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Elevated water tanks in high susceptibility to an earthquake are one of the greatest structures of support system. These structures have a large concentration on slender support structures and are at risk of horizontal forces due to the earthquake in specific. They are essential elements in municipal water deliver, hearth combating structures and in many commercial centres for garage of water. Hence increased water tanks ought to continue to be functional even after the earthquake. In this paper guide seismic analysis of improved square water tank is achieved according with IS: 1893–1984 (i.e. Lumped mass version) and IS: 1893–2002 (Part-2) draft code (i.e. Two mass version). The structures are analysed with different simulated soft ware’s Staad-pro and E-tabs. The results are compared for optimal value analysis in particular forces. The deviational error found to be less in E-tabs when compared to stad- pro for given load conditions in simulation.

This paper analyses the health policy response to the COVID-19 pandemic in the four Visegrad countries – Czechia, Hungary, Poland, and Slovakia – in spring and summer 2020. The four countries implemented harsh transmission prevention measures at the beginning of the pandemic and managed to effectively avoid the first wave of infections during spring. Likewise, all four relaxed most of these measures during the summer and experienced uncontrolled growth of cases since September 2020. Along the way, there has been an erosion of public support for the government measures. This was mainly due to economic considerations taking precedent but also likely due to diminished trust in the government. All four countries have been overly reliant on their relatively high bed capacity, which they managed to further increase at the cost of elective treatments, but this could not always be supported with sufficient health workforce capacity. Finally, none of the four countries developed effective find, test, trace, isolate and support systems over the summer despite having relaxed most of the transmission protection measures since late spring. This left the countries ill-prepared for the rise in the number of COVID-19 infections they have been experiencing since autumn 2020.

Introduction Lateral radiography of the knee joint is frequently performed; however, the retake rate is high owing to positioning errors. Therefore, in this study, to reduce the required number and time of image retakes, we developed a system that can classify the tilting directions of lateral knee radiographs and evaluated the accuracy of the proposed method. Methods Using our system, the tilting directions of a lateral knee radiographs were classified into four direction categories. The system was developed by training the DCNN based on 50 cases of Raysum images and tested on three types test dataset; ten more cases of Raysum images, one case of flexed knee joint phantom images and 14 rejected knee joint radiographs. To train a deep convolutional neural network (DCNN), we employed Raysum images created via three-dimensional (3D) X-ray computed tomography (CT); 11 520 Raysum images were created from 60 cases of 3D CT data by changing the projection angles. Thereby, we obtained pseudo images attached with correct labels that are essential for training. Results The overall accuracy on each test dataset was 88.5 ± 7.0% (mean ± standard deviation), 81.4 ± 11.2%, and 73.3 ± 9.2%. The larger the tilting degree of the knee joint, the higher the classification accuracy. Conclusion DCNN could classify the tilting directions of a knee joint from lateral knee radiographs. Using Raysum images made it possible to facilitate creating dataset for training DCNN. The possibility was indicated for using support system of lateral knee radiographs. Implications for practice The system may also reduce the burden on patients and increase the work efficiency of radiological technologists.

In light of the need for objective mechanism-based diagnostic tools, the current research describes a novel diagnostic support system aimed to differentiate between anxiety and depression disorders in a clinical sample. Eighty-six psychiatric patients with clinical anxiety and/or depression were recruited from a public hospital and assigned to one of the experimental groups: Depression, Anxiety, or Mixed. The control group included 25 participants with no psychiatric diagnosis. Participants performed a battery of six cognitive-behavioral tasks assessing biases of attention, expectancies, memory, interpretation and executive functions. Data were analyzed with a machine-learning (ML) random forest-based algorithm and cross-validation techniques. The model assigned participants to clinical groups based solely on their aggregated cognitive performance. By detecting each group's unique performance pattern and the specific measures contributing to the prediction, the ML algorithm predicted diagnosis classification in two models: (I) anxiety/depression/mixed vs. control (76.81% specificity, 69.66% sensitivity), and (II) anxiety group vs. depression group (80.50% and 66.46% success rates in classifying anxiety and depression, respectively). The findings demonstrate that the cognitive battery can be utilized as a support system for psychiatric diagnosis alongside the clinical interview. This implicit tool, which is not based on self-report, is expected to enable the clinician to achieve increased diagnostic specificity and precision. Further, this tool may increase the confidence of both clinician and patient in the diagnosis by equipping them with an objective assessment tool. Finally, the battery provides a profile of biased cognitions that characterizes the patient, which in turn enables more fine-tuned, individually-tailored therapy.

Study objective To explore the social and environmental conditions in emergency departments that contribute to perceived barriers and supports for workplace lactation among individuals working in emergency medicine. Methods Constructivist grounded theory was used by our team to understand the social processes and behaviors associated with workplace lactation for health care professionals working in EDs. A total of 24 interviews of individuals in EDs with recent return-to-work experience after childbirth were performed. The interviews yielded 36 unique experiences (from 21 faculty, 12 trainees, and 3 nurses) because some participants had more than 1 child, in which case all lactation experiences were discussed. Interview transcriptions were coded and analyzed iteratively for the development of themes, per constructivist grounded theory. Results Using constant comparative inductive methods, we describe 3 pervasive themes as they relate to workplace lactation that emerged from the analysis of interview data: (1) emergency medicine culture, (2) workplace lactation policies, and (3) supports for workplace lactation. Conclusion Although formalized workplace lactation policies and other identifiable supports for workplace lactation aid individuals desiring to lactate after returning to work in EDs, many individuals still experience cultural barriers to their desired lactation habits. Policies and individual support systems may continue to fall short of meeting the needs of lactating individuals in emergency medicine unless broader cultural change occurs. Our work offers initial recommendations for shifting the landscape of lactation practices in emergency medicine.

Social networks are a very popular channel for people to communicate with, to find, to reference other users before making decisions, especially those concerning purchase. How can users’ opinions within social networks be used in making decisions cost-effective and reliable? In this paper, we propose an approach for supporting decision-making based on measuring the user satisfaction level by analyzing the sentiment of aspects and mining the fuzzy decision trees. Our proposal has been proved to overcome some of the disadvantages of previous methods. Specifically, we consider the fuzzy sentiments of users for aspects and the effects of user satisfaction, dissatisfaction, and hesitation for decision-making. The proposed method comprises four main stages. The first stage identifies a topic, which the user is interested. In the second stage, aspects of the topic and their sentiments within tweets are extracted. At the third stage, the user satisfaction level is calculated according to each kind of sentiment identified in the second step. Finally, a decision matrix is constructed, and the fuzzy decision tree is built to generate a set of rules for supporting users in decision-making. The experiments using tweets show that the proposed method achieves promising results regarding the accuracy and gained information.

