Business Days Research Articles

Emerging economies in business news: Repositioning leaders in the Global South

Drawing from nation-branding as a recent development in contemporary globalization, and new middle power theory that examines hierarchies of nations, we used thematic textual analysis to examine business press coverage of the IBSA (India, Brazil, South Africa) consortium for business news representations and the positioning of IBSA nations in the global arena. Analysis of coverage in India’s The Financial Express, Brazil’s Valor Econômico and South Africa’s Business Day revealed that regional economic leadership, strengths in trade and technology, development aid and the consortium’s collective engagement in global activism inform the business press’ positioning of the IBSA countries as new middle powers.

Detection of abdominopelvic lymph nodes in multi-parametric MRI

Reliable localization of lymph nodes (LNs) in multi-parametric MRI (mpMRI) studies plays a major role in the assessment of lymphadenopathy and staging of metastatic disease. Radiologists routinely measure the nodal size in order to distinguish benign from malignant nodes, which require subsequent cancer staging. However, identification of lymph nodes is a cumbersome task due to their myriad appearances in mpMRI studies. Multiple sequences are acquired in mpMRI studies, including T2 fat suppressed (T2FS) and diffusion weighted imaging (DWI) sequences among others; consequently, the sizing of LNs is rendered challenging due to the variety of signal intensities in these sequences. Furthermore, radiologists can miss potentially metastatic LNs during a busy clinical day. To lighten these imaging and workflow challenges, we propose a computer-aided detection (CAD) pipeline to detect both benign and malignant LNs in the body for their subsequent measurement. We employed the recently proposed Dynamic Head (DyHead) neural network to detect LNs in mpMRI studies that were acquired using a variety of scanners and exam protocols. The T2FS and DWI series were co-registered, and a selective augmentation technique called Intra-Label LISA (ILL) was used to blend the two volumes with the interpolation factor drawn from a Beta distribution. In this way, ILL diversified the samples that the model encountered during the training phase, while the requirement for both sequences to be present at test time was nullified. Our results showed a mean average precision (mAP) of 53.5% and a sensitivity of ∼78% with ILL at 4 FP/vol. This corresponded to an improvement of ≥10% in mAP and ≥12% in sensitivity at 4FP (p ¡ 0.05) respectively over current LN detection approaches evaluated on the same dataset. We also established the out-of-distribution robustness of the DyHead model by training it on data acquired by a Siemens Aera scanner and testing it on data from the Siemens Verio, Siemens Biograph mMR, and Philips Achieva scanners. Our pilot work represents an important first step towards automated detection, segmentation, and classification of lymph nodes in mpMRI.

Effect of a Patient Portal Reminder Message After No-Show on Appointment Reattendance in Ophthalmology: A Randomized Clinical Trial

PurposeTo assess the efficacy of electronic health record (EHR) messaging for re-engaging patients with ophthalmology care after a missed appointment. DesignProspective, randomized clinical trial. MethodsThe study setting was an academic ophthalmology department. The patient population comprised return patients age 18 years or older with an appointment “no show,” or missed appointment. Over two phases of recruitment, 362 patients with an active patient portal in the EHR were selected consecutively each business day. Patients were randomized using a web-based tool to receive a reminder to reschedule via a standard mailed letter only (control) or the mailed letter plus an electronic message through the electronic record within one business day of the missed appointment (intervention). Reengagement with eye care was defined as attendance of a rescheduled appointment within 30 days of the no-show visit. Patient charts were reviewed for demographic and clinical data. ResultsThe average age of recruited patients was 59.9 years, just under half of the sample was male (42.5%, 154/362), and most patients were White (56.9%, 206/362) or Black (36.2%, 131/362). Patients were most commonly recruited from the retina service (39.2%, 142/362) followed by the glaucoma service (29.3%, 106/362). Many patients in this study had previous no-show appointments, with an average no-show rate of 18.8% out of all scheduled visits across our health system. In total, 22.2% (42/189) of patients in the intervention group attended a follow-up appointment within 30 days of their no-show visit compared to 11.6% (20/173) of the control group (OR, 2.186; 95% CI, 1.225-3.898; p=0.008). When including only the 74 patients in the intervention group who read the intervention message in the patient portal, 28.4% (21/74) attended a follow-up compared to 11.6% (20/173) of the control group (p=0.001). ConclusionsEHR-based reminder messages sent within a business day of a missed appointment may promote re-engagement in ophthalmology care after appointment no-show.

