Types Of Requests Research Articles

P73 Trends in ultrasound guided musculoskeletal injections at one tertiary care centre over 6 years

Abstract Background Ultrasound (US) has brought many benefits into rheumatologic practice, delivery of targeted injections into joints, bursae and other structures. Whilst many joints may be accurately injected in clinic, guided by clinical landmarks, US permits injections into anatomically less accessible sites. We have assessed trends in the number and type of requests for US guided joint or soft tissue injections from the rheumatology department over the last 6 years, and the impact on waiting times. Methods Details of all requests for US guided joint or soft tissue injections were obtained from the St George’s PACS system from 1 January 2013 - 31 December 2018. Review of patient records was conducted to determine whether the referral was routine or urgent, the waiting time between referral and appointment, the joint or structure to be injected, and whether an injection into the requested site was actually performed. Results Table 1 shows the total number of out-patient attendances in rheumatology per year from 2013 - 2018, the number of referrals for US-guided injection, the proportion requested urgently and waiting times for routine and urgent cases. Over 6 years requests for US guided injections have risen 2.3-fold, from <1% to nearly 2% of all out-patient attendances. Of 1834 requests, no injections were given in 420 instances (23%), due to patient preference or lack of indication at time of US. In 2018 of all joint or tendon/bursa injections initiated in rheumatology, 260 (38%) were given in routine clinic time without delay, and 420 (62%) were requested by US with a delay of over 2 months. Conclusion Over 6 years a 33% increase in out-patient clinic workload has been accompanied by a disproportionate 2.3-fold increase in requests for US guided injections, representing >50% of injections initiated by the service. One explanation may be time pressure in clinic. This trend has not been matched by increased radiology capacity, with urgent requests now waiting >6 weeks. This has implications for quality of care, staffing and effective service delivery. The trend to fewer injections in clinic will continue if clinicians become increasingly reliant on radiology colleagues. Disclosures K. Lall None. V. Ejindu None. P.D.W. Kiely None.

An Interlanguage Study of Request Perspective: Evidence from German, Greek, Polish and Russian Learners of English

Abstract The present study examines request perspective, the least researched form of mitigation in requesting, while focusing on a type of request characterized by a strong preference for speaker perspective in English and for hearer perspective in most other languages researched to date. It examines requests produced by 900 speakers from nine different (inter)language groups: five groups of native speakers (English, German, Greek, Polish and Russian) and four groups of advanced learners of English as a foreign language (German, Greek, Polish and Russian L1s). While our learners used more conventionally indirect forms than did the native speakers of the respective L1s, showing awareness of this English pragmatic norm, they retained a preference for the hearer perspective. These results suggest reliance on pragmatic universals as an alternative explanation to pragmatic transfer, also illustrating the need to address less salient pragmatic features in English language teaching.

Command queue-aware host I/O stack for mobile flash storage

Abstract Recently, mobile storage devices such as an embedded multimedia card (eMMC) and universal flash storage (UFS) support command queuing. However, the current Linux I/O stack is not designed considering flash memory devices that support command queuing. In this paper, we observe the I/O performance at a command queue-supporting device and introduce several pitfalls of the current host I/O stack. First, although the latency of synchronous I/O requests can be increased due to the priority inversion in the command queue, the Linux I/O scheduler has no concern about the issue. Second, although the I/O bandwidth is determined by the total size of pending I/O requests rather than the total number of them in the command queue, the current I/O scheduler does not have a size-based scheduling scheme. Third, there can be interference between different types of requests in the command queue degrading the overall I/O performance. To resolve these problems, we introduce a novel command queue-aware host I/O stack, which consists of three techniques, latency-aware throttling, aggressive readahead, and interference-preventive scheduling. The experiments show that the command queue-aware techniques can improve both the foreground synchronous request latency and the background sequential I/O bandwidth when the two different types of tasks run concurrently.

Comparative application of two methods in the second order elastic analysis of the steel structures

In most situations, in the case of metal structures, the loss of stability occurs before plastic elements enter the structure. The present paper aims to compare the response of a metallic structure obtained by an elastic analysis of the 2nd order developed with the two methods provided in SR-EN 1993-1-1:1) global analysis that takes full account of geometrical and material imperfections and second-order effects; 2)-individual stability check of the equivalent bars using buckling lengths corresponding to the overall instability mode. Obviously the first method is the most complex because it takes into account both global and local imperfections. The second method is the simplest and most used method. In this case, the verification relationships take account of the imperfections of the elements. For global analysis, the global imperfections and local bar imperfections will be considered. These imperfections will be taken into account in the worst form and sense. The check for global analysis will be done using finite element meshing, while using the geometric nonlinearity option so that the stiffness matrix is calculated at each loading step. The individual check of the elements shall be performed according to SR EN1993-1-1 according to the type of request.

