Search results for: standardized protocols

Authors: Kumar Kanudkuri, A. Sandhya

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Typically, in a MRI clinical setting, there are several protocols run, each indicated for a specific anatomy and disease condition. However, these protocols or parameters within them can change over time due to changes to the recommendations by the physician groups or updates in the software or by the availability of new technologies. Most of the time, the changes are performed by the MRI technologist to account for either time, coverage, physiological, or Specific Absorbtion Rate (SAR ) reasons. However, giving properly guidelines to MRI technologist is important so that they do not change the parameters that negatively impact the image quality. Typically a standard American College of Radiology (ACR) MRI phantom is used for Quality Control (QC) in order to guarantee that the primary objectives of MRI are met. The visual evaluation of quality depends on the operator/reviewer and might change amongst operators as well as for the same operator at various times. Therefore, overcoming these constraints is essential for a more impartial evaluation of quality. This makes quantitative estimation of image quality (IQ) metrics for MRI quality control is very important. So in order to solve this problem, we proposed that there is a need for a robust, open-source, and automated MRI image control tool. The Designed and developed an automatic analysis tool for measuring MRI image quality (IQ) metrics like Signal to Noise Ratio (SNR), Signal to Noise Ratio Uniformity (SNRU), Visual Information Fidelity (VIF), Feature Similarity (FSIM), Gray level co-occurrence matrix (GLCM), slice thickness accuracy, slice position accuracy, High contrast spatial resolution) provided good accuracy assessment. A standardized quality report has generated that incorporates metrics that impact diagnostic quality.

Keywords: ACR MRI phantom, MRI image quality metrics, SNRU, VIF, FSIM, GLCM, slice thickness accuracy, slice position accuracy

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Authors: Anu Malhotra

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An Ad-hoc network is one that is an autonomous, self configuring network made up of mobile nodes connected via wireless links. Ad-hoc networks often consist of nodes, mobile hosts (MH) or mobile stations (MS, also serving as routers) connected by wireless links. Different routing protocols are used for data transmission in between the nodes in an adhoc network. In this paper two protocols (OLSR and AODV) are analyzed on the basis of two parameters i.e. time delay and throughput with different data rates. On the basis of these analysis, we observed that with same data rate, AODV protocol is having more time delay than the OLSR protocol whereas throughput for the OLSR protocol is less compared to the AODV protocol.

Keywords: routing adhoc, mobile hosts, mobile stations, OLSR protocol, AODV protocol

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Authors: Ramin Karimi

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One of common highly mobile wireless ad hoc networks is Vehicular Ad Hoc Networks. Hence routing in vehicular ad hoc network (VANET) has attracted much attention during the last few years. VANET is characterized by its high mobility of nodes and specific topology patterns. Moreover these networks encounter a significant loss rate and a very short duration of communication. In vehicular ad hoc networks, one of challenging is routing of data due to high speed mobility and changing topology of vehicles. Geographic routing protocols are becoming popular due to advancement and availability of GPS devices. Delay Tolerant Networks (DTNs) are a class of networks that enable communication where connectivity issues like sparse connectivity, intermittent connectivity; high latency, long delay, high error rates, asymmetric data rate, and even no end-to-end connectivity exist. In this paper, we review the existing Geographic Routing Protocols for VANETs and also provide a qualitative comparison of them.

Keywords: vehicular ad hoc networks, mobility, geographic routing, delay tolerant networks

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Authors: Georgi Bebrov, Rozalina Dimova

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In the field of quantum secure communication, there is no evaluation that characterizes quantum secure communication (QSC) protocols in a complete, general manner. The current paper addresses the problem concerning the lack of such an evaluation for QSC protocols by introducing an optimality evaluation, which is expressed as the average over the three main parameters of QSC protocols: efficiency, security, and practicality. For the efficiency evaluation, the common expression of this parameter is used, which incorporates all the classical and quantum resources (bits and qubits) utilized for transferring a certain amount of information (bits) in a secure manner. By using criteria approach whether or not certain criteria are met, an expression for the practicality evaluation is presented, which accounts for the complexity of the QSC practical realization. Based on the error rates that the common quantum attacks (Measurement and resend, Intercept and resend, probe attack, and entanglement swapping attack) induce, the security evaluation for a QSC protocol is proposed as the minimum function taken over the error rates of the mentioned quantum attacks. For the sake of clarity, an example is presented in order to show how the optimality is calculated.