Combining Health and Well-being: Designing a Modern Medicinal Garden to Meet Tourists' Expectations


 
 
 The tourism sector, a fast-growing, competitive, and diversified industry is a significant contributor to the global economy. Modern-day tourism embraces characteristics associated with history, nature, and leisure, thereby linking them with new destinations in a continual expansion. The main objective of this study was to develop a perception-based conceptual model for a sustainable medicinal garden (MG) that could benefit the tourism industry while supporting biodiversity conservation. The proposed MG aims to fulfill six intentions, such as, relaxing the mind from a busy day while treating illnesses and improving mental healthiness; incorporating leisure activities that are closely related to medical treatments; disseminating knowledge on Sri Lankan traditional medicine; promoting sustainable eco- friendly practices; increasing economic benefits for the country; and improving the community livelihood of the people in the region. The research focused on developing an MG using the perception intended for 144 local and foreign participants representing four tourist hubs (Galle, Kandy, Dambulla, and Udawalawe) in Sri Lanka. The study examined the expectations of MGs and their preference for the experience. The questionnaire was used to evaluate the visitors' perceptions of the proposed 40 components for the proposed MG, which enabled their ranking based on preferences. The mean preference value for the MG experience was recorded as 72.1%. 97.0% of tourists who participated in the survey preferred to experience the MG, exceeding the 50% acceptance level for all 40 components. Therefore, all 40 components were applied to the MG. However, 18 components exceeded the 75% acceptance level; therefore, they could be incorporated into the MG without changes. The other 22 were considered the accepted components with some minor modifications. Considering the selected region (Dambulla) and the architectural view, 124 medicinal plants were accepted for application to the MG, including terrestrial, water, fruit, and poisonous plants. The model MG consists of 3545 medicinal plants. Creating an MG with the concepts of traditional, cultural, sustainable, and eco-friendly was a different angle to addressing the Sri Lankan tourism sector. This research presents an overturned vision that considers tourism demand on novel concepts of traditional herbal tourism. A model MG was developed with modern architectural and environmental knowledge. Within a five-acre arbitrary land, three-dimensional structures were designed around the proposed model MG. The actual structure of the MG was visualized with a virtual walk-through using architectural software (i.e., AutoCAD 19.0, Sketch-Up Pro 2015, and Lumion 5.0). This model can promote minimal environmental impact through the processes, conserve the environment and gain economic benefits from all these eco-services to the tourism sector and Sri Lankan economy to the advantage of the community or country.
 Keywords: Eco-tourism, Architectural software, Medicinal plants, Traditional medicine, Sri Lankan economy
 
 

Effect of an Outbound Scheduling Team on the Timeliness of Scheduling Referrals to Pediatric Otolaryngology.

Families preferring to receive care in a language-other-than-English have disparities in access to care. We studied the effect of implementing an ambulatory outbound scheduling team on the timeliness of scheduling referrals to pediatric otolaryngology. We hypothesized this intervention could increase access to care. Retrospective cohort analysis. Tertiary care academic center. Data were abstracted from the hospital's enterprise database for patients referred to Otolaryngology over 3 years (October 2019-August 2022; 7675 referrals). An outbound scheduling team was created April 2021 and tasked with calling out to schedule referrals within one business day of receipt. Referral lag was compared across patient cohorts before and after the scheduling intervention. Log-transformed linear regression models were used to assess the impact of the scheduling intervention on referral lag for language cohorts. The median preintervention referral lag was 6 days (interquartile range [IQR] 2-18), which was reduced to 1 day postintervention (IQR 0-5; P < .001). Preintervention language-other-than-English families had a median referral lag of 8 days (IQR 2-23), which was 1.27 times higher than for patients speaking English (P < .001). With implementation of the scheduling intervention, language-other-than-English families were scheduled in a median of 1 day (IQR 0-6), and the disparity in timeliness of scheduling was eliminated (P = .131). Postintervention, referral lag was reduced by 58% in the English and 64% in the language other than English cohorts. Implementation of an outbound ambulatory scheduling process reduces referral lag for all patients and eliminated a disparity in referral lag for language-other-than-English families.