Supporting the Priorities in the Multi-queue Block I/O Layer for NVMe SSDs

Recently, a multi-queue block I/O layer has been introduced in the Linux kernel to support NVMe SSDs efficiently. It can provide a high I/O bandwidth by employing several queues but does not provide a differentiated I/O services yet. In this paper, we present a new scheme that supports the priorities in the multi-queue block I/O layer. Our scheme brings the CFS (Completely Fair Scheduler) technique that is one of CPU scheduler into the I/O layer. In this way, we can provide a differentiated I/O service regardless of whether processes are CPU-intensive or I/O intensive. Besides, by considering the I/O request type, read requests are preferentially handled over write requests. Through implementation on the Linux kernel, we show that the proposed scheme appropriately services the I/O requests according to priority and request type and improves runtimes of read-intensive and write-intensive processes by 33% and 15%, respectively.

Characteristics Associated With Recruitment and Re-contact in Mayo Clinic Biobank.

Objective: To better understand the characteristics associated with a participant's willingness to consent to the Mayo Clinic Biobank (MCB) and examine factors associated with willingness to participate in follow-up studies embedded within MCB that require re-contact and participant approval.Participants and Methods: Consent rates were compared across patient demographics to the MCB. Rates of participation to follow-up studies were also compared across demographics and request types.Results: Among 272,102 Mayo Clinic patients invited to the MCB, 48,314 (19%) consented across the three recruitment sites within 90 days of initial invitation. A significant age by gender interaction was identified, showing young males consent at a lower rate than young females and older males consent at a higher rate than older females. Over the recruitment time frame of 2009–2015, there was a significant decrease in consent rates (decline of 2.5%/year). Of the 57,041 consented MCB participants, 33,487 participants (59%) have been invited to participate in follow-up studies via re-contact. Follow-up studies of the MCB may require participants to provide additional samples, complete questionnaires, and/or release their identity to a research team. MCB participants have been invited to enroll in a median of two studies (IQR: 1–3). Seventy-one percent of participants consented to at least one follow-up study, with individual follow-up study consent rates ranging from 14 to 87% depending on study type, with a median consent rate of 61% (IQR: 47–70%). Studies requesting return of a questionnaire had the highest participation rates. White participants, older participants, and participants with some college or a degree were significantly more likely to participate to follow-up studies, while there was no association with gender.Conclusion: Consent rates among younger and non-white patients were lower than in older, white patients. However, we also found that participation rates among those already enrolled in the biobank were much higher than those seen in new recruitment efforts, external to an existing biobank. We thus demonstrate an important way that biobanks can advance precision medicine goals: through provision of populations from which studies can draw participants for future studies.

A novel efficient cross layer-based bandwidth reservation mechanism for next generation wireless networks

In this paper, a cross-layer-based efficient bandwidth reservation mechanism (CLBRM) is proposed for next generation wireless networks. Application layer and network layer are involved in the design of the cross-layer architecture. Cross-layer architecture is used to reduce the delay. Shared database is used to implement the cross-layer architecture which allows to share the information among the application layer and the network layer. Bandwidth is reserved based on the type of requests and past history of the users. Four types of requests are used in this paper and priority is assigned among these requests. Two queues are maintained for last two priority requests and pre-emption of these requests is incorporated in order to serve the highly prioritised requests in a better way. The QoS parameters like delay, throughput, blocking probability, and dropping probability are used to evaluate the performance of the proposed mechanism. The performance of the proposed mechanism, CLBRM is compared with the data driven allocation (DDA) scheme (Fan et al., 2016) and proved to perform better.

An investigation into the number and nature of the urgent care consultations managed and referred by community pharmacists in South-East England.

