Delay Factors Research Articles

Influencing factors of delay in seeking medical attention of patients with obstructive sleep apnea based on the Model of Pathways to Treatment in China: a qualitative analysis

BackgroundThere is the highest estimated number of patients with obstructive sleep apnea (OSA) in China. Early treatment could lead to fewer complications associated with OSA. This study aimed to analyze the factors influencing help-seeking from the first symptom discovery to treatment in OSA.MethodsSemi-structured interview outline was designed to conduct face-to-face interview based on the analyses of a great number of related literatures on the delay in seeking medical attention of patients with OSA. 15 patients diagnosed were interviewed between June 2021 to September 2022 in general hospital of Shenyang, Northeastern of China. Qualitative data was analyzed by content analysis using the Model of Pathways to Treatment.ResultsAnalyses identified factors contributing to elapsed time from first symptom discovery to received treatment that are linked to disease characteristic, patients, health system organization. Appraisal interval is most obvious for patients with OSA, but it is difficult to pinpoint precisely because the patients didn’t remember exactly when the first symptom was detected.ConclusionsPatients diagnosed with OSA didn’t initially interpret the snore as a warning sign and even thought it was a blessing. The findings provided guidance or avenues for reducing elapsed time between the first symptom and received treatment.

PCR236 Analyzing Possible Diagnostic Delay Factors in Gynaecological and Andrological Diseases Among Secondary School Students

PCR236 Analyzing Possible Diagnostic Delay Factors in Gynaecological and Andrological Diseases Among Secondary School Students

Developmental pyrethroid exposure in mouse leads to disrupted brain metabolism in adulthood

Environmental and genetic risk factors, and their interactions, contribute significantly to the etiology of neurodevelopmental disorders (NDDs). Recent epidemiology studies have implicated pyrethroid pesticides as an environmental risk factor for autism and developmental delay. Our previous research showed that low-dose developmental exposure to the pyrethroid pesticide deltamethrin in mice caused male-biased changes in the brain and in NDD-relevant behaviors in adulthood. Here, we used a metabolomics approach to determine the broadest possible set of metabolic changes in the adult male mouse brain caused by low-dose pyrethroid exposure during development. Using a litter-based design, we exposed mouse dams during pregnancy and lactation to deltamethrin (3 mg/kg or vehicle every 3 days) at a concentration well below the EPA-determined benchmark dose used for regulatory guidance. We raised male offspring to adulthood and collected whole brain samples for untargeted high-resolution metabolomics analysis. Developmentally exposed mice had disruptions in 116 metabolites which clustered into pathways for folate biosynthesis, retinol metabolism, and tryptophan metabolism. As a cross-validation, we integrated metabolomics and transcriptomics data from the same samples, which confirmed previous findings of altered dopamine signaling. These results suggest that pyrethroid exposure during development leads to disruptions in metabolism in the adult brain, which may inform both prevention and therapeutic strategies.

Door-to-Balloon Time in ST-Elevation Myocardial Infarction (STEMI) Patients Undergoing Primary Angioplasty in Myocardial Infarction (PAMI): An Observational Study From a Tertiary Care Centre.