Abstract WP50: Analyzing Post Discharge Follow-Up of a Disparate Population Utilizing Mobile Integrated Health

Introduction: Transition of care (TOC) to home for many stroke patients is suboptimal. Recent studies estimate 30-day all-cause readmission of stroke patients at 17.4%. The Wisconsin (WI) Coverdell Stroke Program partnered with the Milwaukee Fire Department- Mobile Integrated Health Program (MFD-MIH) and Milwaukee County hospitals three times since January 2019. The aim of our MIH focused partnership was to improve follow up care and care coordination after an acute stroke hospitalization to a vulnerable urban population. Methods: A charter, project algorithm, and referral forms were created to guide our work. Patient referral forms and MFD-MIH home visit summaries were sent via secure email. Upon receiving a home visit referral from the hospital MFD-MIH attempted to engage the patient within two business days. After a completed visit, MFD-MIH sent a summary form to the referring hospital mimicking post-discharge data metrics in Get With The Guidelines® (GWTG). Upon receiving the summary form, hospital abstractors entered the data into GWTG. The data was then analyzed by the Coverdell team. Results: As of May 2023, 73 stroke patients have received a home visit from MIH-MFD with data entry in GWTG. Analysis of the third iteration of the program will occur after it ends in April 2024. We compared our first two MIH projects to all Wisconsin hospitals entering into the GWTG Post-Discharge tab. Our results showed: • Coverdell MIH hospitals outperform WI hospitals in Blood Pressure Monitoring by Patient and Appointment Scheduled Prior to Discharge • Coverdell MIH hospitals underperform WI hospitals in ED Visits , Falls Reported by Patient , Medication Stoppage and Tobacco Use Conclusions: Many factors influenced our data. First, the population in the Coverdell MIH program was from an urban environment with more proximate post-discharge resources. All WI hospitals do not share this setting. Secondly, MIH data collection involves an in-person home visit. Conversely, WI hospitals data collection occurred via a phone call or chart review. The Coverdell MIH method facilitates a collegial environment where more truthful disclosures may result.

Frances Burney’s A Busy Day; or, an Arrival from India (1800-1802) and the Family Business

Frances Burney (1752-1840) became one of the most famous eighteenth-century English novelists after the publication of her first work Evelina (1778), which was followed by other successful novels that made her a household name in Britain. Though Burney was always very attracted by the stage and there is a close relationship between her narrative and dramatic production, her comedies and tragedies have been considerably less explored and celebrated by eighteenth-century scholars and feminism. This article examines Burney’s comedy A Busy Day; or, an Arrival from India (1800-1802), which was never performed on stage during her lifetime and was one of the author’s last compositions paving the way for her harsh social criticism in The Wanderer (1814). Like all of Burney’s works, A Busy Day contains a good deal of satire and a provoking view of the domestic ideology, colonialism and the economic interests of the family at the turn of the nineteenth century. Burney introduces an insightful analysis of vulgarity and prejudice against the middle class. By drawing on the work of several Burney scholars, gender and theatre studies, I show how gender and colonialism are interrelated in A Busy Day, which showcases an evolution from Burney’s first heroine in Evelina to a more mature woman that would continue up to The Wanderer and it turns out to be Burney’s fiercest dramatic criticism against bias based on class, race and sex.