Community pharmacies are recognised as an under-utilised, accessible resource that could support the urgent care agenda. This study aimed to provide a snapshot of the number and nature of urgent care requests presented to a sample of community pharmacies in three counties in southern England, to determine how requests are managed, whether management is appropriate, as assessed by a group of experts, and whether customers receiving the care are satisfied with pharmacists' interventions. A representative sample of pharmacists across the region was invited to keep a log-book documenting all urgent care requests over a two-week period. Data were analysed to estimate frequency and type of requests and to compare consultations in core and non-core hours. Log-book entries were scrutinised blind by an expert panel to determine appropriateness of pharmacist's responses. Customers receiving pharmacists' interventions were surveyed to assess satisfaction. Seventeen pharmacies kept log-books detailing 432 urgent care consultations, equating to 13 consultations per pharmacy per week. Of these, 70% (n = 302) were dealt with by the pharmacist in-house with 30% (n = 130) resulting in referrals. Locum pharmacists were significantly more likely to refer to other NHS services than regular pharmacists. Over half the requests were for symptom management, skin problems presenting most commonly (38% of all symptoms presented). Forty-seven percent of consultations were considered to have 'averted the need for other NHS services'. Pharmacists' referral (but not assessment of urgency) was deemed appropriate by the expert panel in 90% of consultations. Ninety-five percent of customers surveyed were satisfied with the service and would use the pharmacy again. Extrapolating findings across the study population (approximately 4.4 million) suggests that community pharmacists manage over 11 500 urgent care consultations per week, with 8050 managed independently. These prevent approximately 5400 other NHS encounters, while also meeting customer expectations and expert panel endorsement.

Analyzing the Models of Systems with Heterogeneous Servers

The mathematical model of a queueing system with heterogeneous servers, without queues, and with two types of requests is investigated. High-priority requests are processed in fast servers while low-priority calls are processed in slow servers. If all servers in some group are busy, then reassigning of requests to another group is allowed. Reassigning is based on random schemes and reassignment probability depends on the number of busy servers in appropriate group. Exact and approximate methods are developed for the analysis of characteristics of the system. Explicit approximate formulas to calculate the approximate values of characteristics are proposed.

IoT Enabled Multi-Antenna Communication Channel with Deep Learning Network

The base station preserves all the communications between the UEs and the network through RAN. Each radio has some frequency and based upon that frequency communication link becomes active and then handover to another radio. Currently there are several mechanisms that define the data structures to drive the network without any disturbance. Although those mechanisms are easy to implement but they are not able to handle user’s demand on time. This paper focuses on the use of artificial intelligence concepts with the base station system. The idea is to model through the standard parameters with a deep learning network. The goal is predicting the value for carrier, beam, fault tolerance etc. The correlation between Base station, Slave station, through puts and the type of user request will be taken into the account while predicting the best possible results.

A Profit Maximization Scheme in Cloud Computing With Deadline Constraints

Cloud computing has attracting more and more attention for its flexibility and economic benefits. To maintain the supply-demand relationship among different participants in cloud computing environment, the exchange of value is the inner drive. From the perspective of cloud service provider, its primary concern is to earn the profit, which can be obtained by finishing the tasks published from customers. In this paper, we consider each task consists of numbers of sub-tasks in the logical order, each sub-task corresponds to a type of service requests, which can be served in unique multi-server system. On this basis, we propose a profit maximization problem in the multistage multi-server queue systems, in which customers are served at more than one stage, arranged in a series structure. Moreover, a deadline constraint is taken into consideration, which demonstrates the maximum tolerance degree that the customers can wait. Therefore, how to configure the parameters in multistage multi-server queue systems to maximize profit on the premise of reducing the waiting times of customers is a critical issue for cloud service provider. To address this problem, we first discuss the probability distribution function of the waiting time for single multi-server system and multistage multi-server queue systems respectively, and then propose a profit maximization model under the deadline constraint. Due to the complexity of this model, the analytical solution can hardly be obtained, we study a heuristic method to search for the optimal solution. At last, a series of numerical simulations are implemented to describe the performance of the proposed profit maximization scheme, the results show that not only the profit can be maximized, but also the waiting time of customers have been reduced effectively.

Christian Doctrine and the Old Testament: Theology in the Service of Biblical Exegesis

Christian Doctrine and the Old Testament: Theology in the Service of Biblical Exegesis

Why Young People Obey Private Security Guards? A Scenario-Based Study

Private security guards (PSG) are prominent social control agents in many contexts of youth attendance. However, studies about youth’s acceptance of PSG authority are scarce. In a scenario-based survey, this study examines youngsters’ compliance with three types of PSG requests and explores factors influencing compliance, particularly instrumental and normative ones. Findings from 631 high school students from the metropolitan areas of Lisbon and Porto (Portugal) suggest that youth typically obey PSG requests, and that perceptions about the role of PSG in protecting public interests and normative judgments about these guards and their requests are important in shaping compliance. Interestingly, variations according to the type of demand are observed. Youth obey more and see their requests as more legitimate when those requests echo shared moral positions.