Keywords: quantum cryptography, quantum secure communcation, quantum secure direct communcation security, quantum secure direct communcation efficiency, quantum secure direct communcation practicality

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Authors: Raffaele Danilo Esposito, Domingo Planes Meseguer, Maria Del Pilar Dorado Rodriguez

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As far as we know, it is still unavailable a commercial solution which would allow to manage, openly and configurable up to user needs, the huge amount of data generated in a modern Radiation Oncology Department. Currently, available information management systems are mainly focused on Record & Verify and clinical data, and only to a small extent on physical data. Thus, results in a partial and limited use of the actually available information. In the present work we describe the implementation at our department of a centralized information management system based on a web server. Our system manages both information generated during patient planning and treatment, and information of general interest for the whole department (i.e. treatment protocols, quality assurance protocols etc.). Our objective it to be able to analyze in a simple and efficient way all the available data and thus to obtain quantitative evaluations of our treatments. This would allow us to improve our work flow and protocols. To this end we have implemented a relational data base which would allow us to use in a practical and efficient way all the available information. As always we only use license free software.

Keywords: information management system, radiation oncology, medical physics, free software

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Authors: Sachin Sharma

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A wireless sensor network (WSN) consists of a large number of sensor nodes which are deployed over an area to perform local computations based on information gathered from the surroundings. With the increasing demand for real-time applications in WSN, real-time critical events anticipate an efficient quality-of-service (QoS) based routing for data delivery from the network infrastructure. Hence, maximizing the lifetime of the network through minimizing the energy is an important challenge in WSN; sensors cannot be easily replaced or recharged due to their ad-hoc deployment in a hazardous environment. Considerable research has been focused on developing robust energy efficient QoS based routing protocols. The main focus of this article is primarily on periodical cycling schemes which represent the most compatible technique for energy saving and we also focus on the data-driven approaches that can be used to improve the energy efficiency. Finally, we will make a review on some communication protocols proposed for sensor networks.

Keywords: energy efficient, quality of service, wireless sensor networks, MAC

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Authors: Noman Shabbir, Roheel Nawaz, Muhammad N. Iqbal, Junaid Zafar

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This paper focuses on the performance evaluation of routing protocols in WLAN based Wireless Sensor Networks (WSNs). A comparative analysis of routing protocols such as Ad-hoc On-demand Distance Vector Routing System (AODV), Dynamic Source Routing (DSR) and Optimized Link State Routing (OLSR) is been made against different network parameters like network load, end to end delay and throughput in small, medium and large-scale sensor network scenarios to identify the best performing protocol. Simulation results indicate that OLSR gives minimum network load in all three scenarios while AODV gives the best throughput in small scale network but in medium and large scale networks, DSR is better. In terms of delay, OLSR is more efficient in small and medium scale network while AODV is slightly better in large networks.

Keywords: WLAN, WSN, AODV, DSR, OLSR

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Authors: Rozan El-Khateeb

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This literature review examines the effectiveness of therapy programs that utilize play as an intervention for reducing symptoms associated with Autism Spectrum Disorder (ASD). Play-based therapy approaches provide a child-centered and developmentally appropriate framework to address the core symptoms of ASD, including social communication deficits, restricted and repetitive behaviors, and sensory sensitivities. The review explores various play-based therapy strategies and their impact on improving social skills, communication abilities, adaptive behaviors, and overall functioning in individuals with ASD. The findings suggest that play-based therapy programs hold promise as effective interventions for reducing symptoms and enhancing the quality of life for individuals with ASD. However, further research is necessary to establish standardized protocols, identify optimal dosage and duration, and evaluate long-term outcomes.