Background ST-elevation myocardial infarction (STEMI) requires swift intervention, with primary percutaneous coronary intervention (PCI) being essential to limit myocardial damage. The key factor affecting PCI effectiveness is the door-to-balloon (DTB) time. This observational study evaluated DTB times in STEMI patients at a tertiary care center who underwent primary angioplasty, examining adherence to benchmarks and identifying factors contributing to delays. Methodology This prospective observational study was conducted from March 2017 to August 2018 at Fortis Hospital Mulund, Mumbai, India. It included 171 STEMI patients aged 18 and older who underwent primary angioplasty. Patients with non-ST elevation myocardial infarction (NSTEMI), those who received thrombolysis, or had medical contraindications to primary angioplasty were excluded. Data on key time intervals were collected via direct observation and then analyzed using SPSS for Windows, Version 15 (Released 2006; SPSS Inc., Chicago, United States). Qualitative data were summarized using frequency and percentages, whereas quantitative data were presented as mean (±SD). T-test was applied to compare the mean duration between the two groups, i.e., DTB time ≤90 minutes and DTB time >90 minutes, and a p-value <0.05 was considered statistically significant. Results The participants had a mean age of 56.5 (±13.1) years and were predominantly male (78.4%). The mean DTB time was 70.21 (±29.16) minutes, with 79.5% achieving ≤90 minutes. Patient-related delays (48.6%) were mainly due to consent issues (31.4%), which was the most predominant cause. Hospital-related delays (51.4%) included catheterization laboratory occupancy (14.3%) and diagnostic delays (14.3%). Patients with DTB times >90 minutes had significantly longer durations in all procedural steps except door-to-ECG time. Conclusion This study underscores the complex challenges in achieving timely DTB times for STEMI patients undergoing primary angioplasty. Overcoming these barriers through targeted interventions is essential for optimizing management and enhancing outcomes. Insights into delay factors inform evidence-based strategies to improve the timeliness and effectiveness of STEMI care delivery.

Risk factors of developmental delay in children from the age group of 6 months to 6 years

Background: Infants at risk for developmental delay (DD) have a history of one or more risk factors that occurred during pregnancy, the perinatal period, or after birth. Despite numerous studies on high-risk pregnancies and child development in advanced countries, there is scanty data from developing nations like India. Objectives: To determine the antenatal, natal and postnatal risk factors of DD in children aged 6 months to 6 years. Method: A case-control study comprising 61 infants with DD and 61 controls was carried out at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe) in Maharashtra from December 2019 to May 2020. Children with DD were taken as cases and children without DD as controls. A questionnaire delivered to mothers was used to gather data. Data analysis was carried out using STATA, version 10 software. Results: Common risk factors were caesarean sections (55%), infections (58%), and chronic disorders during pregnancy (49%). Maternal infections, chronic diseases during pregnancy, caesarean section, failure to cry after birth and absence of breastfeeding were significantly more in cases compared to controls. Conclusions: In this case-control study, maternal infections, chronic diseases during pregnancy, caesarean section, failure to cry after birth and absence of breastfeeding were risk factors of DD in children aged 6 months to 6 years.

Healthcare Provider-Related Factors in the Diagnostic Delay of Cervical Cancer: A Cross-Sectional Study.

Background and objective Cervical cancer is the second most common malignancy among Indian women. In 2018, the World Health Organization (WHO) called for global action toward the elimination of cervical cancer through the triple-intervention strategy. One of its pillars is ensuring 70% screening coverage of eligible women with a high-performance test at least twice in their lifetime. Various factors contribute to the delayed diagnosis of cervical cancer, increasing the burden of the disease. In this study, we aimed to determine the healthcare provider (HCP)-related factors in the diagnostic delay of advanced cervical cancer. Methods This prospective cross-sectional study was conducted over two months in the cancer clinic of the Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. We interviewed 384 women diagnosed with advanced cervical cancer [the International Federation of Gynecology and Obstetrics (FIGO) stage IB3-IVB] by using a questionnaire to capture data inputs regarding the various healthcare services they had received in the past 10 years along with details of HCPs. The collected data were analyzed using the software STATA version 17.0. Results Among 384 participants, 185 (48.1%) had interacted with an HCP in the past 10 years; 157 (40.8%) of them had visited a healthcare facility.Among these 185 women, only 22.16% had been advised to undergo screening, and only 15.18% had been tested despite several having access to primary health centers within 10 km of their residence. The lack of screening guidance by HCPs accounted for 78% of delayed diagnoses of cervical cancer. Conclusions Based on our findings, a deficiency in screening guidance in the asymptomatic period by healthcare providers across various levels of our healthcare system contributed significantly to the delayed diagnosis of cervical cancer.

Developmental pyrethroid exposure in mouse leads to disrupted brain metabolism in adulthood.

