Setting Approach Research Articles

Dynamics of post-stroke hand paresis kinematic pattern during rehabilitation

According to the literature data, only 5–20% of post-stroke patients are able to restore the hand motor function completely. Correct goal setting and individual approach to the patient's functional recovery are important. Our study aimed to develop an algorithm of impaired hand motor functioning assessment for post-stroke patients and to determine the principles of the rehabilitation tactics choosing based on the biomechanical analysis. Twenty five patients with hemispheric stroke and 10 healthy volunteers participated in the study. Formal clinical observation scales (Fugl-Meyer Assessment, Ashworth Scale, ARAT) and video motion analysis were used for evaluation of the hand motor function. Patients were divided into 2 groups according to the hand paresis severity (mild/moderate and pronounced/severe). Rehabilitation was carried out in both groups, including mechanotherapy, massage and physical therapy. It was revealed that in the 1st group of patients the motor function recovery in the paretic hand was due to movement performance recovery: biomechanical parameters restoration directly correlated with a decrease in the paresis degree according to the Fugl-Meyer Assessment Scale (r = 0.94; p = 0.01). In the 2nd group of patients, the motor function recovery in the paretic hand was due to motor deficit compensation: according to biomechanical analysis, the pathological motor synergies inversely correlated with a decrease in the paresis degree (r = –0.9; p = 0.03). As a result of the study, an algorithm for selecting the patient management tactics based on the baseline clinical indicators was developed.

Towards Guideline-Based Management of Tethered Cord Syndrome in Spina Bifida: A Global Health Paradigm Shift in the Era of Prenatal Surgery.

An estimated 60% of the world’s population lives in Asia, where the incidence of neural tube defects is high. Aware that tethered cord syndrome (TCS) is an important comorbidity, the purpose of this systematic review was to explore the treatment of TCS among individuals living with spina bifida (SB) in Asia. MEDLINE and Embase databases were searched for relevant studies published from January 2000 to June 2018. Search terms such as ‘spinal dysraphism,’ ‘spinabifida,’ ‘diastematomyelia,’ ‘lipomeningocele,’ ‘lypomyelomeningocele,’ ‘meningomyelocele,’ and ‘tethered cord syndrome’ were used in diverse combinations. Of the 1,290 articles that were identified in accordance with PRISMA (Preferred Items for Systematic Reviews and Meta-Analyses) guidelines, 15 Asia-based studies met the inclusion criteria. Significant differences in the diagnostic criteria and management of TCS were documented. As the surgical techniques for prenatal closure of the spinal defect continue to evolve, their adoption internationally is likely to continue. In this setting, a clear and evidence-based approach to the definition and management of TCS is essential. The recent publication by the Spina Bifida Association of America of their updated care guidelines may serve as a tool used to promote a systematized approach to diagnosing and treating TCS among individuals with SB in the region, as well as globally.

DEA target setting approach within the cross efficiency framework

Target setting is an important reason that data envelopment analysis (DEA) is widely applied to analyze efficiency. However, the efficiency overestimation of traditional DEA may affect the rationality of target setting, and even may make this method invalid in target setting. This paper innovatively proposes the definition of cross efficient, and develops two new target setting approaches for individual decision-making unit (DMU) and global optimization to improve the cross efficiency of DMUs in different decision-making situations. Then the influence of decision maker's preference on the improvement direction is discussed, and then these approaches are further extended. This paper solves the limitations of traditional DEA in target setting, and provides different directions to improve cross efficiency for meeting decision makers’ needs. Finally, two examples are provided to illustrate the effectiveness of these approaches.

