costs involved and the limited availability and familiarity with computers and other devices, which pose as an impedance for continued therapy. Cognitive rehabilitation in India uses a plethora of retraining methods for the patients with schizophrenia targeting the functions of attention, information processing, executive functions, learning and memory, and comprehension along with Social Cognition. Psychologists often have to follow an integrative therapy approach involving social skills training, family therapy and psychoeducation in order to maintain the gains from the cognitive rehabilitation in the long run. This paper reviews the methodologies and cognitive retaining programs used in India. It attempts to elucidate the evolution and development of methodologies used, from traditional paper-pencil based retraining to more sophisticated neuroscience-informed techniques in cognitive rehabilitation of deficits in schizophrenia as home-based or supervised and guided programs for cognitive rehabilitation.

Keywords: schizophrenia, cognitive rehabilitation, neuropsychological interventions, integrated approached to rehabilitation

Procedia PDF Downloads 336
342 Factors Associated with Non-Adherence to Antiretroviral Treatment among HIV Infected Patients in Ukraine

Authors: Larissa Burruano, Sergey Grabovyj, Irina Nguen

Abstract:

The study aimed to assess the level of adherence to anti retroviral therapy (ART) and to examine the relationship between adherence and risk behavior factor (drug use) among patients infected with HIV. The patients with newly diagnosed or established HIV infection under follow-up at the Sumskij Regional Centre for AIDS Prevention in Ukraine were eligible for this study. Medical records were used to measure the patient’s adherence to medication. Measurements were obtained at month 6 and at month 12 to calculate the number of medication omission during the past 30 days: (on a 2-point scale – once until three in a month – were considered adherent, three and more in a month – were considered non-adherent). Of the 50 study participants, 27 (54.0%) were men and 23 (46.0%) women. The mean age is 35.2 years (SD= 5.1). A majority of the patients (82.0%) is in the age group of 25-30 years. The main level of adherence was 74.0% and 66.0% at 6 and 12 months, respectively. The main routes of HIV transmission were drug injection among men 12 (44.4%) and sexual contact among women 11 (47.8%). Univariate analyses indicated that patients who had lower level of education were more likely to have been non-adherent at month 6- (X2 =5.1, n=50, p < .05) and at month 12 (X2 = 4.34, n=50, p < .05). Multivariate tests showed that only age (OR= 1.163 [95% CI 0.98–1.370]) was significant independent predictor of treatment adherence, while gender, education, employment status were not predictive for the risk of developing non-compliance. There was not a significant interaction between non-adherence and intravenous drug use. Consistent with these findings, younger people were more likely to have missed a dose of their medication because they had a greater sense of invulnerability than older patients. The study indicates that the socio demographic characteristic should be taken into an account in the future research regarding adherence in the case of HIV infection. If the patient anti retroviral adherence can be improved by qualitatively better medical care in all regions of the Ukraine, behavioral changes in the population can to be expected in the long term.

Keywords: HIV, antiretroviral therapy, adherence, Ukraine, Eastern Europe

Procedia PDF Downloads 267
341 Mediation Role of Teachers’ Surface Acting and Deep Acting on the Relationship between Calling Orientation and Work Engagement

Authors: Yohannes Bisa Biramo

Abstract:

This study examined the meditational role of surface acting and deep acting on the relationship between calling orientation and work engagement of teachers in secondary schools of Wolaita Zone, Wolaita, Ethiopia. A predictive non-experimental correlational design was performed among 300 secondary school teachers. Stratified random sampling followed by a systematic random sampling technique was used as the basis for selecting samples from the target population. To analyze the data, Structural Equation Modeling (SEM) was used to test the association between the independent variables and the dependent variables. Furthermore, the goodness of fit of the study variables was tested using SEM to see and explain the path influence of the independent variable on the dependent variable. Confirmatory factor analysis (CFA) was conducted to test the validity of the scales in the study and to assess the measurement model fit indices. The analysis result revealed that calling was significantly and positively correlated with surface acting, deep acting and work engagement. Similarly, surface acting was significantly and positively correlated with deep acting and work engagement. And also, deep acting was significantly and positively correlated with work engagement. With respect to mediation analysis, the result revealed that surface acting mediated the relationship between calling and work engagement and also deep acting mediated the relationship between calling and work engagement. Besides, by using the model of the present study, the school leaders and practitioners can identify a core area to be considered in recruiting and letting teachers teach, in giving induction training for newly employed teachers and in performance appraisal.