Environmental and genetic risk factors, and their interactions, contribute significantly to the etiology of neurodevelopmental disorders (NDDs). Recent epidemiology studies have implicated pyrethroid pesticides as an environmental risk factor for autism and developmental delay. Our previous research showed that low-dose developmental exposure to the pyrethroid pesticide deltamethrin in mice caused male-biased changes in the brain and in NDD-relevant behaviors in adulthood. Here, we used a metabolomics approach to determine the broadest possible set of metabolic changes in the adult male mouse brain caused by low-dose pyrethroid exposure during development. Using a litter-based design, we exposed mouse dams during pregnancy and lactation to deltamethrin (3 mg/kg or vehicle every 3 days) at a concentration well below the EPA-determined benchmark dose used for regulatory guidance. We raised male offspring to adulthood and collected whole brain samples for untargeted high-resolution metabolomics analysis. Developmentally exposed mice had disruptions in 116 metabolites which clustered into pathways for folate biosynthesis, retinol metabolism, and tryptophan metabolism. As a cross-validation, we integrated metabolomics and transcriptomics data from the same samples, which confirmed previous findings of altered dopamine signaling. These results suggest that pyrethroid exposure during development leads to disruptions in metabolism in the adult brain, which may inform both prevention and therapeutic strategies.

Ultra-slow-light and dynamically quantitative optical storage modulation via quasi-BICs.

We achieve dynamically tunable dual quasi-bound states in the continuum (quasi-BICs) by implementing them in a silicon-graphene multilayer composite structure and utilize the quasi-BIC modes to achieve ultra-large group delays (velocity of light slows down 105 times), showing 2-3 orders of magnitude higher than the group delays of previous electromagnetically induced transparency modes. The double-layer graphene holds great tuning capability and leads to the dramatically reduced group delay from 1929.82 to 1.58 ps with only 100 meV. In addition, the log-linear variation rule of group delay with Fermi level (Ef) in the range of 0-10 meV is analyzed in detail, and the double-logarithmic function relationship between the group delay and quality factor (Q-factor) is theoretically verified. Finally, the quantitative modulation of the optical storage is further realized in this basis. Our research provides ideas for the reform and upgrading of slow optical devices.

Delayed elective total shoulder arthroplasty: causes and eventual outcomes.

The purpose of this study is to identify risk factors for delays in planned total shoulder arthroplasty (TSA) and determine the perioperative outcomes of TSAs that experienced a delay. The American College of Surgeons National Quality Improvement Program (NSQIP) database was queried from 2006 to 2019 for primary TSA. Delayed TSA was defined as surgery that occurred greater than one day after hospital admission. Patient demographics, comorbidities, and post-operative complications were collected and compared; the incidence of delayed TSA was analyzed. The delayed patients were older, had a higher BMI, a higher rate of recent prior major surgery, and more comorbidities. Delayed patients had higher rates of postoperative complications, return to the OR, and 30-day readmission. Between 2006 and 2019, the rate of delayed TSA decreased. Surgeons should take care to ensure that patients with comorbidities undergo thorough preoperative clearance to prevent same-day cancellations and postoperative complications.

Influence of BIM and Lean on mitigating delay factors in building projects

Building projects are affected by various phenomena that can affect their success and continuity and, in the worst cases, can lead to project abandonment. The delay has been identified as one of the phenomena with the most significant impact and recurrence; therefore, mitigation actions are required. BIM and Lean Construction are two approaches with great potential to mitigate delay-generating factors. However, more studies need to be conducted to analyze their influence on mitigating schedule delays. Considering this gap, this paper focuses on analyzing the influence of Lean Construction tools, and BIM uses that favor mitigating the main factors that generate variations in the construction schedules of residential buildings. The research method was divided into five main stages: (1) delay factors identification; (2) BIM uses identification; (3) Lean tools identification; (4) questionnaire design, validation, and application; and (5) influence quantitative analysis. A total of 20 delay factors, eight BIM uses, and eight Lean tools were selected. Next, a consultation was conducted with 50 building project managers and two residential building projects were analyzed. The findings show that implementing BIM and Lean tools greatly influences mitigating delay factors such as errors and deficiencies in design documents, inefficient project planning and scheduling, and poor communication and coordination with designers. BIM uses that have a strong influence on reducing delays include 4D construction planning and 4D construction analysis and optimization. In the Lean domain, the Last Planner System (LPS) and collaborative meetings have a high influence on mitigating delays. This study provides valuable insights for construction project managers to improve overall project efficiency by optimizing the implementation of BIM uses and Lean tools.