It is significant to research the impact resistance properties of hydraulic support due to its key support role in the fully mechanized mining face. However, it is difficult for the entire hydraulic support to implement the impact experiment underground and analyze the response characteristic. Therefore, a dynamic impact experiment for the entire hydraulic support was proposed in this paper, where a 1:2 reduced-scale model of hydraulic support was designed and its response characteristics under dynamic impact load were analyzed. Firstly, a comprehensive monitoring scheme was proposed to achieve an effective monitoring for dynamic response of hydraulic support. Secondly, a multi-scale impact experiment was carried out for the entire hydraulic support and dynamic behaviors of hydraulic support under the multi-scale impact load were revealed by experimental data. Then a dynamic impact experiment of the entire hydraulic support was simulated in ADAMS with the same experiment conditions, and the experimental and simulation data were verified mutually. Finally, the characteristics of energy conversion and dissipation of the entire experiment system after impact were analyzed. The experiment results showed that the impact resistance properties of hydraulic support largely depended on the initial support conditions and different vertical rigidities affected energy distribution proportion of the entire support system.

As part of our commitment to amplifying the voices of underrepresented scientists, we are publishing the insights and experiences of a panel of underrepresented scientists. In this segment, we asked about support systems-the types of support that are most helpful (and less helpful), how to find a supportive network, and how institutions can better support underrepresented scientists. These are the personal opinions of the authors and may not reflect the views of their institutions.

As grandparental childcare in Japan becomes highly uncommon in recent years, working mothers need to rely more on formal childcare services. In 2015, the Japanese government launched the Comprehensive Support System for Children and Child-rearing (CSSCC) to promote the expansions of early childhood education and care (ECEC) services. This study estimates the effects of ECEC availability on maternal employment in the new context, using a fresh dataset combining official municipality data and individual-level data of a sample of mothers with preschool children extracted from an original Japanese nationwide survey dataset for 2015, 2016, and 2017. Identification for the maternal employment effects is based on the variation across municipalities and over time in the pace of ECEC expansions triggered by the CSSCC. The empirical results show that a one percentage point increase in the capacity rate of ECEC facilities targeted at the 0–5 age group predicts an increase of 0.27 percentage points in mothers’ working probability. The overall increase in working probability is almost entirely explained by the increase in nonregular employment rather than regular employment and is mainly driven by mothers with low education. A new type of ECEC service established under the CSSCC for the 0–2 age group has a sizable effect exclusively on the nonregular employment of mothers from three-generation households. Comparisons with the findings by previous studies and implications for the future design and implementation of family policy are discussed.

If a far-off future generation writes a complete history of human civilisation, the century from 1950 to 2050 will loom large. This was the era of the Great Acceleration, a rapacious, unrestrained plundering of Earth's natural support systems. But it was also the era of the Great Restoration, when humanity learned again how to live sustainably and in harmony with nature. That second part hasn't happened yet. Whether this history is ever written depends on what happens now: on decisions to be made this year as the world emerges from the covid-19 pandemic, and on our actions in the coming decade. Graham Lawton kicks off a special report on Earth's ecosystems and biodiversity at a critical juncture by asking: how can we deliver a rescue plan for nature that is also a rescue plan for us?

Background In older medical patients polypharmacy is often associated with poor prescription appropriateness and harmful drug-drug interactions. An effort that jointly involved hospital pharmacists and clinicians attending multimorbid older patients acutely admitted to medical wards was implemented for medication recognition and reconciliation aided by the use of a computerized support system. Methods Six internal medicine wards enrolled consecutively 90 acutely admitted multimorbid patients aged 75 years or more taking 5 or more different drugs. Two hospital pharmacists carried out the recognition of medications taken at hospital ward admission, and interacted with the clinicians in a process of drug reconciliation, using also the computerized support system to evaluate drug related problems, prescription inappropriateness or drug-drug interactions. The process was repeated at hospital discharge. Results Among a total number of 911 drugs prescribed to 90 older medical patients at ward admission, the pharmacists identified during their recognition/reconciliation 455 drug-related problems, mainly due to prescription of medications inappropriate for older multimorbid patients and clinically harmful drug-drug interactions. When these drug-related problems were identified by the pharmacist, the attending clinicians accepted and implemented the suggestions for changes for approximately two thirds of the discrepancies, thereby leading to deprescribing the implicated drugs or at least to their closer monitoring. Conclusions This interventional prospective study based upon the integrated expertise of hospital pharmacists and clinicians confirms that drug-related problems are frequent in multimorbid older patients acutely admitted to hospital medical wards, and demonstrates afresh the feasibility and mutual acceptance of a trajectory of recognition/reconciliation based upon an integrated collaboration between hospital pharmacists and ward clinicians in the process of medication optimization.

Longwall gateroad entries are subject to changing horizontal and vertical stress induced by redistribution of loads around the extracted panel. The stress changes can result in significant deformation of the entries that may include roof sag, rib dilation, and floor heave. Mine operators install different types of supports to control the ground response and maintain safe access and ventilation of the longwall face. This paper describes recent research aimed at quantifying the effect of longwall-induced stress changes on ground stability and using the information to assess support alternatives. The research included monitoring of ground and support interaction at several operating longwall mines in the U.S., analysis and calibration of numerical models that adequately represent the bedded rock mass, and observation of the support systems and their response to changes in stress. The models were then used to investigate the impact of geology and stress conditions on ground deformation and support response for various depths of cover and geologic scenarios. The research results were summarized in two regression equations that can be used to estimate the likely roof deformation and height of roof yield due to longwall-induced stress changes. This information is then used to assess the ability of support systems to maintain the stability of the roof. The application of the method is demonstrated with a retrospective analysis of the support performance at an operating longwall mine that experienced a headgate roof fall. The method is shown to produce realistic estimates of gateroad entry stability and support performance, allowing alternative support systems to be assessed during the design and planning stage of longwall operations.