Keywords: autism, ABA, play, NET, systematic review

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Authors: Victor Toom

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Albeit it is never possible to anticipate the full range of difficulties after a catastrophe, efforts to identify victims of mass casualty events have become institutionalized and standardized with the aim of effectively and efficiently addressing the many challenges and contingencies. Such ‘disaster victim identification’ (DVI) practices are dependent on the forensic sciences, are subject of national legislation, and are reliant on technical and organizational protocols to mitigate the many complexities in the wake of catastrophe. Apart from such technological, legal and bureaucratic elements constituting a DVI operation, victims’ families and their emotions are also part and parcel of any effort to identify casualties of mass human fatality incidents. Take for example the fact that forensic experts require (antemortem) information from the group of relatives to make identification possible. An identified body or body part is also repatriated to kin. Relatives are thus main stakeholders in DVI operations. Much has been achieved in years past regarding facilitating victims’ families’ issues and their emotions. Yet, how families are dealt with by experts and authorities is still considered a difficult topic. Due to sensitivities and required emphatic interaction with families on the one hand, and the rationalized DVI efforts, on the other hand, there is still scope for improving communication, providing information and meaningful inclusion of relatives in the DVI effort. This paper aims to bridge the standardized world of DVI efforts and families’ experienced realities and makes suggestions to further improve DVI efforts through inclusion of victims’ families. Based on qualitative interviews, the paper narrates involvement and experiences of inter alia DVI practitioners, victims’ families, advocates and clergy in the wake of the 1995 Srebrenica genocide which killed approximately 8,000 men, and the 9/11 in New York City with 2,750 victims. The paper shows that there are several models of including victims’ families into a DVI operation, and it argues for a model of where victims’ families become a partner in DVI operations.

Keywords: disaster victim identification (DVI), victims’ families, social science (qualitative), 9/11 attacks, Srebrenica genocide

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Authors: J. E. Jung, J. M. Yang, J. W. Kim

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The railway market across the world has been standardized with the globalization strategy of Europe. On the other hand, the Korean urban railway system is operated by 10 operators which have established their standards and independently managed BOMs. When operators manage different BOMs, lack of system compatibility prevents them from sharing information and hinders work linkage and efficiency. Europe launched a large-scale railway project in 1993 when the European Union went into effect. In particular, the recent standardization efforts of the EU-funded MODTRAIN project are similar to the approach of the urban rail system standardization research that is underway in Korea. This paper looks into the BOMs of Koran urban rail transit operators and suggests the standard BOM for the rail transit system in Korea by reviewing rail vehicle technologies and the MODTRAIN project of Europe. The standard BOM is structured up to the key device level or module level, and it allows vehicle manufacturers and component manufacturers to manage their lower-level BOMs and share them with each other and with operators.

Keywords: BOM, Korean rail, urban rail, standardized

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Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

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Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

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Authors: Panprapa Yongtrakul, Punyaphat Sirithanabadeekul, Pakjira Siriphan

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Background: The thread lift technique has become popular because it is less invasive, requires a shorter operation, less downtime, and results in fewer postoperative complications. The advantage of the technique is that the thread can be inserted under the skin without the need for long incisions. Currently, there are a lot of thread lift techniques with respect to the specific types of thread used on specific areas, such as the mid-face, lower face, or neck area. Objective: To review the thread lift technique for specific areas according to type of thread, patient selection, and how to match the most appropriate to the patient. Materials and Methods: A literature review technique was conducted by searching PubMed and MEDLINE, then compiled and summarized. Result: We have divided our protocols into two sections: Protocols for short suture, and protocols for long suture techniques. We also created 3D pictures for each technique to enhance understanding and application in a clinical setting. Conclusion: There are advantages and disadvantages to short suture and long suture techniques. The best outcome for each patient depends on appropriate patient selection and determining the most suitable technique for the defect and area of patient concern.