Online Food Service Awareness and Perspective of Tertiary Institution Students: The Case of Federal University Oye-Ekiti, Nigeria

This study assessed tertiary students’ awareness of the emergence of the online food delivery (OFD) services could be attributed to the changing nature of urban consumers. These consumers use food delivery services for a variety of reasons but, unsurprisingly, the most common reason seems to be the need for quick and convenient meals during or after a busy day. The study used the cross-sectional survey conducted in Federal University Oye-Ekiti, Ekiti State, Nigeria, using random sampling technique. A total of 245 undergraduate students at the university were assessed with a structured online questionnaire. The data collected data was analyzed using Microsoft excel and GraphPad. Results showed that a majority of the students use online food services for their food service needs, hence the study concluded that the majority of the students at the University are aware of online food service. It was recommended that the quality of service of the online food service system needs improvement by enhancing the efficiency of service as well as accessibility, which will enable more students to opt for the food service and delivery system.

Making Malaysia A Logistic HUB: A Vision of PKT Logistics Group Sdn Bhd

Dato' Seri Michael Tio (DMT), the CEO of PKT Logistics, is returning to his residence after a busy day at his office in Shah Alam, Selangor, Malaysia. He will have dinner with his family and, after dinner, must consider next week’s crucial strategic group meeting. As a visionary entrepreneur, DMT is not just focused on the present success of PKT Logistics but is deeply invested in the company's core values and long-term ambitions. His leadership has already navigated PKT through numerous challenges, significantly contributing to its strong reputation and leadership position in the logistics and supply chain industry.&#x0D; &#x0D; DMT’s aspiration is not limited to maintaining PKT's current success; he envisions elevating Malaysia as a central hub in the ASEAN region. This goal reflects his commitment to advancing his company and boosting the nation's standing in the global logistics arena. Under his guidance, PKT has demonstrated remarkable growth, and its value system has been a cornerstone in differentiating it from competitors.&#x0D; &#x0D; As DMT prepares for the strategic meeting, he contemplates the future trajectory of PKT. He plans to propose a forward-thinking strategy to steer the company towards significant achievements in the next five to ten years, targeting 2025 to 2030. His vision includes expanding PKT's reach, embracing innovative technologies, and further integrating sustainable practices while nurturing the company's human capital.&#x0D; &#x0D; DMT understands that the logistics industry is rapidly evolving, driven by technological advancements and changing global trade dynamics. He recognizes the importance of adapting to these changes and staying ahead of the curve. Thus, his strategy for the meeting will focus on exploring new market opportunities, investing in cutting-edge logistics technology, and fostering a culture of continuous learning and innovation within PKT.&#x0D; &#x0D;

Online Shopping and Customer Satisfaction in College–Level Students in Kathmandu Valley

Background: Online shopping is becoming a popular electronic business day by day even in. Consumers can directly buy goods or services through the internet using a web browser when they engage in online shopping. Objectives: The primary objective of the study is to investigate how factors such as product quality, information accessibility, and shipping costs affect customer satisfaction toward online shopping in Kathmandu Valley. Methods: The study used an analytical research design. By utilizing a convenience sampling technique, 400 respondents were chosen from college-level students in Kathmandu Valley. The questionnaire survey was used to gather the primary data, which was then analyzed using cross-tabulation, an independent t-test, correlation analysis, and regression to produce the study's findings. Results: There is an association between information availability, product quality, and shipping cost with customer satisfaction toward online shopping, however, there is a strong association between the information availability and customer satisfaction. Customer satisfaction was highly impacted by the product quality and information availability, whereas it was not affected by the shipping cost. The quality of the product, the availability of information, and customer satisfaction were not impacted by gender; only shipping costs were affected. Conclusion: In conclusion, the online company needs to provide accurate information about their products and their business to draw potential customers and maintain the standard of websites with up-to-date information to retain regular customers. The company also needs to sell a high standard of its products and services to improve the company’s reputation to fulfill customers’ expectations. The company should also consider providing better service by timely delivering items at low cost. Future researchers will have access to a larger sample size across a variety of geographic concentrations to evaluate customer satisfaction in online shopping together with other independent factors of the general public.