This paper focuses on the complex selection process of worker assistance systems for human-centered manufacturing systems. Due to rising complexity of products and processes in the manufacturing sector, as well as changing work environments, the choice for suitable support systems on the shop floor becomes more difficult. The selection of worker assistance systems is yet not well studied and there is a lack in scientifically based methodologies to assist designers of manufacturing systems in this process. In this work we identify a broad variety of influencing attributes for selecting the most appropriate worker assistance systems depending on each individual field of application. These attributes are building the ground for the development of a morphological box to facilitate the selection process of worker assistance systems. The proposed procedure to use the morphological box is finally explained with a practical example.

The management of biventricular heart failure presents a significant challenge. Recently, percutaneous options for univentricular support that may be combined to provide full biventricular support have come to market. These support configurations allow patients to be bridged to recovery, durable mechanical circulatory support, or to transplantation. Due to the minimally invasive nature of these systems, patients may be rapidly extubated, and some may be mobilized with full biventricular support. Varied approaches for implementation of these temporary support systems exist, with some of the most common techniques presented here.

Despite the recent increase in Sub-Saharan African newcomers to Canada, little is known about their experiences, specifically the challenges they face rebuilding their lives and the strategies they adopt to tackle these challenges. This scoping review of 48 articles provides a critical basis for further research on Sub-Saharan African international migration to Canada. Five themes emerged from the extant literature: 1) structural barriers to rebuilding self, family, and community; 2) limited support systems available in the transition period; 3) transnational ties and commitments as a recurring mediator of migrant life; 4) mechanisms for navigating transition and integration; and 5) changing gender relations and roles. Findings across these themes strongly project gender relations as a crucial engine of migrant life, yet studies do not extensively probe the nature and dynamics of key facets of post-migration gender relations. While transnational linkages could provide some support and sense of identity, the demands of and commitments to extended family members and other entities could stall or undermine efforts to rebuild lives and community in a new homeland. The coping mechanisms identified here appear to relieve or postpone the consequences of Sub-Saharan African migrants’ adaptations to the realities of life in Canada. Our review also underscores the need for strength-based approaches, such as resilience, in exploring the experiences of Sub-Saharan African migrants as newcomers in advanced Western nations like Canada. Future studies should consider that international migration presents complex challenges to both migrant sending and receiving countries, traceable to both localized and transnational historical and social linkages.

In the present report, we have broadly outlined the potential advances in the field of skull base surgery, which might occur within the next 20 years based on the many areas of current research in biology and technology. Many of these advances will also be broadly applicable to other areas of neurosurgery. We have grounded our predictions for future developments in an exploration of what patients and surgeons most desire as outcomes for care. We next examined the recent developments in the field and outlined several promising areas of future improvement in skull base surgery, per se, as well as identifying the new hospital support systems needed to accommodate these changes. These include, but are not limited to, advances in imaging, Raman spectroscopy and microscopy, 3-dimensional printing and rapid prototyping, master-slave and semiautonomous robots, artificial intelligence applications in all areas of medicine, telemedicine, and green technologies in hospitals. In addition, we have reviewed the therapeutic approaches using nanotechnology, genetic engineering, antitumor antibodies, and stem cell technologies to repair damage caused by traumatic injuries, tumors, and iatrogenic injuries to the brain and cranial nerves. Additionally, we have discussed the training requirements for future skull base surgeons and stressed the need for adaptability and change. However, the essential requirements for skull base surgeons will remain unchanged, including knowledge, attention to detail, technical skill, innovation, judgment, and compassion. We believe that active involvement in these rapidly evolving technologies will enable us to shape some of the future of our discipline to address the needs of both patients and our profession.

Introduction Despite the known prevalence and detrimental health outcomes associated with adverse childhood experiences (ACEs), extant literature has rarely focused on the impact of ACEs on mothers’ parenting practices. The purpose of this metasynthesis was to synthesize qualitative studies to understand how mothers with a history of ACEs parent their children. Method A systematic search was conducted across five databases with 11 studies meeting eligibilty criteria. Relevant data were extracted and analyzed with qualitative description. Results Six subthemes and three themes emerged from the data. Themes included breaking the cycle, parent and child well-being, and supporting mothers. All mothers described strategies to protect their children, with some describing hypervigilant parenting practices. Mothers discussed worries about appropriate discipline and a pervasive fear of community-based services for fear of removal of the child. Across studies, mothers described their current support system and offered several suggestions for formal support services. Discussion This metasynthesis provides the synthesized perspectives of traumatized mothers’ parenting practices, which may inform future interventions.