Use of e-resources by unmotivated students: a success story from a library in Russia

Purpose This paper aims to examine how new educational approaches to the presentation of electronic information resources can influence interest in their use among first-year undergraduates. Despite the variety of technological facilities available in universities, the learning process sometimes fails to keep pace with their advantages. Universities are investing in high-technology classrooms and an extensive multidisciplinary subscription to e-resources in the belief that students will make use of these opportunities. However, students often ignore the availability of relevant and verified content and prefer to retrieve information from Google’s search results. The absence of students’ initial motivation to work with a complex product is perhaps the greatest challenge faced by the teacher-librarian. Limited time available for training (a lecture and a seminar) and lack of preparedness among information specialists aggravates the situation. Design/methodology/approach The efficacy of new educational approaches to the presentation of e-resources was examined in a pilot study involving 940 first-year undergraduates at the North-West Institute of Management of the Presidential Academy (RANEPA). The authors replaced academic lectures with flexible and interesting techniques based on student’s interests, used attention triggers for each e-resource in lecture materials and focused the seminar on multiple specific searches to attract and keep students engaged. New educational approaches were implemented in four-hour sessions for first-year students in all disciplines. Findings The results suggest that the new educational approaches and teaching techniques can raise the level of students’ involvement and interest in the use of subscribed e-resources. To assess the developed approach, the authors analyzed the dynamics of the students’ visits to subscribed resources and observed a significant increase in the number of visits. The authors found such a trend for all the types of requests and resources. Overall, the number of visits and full-text requests increased from 88 to 284 per cent for the 2017-2018 academic year compared to the 2016-2017 one. Practical implications The findings of the study demonstrate the necessity of applying new educational approaches to teaching students who lack the motivation to use high-quality electronic resources. The teacher-librarian can be an important link between scientific information and consumers. The newly developed techniques have great potential for a wide range of educational applications including the development of teaching materials and training programs. Social implications The approach combines teaching methodology with rich informational environment, enhancing students’ motivation to information literacy through mastering their digital skills. Students’ interest in subscribed resources initiates their professional work with scientific information. Students need to constantly use subscribed resources. Otherwise, the skills of using information e-resources will disappear and motivation for their use will decrease. The development of techniques that can help to maintain students’ interest in information e-resources is continuing, and new findings will be presented in future papers. Originality/value In the scientific literature, to the best of the authors’ knowledge, no information is available on the use of similar techniques at Russian universities. It is hoped that developed techniques helps students with low digital literacy from other universities or colleges overcome their bias against high technology.

Multi Level SLA Violation Based Resource Allocation in Cloud using Kernel Fuzzy C Means with Aid of EABC

In our proposed work we are considering four types of agent such as monitoring agent, coordinator agent, user agent and violation agent. Initially, user agent wants to generate the resource in cloud based on the SLA properties and coordinator agent is verifying the request type and SLA properties. The violation of the SLA is a major aspect of cloud computing and the violation leads to the reduction of customer satisfaction level and further affects the cloud provider leading to penalty. Initially the available resources are grouped by kernel fuzzy C means clustering algorithm (KFCM). Then monitoring agent report the resource list to the coordinator agent. Based on the resource list, the coordinator agent allocates the optimal resource with the help of enhanced artificial bee colony algorithm. The performance of the proposed work is evaluated by profit, penalty, cost, execution time and successful execution rate.

ESTRUTURAÇÃO DE UM SERVIÇO DE INFORMAÇÕES SOBRE MEDICAMENTOS (SIM) EM UM HOSPITAL DO RIO GRANDE DO NORTE, BRAZIL

Centros/Serviços de Informações sobre Medicamentos são importantes e úteis, pois contribuem para o uso racional de medicamentos. O objetivo deste estudo foi avaliar as informações prestadas pelo Serviço de Informações sobre Medicamentos do Hospital Regional Dr. Mariano Coelho em Currais Novos, RN. Para tanto, foi realizado um estudo observacional a partir do banco de dados do Serviço, cujas solicitações de informação foram recebidas entre abril de 2017 e novembro de 2018. As informações foram avaliadas a partir de média mensal de solicitações de informação, temas das perguntas, meio pelo qual foi recebida, perfil do solicitante, fontes de informação utilizadas e classificação farmacológica dos medicamentos envolvidos. Durante o período, foram recebidas 31 solicitações (1,6 solicitações/mês), a maioria tinha como tema a indicação de uso de medicamentos (22,6%) e foi solicitada pessoalmente (71,0%) por residentes multiprofissionais (45,2%). Bases de dados eletrônicas foram as fontes de informações mais utilizadas para responder às solicitações (40,0%); e os antibióticos de uso sistêmico os medicamentos mais presentes nas solicitações (23,7%). Depreende-se que este Serviço foi potencialmente útil para se evitar uso irracional de medicamentos. Em relação ao perfil de solicitações de outros centros/serviços, este apresentou perfil pouco semelhante aos demais.