Finansal Zaman Serilerinin Derin Öğrenme Algoritmaları ile Tahminlenmesi

Stock market index data, foreign currency, and gold have an important place in financial time series. Therefore, value or direction of movement estimation studies on this subject attracts the attention of both investors and researchers. This study aims to estimate the daily value of the US Dollar, Gold, and Borsa Istanbul (XU) 100 index using deep learning methods: Recurrent Neural Networks and Long-Short-Term Memory. A data set consisting of 2280 business days between 2013-2022, which includes the date, US Dollar, Gold, and XU 100 closing data, was used in the study. Mean absolute error, mean square error, root mean square error, and coefficient of determination were used to evaluate the performance of the developed prediction models. When the results were examined, it was seen that the Long-Short-Term Memory algorithm performs better than the Recurrent Neural Network algorithm and achieved a determination coefficient value of over 95% for the US Dollar, Gold, and XU 100 index. Moreover, the findings obtained in the study indicate that deep learning algorithms can show high prediction performance on financial time series without using extra independent variables.

Development of the FlagIt Report and Response System for Concerning or Harassing Messages Related to Public Health Work.

In response to growing reports of concerning/harassing messages and backlash related to public health work, the Johns Hopkins Bloomberg School of Public Health established the FlagIt report and response system. The system uses a dedicated FlagIt email inbox for faculty and staff to report harassing or concerning messages related to public-facing work and has an autoreply message sharing available institutional resources. The Johns Hopkins University public safety investigators review, inventory, and investigate the reported messages and share their findings with the reporter within 2 business days. In addition, the Johns Hopkins Bloomberg School of Public Health faculty FlagIt team volunteers reach out to the reporter to check in on how they are doing and offer additional supports if needed The FlagIt system was developed with existing institutional resources and did not require additional funding. Given the continued backlash against public health, other public health institutions and agencies may consider implementing similar report and response systems.

Smart Wearable Device for Child Safety by Using IOT

Now-a-days we can see that human life is becoming very fast. Moreover, the city life is getting very busy day- by- day. So in the daily busy schedule it is becoming very difficult for the parents to monitor their children closely. This paper discusses about a smart wearable device like a wristband which tracks the child from time to time to ensure their safety. If any problem occurs it would alert parents through the cell phone so that they can take immediate action. This paper focus on the SMS text enabled communication. Parents can send SMS with some keywords and the device reply back. The device can detect the child’s approximate location, it can detect the body temperature and the surrounding temperature, humidity and also the heartbeat of a child. For the emergency situation, the device would have some measures like an alarm buzzer, SOS light which will notify the bystanders to help the child. So this paper is all about the safety and security of a child to help them to recover from any type of difficulty. Keywords = Wearable, wristband, child safety, IoT, location, SMS

Understanding individuals with spinal cord injury’s self-care practices: a technology probe study to promote pressure relief adherence

Pressure reliefs (PRs) are self-care practices essential for individuals with spinal cord injury (SCI) to prevent life-threatening pressure injuries (PIs). Despite the benefits, individuals often do not do these exercises at home, leading to increased patient morbidity and mortality. To examine how digital technology could improve this population’s adherence to PR exercises, we conducted a technology probe study with five individuals with SCI over ten consecutive business days. A chat-based intervention was created to send user-scheduled PR reminders, which were personalized with visual elements and progress trackers. Participants were interviewed before and after interacting with the probe to better understand their experiences with PIs and PR practices. Results shed light on specific factors that may impact individuals with SCI’s behaviours towards PRs and four considerations to design a customisable reminder intervention: (1) easy to use and friendly technology, (2) design-your-own- schedule feature, (3) communication style feature, and (4) dialogue support features. Personalisation supported with gamified visual progress tracking and motivational messages emerged as a strong strategy to increase PR adherence. Both sets of findings expand upon the human-computer interaction (HCI) literature for mobile health tools that encourage self-care practices; in particular, to the specific needs of individuals with SCI and the use of visual elements to increase engagement.