espanolIntroduccion El Educational Needs Assessment Tool-version espanola (SpENAT) es un cuestionario autorreportado que evalua las necesidades educacionales (NEd) con el fin de dar informacion adaptada y centrada en el paciente con artritis reumatoide (AR). Comprende 39 preguntas agrupadas en 7 dominios: Manejo del dolor, Movimiento, Sentimientos, Proceso de artritis, Tratamientos, Medidas de autoayuda y Sistemas de apoyo. Objetivos Evaluar las NEd en pacientes con AR mediante el SpENAT y determinar cuales son las principales fuentes de informacion a las que consultan. Material y metodos Estudio multicentrico, observacional, analitico, de corte transversal. Se incluyeron pacientes consecutivos ≥ 18 anos con diagnostico de AR (ACR 87 y/o ACR-EULAR 2010). Se consignaron datos demograficos, nivel educativo, caracteristicas de la enfermedad y medidas clinimetricas. Todos los pacientes completaron el SpENAT y fueron interrogados acerca de las fuentes a las que acuden para obtener informacion de su enfermedad. Analisis estadistico Se describieron las caracteristicas poblacionales. Se determinaron las NEd como porcentajes del puntaje maximo posible de cada dominio. Se compararon las necesidades por dominio segun sexo, anos de educacion, tiempo de evolucion, uso de biologico y capacidad funcional mediante test de Anova y las comparaciones de a pares con prueba t de Student y correccion de Bonferroni. Se determino correlacion entre los dominios con test de Spearman. Se comparo la edad segun la fuente de informacion con la prueba t de Student. Resultados Se incluyeron 496 pacientes de 20 centros de todo el pais. Se observaron mayores NEd en los dominios Movimiento, Sentimientos y Proceso de artritis. Los pacientes de mayor nivel educacional (> 7 anos) refirieron mayores NEd en los dominios Proceso de artritis y Medidas de autoayuda. Un mayor deterioro funcional (HAQ ≥ 0,87) se asocio con unas mayores NEd en todos los dominios. Los pacientes con alta actividad mostraron mayores NEd que los pacientes en remision en los dominios Manejo del dolor, Movimiento, Sentimientos, Tratamientos y Sistemas de apoyo, y que los pacientes con baja actividad en los dominios Medidas de autoayuda y Sistemas de apoyo. Todos los dominios del SpENAT mostraron correlaciones positivas entre si (p Conclusion Los pacientes con AR manifestaron un gran interes por conocer mas sobre su enfermedad. Un elevado deterioro funcional se asocia con mayores NEd. Los pacientes con alta actividad de la enfermedad presentan mayores NEd en casi todos los dominios. El medico reumatologo es la principal fuente de informacion del paciente con AR. EnglishBackground The SpENAT, a Spanish version of the Educational Needs Assessment Tool, is a self-completed questionnaire that assesses educational needs (ENs) with the purpose of providing tailored and patient-centered information. It consists of 39 questions grouped into the 7 following domains: Pain management, Movement, Feelings, Arthritic process, Treatments, Self-help measures and Support system. Objectives The objective of the study was to describe the ENs of rheumatoid arthritis (RA) patients using the SpENAT and to determine the main sources of information consulted by these patients. Material and methods Multicenter, observational, cross-sectional study. We included consecutive patients ≥ 18 years with diagnosis of RA (ACR 87/ACR-EULAR 2010). Sociodemographic data, disease characteristics and clinimetric properties were recorded. All patients completed the SpENAT and were asked about the sources employed to obtain information about their disease. Statistical analysis Population characteristics were described. ENs were determined as percentages of the highest possible score for each domain. Needs for each domain according to sex, years of education, disease duration, use of biologicals and functional capacity were analyzed by means of ANOVA, and bivariate comparisons were made with Student's t-test and the Bonferroni correction. Correlation between domains was determined with the Spearman correlation coefficient. We compared patients’ age by source of information with Student's t-test. Results We included 496 patients from 20 centers across the country. More ENs were observed in the domains of Movement, Feelings and the Arthritic process. Patients with higher educational level (> 7 years) reported more ENs in the Arthritic process and Self-help measure domains. A higher functional impairment (HAQ-A ≥ 0.87) was associated with more ENs in every domain. Patients with high activity showed more ENs than those in remission in the domains of Pain management, Movement, Feelings, Treatments and Support system, as well as those with low activity in Self-help measures and Support system domains. All SpENAT domains showed positive correlations among each other (P Conclusion RA patients were very interested about knowing more about their disease. High functional impairment was associated with more ENs. Patients with high disease activity had higher EN levels in almost every domain. The rheumatologist was the main source of information for the patient with RA.

Cardiovascular diseases remain the most common cause of sudden death and cause significant morbidity. We planned this study to assess awareness of cardiovascular risk factors among kin of myocardial infarction patients. We assessed 382 individuals for their knowledge of cardiovascular risk factors. Less than 50% of subjects identified cardiovascular risk factors correctly. Amongst the kins of patients 19.1%, 18.5%, 15.4% were newly diagnosed to have hypertension, impaired fasting blood glucose, diabetes in this study. This study reveals that most of the subjects were unaware of risk factors and were reluctant to adopt a healthy lifestyle. This is a lost opportunity for community-level preventive interventions. There is an unmet need for active health education, follow up with electronic support systems, and a team approach for a model preventive clinic.

This article contributes to the literature on sustainability transitions, innovation systems, and eco-innovation by addressing conceptual challenges regarding the systemic activities of inter-mediaries. Specifically, the article addresses a research gap pertaining to the ways in which the systemic activities of (eco-)innovation intermediaries can be conceptualised and empirically demonstrated. Empirically, the paper examines selected intermediaries in the context of support systems for eco-innovators in three regions across Finland, Germany, and Sweden. Drawing from our empirical findings and the literature on intermediaries, we conceptualise three system levels within which intermediation occurs: (i) in-between entities in a network, (ii) in-between networks of entities, and (iii) in-between actors, networks, and institutions. Our discussion suggests a heterogeneity of roles that individual intermediaries take at multiple system levels, complementing an emerging, more nuanced perspective of intermediaries in sustainability transitions. Thus, we suggest the term systemic intermediation for describing the system-level activities of intermediaries. Funding agencies: Formas (The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning)Swedish Research Council Formas; European UnionEuropean Union (EU); European Commission Erasmus + knowledge Alliances; Academy of FinlandAcademy of Finland [2

This article reviews different approaches for describing pelvic floor anatomy; "Classic 3-Compartment Approach", "Active and Passive Conceptual Approach" and "Multilayered System Approach". However, these approaches cannot explain pathogenesis of various dysfunctions. "Functional 3-Part Pelvic Supporting Systems Approach" a new, more function-based classification of the pelvic floor support system is introduced in which all structures that contribute to same function are grouped under 1 system. Indications for MR imaging of pelvic floor dysfunction, patients' preparation, static, dynamic and MR Defecography imaging protocols are detailed according to the concordance of experts in two recently published consensus papers.

Increasing the efficiency of regional and municipal passenger transport, comfort and safety of transportation by using the principles of the digital transformation of technological and management processes is the main goal and result of this paper. A methodology is developed for designing a state-of-the-art regional passenger transportation system based on establishing a set of digital services and hardware and software modules comprising the digital platform, to which regional support systems, mobile and external services are connected. This creates an ecosystem with passengers in the center together with various services around providing comfort, safety and economic efficiency. The methodology is used in the development of an interregional platform. The mathematical support for the basic subsystems of centralized control and passenger information is being designed and undergoing pilot testing.