Keywords: calling, surface acting, deep acting, work engagement, mediation, teachers

Procedia PDF Downloads 53
340 Predicting High-Risk Endometrioid Endometrial Carcinomas Using Protein Markers

Authors: Yuexin Liu, Gordon B. Mills, Russell R. Broaddus, John N. Weinstein

Abstract:

The lethality of endometrioid endometrial cancer (EEC) is primarily attributable to the high-stage diseases. However, there are no available biomarkers that predict EEC patient staging at the time of diagnosis. We aim to develop a predictive scheme to help in this regards. Using reverse-phase protein array expression profiles for 210 EEC cases from The Cancer Genome Atlas (TCGA), we constructed a Protein Scoring of EEC Staging (PSES) scheme for surgical stage prediction. We validated and evaluated its diagnostic potential in an independent cohort of 184 EEC cases obtained at MD Anderson Cancer Center (MDACC) using receiver operating characteristic curve analyses. Kaplan-Meier survival analysis was used to examine the association of PSES score with patient outcome, and Ingenuity pathway analysis was used to identify relevant signaling pathways. Two-sided statistical tests were used. PSES robustly distinguished high- from low-stage tumors in the TCGA cohort (area under the ROC curve [AUC]=0.74; 95% confidence interval [CI], 0.68 to 0.82) and in the validation cohort (AUC=0.67; 95% CI, 0.58 to 0.76). Even among grade 1 or 2 tumors, PSES was significantly higher in high- than in low-stage tumors in both the TCGA (P = 0.005) and MDACC (P = 0.006) cohorts. Patients with positive PSES score had significantly shorter progression-free survival than those with negative PSES in the TCGA (hazard ratio [HR], 2.033; 95% CI, 1.031 to 3.809; P = 0.04) and validation (HR, 3.306; 95% CI, 1.836 to 9.436; P = 0.0007) cohorts. The ErbB signaling pathway was most significantly enriched in the PSES proteins and downregulated in high-stage tumors. PSES may provide clinically useful prediction of high-risk tumors and offer new insights into tumor biology in EEC.

Keywords: endometrial carcinoma, protein, protein scoring of EEC staging (PSES), stage

Procedia PDF Downloads 197
339 Public Preferences for Lung Cancer Screening in China: A Discrete Choice Experiment

Authors: Zixuan Zhao, Lingbin Du, Le Wang, Youqing Wang, Yi Yang, Jingjun Chen, Hengjin Dong

Abstract:

Objectives: Few results from public attitudes for lung cancer screening are available both in China and abroad. This study aimed to identify preferred lung cancer screening modalities in a Chinese population and predict uptake rates of different modalities. Materials and Methods: A discrete choice experiment questionnaire was administered to 392 Chinese individuals aged 50–74 years who were at high risk for lung cancer. Each choice set had two lung screening options and an option to opt-out, and respondents were asked to choose the most preferred one. Both mixed logit analysis and stepwise logistic analysis were conducted to explore whether preferences were related to respondent characteristics and identify which kinds of respondents were more likely to opt out of any screening. Results: On mixed logit analysis, attributes that were predictive of choice at 1% level of statistical significance included the screening interval, screening venue, and out-of-pocket costs. The preferred screening modality seemed to be screening by low-dose computed tomography (LDCT) + blood test once a year in a general hospital at a cost of RMB 50; this could increase the uptake rate by 0.40 compared to the baseline setting. On stepwise logistic regression, those with no endowment insurance were more likely to opt out; those who were older and housewives/househusbands, and those with a health check habit and with commercial endowment insurance were less likely to opt out from a screening programme. Conclusions: There was considerable variance between real risk and self-perceived risk of lung cancer among respondents, and further research is required in this area. Lung cancer screening uptake can be increased by offering various screening modalities, so as to help policymakers further design the screening modality.

Keywords: lung cancer, screening, China., discrete choice experiment

Procedia PDF Downloads 219
338 Diabetes Mellitus and Blood Glucose Variability Increases the 30-day Readmission Rate after Kidney Transplantation

Authors: Harini Chakkera

Abstract:

Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

Procedia PDF Downloads 45
337 Recent Developments in the Application of Deep Learning to Stock Market Prediction

Authors: Shraddha Jain Sharma, Ratnalata Gupta

Abstract:

Predicting stock movements in the financial market is both difficult and rewarding. Analysts and academics are increasingly using advanced approaches such as machine learning techniques to anticipate stock price patterns, thanks to the expanding capacity of computing and the recent advent of graphics processing units and tensor processing units. Stock market prediction is a type of time series prediction that is incredibly difficult to do since stock prices are influenced by a variety of financial, socioeconomic, and political factors. Furthermore, even minor mistakes in stock market price forecasts can result in significant losses for companies that employ the findings of stock market price prediction for financial analysis and investment. Soft computing techniques are increasingly being employed for stock market prediction due to their better accuracy than traditional statistical methodologies. The proposed research looks at the need for soft computing techniques in stock market prediction, the numerous soft computing approaches that are important to the field, past work in the area with their prominent features, and the significant problems or issue domain that the area involves. For constructing a predictive model, the major focus is on neural networks and fuzzy logic. The stock market is extremely unpredictable, and it is unquestionably tough to correctly predict based on certain characteristics. This study provides a complete overview of the numerous strategies investigated for high accuracy prediction, with a focus on the most important characteristics.