Gaussian Bayesian network model of healthcare, food and energy sectors in the pandemic: Türkiye case

Healthcare, food, and energy are the basic needs of life in the globalizing world. Humankind's quest to maintain a healthy life and find ways to meet its needs has continued since its existence. The causal relations between the healthcare, food, and energy sectors are explored using data from the pandemic when COVID-19 was a global risk, and human health sustainability underwent a complicated process. It aims to examine the interaction between the healthcare, food, and energy sectors and model the causal relationship within the framework of probabilistic dependencies. For this purpose, the relationships between these sectors during the pandemic are modeled via Bayesian Networks (BNs). This highly successful inference method makes the complex structure of causal relationships graphically understandable. The data consists of stock returns at the end of the business day between March 11, 2020, when the pandemic was declared, and December 26, 2022. Data on 13 stocks actively traded on the Istanbul Stock Exchange (BIST) during the 700 days were obtained from tr.investing.com. Causal modeling uses Gaussian Bayesian Networks (GBNs) for continuous variables. To make the inferences drawn from the data more successful and minimize the loss of information, the GBN model is built with continuous variables. The posterior Probability Density Functions (PDFs) of the stocks in the network are constructed over the structure of the Directed Acyclic Graphs (DAG) of the BNs, and inferences are made by querying possible cases (tips). Markov Chain Monte Carlo (MCMC) simulations are performed with the posterior PDFs, and measures of the central tendency of the stocks are calculated. GBNs are used to generate daily return estimates for ULKER with the lowest MSE (1.06e-03) and RMSE (3.22e-02) values and ULUUN with the highest MSE (3.43e-03) and RMSE (5.83e-02) values.

EMISSIONS OF GREENHOUSE GASES IN TERNOPIL TOWN DURING THE SPRING OF 2023

The paper analyses the sources of air pollution in Ternopil town. The tendency of change in climatic conditions due to greenhouse gas emissions from motor vehicles is considered. It has been established that cars are the main source of changes in the atmospheric and ecological state. They produce 72% of pollution, while enterprises in the city produce only 28%. The study revealed a lack of statistical data on pollutant emissions into the city's atmosphere from mobile sources. The decision was made to collect the data on our own and to create the relevant peak load schedules by day of the week. Also, for better understanding, the percentage of transport is illustrated on the example of the central street of Ternopil (Ruska Street). The study found that passenger cars make up the bulk of the traffic flow per day - 89%. The busiest days are Tuesday - 57,912, Monday - 46,464 and Friday - 45,360. The lowest number of cars is observed on weekends, with 27,240 on Saturday and 28,544 on Sunday. According to the Begg's formula, modified by Shapovalov, the average level of carbon monoxide pollution on Ruska Street in the spring of 2023 was 52.95 mg/m³, which exceeds the MPC (5.5 mg/m³) by 10.9 times. We analysed the main works that addressed the problem of air pollution in the town and allowed us to better understand the situation. Attention was paid to this issue in the works of L.V. Yankovska, where the problem of motor transport in Ternopil town is repeatedly raised. N.P. Stetsko in her work «Transport and Technogenic Load on the Air Environment in Ternopil Region» examines in detail the issue of air pollution in Ternopil region. In his work "Complex green zone of Ternopil town, geoecological principles of sustainable functioning", I.R. Kuzyk examines the green zone of the city, production of oxygen and assimilation of carbon dioxide. In the work of I.R. Kuzyk is also conducting an analysis of the increase in the share of pollutants in the structure of the city's atmospheric air.&#x0D; In the current work, the problem of using generators is considered. According to the state customs statistics, during the 11 months of 2022, almost 354,000 generators worth 355 million US dollars were imported into Ukraine. After the massive missile strikes on the Ukrainian power grid, the "Epicentr" network reports a 5-7 times increase in demand for generators. It was investigated that in the central part of Ternopil town (according to the schedule of blackouts) in week 1, a gasoline generator produces 0.0476 tons of emissions. Valova Street is taken as an example. Its length is 170 meters, and its width is 8 meters. This is a street with two-sided buildings. On the first floor there are public institutions, on the second - residential apartments. There are 12 generators in this area that work simultaneously for several hours in a row. In addition to the above, the situation regarding the country's car fleet, which is similar for all cities, was analyzed. In particular, attention was drawn to the predominance of Euro-2 and Euro-3 cars. When Euro-5 standards are in force in the country from 2016. At the end, ways to resolve the situation are proposed. These measures include the improvement of environmental monitoring systems, the transition to alternative energy sources, the creation of traffic-free zones, and others.&#x0D; Key words: atmosphere; greenhouse gas emissions; Ternopil town; generators; transport load.