Keywords: thread lift, thread lift method, thread lift technique, thread lift procedure, threading

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Authors: Salman Naseer, Usman Zafar, Iqra Zafar

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This study explores the implication of Vehicular Adhoc Network (VANET) - in the rural and urban scenarios that is one domain of Mobile Adhoc Network (MANET). VANET provides wireless communication between vehicle to vehicle and also roadside units. The Federal Commission Committee of United States of American has been allocated 75 MHz of the spectrum band in the 5.9 GHz frequency range for dedicated short-range communications (DSRC) that are specifically designed to enhance any road safety applications and entertainment/information applications. There are several vehicular related projects viz; California path, car 2 car communication consortium, the ETSI, and IEEE 1609 working group that have already been conducted to improve the overall road safety or traffic management. After the critical literature review, the selection of routing protocols is determined, and its performance was well thought-out in the urban and rural scenarios. Numerous routing protocols for VANET are applied to carry out current research. Its evaluation was conceded with the help of selected protocols through simulation via performance metric i.e. throughput and packet drop. Excel and Google graph API tools are used for plotting the graphs after the simulation results in order to compare the selected routing protocols which result with each other. In addition, the sum of the output from each scenario was computed to undoubtedly present the divergence in results. The findings of the current study present that DSR gives enhanced performance for low packet drop and high throughput as compared to AODV and DSDV in an urban congested area and in rural environments. On the other hand, in low-density area, VANET AODV gives better results as compared to DSR. The worth of the current study may be judged as the information exchanged between vehicles is useful for comfort, safety, and entertainment. Furthermore, the communication system performance depends on the way routing is done in the network and moreover, the routing of the data based on protocols implement in the network. The above-presented results lead to policy implication and develop our understanding of the broader spectrum of VANET.

Keywords: AODV, DSDV, DSR, Adhoc network

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Authors: Reyard Mutamiswa, Frank Chidawanyika, Casper Nyamukondiwa

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Under stressful thermal environments, insects adjust their behaviour and physiology to maintain key life-history activities and improve survival. For interacting species, mutual or antagonistic, thermal stress may affect the participants in differing ways, which may then affect the outcome of the ecological relationship. In agroecosystems, this may be the fate of relationships between insect pests and their antagonistic parasitoids under acute and chronic thermal variability. Against this background, we therefore investigated the thermal tolerance of different developmental stages of Chilo partellus Swinhoe (Lepidoptera: Crambidae) and its larval parasitoid Cotesia sesamiae Cameron (Hymenoptera: Braconidae) using both dynamic and static protocols. In laboratory experiments, we determined lethal temperature assays (upper and lower lethal temperatures) using direct plunge protocols in programmable water baths (Systronix, Scientific, South Africa), effects of ramping rate on critical thermal limits following standardized protocols using insulated double-jacketed chambers (‘organ pipes’) connected to a programmable water bath (Lauda Eco Gold, Lauda DR.R. Wobser GMBH and Co. KG, Germany), supercooling points (SCPs) following dynamic protocols using a Pico logger connected to a programmable water bath, heat knock-down time (HKDT) and chill-coma recovery (CCRT) time following static protocols in climate chambers (HPP 260, Memmert GmbH + Co.KG, Germany) connected to a camera (HD Covert Network Camera, DS-2CD6412FWD-20, Hikvision Digital Technology Co., Ltd, China). When exposed for two hours to a static temperature, lower lethal temperatures ranged -9 to 6; -14 to -2 and -1 to 4ºC while upper lethal temperatures ranged from 37 to 48; 41 to 49 and 36 to 39ºC for C. partellus eggs, larvae and C. sesamiae adults respectively. Faster heating rates improved critical thermal maxima (CTmax) in C. partellus larvae and adult C. partellus and C. sesamiae. Lower cooling rates improved critical thermal minima (CTmin) in C. partellus and C. sesamiae adults while compromising CTmin in C. partellus larvae. The mean SCPs for C. partellus larvae, pupae and adults were -11.82±1.78, -10.43±1.73 and -15.75±2.47 respectively with adults having the lowest SCPs. Heat knock-down time and chill-coma recovery time varied significantly between C. partellus larvae and adults. Larvae had higher HKDT than adults, while the later recovered significantly faster following chill-coma. Current results suggest developmental stage differences in C. partellus thermal tolerance (with respect to lethal temperatures and critical thermal limits) and a compromised temperature tolerance of parasitoid C. sesamiae relative to its host, suggesting potential asynchrony between host-parasitoid population phenology and consequently biocontrol efficacy under global change. These results have broad implications to biological pest management insect-natural enemy interactions under rapidly changing thermal environments.