In India, the coal seams are called contiguous, when the thickness of the parting formation between two coal seams is within 9 m. When the extraction is carried out in one seam, it not only disturbs the stress regime of the current working and its adjoining mined out areas but also alters the stress regime of the overlying and underlying formations. The interactions among coal seams become more pronounced when the thicknesses of the partings are lesser. If the parting between two coal seams collapses during their extractions, there may be a chance of casualty. The extraction of the contiguous seams becomes more difficult if the surface structures are present above the seams. If the seams are situated at a shallow depth of cover, the effects of the contiguous seams working easily reach to the ground surface. Therefore, the contiguous coal seams require suitable extraction methodology to ensure safety. In this study, a methodology is designed for safe extraction of the contiguous coal seams under surface structures. The safety of the parting is assessed by the analytical models, the numerical simulations and field investigation. The support system is designed to ensure the safety of the parting during the extraction of the coal seams. To assess the impact of mining on the surface structures, subsidence parameters are evaluated which are found to be within the permissible limits. Thus, this extraction methodology and the safety control measures can be applied for safe extraction of the contiguous coal seams having similar geomining conditions.

The purpose of the 'Dites Je Suis La' platform is to disseminate a simple, clear and scientifically validated message to the general public to raise awareness of the warning signs of suicide. This awareness-raising campaign complements the existing support systems for suicidal people. Their loved ones can find tools for understanding and questioning their potential as caregivers. If they are willing to support a person in pain, six steps guide them in how to act to prevent suicide. Lifting the taboo around suicidal thoughts, encouraging the use of help and care, and maintaining a sincere and warm relationship are among the key elements.

An arrival manager (AMAN) is a support system for air traffic controllers in the airspace near an airport. The AMAN assists the air traffic controller in facilitating efficient arrival sequences and arrival times to ensure smooth arrival traffic. Although the aircraft sequencing problem that optimizes the arrival sequence has already been studied for the AMAN algorithm, the AMAN algorithm must also optimize aircraft trajectories to accommodate trajectory-based operations. This study proposes a novel AMAN algorithm based on the merging optimization method. Although the merging optimization method can simultaneously optimize the arrival sequence and trajectory, it cannot be easily applied to a realistic AMAN algorithm. Thus, the receding horizon approach is employed here to apply the merging optimization method to the AMAN algorithm. To demonstrate the performance of the proposed AMAN algorithm, numerical simulations are conducted. Actual radar data are used to conduct realistic air traffic simulations and evaluate the AMAN algorithm. A conventional AMAN algorithm is also simulated for comparison. Simulation results show that the proposed AMAN algorithm reduces both the total flight time and fuel consumption of all aircraft compared with the conventional AMAN algorithm. Furthermore, the proposed AMAN algorithm reveals the trade-off relationship between the minimization of flight time and fuel consumption.

In recent years ontology-based systems engineering has grown significantly. Its raison d’etre is to use ontologies to improve the systems engineering body of knowledge. Specifically, ontologies act as an enabler of good knowledge management as they focus on establishing well-defined domain concepts in terms of terminologies, definitions, and relationships. In addition, the use of formal semantics is essential for explicit, sharable, and reusable knowledge representation. However, little research exists that evaluates the impact and real benefits of ontologies for systems engineering. A thorough review of the state of the art of ontology-based systems engineering will contribute to the future development of the discipline. Therefore, the primary objective of this paper is to draw a clear roadmap of how ontologies support systems engineering and to determine what extent they have been applied in this domain. This review contributes to a holistic examination of the primary studies relevant to the topic of ontology-based systems engineering, spanning nearly two decades. The findings provide an integrated and comprehensive understanding of and shed new light on (1) the systems engineering knowledge areas supported by ontologies; (2) the contribution that ontologies make to systems engineering problems; (3) the existing ontologies that are created to support systems engineering; and (4) the techniques adopted from an ontology engineering perspective. It assesses the influence of ontologies in systems engineering knowledge areas, expounding and highlighting the effects of ontologies. All in all, it presents a comprehensive summary of the state of the art of ontology-based systems engineering, as well as illuminating a roadmap for future directions.

Rockburst, earthquake and blasting cause some dynamic loads on rock support and rock reinforcement system. Elements of rock support and rock reinforcement are generally made of steel bar or cables, which are resistant against corrosion. These support elements may be subjected to vibrations induced by turbines, vehicle traffic and long-term corrosion in addition to dynamic loading caused by earthquake, rockburst and blasting. In this study, some theoretical, numerical and experimental studies are conducted on rockbolts and rock anchors under shaking and impulsive loading. Then the outcomes of these studies are presented and their practical implications are discussed accordingly. Keywords: Rockbolt, Dynamic behaviour, Pull-out test, Planar sliding, Underground openings, Slopes

Aim To explore the experience of both the mothers and the fathers regarding the care received during delivery in cases of stillbirth. Design A hermeneutic phenomenological study based on semi-structured interviews with eleven mothers and fathers who experienced stillbirth. Participants A purposive sample was recruited in Hospital XXX of XX and through a local pregnancy loss support organization. Methods Interviews were recorded and transcribed verbatim and analysed using inductive thematic analysis. Findings Four main categories identified: 1) denial of grief, 2) the life and death paradox, 3) guilt, and 4) go through and overcome the loss. The parents manifested a lack of recognition of their loss and their parenthood. Although the midwife was the highest valued professional, not all the experiences were positive and the parents would have appreciated being accompanied by trained people with good communication skills. They also referred to in-hospital logistic barriers that complicated the process, as well as the fact that these births occurred in the same place where healthy deliveries were attended. Conclusion Findings highlight the importance of tailoring support systems according to mothers’ and fathers’ needs. Promoting social and institutional recognition of this kind of loss and training healthcare professionals in the accompaniment of this type of mourning is useful to plan comprehensive care to facilitate the initiation and subsequent evolution of healthy mourning.