New Content Formats in Digital Communications

The emergence of new media channels goes hand in hand with the advent of new content formats and their subsequent rise in popularity. The digital era brings forth numerous new formats, with short video content currently emerging as the winner in terms of interaction, popularity, and return on investment (ROI) for content creators. This analysis examines a combination of psychological, lifestyle, and practical factors to explain why online users find this type of content so appealing and why the number of content creators joining this trend is increasing in the coming years. Social media with short video formats is studied from the perspectives of attachment theory and the socio-technical approach, which are useful in revealing the psychological motivators for online users actively seeking this type of content. Scientific literature about subjective feelings of engagement provides guidance on the fragmented workday and the usefulness of short-format content to fill small breaks in a busy day. From a practical standpoint, considering recent statistics on mobile usage, short-format content, especially vertical video, is faster, easier, and cheaper to create. At the same time, it is highly appealing, easy to distribute, and convenient to consume on smartphones without rotating the screen.

Mental Health Guidance and Support Bot

In an era characterized by the relentless pace of life and the escalating challenges to mental well-being, the emergence of the Mental Health Support Bot represents a revolutionary advancement in addressing the universal struggle with stress, anxiety, and depression. This abstract delves deeper into the conceptualization, methodology, results, and broader implications of this virtual companion, highlighting its transformative impact on the landscape of mental health support. The Mental Health Support Bot is rooted in the synergy of cutting-edge artificial intelligence and a profound understanding of the nuanced nature of mental health challenges. Its conceptualization arises from the recognition that these challenges are not confined to specific demographics but are pervasive, transcending geographical, cultural, and temporal boundaries. The bot is designed to be a dynamic and responsive virtual companion that tailors its approach to the unique needs of each individual user. Powered by advanced artificial intelligence, the Support Bot employs adaptive algorithms that continuously learn and evolve based on user interactions. The profound impact of the Mental Health Support Bot is reflected in its ability to transcend traditional limitations of mental health support systems. Its continuous accessibility, operating 24/7, ensures that users can seek assistance whenever the need arises, breaking down the temporal constraints of conventional models. Moreover, the bot's adaptability to users' schedules, whether during quiet moments in the night or amid the rush of a busy day, enhances the likelihood of individuals seeking timely assistance. The results signify a paradigm shift in mental health support, moving towards a more user-centric and proactive approach.

Hemapheresis Clinic Scheduling Quality Improvement Project

Abstract Introduction/Objective Outpatient (OP) Red blood cell exchange (RCE) therapy is used to treat patients with severe manifestations of sickle cell disease. Like any blood transfusion, a patient must have an active type and screen, drawn 24 to 72 hours prior to scheduled RCE procedure. UIH Hemapheresis clinic performs several types of apheresis procedures treating sickle cell disease, kidney transplant rejection and autoimmune disorders. Outpatient clinic staff perceived that most RCE procedures are scheduled disproportionately between Wednesday through Friday, which creates an unbalanced schedule that is lighter on Monday and Tuesday, and heavier Wednesday through Friday. The study's objective was to determine if there is a significant difference between the number of outpatient procedures scheduled on the different days of the week. If significant differences are identified, processes may be improved to schedule a more balanced OP clinic week. Potential benefits may include a more balanced patient to nursing staff ratios which can improve patient care and more efficient RBC utilization which can ease workload across multiple cross-functional departments such as nursing staff, reference labs and in-house blood bank staff. Methods/Case Report The UIH Epic Hemapheresis Clinic schedule was searched to identify how many total OP procedures, including RCE, were scheduled each day of the week between 01AUG2021 – 31JUL2022. Only OP procedures occurring in complete five-day weeks were included. Weekends and weeks having clinic closures for holidays were excluded Results (if a Case Study enter NA) Our study show that the lowest number of OP RCE (mean 1.4) and total number of OP procedures (mean 2.6) were on Monday. Wednesday is the busiest day with overall averaging 3.5 total procedures (Standard Deviation: 1.56). However, Friday is the most variable, with the largest SD for both RBCX (SD 1.4) and Total number of procedures (SD 1.7). Conclusion Contributing factors to low procedure volume on Monday are likely multifactorial. Some patients may prefer not to come to the hospital on Saturday for type and screen, while some may forget they need labs. Transportation issues are another factor. One intervention the clinic has implemented is automatic appointment call reminders. Staff encourage patients or caregivers to sign up for the EPIC MyChart app which also notifies patients of upcoming appointments. Future studies need to be conducted to address other bottlenecks within the scheduling workflow and to determine ways to optimize patient appointment adherence.