Keywords: stock market prediction, artificial intelligence, artificial neural networks, fuzzy logic, accuracy, deep learning, machine learning, stock price, trading volume

Procedia PDF Downloads 59
336 Computational Intelligence and Machine Learning for Urban Drainage Infrastructure Asset Management

Authors: Thewodros K. Geberemariam

Abstract:

The rapid physical expansion of urbanization coupled with aging infrastructure presents a unique decision and management challenges for many big city municipalities. Cities must therefore upgrade and maintain the existing aging urban drainage infrastructure systems to keep up with the demands. Given the overall contribution of assets to municipal revenue and the importance of infrastructure to the success of a livable city, many municipalities are currently looking for a robust and smart urban drainage infrastructure asset management solution that combines management, financial, engineering and technical practices. This robust decision-making shall rely on sound, complete, current and relevant data that enables asset valuation, impairment testing, lifecycle modeling, and forecasting across the multiple asset portfolios. On this paper, predictive computational intelligence (CI) and multi-class machine learning (ML) coupled with online, offline, and historical record data that are collected from an array of multi-parameter sensors are used for the extraction of different operational and non-conforming patterns hidden in structured and unstructured data to determine and produce actionable insight on the current and future states of the network. This paper aims to improve the strategic decision-making process by identifying all possible alternatives; evaluate the risk of each alternative, and choose the alternative most likely to attain the required goal in a cost-effective manner using historical and near real-time urban drainage infrastructure data for urban drainage infrastructures assets that have previously not benefited from computational intelligence and machine learning advancements.

Keywords: computational intelligence, machine learning, urban drainage infrastructure, machine learning, classification, prediction, asset management space

Procedia PDF Downloads 117
335 Predictive Factors of Healthcare-Associated Infections and Antibiotic Use Patterns: A Cross-Sectional Survey at the Charles Nicolle Hospital of Tunis

Authors: Nouira Mariem, Ennigrou Samir

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

Procedia PDF Downloads 49
334 Predictors of Pelvic Vascular Injuries in Patients with Pelvic Fractures from Major Blunt Trauma

Authors: Osama Zayed

Abstract:

Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

Procedia PDF Downloads 314
333 Energy Storage in the Future of Ethiopia Renewable Electricity Grid System

Authors: Dawit Abay Tesfamariam

Abstract:

Ethiopia’s Climate- Resilient Green Economy strategy focuses mainly on generating and utilization of Renewable Energy (RE). The data collected in 2016 by Ethiopian Electric Power (EEP) indicates that the intermittent RE sources on the grid from solar and wind energy were only 8 % of the total energy produced. On the other hand, the EEP electricity generation plan in 2030 indicates that 36 % of the energy generation share will be covered by solar and wind sources. Thus, a case study was initiated to model and compute the balance and consumption of electricity in three different scenarios: 2016, 2025, and 2030 using the Energy PLAN Model (EPM). Initially, the model was validated using the 2016 annual power-generated data to conduct the EPM analysis for two predictive scenarios. The EPM simulation analysis using EPM for 2016 showed that there was no significant excess power generated. Hence, the model’s results are in line with the actual 2016 output. Thus, the EPM was applied to analyze the role of energy storage in RE in Ethiopian grid systems. The results of the EPM simulation analysis showed there will be excess production of 402 /7963 MW average and maximum, respectively, in 2025. The excess power was dominant in all months except in the three rainy months of the year (June, July, and August). Consequently, based on the validated outcomes of EPM indicates, there is a good reason to think about other alternatives for the utilization of excess energy and storage of RE. Thus, from the scenarios and model results obtained, it is realistic to infer that; if the excess power is utilized with a storage mechanism that can stabilize the grid system; as a result, the extra RE generated can be exported to support the economy. Therefore, researchers must continue to upgrade the current and upcoming energy storage system to synchronize with RE potentials that can be generated from RE.

Keywords: renewable energy, storage, wind, energyplan

Procedia PDF Downloads 47
332 Analyzing the Influence of Hydrometeorlogical Extremes, Geological Setting, and Social Demographic on Public Health

Authors: Irfan Ahmad Afip

Abstract:

This main research objective is to accurately identify the possibility for a Leptospirosis outbreak severity of a certain area based on its input features into a multivariate regression model. The research question is the possibility of an outbreak in a specific area being influenced by this feature, such as social demographics and hydrometeorological extremes. If the occurrence of an outbreak is being subjected to these features, then the epidemic severity for an area will be different depending on its environmental setting because the features will influence the possibility and severity of an outbreak. Specifically, this research objective was three-fold, namely: (a) to identify the relevant multivariate features and visualize the patterns data, (b) to develop a multivariate regression model based from the selected features and determine the possibility for Leptospirosis outbreak in an area, and (c) to compare the predictive ability of multivariate regression model and machine learning algorithms. Several secondary data features were collected locations in the state of Negeri Sembilan, Malaysia, based on the possibility it would be relevant to determine the outbreak severity in the area. The relevant features then will become an input in a multivariate regression model; a linear regression model is a simple and quick solution for creating prognostic capabilities. A multivariate regression model has proven more precise prognostic capabilities than univariate models. The expected outcome from this research is to establish a correlation between the features of social demographic and hydrometeorological with Leptospirosis bacteria; it will also become a contributor for understanding the underlying relationship between the pathogen and the ecosystem. The relationship established can be beneficial for the health department or urban planner to inspect and prepare for future outcomes in event detection and system health monitoring.