The characteristics of drug information inquiries in an Ethiopian university hospital: A two-year observational study

The types of drug-related information request from patients and health professionals, the extent of inquiry and capability of existing drug information centers are seldom studied in Ethiopia. This study aimed to identify the types and potential areas of drug information inquiry at the Drug Information Center (DIC) of Gondar University specialized Hospital (GUSH), Ethiopia. An observational study was employed. The drug information query was collected by distributing the drug information queries in different hospital units through two batches of graduating undergraduate pharmacy students. Descriptive statistics used to describe, characterize and classify drug related queries. Binary logistic regression test was employed to identify predictor variables to type of drug information query. A total of 781 drug related queries were collected and 697 were included in the final analysis. Near to half (45.3%) of queries comes from the pharmacists followed by general practitioners (11.3%) and nurses (10.2%). Slightly greater than half of the queries (51.9%) were focused on therapeutic information. 39.6% of drug related queries related to infectious disease case scenarios, followed by cardiovascular cases in 21.3% of queries. More than half of (53.9%) and nearly one in five (19.4%) of the queries took 5 to 30 minutes and 30 minutes to 1 hour of literature searching to answer, respectively. Pharmacists (with odds ratio of 2.474(95% CI (1.373-4.458)) and patients (with odds ratio of 4.121(1.403–12.105)) ask patient-specific questions in their drug related queries higher than other group of health professionals. Pharmacists are the primary drug information users and frequent drug related information inquirers at the DIC. Most of the queries targeted therapeutic indications, adverse drug events, infectious or cardiovascular disease related requests. This is imperative that drug information services can assist the growing role of pharmacists in addressing the patient specific drug related needs.

Analysis and Optimization of Systems with Heterogeneous Servers and Jump Priorities

Markov models of systems with heterogeneous servers, various types of requests, and jump priorities are proposed. It is assumed that there are high and low priority requests; the high priority requests are assigned to the server with the high service rate, and the low priority requests are assigned to the server with the low service rate. Models of two types are studied: with separate queues and the shared queue for requests of different types. Jump priorities determine the rules according to which the type of low priority requests changes depending on the state of the queue. Methods for calculating the distribution of the probability of the system states are developed, formulas for the calculation of the characteristics of the system are derived, and the problem of the optimization of these characteristics is solved. The results of numerical experiments are presented.

CBCT of Swedish children and adolescents at an oral and maxillofacial radiology department. A survey of requests and indications

Objectives: This retrospective study investigated requests and indications for cone-beam computed tomography (CBCT) in children and adolescents over a 3-year period at one oral and maxillofacial radiology department. Specific aims were to determine what technical settings were used, which caregivers write the referrals, and how often and for what reasons re-exposure was necessary.Materials and methods: Patients <19 years of age who had been referred to the department and undergone a CBCT scan during 2015–2017 were included in the study.Results: CBCT were made in 617 of the 3847 eligible referrals. The most common referral was from general practice dentists (GPD) (43%). Mean age of the patients was 12.5 years (range: 6–18). Nineteen different types of requests were identified. The most common request was assessment of an ectopic canine with a question about potential resorption of adjacent teeth (38.6%). Forty (6.5%) of the CBCT needed to be re-taken due to patient motion artefacts.Conclusions: The most common request and indication for CBCT examination of children and young adults were to assess an ectopic canine and determine the presence of resorption of adjacent teeth. Referrals from GPDs were the most frequent and the largest age group was the 11- to 15-year olds. The reason for re-exposures was motion artefacts. High scanning speed to reduce motion artefacts and a half rotation (180°) to reduce the radiation dose to the patient should be preferred. The need for continuous work with quality and systematic monitoring of radiographic procedures at any radiology department should be given high priority.

Threshold Analysis of Request Degradation in the Computer Network

In this paper, the existing approaches to the assessment of computer networks performance are considered. The standard structure of a network of the application layer of the OSI model using the example of SBIS3 application (product of Tensor Company) is treated. Further, two approaches allowing to analyze degradations in a network are considered - on the basis of aggregated data and the operational analysis. The degradation study of more than 60 000 request types between two versions of application which works on the basis of the computer network is the cornerstone of the first decision. Each type of requests is described by four based metrics, each metrics representing a time series. The input data are aggregated every 10 minutes before an analysis algorithm. Further, the threshold criteria based on mathematical expectation and dispersion within two adjacent versions of the software are used. Such an approach allows to significantly reduce time for the analysis of potential problems in case of updates within the computer network. The second decision is based on not aggregated input data. It consists of detail information about all requests, there are data section of the computer network. A threshold criterion is based on durations in the selected queue. This analysis type allows to diagnose the errors with problem clients.