Keywords: chill-coma recovery time, climate change, heat knock-down time, lethal temperatures, supercooling point

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Authors: Navneet Kaur, Amarpreet Singh

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In Vehicular Adhoc Networks, Data Dissemination is a challenging task. There are number of techniques, types and protocols available for disseminating the data but in order to preserve limited bandwidth and to disseminate maximum data over networks makes it more challenging. There are broadcasting, multicasting and geocasting based protocols. Multicasting based protocols are found to be best for conserving the bandwidth. One such protocol named BEAM exists that improves the performance of Vehicular Adhoc Networks by reducing the number of in-network message transactions and thereby efficiently utilizing the bandwidth during an emergency situation. But this protocol may result in multicar chain collision as there was no V2V communication. So, this paper proposes a new protocol named Enhanced Bandwidth Efficient Cluster Based Multicasting Protocol (EBECM) that will overcome the limitations of existing BEAM protocol. And Simulation results will show the improved performance of EBECM in terms of Routing overhead, throughput and PDR when compared with BEAM protocol.

Keywords: BEAM, data dissemination, emergency situation, vehicular adhoc network

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Authors: Jamel Miri, Bechir Nsiri, Ridha Bouallegue

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Ultra WidBand-IR physical layer technology has seen a great development during the last decade which makes it a promising candidate for short range wireless communications, as they bring considerable benefits in terms of connectivity and mobility. However, like all wireless communication they suffer from vulnerabilities in terms of security because of the open nature of the radio channel. To face these attacks, distance bounding protocols are the most popular counter measures. In this paper, we presented a protocol based on distance bounding to thread the most popular attacks: Distance Fraud, Mafia Fraud and Terrorist fraud. In our work, we study the way to adapt the best secure distance bounding protocols to mapping code of ultra-wideband (TH-UWB) radios. Indeed, to ameliorate the performances of the protocol in terms of security communication in TH-UWB, we combine the modified protocol to ultra-wideband impulse radio technology (IR-UWB). The security and the different merits of the protocols are analyzed.

Keywords: distance bounding, mapping code ultrawideband, terrorist fraud, physical layer technology

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Authors: Mehmet Cogal

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Students with disabilities perform historically lower than their peers on standardized assessments. There needs to be more work in the literature providing strategies to improve student scores on standardized assessments and how they are connected to teacher in-service programs. This quantitative causal-comparative study measured the impact of a teacher in-service program geared toward special education teachers. The study was conducted at a small public charter school serving grades 6-12 in Massachusetts. The students were given a pre and post-test before and after the teacher in-service program. Data were collected from 34 students’ reading scores in grades six, seven, eight, and 10. A paired t-test was conducted to measure if there was an increase in reading scores after the teacher in-service program. The study assumed that the teachers had implemented the strategies they learned during the teacher in-service program. The study also had limitations, including a small sample size, and the findings may not be generalized for the entire special education population. Although the study indicated no significant difference in the test scores, the teacher in-service programs and their effects on student achievement can still be further investigated.

Keywords: student achievement, standardized testing, teacher in-service, special education

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Authors: Seongsoo Lee

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IP reuse is an effective design methodology for modern SoC design to reduce effort and time. However, description and modeling methods of IP interfaces are different due to different IP designers. In this paper, standardized description and modeling methods of IP interfaces are proposed. It consists of 11 items such as IP information, model provision, data type, description level, interface information, port information, signal information, protocol information, modeling level, modeling information, and source file. The proposed description and modeling methods enables easy understanding, simulation, verification, and modification in IP reuse.