Keywords: geographical information system, hydrometeorological, leptospirosis, multivariate regression

Procedia PDF Downloads 83
331 Preliminary Studies of Transient Stability for the 380 kV Connection West-Central of Saudi Electricity Company

Authors: S. Raja Mohamed, M. H Shwehdi, D. Devaraj

Abstract:

This paper is to present and discuss the new planned 380 kV transmission line performance under steady and transient states. Dynamic modeling and analysis of such inter-tie, which is, proposed to transfer energy from west to south and vice versa will be demonstrated and discussed. The west-central-south inter-tie links Al-Aula-Zaba-Tabuk-Tubajal-Jawf-Hail. It is essential to investigate the transient over-voltage to assure steady and stable transmission over such inter-tie. Saudi Electricity Company (SEC) has been improving its grid to make the whole country as an interconnected system. Already east, central and west were interconnected, yet mostly each is fed with its local generation. The SEC is planning to establish many inter-ties to strengthen the transient stability of its grid. The paper studies one of the important links of 380 kV, 220 km between Tabouk and Tubarjal, which is a step towards connecting the West with the South region. Modeling and analysis using some softwares will be utilized under different scenarios. Adoption of methods to stabilize and increase its power transmission are also discussed. Improvement of power system transients has been controlled by FACTS elements such the Static Var Compensators (SVC) receiving a wide interest since many technical studies have proven their effects on damping system oscillations and stability enhancement. Illustrations of the transient at each main generating or load bus will be checked in all inter-tie links. A brief review of possible means to solve the transient over-voltage problem using different FACTS element modeling will be discussed.

Keywords: transient stability, static var compensator, central-west interconnected system, damping controller, Saudi Electricity Company

Procedia PDF Downloads 575
330 Pulmonary Embolism Indicative of Myxoma of the Right Atrium

Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

Abstract:

Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

Procedia PDF Downloads 110
329 Urine Neutrophil Gelatinase-Associated Lipocalin as an Early Marker of Acute Kidney Injury in Hematopoietic Stem Cell Transplantation Patients

Authors: Sara Ataei, Maryam Taghizadeh-Ghehi, Amir Sarayani, Asieh Ashouri, Amirhossein Moslehi, Molouk Hadjibabaie, Kheirollah Gholami

Abstract:

Background: Acute kidney injury (AKI) is common in hematopoietic stem cell transplantation (HSCT) patients with an incidence of 21–73%. Prevention and early diagnosis reduces the frequency and severity of this complication. Predictive biomarkers are of major importance to timely diagnosis. Neutrophil gelatinase associated lipocalin (NGAL) is a widely investigated novel biomarker for early diagnosis of AKI. However, no study assessed NGAL for AKI diagnosis in HSCT patients. Methods: We performed further analyses on gathered data from our recent trial to evaluate the performance of urine NGAL (uNGAL) as an indicator of AKI in 72 allogeneic HSCT patients. AKI diagnosis and severity were assessed using Risk–Injury–Failure–Loss–End-stage renal disease and AKI Network criteria. We assessed uNGAL on days -6, -3, +3, +9 and +15. Results: Time-dependent Cox regression analysis revealed a statistically significant relationship between uNGAL and AKI occurrence. (HR=1.04 (1.008-1.07), P=0.01). There was a relation between uNGAL day +9 to baseline ratio and incidence of AKI (unadjusted HR=.1.047(1.012-1.083), P<0.01). The area under the receiver-operating characteristic curve for day +9 to baseline ratio was 0.86 (0.74-0.99, P<0.01) and a cut-off value of 2.62 was 85% sensitive and 83% specific in predicting AKI. Conclusions: Our results indicated that increase in uNGAL augmented the risk of AKI and the changes of day +9 uNGAL concentrations from baseline could be of value for predicting AKI in HSCT patients. Additionally uNGAL changes preceded serum creatinine rises by nearly 2 days.

Keywords: acute kidney injury, hemtopoietic stem cell transplantation, neutrophil gelatinase-associated lipocalin, Receiver-operating characteristic curve

Procedia PDF Downloads 377
328 Induced Affectivity and Impact on Creativity: Personal Growth and Perceived Adjustment when Narrating an Intense Emotional Experience

Authors: S. Da Costa, D. Páez, F. Sánchez

Abstract:

We examine the causal role of positive affect on creativity, the association of creativity or innovation in the ideation phase with functional emotional regulation, successful adjustment to stress and dispositional emotional creativity, as well as the predictive role of creativity for positive emotions and social adjustment. The study examines the effects of modification of positive affect on creativity. Participants write three poems, narrate an infatuation episode, answer a scale of personal growth after this episode and perform a creativity task, answer a flow scale after creativity task and fill a dispositional emotional creativity scale. High and low positive effect was induced by asking subjects to write three poems about high and low positive connotation stimuli. In a neutral condition, tasks were performed without previous affect induction. Subjects on the condition of high positive affect report more positive and less negative emotions, more personal growth (effect size r = .24) and their last poem was rated as more original by judges (effect size r = .33). Mediational analysis showed that positive emotions explain the influence of the manipulation on personal growth - positive affect correlates r = .33 to personal growth. The emotional creativity scale correlated to creativity scores of the creative task (r = .14), to the creativity of the narration of the infatuation episode (r = .21). Emotional creativity was also associated, during performing the creativity task, with flow (r = .27) and with affect balance (r = .26). The mediational analysis showed that emotional creativity predicts flow through positive affect. Results suggest that innovation in the phase of ideation is associated with a positive affect balance and satisfactory performance, as well as dispositional emotional creativity is adaptive.