A survey of dynamic parameter setting methods for nature-inspired swarm intelligence algorithms

Parameter settings for nature-inspired optimization algorithms are essential for their effective performance. Evolutionary algorithms and swarm intelligence algorithms are prominent types of nature-inspired optimization. There are comprehensive reviews of parameter setting techniques for evolutionary algorithms. Counterparts providing an overview of parameter setting techniques for swarm intelligence algorithms are needed also. Therefore, in this paper, we provide a critical and comprehensive review, focusing in particular on dynamic parameter setting techniques. The paper describes a variety of swarm intelligence algorithms and parameter setting approaches that have been applied to them. This review simplifies the selection of parameter setting techniques for each algorithm by collecting them in a single document and classifying them under a taxonomy. Recommendations for parameter setting approach selection are provided in this review. We explore the open problems related to dynamic parameter setting techniques for swarm intelligence optimization and discuss the trade-off between run-time computation and flexibility of these algorithms.

A setting approach for tolerance table of couch position in record and verify system

Objective To evaluate the effect of the tolerance table of different couch positions in the record and verify system (R&V system) upon the setup accuracy. Methods Clinical data of 715 patients (15 743 fractions of treatment) were extracted from the R&V system database and assigned into four categories including thorax and abdomen, head and neck, breast, and rectum based on the disease site and immobilization device. The first day couch position (FstD) and cumulative average couch position (CumA) were utilized as the references to analyze the couch setup of each faction of treatment, and to establish the tolerance tables of different sites. The sensitivity and specificity of two methods were evaluated by the actual clinical treatment record of the patients. Results For the FstD as the reference, the couch tolerance in the breast was significantly higher than those in other parts. When the CumA was used as the reference, the couch tolerance tended to be stable after a certain fractions of treatment, and the tolerance of all sites was less than that of the FstD.The tolerance tables significantly differed between these two methods (P=0.000). Both two methods possessed high specificity, whereas the CumA method yielded higher sensitivity than the FstD approach. Conclusion Setting a reasonable tolerance table of couch position can effectively improve the setup accuracy. Key words: Record and verify system; Couch tolerance; Setup error

State‐space analysis based pole‐to‐ground line fault isolation strategy for LCC–HVDC systems

The common way to isolate the line fault in line-commutated converter-based high-voltage direct current (LCC-HVDC) transmission grids is regulating the trigger angle of converters on both terminals of the faulted line, which usually depends entirely on the conventional controller and goes with large current peak and lengthy overcurrent duration. In this study, a trigger-angle setting approach with adaptability is, therefore, proposed to provide a theoretical basis for the generation of fault isolation strategies under different scenarios. First, equivalent circuits of solid pole-to-ground line faults at rectifier and inverter terminals are established, and time-domain expressions of the fault and converter currents are obtained. Secondly, based on the analysis of current characteristics, the non-linear programming method is utilised to obtain the optimal trigger-angle sequence after the fault, which can be applied in the following fault isolation. Finally, the proposed approach is verified via power systems computer aided design (PSCAD)/electromagnetic transients including DC (EMTDC) simulation. The results show that it can effectively reduce the current peak and the overcurrent duration of the converter, which is of positive significance for maintaining the power system security and stability.

Finite-time nonsingular terminal sliding mode control: A time setting approach

This article proposes a combination of linear and nonlinear sliding surfaces to design a new structure for terminal sliding mode control, capable of accepting a definite final time as an input data. The structures of both single-input-single-output and multi-input-multi-output systems are expressed. The controller operates in two modes: first, reaching the states to linear sliding surface, defining control parameters and rise time; second, switching to nonlinear sliding surface and defining a convergence time. Sum of rise time and convergence time, both of which as inputs, sets the final time. The control gains are adaptively tuned and parameter uncertainty in dynamics is considered in the design. The proposed method is implemented theoretically and experimentally on Scout robot in point-to-point motion and trajectory tracking. The results are compared to conventional terminal sliding mode control and finite-time state-dependent Riccati equation to assess the improvement.

Expenditures of The German Statutory Health Insurance for Health Promotion and Disease Prevention 2012-2017: Positive Effects Due To The Disease Prevention Law?