Rockburst is a complex mining-induced phenomenon that remains difficult to be quantified. In particular, geological conditions contributing to rockbursts are more variable than those in many conventional engineering approaches. Faults, intact rock properties, and other rock mass conditions vary, sometimes, within small distance. Stress levels that store energy or drive structures can change with geological complications. For example, faults may channel stress between the void and the discontinuity, and/or alter the local stress direction. High-strength rock masses may be very massive at shallow depth, allowing for large/stable excavations. The same rock type may store excessive strain energy at depth or high mineral extraction, and lead to rockbursts. More robust ground support systems that can bear dynamic loading are now commonplace in mining industry. A typical approach would be able to evaluate rockburst potential, and selectively deploy more robust ground support systems. Rockburst resistant support is more expensive in installation than most support systems designed for gravity loading. Thus, an excessively conservative risk assessment can affect both direct support costs and productivity. As mines continue to go deeper, selective use of burst-prone support may not be an optimal choice, and pervasive installation may become necessary. This implies a need to maintain a reasonable installation speed, and the time to get to deep orebodies is a major economic factor. This paper shows field examples of rockbursts to highlight some of the complex issues related to the rockburst. A multi-tiered risk mitigation approach is used for rockburst conditions. Examples of risk reduction strategies are given and some examples from a deep hard rock mine are used to illustrate the relative success of the strategies. Given that some residual risks to worker safety remain, discussion is presented on where more research or process improvements would be beneficial. Keywords: Rockburst, Dynamic support, Seismic monitoring

Objectives The objective of this study was to evaluate the pharmacy adoption rates of an online Risk Evaluation and Mitigation Strategy (REMS) Pharmacy Portal designed as an alternative for REMS-certified pharmacies to perform mandatory pharmacy dispense confirmations and to assess whether Pharmacy Portal uptake was affected by the pharmacy daily dispense volume. Setting REMS-certified pharmacies dispensing lenalidomide (Revlimid), pomalidomide (Pomalyst), or thalidomide (Thalomid). Practice description Primarily specialty and hospital pharmacies in the limited distribution network that used the REMS Pharmacy Portal. Practice innovation A self-service pharmacy portal was developed to allow REMS-certified pharmacies to obtain confirmation numbers instead of calling a Celgene Customer Care Representative (CCR) or using the Interactive Voice Response System (IVR) system. Evaluation The numbers of pharmacy dispense confirmations obtained were identified, and the mean percentages by quarter (Q) were calculated from January 2013 through August 2016 for the Pharmacy Portal, Celgene CCR, and IVR. Results In Q1 2013, the CCR and IVR options were used for 57% and 43% of dispense confirmations, respectively. After the training period, the Pharmacy Portal rapidly became the most used option (67% of confirmations from Q2 2014). By August 2016, data displayed the continued preference for the pharmacy portal (98% of all confirmations) regardless of the daily dispense volume of the pharmacy. As of March 30, 2018, the pharmacy portal continued to be the preferred option for all pharmacies (maintained at 98.5% use). Conclusion There is an overwhelming REMS pharmacy preference to use the pharmacy portal over the IVR and CCR options, irrespective of the pharmacy daily dispense volume. The rapid uptake of the pharmacy portal is most likely attributed to robust and comprehensive 1-on-1 training and support provided by the REMS sponsor to the REMS-certified pharmacies, but also because it might be easier to use than the other options, resulting in reduced REMS burden for the pharmacy.

Objective To determine the most effective orientation program for new graduate nurses (NGNs) in hospital settings. Method A systematic review of existing literature was conducted following a search of the electronic databases Science Direct, PubMed, EBSCOhost, ProQuest, and Wiley Online (2008–2018). Searches utilized the following keywords nurse orientation, new nurse orientation, practical orientation, nurse transition, and nurse transition program. Results A total of fourteen studies met our review criteria. Evidence from these studies showed that current orientation protocols consist of preceptorship, classes, and simulations of patient care. The most efficacious orientations had well-established goals and utilized proven learning materials, support systems such as preceptorship and mentorship, learning methods, and evaluation instruments within the organization. Conclusion Well-designed orientation programs will result in positive effects on NGNs and patient care in the hospital.

Approximately, 65% of the existing residential structures are adjacent in Turkey. In addition to the social disadvantages of living in adjacent buildings, these structures are prone to pounding during earthquakes and they are under threat during the construction and demolition of the neighboring structures. The neighboring structures may experience damage during/after the demolition of adjacent structures due to pounding of structural components. There are many cases of casualties and economic losses due to the collapse of neighboring structures during the demolition of old structures. The damage can be occurred as a result of constructing shared foundations, different foundation depths, the groundwater level, and possible impact of the work machine during demolition. Also, in areas with high seismic risk, there is a possibility of an earthquake at a time between the demolition and reconstruction stages of a building, which can cause significant damage. Due to these reasons, the design and construction stages of adjacent structures should be described by building codes in detail. In order to renew the adjacent structures at different times, horizontal support elements should be used and required design calculations should be made. This study examines the truss system applications as horizontal support in such structures built in Eskisehir. The characteristics of the section and system properties, the horizontal load carrying capacity, the choice of support zones between the adjacent structures, and the characteristics of strain deformation are determined. It is concluded that the horizontal support applications prevent horizontal forces due to earthquakes and various vibrations in neighboring structures and prevent structural deformation.

Increasing number of building owners is adopting vertical greenery system (VGS) as an alternative to building facades or claddings due to its environmental, aesthetic and social benefits in recent years. While numerous studies have been conducted on its potential benefits and its environmental impacts, there has been little focus on its life-cycle cost (LCC) which is a crucial factor for building owners to adopt a VGS as well as to compare among various types of system. To fill this gap, this study aims to identify and calculate the LCC of 3 main types of VGS available in Singapore, where is the tropical climate, namely the carrier, planter and support systems. The cost incurred during each life-cycle stage including initialisation, installation, operation and demolition, are recorded based on 8 completed and ongoing cases selected in Singapore. The analysis of the results shows that the support system has the lowest life-cycle cost (S$885) followed by planter (S$3,786) and then the carrier system (S$4,919). During the life-cycle, the stage of Operations and Maintenance contributed the most to the LCC of a VGS (73.7–83.9%), while plants related parameters, e.g. plant replacement rate and price, affect the largest variances of LCC. for the support system, the LCC of VGS can be balanced off by building energy cost savings within 30 years, but not for other two systems. Suggestions on selecting VGS types, plants and supporting structures to reduce the cost of VGS have been discussed to conclude the study.