Keywords: affectivity, creativity, induction, innovation, psychological factors

Procedia PDF Downloads 80
327 Normalizing Flow to Augmented Posterior: Conditional Density Estimation with Interpretable Dimension Reduction for High Dimensional Data

Authors: Cheng Zeng, George Michailidis, Hitoshi Iyatomi, Leo L. Duan

Abstract:

The conditional density characterizes the distribution of a response variable y given other predictor x and plays a key role in many statistical tasks, including classification and outlier detection. Although there has been abundant work on the problem of Conditional Density Estimation (CDE) for a low-dimensional response in the presence of a high-dimensional predictor, little work has been done for a high-dimensional response such as images. The promising performance of normalizing flow (NF) neural networks in unconditional density estimation acts as a motivating starting point. In this work, the authors extend NF neural networks when external x is present. Specifically, they use the NF to parameterize a one-to-one transform between a high-dimensional y and a latent z that comprises two components [zₚ, zₙ]. The zₚ component is a low-dimensional subvector obtained from the posterior distribution of an elementary predictive model for x, such as logistic/linear regression. The zₙ component is a high-dimensional independent Gaussian vector, which explains the variations in y not or less related to x. Unlike existing CDE methods, the proposed approach coined Augmented Posterior CDE (AP-CDE) only requires a simple modification of the common normalizing flow framework while significantly improving the interpretation of the latent component since zₚ represents a supervised dimension reduction. In image analytics applications, AP-CDE shows good separation of 𝑥-related variations due to factors such as lighting condition and subject id from the other random variations. Further, the experiments show that an unconditional NF neural network based on an unsupervised model of z, such as a Gaussian mixture, fails to generate interpretable results.

Keywords: conditional density estimation, image generation, normalizing flow, supervised dimension reduction

Procedia PDF Downloads 65
326 Analysis of Surface Hardness, Surface Roughness and near Surface Microstructure of AISI 4140 Steel Worked with Turn-Assisted Deep Cold Rolling Process

Authors: P. R. Prabhu, S. M. Kulkarni, S. S. Sharma, K. Jagannath, Achutha Kini U.

Abstract:

In the present study, response surface methodology has been used to optimize turn-assisted deep cold rolling process of AISI 4140 steel. A regression model is developed to predict surface hardness and surface roughness using response surface methodology and central composite design. In the development of predictive model, deep cold rolling force, ball diameter, initial roughness of the workpiece, and number of tool passes are considered as model variables. The rolling force and the ball diameter are the significant factors on the surface hardness and ball diameter and numbers of tool passes are found to be significant for surface roughness. The predicted surface hardness and surface roughness values and the subsequent verification experiments under the optimal operating conditions confirmed the validity of the predicted model. The absolute average error between the experimental and predicted values at the optimal combination of parameter settings for surface hardness and surface roughness is calculated as 0.16% and 1.58% respectively. Using the optimal processing parameters, the hardness is improved from 225 to 306 HV, which resulted in an increase in the near surface hardness by about 36% and the surface roughness is improved from 4.84µm to 0.252 µm, which resulted in decrease in the surface roughness by about 95%. The depth of compression is found to be more than 300µm from the microstructure analysis and this is in correlation with the results obtained from the microhardness measurements. Taylor Hobson Talysurf tester, micro Vickers hardness tester, optical microscopy and X-ray diffractometer are used to characterize the modified surface layer.

Keywords: hardness, response surface methodology, microstructure, central composite design, deep cold rolling, surface roughness

Procedia PDF Downloads 384
325 Facilitating Written Biology Assessment in Large-Enrollment Courses Using Machine Learning

Authors: Luanna B. Prevost, Kelli Carter, Margaurete Romero, Kirsti Martinez

Abstract:

Writing is an essential scientific practice, yet, in several countries, the increasing university science class-size limits the use of written assessments. Written assessments allow students to demonstrate their learning in their own words and permit the faculty to evaluate students’ understanding. However, the time and resources required to grade written assessments prohibit their use in large-enrollment science courses. This study examined the use of machine learning algorithms to automatically analyze student writing and provide timely feedback to the faculty about students' writing in biology. Written responses to questions about matter and energy transformation were collected from large-enrollment undergraduate introductory biology classrooms. Responses were analyzed using the LightSide text mining and classification software. Cohen’s Kappa was used to measure agreement between the LightSide models and human raters. Predictive models achieved agreement with human coding of 0.7 Cohen’s Kappa or greater. Models captured that when writing about matter-energy transformation at the ecosystem level, students focused on primarily on the concepts of heat loss, recycling of matter, and conservation of matter and energy. Models were also produced to capture writing about processes such as decomposition and biochemical cycling. The models created in this study can be used to provide automatic feedback about students understanding of these concepts to biology faculty who desire to use formative written assessments in larger enrollment biology classes, but do not have the time or personnel for manual grading.