The German Prevention Act aims to strengthen health promotion and disease prevention. The law makes changes to the so-called "§20 measures". Target values were newly given for the expenditures of the health insurance funds in this area. The objective here was to examine how the prevention expenditures of the statutory health insurance developed in the period from 2012 to 2017, and whether the requirements of the Prevention Act were met. The accounting results of the statutory health insurance funds were evaluated for the period 2012-2017. The expenditures per insured person were calculated and the changes in expenditures were analysed. The effect of the prevention law was highlighted by differentiation of the time periods 2012-2014 and 2014-2017. In 2017, about 2.5% of the total expenditure of the German statutory health insurance, around 5 billion euros, was accounted for in the reported prevention areas. Nearly 60% of these prevention expenditures were on early detection and vaccinations. Expenditure on "§20 measures" amounted to € 7.17 per insured person and thus reached the statutory guideline but accounted for less than 10% of all prevention expenditure. Although prevention expenditure per insured person increased over the period, the proportion of money spent on prevention measures as a whole had decreased since 2015. Expenditure on prevention measures that were directly aimed at the insured (individual approach, bonus programmes) and the setting approach (non-occupational settings, worksite health promotion) had hardly increased overall since the Prevention Act came into force. This effect is due to the equally strong decrease in bonuses for health-conscious behaviour among insured persons, despite the sharp increase in expenditure on company and noncompany settings. The proportion of money spent on disease prevention in total expenditure is still decreasing. The targets set by the Prevention Act, however, have been reached. Thus, target values have apparently proved to be an effective instrument for regulating prevention expenditure and have led to an increase in expenditure in the setting approach. Overall, there has been no expenditure effect in the area of disease prevention since the Prevention Act was enacted, as compensation was made at the expense of the non-setting measures without target values.

Do Healthy City Performance Awards Lead to Health in All Policies? A Case of Taiwan.

The Healthy Cities (HC) Project, which was introduced by the World Health Organization (WHO) in 1986, has been recognized as the best setting approach for health promotion. However, very few studies have addressed how to use HC approaches to establish public policies in non-health departments in cities. This paper describes the strategies for the HC Performance Awards used in Taiwan to draw attention from different departments and to sustain intersectoral collaboration for the purpose of establishing Health in All Policies (HiAP). The methods include: (1) setting up the Taiwan Healthy City Alliance; (2) establishing HC Innovation Performance Awards; (3) reviewing the award applications according to seven criteria; and (4) analyzing the topic content of the award applications. We collected 961 HC award applications during 2013–2016 to analyze their content. The results showed that the number of applications increased nearly every year while significantly more non-health departments applied for the awards compared to health departments (73.3% vs. 26.7%). The award rates of non-health departments have also increased twice from 13.9% in 2013 to 25.8% in 2016. By examining the topics of the award winners, we concluded that “HC Innovation Performance Awards” indeed provide a role and opportunity for political involvement, intersectoral collaboration, co-opetition and capacity building that is necessary for establishing health in all policies.

Combined education and patient-led goal setting intervention reduced chronic low back pain disability and intensity at 12 months: a randomised controlled trial

BackgroundOne model of care that has not been tested for chronic low back pain (LBP) is patient-led goal setting. We aimed to compare the clinical effectiveness and healthcare use of...

Health Promotion Interventions in Sports Clubs: Can We Talk About a Setting-Based Approach? A Systematic Mapping Review.

Many researchers and authorities have recognized the important role that sports clubs can play in public health. In spite of attempts to create a theoretical framework in the early 2000s, a thorough understanding of sports clubs as a setting for health promotion (HP) is lacking. Despite calls for more effective, sustainable, and theoretically grounded interventions, previous literature reviews have identified no controlled studies assessing HP interventions in sports clubs. This systematic mapping review details how the settings-based approach is applied through HP interventions in sports clubs and highlights facilitators and barriers for sports clubs to become health-promoting settings. In addition, the mapped facilitators and barriers have been used to reformulate previous guidelines of HP in sports clubs. Seven databases were searched for empirical research published between 1986 and 2017. Fifty-eight studies were included, principally coming from Australia and Europe, describing 33 unique interventions, which targeted mostly male participants in team sports. The settings-based approach was not yet applied in sports clubs, as more than half of the interventions implemented in sports club targeted only one level of the socio-ecological model, as well as focused only on study participants rather than the club overall. Based on empirical data, the analysis of facilitators and barriers helped develop revised guidelines for sports clubs to implement settings-based HP. This will be particularly useful when implementing HP initiatives to aid in the development of sports clubs working with a whole setting approach.