Keywords: interface, standardization, description, modeling, semiconductor IP

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Authors: Ammar Khader Almasri

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The software processes play a vital role for delivering a high quality software system that meets the user’s needs. There are many software development models which are used by most system developers, which can be categorized into two categories (traditional and new methodologies). Mobile applications like other desktop applications need appropriate and well-working software development process. Nevertheless, mobile applications have different features which limit their performance and efficiency like application size, mobile hardware features. Moreover, this research aims to help developers in using a standardized model for developing mobile applications.

Keywords: software development process, agile methods , moblile application development, traditional methods

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Authors: A. Andreasyan, C. Connors

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The Elliptic Curve Digital Signature algorithm-based X509v3 certificates are becoming more popular due to their short public and private key sizes. Moreover, these certificates can be stored in Internet of Things (IoT) devices, with limited resources, using less memory and transmitted in network security protocols, such as Internet Key Exchange (IKE), Transport Layer Security (TLS) and Secure Shell (SSH) with less bandwidth. The proposed method gives another advantage, in that it increases the performance of the above-mentioned protocols in terms of key exchange by saving one scalar multiplication operation.

Keywords: cryptography, elliptic curve digital signature algorithm, key exchange, network security protocol

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Authors: Ishtiaq Wahid, Masood Ahmad, Nighat Ayub, Sajad Ali

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Lifetime of a wireless sensor network (WSN) is directly proportional to the energy consumption of its constituent nodes. Routing in wireless sensor network is very challenging due its inherit characteristics. In hierarchal routing the sensor filed is divided into clusters. The cluster-heads are selected from each cluster, which forms a hierarchy of nodes. The cluster-heads are used to transmit the data to the base station while other nodes perform the sensing task. In this way the lifetime of the network is increased. In this paper a comparative study of hierarchal routing protocols are conducted. The simulation is done in NS-2 for validation.

Keywords: WSN, cluster, routing, sensor networks

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Authors: Mohammad Soltani, Sajad Ahmadizad, Fatemeh Hoseinzadeh, Atefe Sarvestan

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The exercise recovery is an important variable in designing resistance exercise training. This study determined the effects of passive and active recoveries on responses of platelet indices and hemodynamic variables to resistance exercise. Twelve healthy subjects (six men and six women, age, 25.4 ±2.5 yrs) performed two types of resistance exercise protocols (six exercises including upper- and lower-body parts) at two separate sessions with one-week intervening. First resistance protocol included three sets of six repetitions at 80% of 1RM with 2 min passive rest between sets and exercises; while, the second protocol included three sets of six repetitions at 60% of 1RM followed by active recovery included six repetitions of the same exercise at 20% of 1RM. The exercise volume was equalized. Three blood samples were taken before exercise, immediately after exercise and after 1-hour recovery, and analyzed for fibrinogen and platelet indices. Blood pressure (BP), heart rate (HR) and rate pressure product (RPP), were measured before, immediately after exercise and every 5 minutes during recovery. Data analyzes showed a significant increase in SBP (systolic blood pressure), HR, rate of pressure product (RPP) and PLT in response to resistance exercise (P<0.05) and that changes for HR and RPP were significantly different between two protocols (P<0.05). Furthermore, MPV and P_LCR did not change in response to resistance exercise, though significant reductions were observed after 1h recovery compared to before and after exercise (P<0.05). No significant changes in fibrinogen and PDW following two types of resistance exercise protocols were observed (P>0.05). On the other hand, no significant differences in platelet indices were found between the two protocols (P>0.05). Resistance exercise induces changes in platelet indices and hemodynamic variables, and that these changes are not related to the type of recovery and returned to normal levels after 1h recovery.