Keywords: machine learning, written assessment, biology education, text mining

Procedia PDF Downloads 249
324 Harmonic Assessment and Mitigation in Medical Diagonesis Equipment

Authors: S. S. Adamu, H. S. Muhammad, D. S. Shuaibu

Abstract:

Poor power quality in electrical power systems can lead to medical equipment at healthcare centres to malfunction and present wrong medical diagnosis. Equipment such as X-rays, computerized axial tomography, etc. can pollute the system due to their high level of harmonics production, which may cause a number of undesirable effects like heating, equipment damages and electromagnetic interferences. The conventional approach of mitigation uses passive inductor/capacitor (LC) filters, which has some drawbacks such as, large sizes, resonance problems and fixed compensation behaviours. The current trends of solutions generally employ active power filters using suitable control algorithms. This work focuses on assessing the level of Total Harmonic Distortion (THD) on medical facilities and various ways of mitigation, using radiology unit of an existing hospital as a case study. The measurement of the harmonics is conducted with a power quality analyzer at the point of common coupling (PCC). The levels of measured THD are found to be higher than the IEEE 519-1992 standard limits. The system is then modelled as a harmonic current source using MATLAB/SIMULINK. To mitigate the unwanted harmonic currents a shunt active filter is developed using synchronous detection algorithm to extract the fundamental component of the source currents. Fuzzy logic controller is then developed to control the filter. The THD without the active power filter are validated using the measured values. The THD with the developed filter show that the harmonics are now within the recommended limits.

Keywords: power quality, total harmonics distortion, shunt active filters, fuzzy logic

Procedia PDF Downloads 451
323 Dual Set Point Governor Control Structure with Common Optimum Temporary Droop Settings for both Islanded and Grid Connected Modes

Authors: Deepen Sharma, Eugene F. Hill

Abstract:

For nearly 100 years, hydro-turbine governors have operated with only a frequency set point. This natural governor action means that the governor responds with changing megawatt output to disturbances in system frequency. More and more, power system managers are demanding that governors operate with constant megawatt output. One way of doing this is to introduce a second set point in the control structure called a power set point. The control structure investigated and analyzed in this paper is unique in the way that it utilizes a power reference set point in addition to the conventional frequency reference set point. An optimum set of temporary droop parameters derived based on the turbine-generator inertia constant and the penstock water start time for stable islanded operation are shown to be also equally applicable for a satisfactory rate of generator loading during its grid connected mode. A theoretical development shows why this is the case. The performance of the control structure has been investigated and established based on the simulation study made in MATLAB/Simulink as well as through testing the real time controller performance on a 15 MW Kaplan Turbine and generator. Recordings have been made using the labVIEW data acquisition platform. The hydro-turbine governor control structure and its performance investigated in this paper thus eliminates the need to have a separate set of temporary droop parameters, one valid for islanded mode and the other for interconnected operations mode.

Keywords: frequency set point, hydro governor, interconnected operation, isolated operation, power set point

Procedia PDF Downloads 345
322 Measurement of Sarcopenia Associated with the Extent of Gastrointestinal Oncological Disease

Authors: Adrian Hang Yue Siu, Matthew Holyland, Sharon Carey, Daniel Steffens, Nabila Ansari, Cherry E. Koh

Abstract:

Introduction: Peritoneal malignancies are challenging cancers to manage. While cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) may offer a cure, it’s considered radical and morbid. Pre-emptive identification of deconditioned patients for optimization may mitigate the risks of surgery. However, the difficulty lies in the scarcity of validated predictive tools to identify high-risk patients. In recent times, there has been growing interest in sarcopenia, which can occur as a result of malnutrition and malignancies. Therefore, the purpose of this study was to assess the utility of sarcopenia in predicting post-operative outcomes. Methods: A single quaternary-center retrospective study of CRS and HIPEC patients between 2017-2020 was conducted to determine the association between pre-operative sarcopenia and post-operative outcomes. Lumbar CT images were analyzed using Slice-o-matic® to measure sarcopenia. Results : Cohort (n=94) analysis found that 40% had sarcopenia, with a majority being female (53.2%) and a mean age of 55 years. Sarcopenia was statistically associated with decreased weight compared to non-sarcopenia patients, 72.7kg vs. 82.2kg (p=0.014) and shorter overall survival, 1.4 years vs. 2.1 years (p=0.032). Post-operatively, patients with sarcopenia experienced more post-operative complications (p=0.001). Conclusion: Complex procedures often require optimization to prevent complications and improve survival. While patient biomarkers – BMI and weight – are used for optimization, this research advocates for the identification of sarcopenia status for pre-operative planning. Sarcopenia may be an indicator of advanced disease requiring further treatment and is an emerging area of research. Larger studies are required to confirm these findings and to assess the reversibility of sarcopenia after surgery.