Te Ara Waiora a Tāne: a kaupapa Māori mental-health assessment and intervention planning approach.

The aims of this paper are to describe a Māori approach to assessment and intervention planning using the Māori creation narrative Te Ara a Tāne (The Journey of Tāne) and to outline an evaluation one year after the model was implemented. Te Ara Waiora a Tāne is a kaupapa Māori (Māori-centred) mental-health engagement, assessment, goal setting and planning approach designed to enhance the mana (spiritual and personal authority) of whānau (individuals and family/families) at the point they enter a Māori service and during ongoing mental-health work. Preliminary evaluation indicated that staff considered the model user-friendly and helpful for whānau. Further evaluation is needed to assess the impact of this approach on Māori whānau engagement with services.

Considerations for Chinese power industry to participate in carbon market

In 2017, China started its national emission trading system. Power industry has been covered as a critical member. During the carbon market construction, the new power market reform has started in 2015 in China. It is crucial for power industry to simultaneously meet the requirements from both power market reform and emissions reduction. This paper puts forward four key considerations for power industry to participate the emission trading system in China, including cap setting approach, the quota allocation approach, coordination mechanism for carbon trading and power trading, and the carbon cost transmission mechanism.

Effect of parameter setting and spectral normalization approach on study of matrix effect by laser induced breakdown spectroscopy of Ag–Zn binary composites

The complex nature of laser-material interaction causes non-stoichiometric ablation of alloy samples. This is attributed to matrix effect, which reduces analyzing capability. To address this issue, the analytical performance of three different normalization methods, namely normalization with background, internal normalization and three point smoothing techniques at different parameter settings is studied for quantification of Ag and Zn by Laser induced breakdown spectroscopy (LIBS). The LIBS spectra of five known concentration of silver zinc binary composites have been investigated at various laser irradiances (LIs). Calibration curves for both Ag(I) line (4d105s2S1/2 → 4d105p2P1/2 at 338.28 nm) and Zn(I) line (4s5s3S1 → 4s4p3P2 at 481.053 nm) have been determined at LI of 5.86 × 1010 W cm−2. Slopes of these calibration curves provide the valuation of matrix effect in the Ag–Zn composites. With careful sample preparation and normalization after smoothing at optimum parameter setting (OPS), the minimization of sample matrix effect has been successfully achieved. A good linearity has been obtained in Ag and Zn calibration curve at OPS when normalized the whole area of spectrum after smoothing and the obtained coefficients of determination values were R2 = 0.995 and 0.998 closer to 1. The results of matrix effect have been further verified by analysis of plasma parameters. Both plasma parameters showed no change with varying concentration at OPS. However, at high concentration of Ag, the observed significant changes in both plasma parameters at common parameter setting PS-1 and PS-2 were the gesture of matrix effect. In our case, the better analytical results were obtained at smoothing function with optimized parameter setting that indicates it is more efficient than normalization with background and internal normalization method.

Utilizing a 3S (strategies, source and setting) approach to understand the patient’s preferences when addressing medication non-adherence in patients with diabetes: a focus group study in a primary outpatient clinic

ObjectiveNon-adherence with diabetes medicines is a challenge. Approximately 54% of patients are non-adherent with their diabetes medicines. The objective of this study was to understand patients’ preferences when addressing non-adherence...