Background Work integrated learning opportunities account for approximately half of the Bachelor of Midwifery program with the goal being to ensure that on graduation students are skilled to provide woman centred evidenced based midwifery care within any environment. There is increasing concern, however, over the quality of clinical experiences students are afforded. Objective This study explored the experiences of third year Bachelor of Midwifery students in South East Queensland undertaking a clinical placement within a midwifery caseload model. Design A qualitative descriptive approach was adopted. Data were collected using semi-structured, digitally recorded telephone interviews. Thematic analysis was used to analyse the data set. Setting Midwifery student clinical placement in caseload practice Participants Twelve third year Bachelor of Midwifery students from one university who had experienced a clinical placement in a caseload midwifery model of between 4 and 8 weeks. Findings Five themes emerged. These were labelled ‘stepping in her shoes’, ‘bringing it all together’, ‘my own captive educator’, ‘knowing the woman’, and ‘it was hard – but it was worth it’. The three-way relationship between midwife, woman and student facilitated deep and active learning leading to a growth in confidence and readiness for practice. Students were afforded the opportunity to constantly integrate theory into practice within a woman centred social model of care where they also grew to understand how midwives operationalise caseload practice in a sustainable way. Students acknowledged the challenges they faced undertaking the placement, but all confirmed the value it had afforded them. Key conclusions and implications for practice This study has provided evidence that situating midwifery students within a continuity of care model facilitated a rich holistic learning experience for students. Not only did the placement enhance student's confidence and competence it also provided a real-world view of what working in that a caseload model could be like on graduation. This is vital if the profession is to support system level change ensuring all women have access to evidence informed maternity care.

Product forecasts are a critical input into sourcing, procurement, production, inventory, logistics, finance and marketing decisions. Numerous quantitative models have been developed and applied to generate and improve product forecasts. The use of human judgement, either solely or in conjunction with quantitative models, has been well researched in the academic literature and is a popular forecasting approach in industry practice. In the context of judgemental forecasting, methods that integrate an expert's judgement into quantitative forecasting models are commonly referred to as “integrating forecasting” methods. This paper presents a systematic review of the literature of judgemental demand forecasting with a focus placed on integrating methods. We explore the role of expert opinion and contextual information and discuss the application of behaviourally informed support systems. We also provide important directions for further research in these areas.

Introduction Epileptologists could benefit from a diagnosis support system that automatically detects seizures because visual inspection of long-term electroencephalograms (EEGs) is extremely time-consuming. However, the diversity of seizures among patients makes it difficult to develop universal features that are applicable for automatic seizure detection in all cases, and the rarity of seizures results in a lack of sufficient training data for classifiers. Methods To overcome these problems, we utilized an autoencoder (AE), which is often used for anomaly detection in the field of machine learning, to perform seizure detection. We hypothesized that multichannel EEG signals are compressible by AE owing to their spatio-temporal coupling and that the AE should be able to detect seizures as anomalous events from an interictal EEG. Results Through experiments, we found that the AE error was able to classify seizure and nonseizure states with a sensitivity of 100% in 22 out of 24 available test subjects and that the AE was better than the commercially available software BESA and Persyst for half of the test subjects. Conclusions These results suggest that the AE error is a feasible candidate for a universal seizure detection feature.

The Volkswagen Foundation under the Program: “Knowledge for Tomorrow – Cooperative Research Projects in Sub-Saharan Africa on Livelihood Management, Reforms and Processes of Structural Change”.

When the photovoltaic (PV) and solar thermal energy (STE) systems, which share the rooftop area, are installed in the same building, a trade-off problem occurs in terms of the energy, economic, and environmental aspects, and thus, steps need to solve this problem. Therefore, this study aimed to develop a multi-criteria decision support system of the PV and STE systems using the multi-objective optimization algorithm. This system was developed in the following six steps: (i) database establishment; (ii) designing the variables of the PV and STE systems; (iii) development of the analysis engine of the PV and STE systems; (iv) environmental and economic assessment from the life cycle perspective; (v) integrated multi-objective optimization (iMOO) with a genetic algorithm; and (vi) establishment of a multi-criteria decision support system. To verify the robustness and reliability of the developed model, an analysis of “D” City Hall and “I” Airport as target facilities was performed. The optimal PV and STE systems that consider the energy, economic, and environmental aspects at the same time were determined with respect to the 1.23 × 1015 and 1.05 × 1016 installation scenarios, respectively, in terms of effectiveness. The iMOO scores of the existing PV and STE systems installed in “D” City Hall and “I” Airport were 0.358 and 0.346, respectively, whereas those of the optimal solutions were 0.249 and 0.280, showing score improvements. In terms of efficiency, the times required for determining the optimal solutions were 20 and 30 min, respectively. The developed model makes the final decision-maker to find the optimal solution in introducing the PV and STE systems in the early design phase at the same time.

Neurodegenerative diseases (NDs) affect millions of people worldwide, with Alzheimer’s and Parkinson’s being the most common ones, and it is expected that their incidence will dramatically increase in the next few decades. Unfortunately, these diseases cannot be cured, but an early diagnosis can help to better manage their symptoms and their evolution. These aspects explain the importance of developing support systems for the early diagnosis of neurodegenarative diseases. Handwriting is one of the abilities that is affected by NDs. For this reason, researchers have also investigated the possibility of using the handwriting alterations caused by NDs as diagnostic signs. This paper presents a review of the literature of handwriting analysis for supporting the diagnosis of Alzheimer’s and Parkinson’s disease as well as of mild cognitive impairments (MCI), with the goal of providing interested researchers with the state-of-the-art research. Moreover, with the aim of providing some guidelines on the features to use for representing handwriting and the writing tasks patients should perform, we also review some widely used approaches for modeling handwriting. Finally, open issues are also discussed to identify promising areas for future research.

This paper has aimed to evaluate the air pollution emissions from maritime transportation arrive in/depart from Port of Incheon using two different approaches; fuel-based (Tier 1) and activity-based (Tier 3) methodologies. So far, Tier 1 or 2 level of estimation approaches, based on the fuel consumption provided by national fuel supply statistics, have been reasonably supported for environmentalists and policy makers at national level of emission inventory analysis, even for the global analysis. When considering the local air quality such as in a port area, however, the fuel based approach would not be properly estimating the shipping air emission sector due to the characteristic of maritime transportation. In this study, the fuel-based air emission inventory provided by Clean Air Policy Support System (CAPSS), South Korea was compared and analyzed with the activity-based emission estimation produced by Portal Air Quality Management System (PAQman©). As a result, there discovered a significant gap in the air pollution emissions between fuel-based and activity-based estimations. The findings in this study implies the necessity and significance of local/regional level focused implementation for air quality improvement and regulatory framework especially in a port-city region e.g. Incheon. Although this paper still contains some limitations and assumption described, the results are confident enough to emphasize the application of the activity-based shipping emission estimation approach to discover the potential limitation, which has been unknown and not listed on the national air emission inventory using fuel-based approach.