Analisis Faktor Keterlambatan Pelaksanaan perbaikan Jalan rusak Lembar-Pelabuahan Gili Mas Lombok Barat

It is hoped that the repair of the damaged road at Lemi Mas Harbor, West Lombok, Gili Mas will be able to facilitate the transportation of goods and services at Gili Mas Harbor, West Lombok. This road repair work is expected to be completed according to the implementation time stated in the contract. The research location is West Lombok Regency. In this research, a survey was conducted using a questionnaire on the workforce on the project. The delay factors considered in data collection were obtained based on literature studies. Factor analysis and ranking are carried out to see the factors that have the most significant value. The results of the analysis show that the 3 factors with the highest ratings causing delays in the repair project for the damaged Lembar-Pelabuhan Gili Mas Road, West Lombok, are unfinished contract changes (Addendums); poor implementation schedule; and slow design review drawings. Keyword: Road repairs, factor analysis, delays

Investigating construction delays in cold storage projects in the Philippines

Construction delays pose significant challenges affecting project timelines, budgets, and quality standards globally. This study focuses on bridging the knowledge between differences of construction between cold storage facility projects among other types of projects and identifying influential factors causing delays in cold storage construction projects in the Philippines. Through a questionnaire survey including 30 critical delay factors derived from comprehensive literature review and expert consultations, data was gathered from 100 stakeholders across diverse cold storage projects via simple random sampling. Analysis using the Relative Importance Index (RII) highlighted inadequate manpower, delays in the concrete slab construction, permit acquisition delays, quality-related rework, problems arising during testing and commissioning of the temperature-controlled room, and late procurement as the primary causes of construction delays in these projects. These findings underscore the critical need for improvements to pre-emptively manage risks leading to project overruns. The study recommends a concentrated effort by construction stakeholders targeting the top 10 critical delay factors identified, to mitigate future delays and ensure smoother project execution. This approach is very crucial for meeting the country’s reliance on timely completion of cold storage facilities which is vital for accommodating the increasing demands across diverse sectors including food, pharmaceuticals, and agriculture.

Analisis Faktor-Faktor Keterlambatan Mahasiswa Tingkat Akhir Di Program Studi Pendidikan Ekonomi FKIP ULM Dalam Menyelesaikan Skripsi

This research aims to determine the factors inhibiting the completion of a thesis in the FKIP ULM economics education study program in the 2016-2019 class. This research uses quantitative research with descriptive quantitative research, using a questionnaire which will be distributed using a Likert Scale with a sample size of 92 participants. With the validity research instrument test used in this research, the validity test itself uses the Product Moment (Pearson) correlation statistical calculation formula. And testing the reliability test was measured using the Cronbach'Alpha method. The data analysis technique used was Descriptive Analysis. Based on research that has been carried out, it is stated that the factors of delay in completing the thesis affect the graduation rate of FKIP ULM economic education students. is in the very high category with a percentage of 97.9%. The factors that cause delays in completing a student's thesis are internal factors and external factors consisting of internal factors, namely motivation, intelligence, health, attitudes and study habits, psychology. External factors consist of family factors, availability of learning resources, peer environment, lecturers, and other factors.

Factor analysis method for delay dynamics in Nigerian Tin Can Island Port for sustainable development

The effect of efficient and effective port system on the economy viability of any nation cannot be over emphasis. This study investigated factors that could be termed as delay causative factors in Nigerian ports industry using TIN CAN Island port complex as a case study. A well-structured questionnaire was developed for this research and 72 respondents, who are port users (custom officers, employees, and customers), were asked to rank the variables perceived to be causing delay at the port according to their respective perception of the effect of each factor on delay factors at the port. The validity of the research instrument was done using Cronbach Alpha. There are several factors that were thought to be working together in reducing efficiency in Nigerian ports and these factors were analyzed using factor analysis method. It was discovered from the analysis that Lack of Government Authority, Ullage Constraint, Inadequate Berthing, Logistics Delay, Financial Constraint and Equipment Breakdown are major factors that cause delay at Tin Can Island Port Lagos. These highlighted factors should be paid special attention in order to reduce delay in Tin Can Island port which will in turns lead to more revenue for the country.