Keywords: hemodynamic variables, platelet indices, resistance exercise, recovery intensity

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Authors: Jaci Mastrandrea

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening is directly correlated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project is to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline from March 15th, 2022, to April 29th, 2022. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated and evidence-based PC referral criteria. The tool was initially implemented using paper forms and later was integrated into the Epic-Beacon EHR system. Patients were screened by registered nurses on the SLCTC treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher were considered to be a positive screen. Scores of five or higher triggered a PC referral order in the patient’s EHR for the oncologist to review and approve. All patients with a positive screen received an educational handout on the topic of PC, and the EHR was flagged for follow-up. Results: Prior to implementation of the PSCNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the first 100 patient screenings completed within the eight-week data collection period. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting the criteria were flagged in the EHR for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative care, symptom management, symptom screening, ambulatory oncology, cancer, supportive care

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Authors: Pui Yong Leo, Normy Maziah Mohd Said

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Change of global economy landscape and business environment has led to companies’ decision to go global and enter international markets. As the companies go beyond the comfort zone (i.e. investing in the home country), it is important to ensure a comprehensive risk assessment is carried out. This paper describes a standardized approach for international investment, ensuring identification of risk, risk appetite, risk rating, risk treatment and mitigation plans for respective international investment proposal. The standardized approach is divided into three (3) stages as follows: Stage 1 – Preliminary Risk profiling; with the objective to gauge exposure to countries and high level risk factors as first level assessment. Stage 2 – Risk Parameters; with the objective to define risk appetite for the international investment from the perspective of likelihood and impact. Stage 3 – Detailed Risk Assessments; with the objectives to assess in detail any triggered elements from Stage 1, and project specific risks. The final output will include the mitigation plans for the identified risks for the total investment. Example will be given in this paper to show how comprehensive risk assessment is carried out for an international investment in power energy sector.

Keywords: international investment, mitigation plans, risk appetite, risk assessment

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Authors: Mahmoud M. Zakaria, Omnia F. Elmoursi, Mahmoud M. Gabr, Camelia A. AbdelMalak, Mohamed A. Ghoneim

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Many protocols were publicized for differentiation of human mesenchymal stem cells (MSCS) into insulin-producing cells (IPCs) in order to excrete insulin hormone ingoing to treat diabetes disease. Our aim is to evaluate relative gene expression for each independent protocol. Human bone marrow cells were derived from three volunteers that suffer diabetes disease. After expansion of mesenchymal stem cells, differentiation of these cells was done by three different protocols (the one-step protocol was used conophylline protein, the two steps protocol was depending on trichostatin-A, and the three-step protocol was started by beta-mercaptoethanol). Evaluation of gene expression was carried out by real-time PCR: Pancreatic endocrine genes, transcription factors, glucose transporter, precursor markers, pancreatic enzymes, proteolytic cleavage, extracellular matrix and cell surface protein. Quantitation of insulin secretion was detected by immunofluorescence technique in 24-well plate. Most of the genes studied were up-regulated in the in vitro differentiated cells, and also insulin production was observed in the three independent protocols. There were some slight increases in expression of endocrine mRNA of two-step protocol and its insulin production. So, the two-step protocol was showed a more efficient in expressing of pancreatic endocrine genes and its insulin production than the other two protocols.

Keywords: mesenchymal stem cells, insulin producing cells, conophylline protein, trichostatin-A, beta-mercaptoethanol, gene expression, immunofluorescence technique

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Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

Abstract:

Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

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Authors: Jung-Hoon Han, Jooyoung Kwak

Abstract:

Distances between cultures, institutions are gaining academic attention once again since the classical debate on the validity of globalization. Despite the incessant efforts to define international segments with various concepts, no significant attempts have been made considering the institutional dimensions. Resource-based theory and institutional theory provides useful insights in assessing market environment and understanding when and how MNEs loose or gain advantages. This study consists of two parts: identifying institutional clusters and predicting the effect of MNEs’ origin on the applicability of competitive advantages. MNEs in one country cluster are expected to use similar management systems.