Keywords: sarcopaenia, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, surgical oncology

Procedia PDF Downloads 51
321 Functional Connectivity Signatures of Polygenic Depression Risk in Youth

Authors: Louise Moles, Steve Riley, Sarah D. Lichenstein, Marzieh Babaeianjelodar, Robert Kohler, Annie Cheng, Corey Horien Abigail Greene, Wenjing Luo, Jonathan Ahern, Bohan Xu, Yize Zhao, Chun Chieh Fan, R. Todd Constable, Sarah W. Yip

Abstract:

Background: Risks for depression are myriad and include both genetic and brain-based factors. However, relationships between these systems are poorly understood, limiting understanding of disease etiology, particularly at the developmental level. Methods: We use a data-driven machine learning approach connectome-based predictive modeling (CPM) to identify functional connectivity signatures associated with polygenic risk scores for depression (DEP-PRS) among youth from the Adolescent Brain and Cognitive Development (ABCD) study across diverse brain states, i.e., during resting state, during affective working memory, during response inhibition, during reward processing. Results: Using 10-fold cross-validation with 100 iterations and permutation testing, CPM identified connectivity signatures of DEP-PRS across all examined brain states (rho’s=0.20-0.27, p’s<.001). Across brain states, DEP-PRS was positively predicted by increased connectivity between frontoparietal and salience networks, increased motor-sensory network connectivity, decreased salience to subcortical connectivity, and decreased subcortical to motor-sensory connectivity. Subsampling analyses demonstrated that model accuracies were robust across random subsamples of N’s=1,000, N’s=500, and N’s=250 but became unstable at N’s=100. Conclusions: These data, for the first time, identify neural networks of polygenic depression risk in a large sample of youth before the onset of significant clinical impairment. Identified networks may be considered potential treatment targets or vulnerability markers for depression risk.

Keywords: genetics, functional connectivity, pre-adolescents, depression

Procedia PDF Downloads 21
320 Hardware-In-The-Loop Relative Motion Control: Theory, Simulation and Experimentation

Authors: O. B. Iskender, K. V. Ling, V. Dubanchet, L. Simonini

Abstract:

This paper presents a Guidance and Control (G&C) strategy to address spacecraft maneuvering problem for future Rendezvous and Docking (RVD) missions. The proposed strategy allows safe and propellant efficient trajectories for space servicing missions including tasks such as approaching, inspecting and capturing. This work provides the validation test results of the G&C laws using a Hardware-In-the-Loop (HIL) setup with two robotic mockups representing the chaser and the target spacecraft. Through this paper, the challenges of the relative motion control in space are first summarized, and in particular, the constraints imposed by the mission, spacecraft and, onboard processing capabilities. Second, the proposed algorithm is introduced by presenting the formulation of constrained Model Predictive Control (MPC) to optimize the fuel consumption and explicitly handle the physical and geometric constraints in the system, e.g. thruster or Line-Of-Sight (LOS) constraints. Additionally, the coupling between translational motion and rotational motion is addressed via dual quaternion based kinematic description and accordingly explained. The resulting convex optimization problem allows real-time implementation capability based on a detailed discussion on the computational time requirements and the obtained results with respect to the onboard computer and future trends of space processors capabilities. Finally, the performance of the algorithm is presented in the scope of a potential future mission and of the available equipment. The results also cover a comparison between the proposed algorithms with Linear–quadratic regulator (LQR) based control law to highlight the clear advantages of the MPC formulation.

Keywords: autonomous vehicles, embedded optimization, real-time experiment, rendezvous and docking, space robotics

Procedia PDF Downloads 95
319 Improving Pneumatic Artificial Muscle Performance Using Surrogate Model: Roles of Operating Pressure and Tube Diameter

Authors: Van-Thanh Ho, Jaiyoung Ryu

Abstract:

In soft robotics, the optimization of fluid dynamics through pneumatic methods plays a pivotal role in enhancing operational efficiency and reducing energy loss. This is particularly crucial when replacing conventional techniques such as cable-driven electromechanical systems. The pneumatic model employed in this study represents a sophisticated framework designed to efficiently channel pressure from a high-pressure reservoir to various muscle locations on the robot's body. This intricate network involves a branching system of tubes. The study introduces a comprehensive pneumatic model, encompassing the components of a reservoir, tubes, and Pneumatically Actuated Muscles (PAM). The development of this model is rooted in the principles of shock tube theory. Notably, the study leverages experimental data to enhance the understanding of the interplay between the PAM structure and the surrounding fluid. This improved interactive approach involves the use of morphing motion, guided by a contraction function. The study's findings demonstrate a high degree of accuracy in predicting pressure distribution within the PAM. The model's predictive capabilities ensure that the error in comparison to experimental data remains below a threshold of 10%. Additionally, the research employs a machine learning model, specifically a surrogate model based on the Kriging method, to assess and quantify uncertainty factors related to the initial reservoir pressure and tube diameter. This comprehensive approach enhances our understanding of pneumatic soft robotics and its potential for improved operational efficiency.