Determining Factors of Audit Delay With Audit Quality as a Moderating Variable

Audit delay is a critical aspect in the realm of financial auditing, reflecting the time lapse between the end of a financial reporting period and the completion of the audit. This delay can be influenced by various factors. Understanding these determinants is crucial for improving the effectiveness and timeliness of audit processes. This research aims to analyze the influence of Profitability, Liquidity and Leverage on Audit Delay using Audit Quality as a moderating variable. This research is quantitative research. The sampling technique was purposive sampling and the sample size was 78 company data. The data used is secondary data. Data collection was carried out using documentary data. The analysis techniques in this research are the classic assumption test, F test, determination test, and T test using the SPSS application. The research results show that 1) Profitability has no effect on Audit Delay, 2) Liquidity has no effect on Audit Delay, 3) Leverage has a significant negative effect on Audit Delay, 4) Audit Quality is able to moderate the influence of liquidity and leverage on Audit Delay.

Data-Driven-Based Intelligent Alarm Method of Ultra-Supercritical Thermal Power Units

In order to ensure the safe operation of the ultra-supercritical thermal power units (USCTPUs), this paper proposes an intelligent alarm method to enhance the performance of the alarm system. Firstly, addressing the issues of slow response and high missed alarm rate (MAR) in traditional alarm systems, a threshold optimization method is proposed by integrating kernel density estimation (KDE) and convolution optimization algorithm (COA). Based on the traditional approach, the expected detection delay (EDD) indicator is introduced to better evaluate the response speed of the alarm system. By considering the false alarm rate (FAR), and EDD, a threshold optimization objective function is constructed, and the COA is employed to obtain the optimal alarm threshold. Secondly, to address the problem of excessive nuisance alarms, this paper reduces the number of nuisance alarms by introducing an adaptive delay factor into the existing system. Finally, simulation results demonstrate that the proposed method significantly reduces the MAR and EDD, improves the response speed and performance of the alarm system, and effectively reduces the number of nuisance alarms, thereby enhancing the quality of the alarms.

Causes of Delay in EPC Projects: The Case of Indonesia

The construction industry is a significant part of the economy in developing countries. During Indonesia's 2010-2020 period, many large-scale EPC projects were launched to build new plants and infrastructure facilities. However, most of these projects experienced delays. This research aims to identify the causes of delays in EPC projects in Indonesia. It also investigates whether specific characteristics of EPC projects within the fertilizer industry in Indonesia, particularly those associated with state-owned companies, contribute to these delays. Data was collected through questionnaires with samples from company construction experts involved in EPC projects consisting of 41 owners, 14 contractors, and 12 consultants. The Relative Importance Index (RII) was subsequently computed, revealing the top ten delay causes for EPC projects in Indonesia based on the highest RII values consisting of delays in procuring equipment/materials, contractor difficulties in funding the project, ineffective project planning and scheduling, the winner of the tender is the lowest bidder, rework due to errors during construction, poor communication and coordination between parties involved in the project, delays in the work of design, disputes in understanding the EPC contract and project specification, unrealistic the duration of the project and delays in the owner's decision. Comparison of delay factors with other developing countries in Asia and Africa shows similarities. Notably, among these categories, contractor-related factors demonstrated the highest RII values. Spearman’s rank correlation coefficient shows that all respondents highly agreed with the individual ranking of delay factors.

Analysis on status quo and related factors of delays in diagnosis and treatment of breast cancer in Ningxia Hui Autonomous Region.