The extent of disaster exposure is a crucial predictor of both negative and constructive changes influenced by natural disasters. Posttraumatic growth (PTG) is the typical psychological growth that is defined by significant changes for the better in self-view, relationships, and life philosophy as a result of exposure to a traumatic incident. However, findings of previous studies examining the effects of disaster exposure on PTG are inconsistent. The primary aim of this study was to re-examine the nature of the association between the extent of disaster exposure and PTG in a sample of 1,000 adult survivors of the 5.12 Wenchuan earthquake (occurred in 2008) over 10 years ago in China. The results indicated that, after controlling for the effects of demographic factors (i.e., gender, age, residential area site, and marital status) and socioeconomic status (i.e., educational background and annual household income), disaster exposure showed weak linear but strong inverted U-shaped relationships with different PTG domains. In other words, participants who had been exposed to low or high levels of disaster showed low levels of PTG, while those exposed to moderate levels of disaster exhibited high levels of PTG. The result of the study not only enhanced current understanding of the consequences of disaster exposure but also outlined a long-term support system for post-disaster construction activities.

Ships using auxiliary power generators when docking can cause serious air pollution and thus pose a threat to port cities. Alternative Maritime Power (AMP) technology is an effective means of pollution control, which has been used in many countries. However, a series of difficulties have surfaced during the demonstration and promotion of AMP in China. To solve the problem, this study first summarizes 12 restrictions for AMP promotion, and then analyzes to what degree the restrictions inhibit promotion and application and their interaction mechanism using the fuzzy DEMATEL model. In the final, the three key factors restricting AMP application and promotion in China, namely policies and support systems, AMP construction standard, and the laws and regulations, are explored. The study results should go a long way in helping government departments and policymakers address issues that hinder accelerated promotion and application of the AMP technology in China.

A shear wall is a vertical member with a relatively large volume that is used frequently as a vertical passage and a lateral load support system in every building without exception. Many studies have been conducted on the sustainable design of buildings, but few have studied the sustainable design of shear walls considering CO2 emissions. Herein, a sustainable design model for shear walls is developed to analyze the relationship between building height, CO2 emissions, and construction cost. The model is applied to the sustainable design of shear walls installed in a 42-story mixed-use building. The characteristics in the change in CO2 emissions and the construction cost according to the building height were analyzed using the slenderness ratio as a variable. The results indicated that as the slenderness ratio increased, the CO2 emissions increased almost linearly in proportion to the height. In particular, when the slenderness ratio increased from 4.40 to 4.93, which is known to be the limit of the efficient applicability of shear walls, the CO2 emissions tended to increase more rapidly. When the slenderness ratio was 4.93, the CO2 emissions for the shear wall were reduced to 27.24% by the proposed model.

The convergence-confinement method used for tunnel analysis is based on the simplifying assumption of axisymmetric conditions. This paper presents a method for tunnel support design which is not limited to the hydrostatic loading simplification. With knowledge of the unsupported tunnel displacements, a circular beam equivalent to the plane strain tunnel boundary is found. Then, the distribution of field stresses between the ground and support system can be readily computed. The proposed method allows utilizing existing solutions for plastic deformations around excavations under non-hydrostatic loading, such as the solution derived by Detournay (1986), in order to compute the non-uniform support response. Significantly less computational resources are required compared to the finite-element method; hence, this method is well suited at the preliminary stage of a project to conduct extensive sensitivity analyses and identify critical support scenarios.

Nowadays, knowledge map as an efficient tool of knowledge management is widely used in various fields. In this paper, addressing the operational support of aerospace manufacturers, we explore the construction method of knowledge map and possible applications. We propose a five-step procedure for knowledge map construction, consisting of knowledge definition, knowledge extraction, knowledge description, knowledge links and knowledge map creation. Following this procedure, the knowledge map of operational support system for aerospace manufacturers is constructed in an example way. We also show the potential applications of knowledge map in aerospace manufactures.

When constructing an excavation, the segmental lining installed in an anisotropic rock mass is susceptible to asymmetrical pressure and substantial local instabilities. To promote liner stability in such cases, a support system that combines a segmental lining with a highly deformable expanded clay and rock bolts is proposed. A series of physical model tests were performed to study the effect of this support system. In the tests, different dip angles of the primary rock mass jointing, different thicknesses of the expanded clay and different lengths and spacings of rock bolts were considered. Variations in the internal forces and deformation of the segmental lining were recorded in each case. The distribution of the internal forces and deformation of the segmental lining were anisotropic due to the rock mass anisotropy; the maximum positive bending moment and positive deformation on the liner mainly developed in the direction normal to the stratification. By using a sufficiently thick deformable clay layer, the anisotropy of the load transferred to the segmental liner can be minimized. By adding rock bolts, the combined support system can take full advantage of the reinforcement effect of the rock bolts and the yielding effect of the deformable clay layer, and the effect of the rock bolts plus the yielding layer is greater than the sum of the two individual effects. Such a system can change the internal force and deformation distribution of the segmental lining to improve liner stability.

Energy absorbing support systems have the potential to contain or prevent rock mass damage on the periphery of underground excavations during a seismic event. Containing rockburst damage can protect employee safety, improve stakeholder relations and save money for the mine or tunnel owner. This is especially the case in deep tunnels, which may experience frequent seismicity and rockbursts. The financial consequences of rockbursts influence the potential value that energy absorbing support systems can provide in these mining and deep tunnel environments. In this paper, the potential value resulting from the use of different support systems in rockbursting conditions in deep tunnelling and mining environments is evaluated, and can be used as an approach to help facilitate the choice of support system.

Acute liver failure is an uncommon and severe disease characterised by a rapid onset of severe hepatocellular failure in individuals without previous liver disease. Initial management of this entity determines the outcome of the patient. Initial contact with the acute liver failure patients usually occurs in the emergency department, digestology clinic or, in more severe cases, intensive care units. The management of acute liver failure patients in all these cases must be multidisciplinary, involving surgeons and hepatologists who are experts in this condition, meaning those from hospitals with active liver transplant programmes. This article reviews the current body of evidence concerning the medical management of acute liver failure patients, from the suspected diagnosis and initial management to intensive medical treatment, including the need for an emergency liver transplantation. Moreover, we also review the use of artificial liver support systems in this setting.