Differing Definitions of Vaso-Occlusion in Clinical Studies of Sickle Cell Disease Can Result in Differing Outcomes

Background: Frequent episodes of vaso-occlusion are the hallmark of sickle cell disease (SCD), but the definition of what constitutes a vaso-occlusive episode is not consistently applied across clinical trials, creating challenges in evaluating and comparing efficacy results among different therapies. Here, we compare vaso-occlusion endpoint definitions from clinical trials for various therapies, including genetic therapies, and use clinical trial data to demonstrate the potential for outcomes differences based on differing definitions of vaso-occlusive episodes. Methods: We reviewed completed and ongoing clinical trials and published articles using endpoints assessing the reduction or elimination of vaso-occlusive crisis/events, including trials of (i) exagamglogene autotemcel (exa-cel, CRISPR/Cas-9 based genome editing treatment), (ii) lovotibeglogene autotemcel (lovo-cel, gene addition therapy), (iii) L-glutamine, (iv) voxelotor, (v) hydroxyurea (HU) and (vi) crizanlizumab. Outcomes related to vaso-occlusion were compared across variables including care setting, care duration, treatments, and complications. Data from the CLIMB SCD-121 trial of exa-cel in patients aged 12 to 35 years with severe SCD (data cut as of 10 Feb 2023) were evaluated using different published definitions of vaso-occlusion. Results: The most substantial differences in vaso-occlusion endpoint definitions were associated with frequency and duration of visits to medical facilities for acute pain and inclusion of specific SCD specific complications. Definitions of vaso-occlusions for acute pain related events differed across studies. The definitions of severe vaso-occlusive crises for exa-cel (severe VOC; exa-cel), sickle cell pain-related crises (SCPC; crizanlizumab and L-glutamine), and VOC (VOC; voxelotor) include events with medical facility visits of any duration (severe VOC and SCPC) or medical records of a patient being seen or contacting a physician within 1 business day of an event (VOC), whereas the definition of severe vaso-occlusive events (severe VOE; lovo-cel) requires a ≥ 24-hour hospital or emergency room (ER) observation unit visit or ≥2 visits to a day unit or ER over 72 hours. Vaso-occlusion definition for HU (painful crisis) required a facility visit of ≥4 hours duration. All endpoints include acute chest syndrome and priapism; however, the definition of severe VOE requires ≥4 visits to a medical facility for priapism to meet criterion, while others require only a single visit. The exa-cel phase 3 trial in SCD employs a broad and inclusive definition for severe VOC which counts each individual medical facility visit, regardless of frequency or duration of hospitalization. Based on this, 19 out of 20 patients (95%) met the primary endpoint of freedom from severe VOCs for at least 12 consecutive months (95% CI, 75.1%, 99.9%; P&amp;lt;0.0001). However, when the primary endpoint was analyzed using the severe VOE definition, all patients (20/20; 100.0%) were free from severe VOEs for at least 12 consecutive months (95% CI: 83.2%, 100.0%; P&amp;lt;0.0001). Conclusions: Requirements for health care facility visits in the definitions of severe VOC (exa-cel), VOC, and SCPC were more broadly inclusive and include events that would not be counted in the definitions of severe VOE (lovo-cel) or painful crisis. Clinically, support for this observation comes from our analysis of exa-cel SCD pivotal clinical trial data using these different definitions, which showed the number of patients free from vaso-occlusive episodes changed depending on the definition of vaso-occlusion employed. These results show differences in vaso-occlusion definitions have the potential to impact assessments of treatment efficacy across different SCD therapies.