This study aimed to explore factors contributing to the delays in the diagnosis and treatment of breast cancer (BC) in Ningxia Hui Autonomous Region. We conducted a cohort analysis of 1012 patients with BC diagnosed at the General Hospital of Ningxia Medical University between January 2018 and December 2019. Sociodemographic data were collected through questionnaires, and clinical data were gathered and analyzed from relevant databases. Furthermore, observations were made regarding delays in the diagnosis and treatment of BC, followed by an analysis of the correlations between patient delay and both sociological factors within the population and clinical factors specific to patients with BC. Subsequently, the factors associated with patient delay and system delay were examined using Cox regression analysis, along with the inclusion of neoadjuvant therapy. In the prevention and treatment of BC in Ningxia, the patient delay rate was 33.20%, the diagnosis delay rate was 17.89%, the treatment delay rate was 0.0099% and the system delay rate was 41.60%. There was a higher proportion of patient delay and system delay in aged patients (age ≥ 61 years) with rural registered permanent residence (RPR), multiple clinical symptoms (such as nipple spillage, axillary abnormalities, etc), a T4 tumor size classification, and the initial use of neoadjuvant therapy. Besides, significant positive correlations were observed between patient delay and system delay time with BC stage. Patients aged 51 to 60 and those with molecular types (Limanal1B: ki-67 > 14%, Limanal1B: HER-2 positive) were prone to patient delay, whereas molecular characteristics influenced system delay, unrelated to sociodemographic factors. The study identifies significant age, residency, and tumor molecular subtype correlations with diagnostic and treatment delays in Ningxia's patients with BC, predominantly affecting women aged 41 to 60, especially urban dwellers. These findings underscore the need for targeted interventions to reduce delays and improve BC care in this region.

A stochastic and time-delay evolutionary game of food safety regulation under central government punishment mechanism

Food safety is a pressing issue affecting public health, and strengthening food safety regulation has become a widespread consensus. This study addresses the three-party game involving food production enterprises, third-party testing agencies, and government regulatory authorities. Considering the influence of random disturbances and time delays on the strategy-choosing and behavioral evolution of game players, a three-party stochastic evolutionary game model for food safety regulation with time delays is established. The stability of the model is analyzed by using Lyapunov's method, and the strategy evolution of the game players is investigated while combining numerical simulations. The study shows that the net benefit of the players' expected strategies is key in determining whether the overall game system can reach the optimal equilibrium. The level of penalties imposed by the central government on local government regulators is key to food safety. The main factors influencing the strategy-choosing of game players are the level of penalties imposed by the local government regulators on third-party testing agencies, together with the supervision costs of the local government regulators. Random disturbances have a certain impact on strategy-choosing of the game players, with a greater impact on testing agencies, followed by food production enterprises, and a weaker impact on government regulatory authorities. The time delay factors exhibit a certain delay effect on the evolutionary path of strategy-choosing among the game players, which aligns with the actual situation. The findings of the study have implications for food safety regulation.

Project Delay Factor Analysis Using Fault Tree Analysis (FTA) Method and Rescheduling with Critical Path Method (CPM) in Ducting Manufacturing Projects at PT. FRA

Ducting manufacturing project at PT. The FRA was planned to be completed in 14 days, but was implemented in 19 days and 5 days late. The method to find the cause of project delays is Fault Tree Analysis (FTA), then analyze rescheduling with the Critical Path Method (CPM). The purpose of this study is to identify factors of work delay, determine new steps for project contractors and reschedule with alternative working hours and labor additions. The results of the analysis using the FTA method obtained the main cause of delay in drawing engineering work of 0.0002592 and obtained 4 new steps for project contractors. The results of rescheduling using the CPM method obtained a percentage increase in productivity with the alternative of adding working for 4 hours with a duration of 25% or 6 days faster than the normal duration of 19 days to 13 days and an additional cost of 91.96%, which is Rp. 21,500,000. While the percentage of productivity increase with alternative labor additions with a duration of 38.75% or 5 days faster than the normal duration of 19 days to 14 days and additional costs of 178.57%, namely Rp. 31,200,000. So it can be concluded by using the FTA method the main cause is drawing engineering work and 4 new steps are obtained and using the CPM method alternative scheduling is obtained to increase overtime work hours more effectively and additional costs are not too large, so that the company does not experience delays for future ducting projects.