A modelling approach for dynamic water quality target setting on multiple time-scales for subzones of Lake Taihu based on ecosystem improvement

科学、合理地制定水体主要污染物浓度控制目标，即水质目标是实施河、湖水质目标管理的基础和前提.本文基于环境条件决定生态系统结构以及自组织适应生态学原理，提出一种可促进水生态改善的太湖分区分时动态水质目标制定方法.该方法在出入湖河道流量情景及分区污染物浓度情景设计的基础上，进行不同情境下水生态系统要素时空演化的数值试验；然后以藻类生物量减小、沉水植物生物量增加为判据，构造水质目标优化模型；最后将湖泊水生态模型与水质目标优化模型耦合，判断各污染物浓度情景下水生态系统健康状况，进而确定不同时间尺度下太湖各分区总氮、总磷、氨氮、高锰酸盐指数等主要污染物指标的动态控制目标.结果表明：本方法制定的太湖各湖区分时水质目标相比传统的静态目标更能促进太湖水生态系统健康发展，并为太湖水环境的精细化管理提供了可能.;Setting a scientific and reasonable water quality target is the basis for water quality target management for water bodies such as rivers and lakes. The purpose of this study is to develop a dynamic water quality target setting approach on multiple time-scales for subzones of Lake Taihu in China. This approach is based on the ecological principles of self-organizing adaptation and that the ecosystem structure is decided by environment conditions. Monthly flow scenarios of main tributaries and pollutant concentration scenarios of each of the eight subzones of Lake Taihu were designed firstly. These scenarios were then fed into the EcoLake model to simulate the evolution of water ecosystem variables. A water quality target optimization model was set up to identify the best pollutant concentration scenarios. The optimization model uses algal biomass and submerged plant biomass as optimization metrics. The optimization model was integrated to the EcoLake model lastly to determine the best control targets of total nitrogen, total phosphorus, ammonia nitrogen and permanganate index. The results suggest that the water quality target set in this study is more advanced in terms of promoting water ecosystem condition and supporting fine water environment management for Lake Taihu, comparing to traditional water quality target.

Sector neutrality: A possible improvement of the accounting standards. Evidence from NZ model

In May and June 2018, the Italian financial crisis (public debt) got back to the news when the new political government was going to be formed. Part of the literature claims that the public sector needed to be more "business-like" and that in order to do so, the adoption of "better", in this case "accrual", accounting was crucial. New Zealand is the pioneer country for accrual-based government accounting. More than ten years ago, when the adoption of IFRS was mandatory, New Zealand standard setters preserved sector neutrality in the financial reporting standards. Thanks to a systematic literature review, the paper investigates the evidence of NZ accounting sector neutrality model, with the purpose to assess if importing NZ public sector accounting model would be efficient for allowing a higher level of transparency in other countries such as Italy. The methodology is to define the economic literature relevant to the topic, considering the year of publication and the citation rate. Recently, standard setters in NZ decided to adopt a sector specific standard setting approach with multiple tiers for each sector. The for-profit sector will continue to follow IFRS but reporting standards for the public sector will be based on International Public Sector Accounting Standards (IPSAS). Amongst the former contributes, no systematic research overview on public sector accounting has been created based on the NZ model. This article fills this void by providing a systematic literature review of 258 publications that examines five key aspects of the literature on the benchmark accounting model.

A sequence of targets toward a common best practice frontier in DEA

Original data envelopment analysis models treat decision-making units as independent entities. This feature of data envelopment analysis results in significant diversity in input and output weights, which is irrelevant and problematic from the managerial point of view. In this regard, several methodologies have been developed to measure the efficiency scores based on common weights. Specifically, Ruiz and Sirvant (Omega 65:1–9, 2016) formulated an aggregated DEA model to minimize the gap between actual performances and best practices and identify a common best practice frontier. Their model is capable of determining target units for all units under evaluation, simultaneously, with the property that all of them are located on a common best practice frontier. However, in practice it is difficult for some units to achieve that specified target in a single step. Consequently, developing a methodology for assisting units to reach their corresponding targets, through a path of intermediate improving targets, is useful. This problem is investigated in this paper, and we propose a stepwise target setting approach which provides a path of intermediate targets for each unit. We study efficient and inefficient units separately and provide two distinct models for each category, although both of them are intrinsically similar. A simple numerical example and an application are also provided to illustrate our approach.