Keywords: pneumatic artificial muscles, pressure drop, morhing motion, branched network, surrogate model

Procedia PDF Downloads 48
318 Frequency Control of Self-Excited Induction Generator Based Microgrid during Transition from Grid Connected to Island Mode

Authors: Azhar Ulhaq, Zubair Yameen, Almas Anjum

Abstract:

Frequency behaviour of self-excited induction generator (SEIG) wind turbines during control mode transition from grid connected to islanded mode is studied in detail. A robust control scheme for frequency regulation based on combined action of STATCOM, energy storage system (ESS) and pitch angle control for wind powered microgrid (MG) is proposed. Suggested STATCOM controller comprises a 3-phase voltage source converter (VSC) that contains insulated gate bipolar transistors (IGBTs) based pulse width modulation (PWM) inverters along with a capacitor bank. Energy storage system control consists of current controlled voltage source converter and battery bank. Both of them acting simultaneously after detection of island compensates for reactive and active power demands, thus regulating frequency at point of common coupling (PCC) and also improves load stability. STATCOM integrates at point of common coupling and ESS is connected to microgrids main bus. Results reveal that proposed control not only stabilizes frequency during transition duration but also minimizes sudden frequency imbalance caused by load variation or wind intermittencies in islanded operation. System is investigated with and without suggested control scheme. The efficacy of proposed strategy has been verified by simulation in MATLAB/Simulink.

Keywords: energy storage system, island, wind, STATCOM, self-excited induction generator, SEIG, transient

Procedia PDF Downloads 124
317 Evaluation of the Analytic for Hemodynamic Instability as a Prediction Tool for Early Identification of Patient Deterioration

Authors: Bryce Benson, Sooin Lee, Ashwin Belle

Abstract:

Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

Procedia PDF Downloads 157
316 Hybrid Velocity Control Approach for Tethered Aerial Vehicle

Authors: Lovesh Goyal, Pushkar Dave, Prajyot Jadhav, GonnaYaswanth, Sakshi Giri, Sahil Dharme, Rushika Joshi, Rishabh Verma, Shital Chiddarwar

Abstract:

With the rising need for human-robot interaction, researchers have proposed and tested multiple models with varying degrees of success. A few of these models performed on aerial platforms are commonly known as Tethered Aerial Systems. These aerial vehicles may be powered continuously by a tether cable, which addresses the predicament of the short battery life of quadcopters. This system finds applications to minimize humanitarian efforts for industrial, medical, agricultural, and service uses. However, a significant challenge in employing such systems is that it necessities attaining smooth and secure robot-human interaction while ensuring that the forces from the tether remain within the standard comfortable range for the humans. To tackle this problem, a hybrid control method that could switch between two control techniques: constant control input and the steady-state solution, is implemented. The constant control approach is implemented when a person is far from the target location, and error is thought to be eventually constant. The controller switches to the steady-state approach when the person reaches within a specific range of the goal position. Both strategies take into account human velocity feedback. This hybrid technique enhances the outcomes by assisting the person to reach the desired location while decreasing the human's unwanted disturbance throughout the process, thereby keeping the interaction between the robot and the subject smooth.

Keywords: unmanned aerial vehicle, tethered system, physical human-robot interaction, hybrid control

Procedia PDF Downloads 71
315 Distributed Leadership and Emergency Response: A Study on Seafarers

Authors: Delna Shroff

Abstract:

Merchant shipping is an occupation with a high rate of fatal injuries caused by organizational accidents and maritime disasters. In most accident investigations, the leader’s actions are under scrutiny and point out the necessity to investigate the leader’s decisions in critical conditions. While several leadership studies have been carried out in the past, there is a tendency for most research to focus on holders of formal positions. The unit of analysis in most studies has been the ‘individual.’ A need is, therefore, felt to adopt a practice-based perspective of leadership, understand how leadership emerges to affect maritime safety. This paper explores the phenomenon of distributed leadership among seafarers more holistically. It further examines the role of one form of distributed leadership, that is, planfully aligned leadership in the emergency response of the team. A mixed design will be applied. In the first phase, the data gathered by way of semi-structured interviews will be used to explore the seafarer’s implicit understanding of leadership. The data will be used to develop a conceptual framework of distributed leadership, specific to the maritime context. This framework will be used to develop a simulation. Experimental design will be used to examine the relationship between planfully aligned leadership and emergency response of the team members during navigation. Findings show that planfully aligned leadership significantly and positively predicts the emergency response of team members. Planfully aligned leadership leads to a better emergency response of the team members as compared to authoritarian leadership. In the third qualitative phase, additional data will be gathered through semi-structured interviews to further validate the findings to gain a more complete understanding of distributed leadership and its relation to emergency response. Above are the predictive results; the study expects to be a cornerstone of safety leadership research and has important implications for leadership development and training within the maritime industry.

Keywords: authoritarian leadership, distributed leadership, emergency response , planfully aligned leadership

Procedia PDF Downloads 137