Keywords: institutional theory, resource-based theory, institutional environment, cultural dimensions, cluster analysis, standardized management

Procedia PDF Downloads 463

Authors: Jin Koo

Abstract:

The main purpose of this study is to investigate the comparability of student scores obtained from Test Center (TC) vs. Online-Proctored (OP) Delivery in the three subject areas of Verbal, Reading, and Mathematics for each level (Middle and Upper). Also, this study examines whether there is an interaction effect between test deliveries (TC vs. OP) and gender/ethnicity/ability level in each subject area. The test used in this study is a multiple-choice standardized test for students in grades 5-11. For this study, data were collected during the 2022-23 test administration. This research used a one-factor between-subjects ANOVA and Cohen’s d to compare the TC and OP groups’ test means for each level and each subject area. Also, 2-factor between-subjects ANOVAs were conducted to investigate examinee characteristics: gender (male and female), ethnicity (African-American, Asian, Hispanic, Multi-racial, and White), and ability level (low, average, and high-ability groups). The author found that students’ test scores in some subject areas varied between TC and OP test deliveries by gender, ethnicity, and ability level, meaning that gender, ethnicity, and ability level were related to the score difference. These results will be discussed according to the current testing systems.

Keywords: ability level, ethnicity, gender, online-proctored delivery, standardized test, test center

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Authors: M. Yosra, A. Mohamed, T. Sami

Abstract:

Over the past few years, mobile communication technologies have seen significant evolution. This fact promoted the implementation of many systems in a multi-technological setting. From one system to another, the Quality of Service (QoS) provided to mobile consumers gets better. The growing number of normalized standards extends the available services for each consumer, moreover, most of the available radio frequencies have already been allocated, such as 3G, Wifi, Wimax, and LTE. A study by the Federal Communications Commission (FCC) found that certain frequency bands are partially occupied in particular locations and times. So, the idea of Cognitive Radio (CR) is to share the spectrum between a primary user (PU) and a secondary user (SU). The main objective of this spectrum management is to achieve a maximum rate of exploitation of the radio spectrum. In general, the CR can greatly improve the quality of service (QoS) and improve the reliability of the link. The problem will reside in the possibility of proposing a technique to improve the reliability of the wireless link by using the CR with some routing protocols. However, users declared that the links were unreliable and that it was an incompatibility with QoS. In our case, we choose the QoS parameter "bandwidth" to perform a supervised classification. In this paper, we propose a comparative study between some routing protocols, taking into account the variation of different technologies on the existing spectral bandwidth like 3G, WIFI, WIMAX, and LTE. Due to the simulation results, we observe that LTE has significantly higher availability bandwidth compared with other technologies. The performance of the OLSR protocol is better than other on-demand routing protocols (DSR, AODV and DSDV), in LTE technology because of the proper receiving of packets, less packet drop and the throughput. Numerous simulations of routing protocols have been made using simulators such as NS3.

Keywords: cognitive radio, multi technology, network simulator (NS3), routing protocol

Procedia PDF Downloads 37

Authors: Qurratulain Safdar

Abstract:

Drought is a temporary aberration in contrast to aridity, as it is a permanent feature of climate. Virtually, it takes place in all types of climatic regions that range from high to low rainfall areas. Due to the wide latitudinal extent of Pakistan, there is seasonal and annual variability in rainfall. The south-central part of the country is arid and hyper-arid. This study focuses on the spatio-temporal analysis of droughts in arid and hyperarid region of Cholistan using the standardized precipitation index (SPI) approach. This study has assessed the extent of recurrences of drought and its temporal vulnerability to drought in Cholistan region. Initially, the paper described the geographic setup of the study area along with a brief description of the drought conditions that prevail in Pakistan. The study also provides a scientific foundation for preparing literature and theoretical framework in-line with the selected parameters and indicators. Data were collected both from primary and secondary data sources. Rainfall and temperature data were obtained from Pakistan Meteorology Department. By applying geostatistical approach, a standardized precipitation index (SPI) was calculated for the study region, and the value of spatio-temporal variability of drought and its severity was explored. As a result, in-depth spatial analysis of drought conditions in Cholistan area was found. Parallel to this, drought-prone areas with seasonal variation were also identified using Kriging spatial interpolation techniques in a GIS environment. The study revealed that there is temporal variation in droughts' occurrences both in time series and SPI values. The paper is finally concluded, and strategic plan was suggested to minimize the impacts of drought.

Keywords: Cholistan desert, climate anomalies, metrological droughts, standardized precipitation index

Procedia PDF Downloads 175