Ecosystem restoration in Europe: Can analogies to Traditional Chinese Medicine facilitate the cross-policy harmonization on managing socio-ecological systems?

EU's Biodiversity Strategy to 2020 sets a 15% restoration target. However, the understanding of restoration as a management tool remains ambiguous at EU and Member State levels.As a country with rich biodiversity but low GDP, a well-defined priority setting approach is key for Bulgaria. The “Methodological framework for assessment and mapping of ecosystem condition and ecosystem services in Bulgaria” proposes a transition towards ecosystem management and monitoring of the Socio-Ecological System (SES), to be embedded in the environmental policy framework.We extend the analogy between SES and the human body's system in the Traditional Chinese Medicine (TCM) as a way to inform restoration priority setting and development of restoration and monitoring tools at several levels:1.Overall objective: the sustainability goals correspond to the TCM's objective of a healthy, balanced body2.Restoration objectives and functioning: the desired ecosystem state can be better understood in analogy between the ecosystem structure and functioning framework for multiparametric optimization, and the TCM framework of Ying-Yang, Eight principles, Five elements and organs3.Ecosystem monitoring: Integrated monitoring may benefit from comparison to TCM diagnostics4.Ecosystem management approaches can benefit from the analogy to the TCM system of meridiansWe apply the analogy and find that spatially explicit decision making on restoration, streamlined ecosystem monitoring and a number of other issues (green infrastructure, designation of protected areas, defragmentation and connectivity, cumulative impact assessment, etc.), are easier to understand, communicate, account for and manage. Ecosystem restoration is priority for China and the country has accumulated research and practical experience, including study of links between ecosystem management and the historical principles of Chinese philosophy.The Bulgarian and European approach to ecosystem based management can benefit from analogies to TCM. We derive policy recommendations by analogy, and illustrate them on the example of Natural Capital Accounting.

Highly flexible and degradable dual setting systems based on PEG-hydrogels and brushite cement

With respect to the composition of natural bone, we established a degradable dual setting system of different poly(ethylene glycol) (PEG)-based hydrogels combined with a brushite cement. The idea was to reinforce the inorganic calcium phosphate mineral phase with an organic, polymeric phase to alter the cement’s properties towards ductility and elasticity. Extremely flexible samples were produced via this dual setting approach with a fully reversible elasticity of the samples containing high molecular weight PEG-based hydrogel precursors. Using the decalcifying agent EDTA, the whole inorganic phase was dissolved due to Ca2+-complexation and dimensionally stable hydrogels were obtained, indicating a homogenous polymeric phase within the composites. This was also confirmed by SEM-analysis, where no discontinuities or agglomerations of the phase were observed. Additional XRD-measurements proved a significant influence of the coherent polymeric matrix on the conversion from β-TCP/MCPA to brushite with a decrease in signal intensity. The results confirmed a parallelly running process of setting reaction and gelation without an inhibition of the conversion to brushite and the formation of interpenetrating networks of hydrogel and cement. The strengths of this newly developed dual setting system are based on the material degradability as well as flexibility, which can be a promising tool for bone regeneration applications in non-load bearing craniomaxillofacial defects. Statement of SignificanceBrushite based calcium phosphate cements (CPCs) are known as bone replacement materials, which degrade in vivo and are replaced by native bone. However, the pure inorganic material shows a brittle fracture behavior. Here, the addition of a polymeric phase can influence the mechanical properties to create more ductile and flexible materials. This polymeric phase should ideally form during cement setting by a polymerization reaction to achieve high polymer loads without altering cement viscosity and it should be degradable in vivo similar to the cement itself. Therefore, we developed a dual setting system based on simultaneous cement setting of brushite and lactide modified poly(ethylene glycol) dimethacrylate (PEG-PLLA-DMA)-based hydrogel. It was evident that the gels form a continuous phase within the cement after radical polymerization with a strong reduction of cement brittleness.