Telemedicine as a Means to an End, Not an End in Itself

Telemedicine (TM)—the management of disease at a distance—has potential usefulness for patients with advanced respiratory disease. Underscoring this potential is the dramatic expansion of its applications in clinical medicine. However, since clinical studies testing this intervention often provide heterogeneous results, its role in the medical management of respiratory disorders remains inconclusive. A major problem in establishing TM’s effectiveness is that it is not a single intervention; rather, it includes a number of divergent diagnostic and therapeutic modalities—and each must be tested separately. Reflecting the discord between the need for further documentation of its approaches and effectiveness and its rapid utilization without this needed information, a major challenge is the lack of international guidelines for its integration, regulation, operational plans, and guidance for professionals. Tailored TM, with increased flexibility to address differing healthcare contexts, has the potential to improve access to and quality of services while reducing costs and direct input by health professionals. We should view TM as a tool to aid healthcare professionals in managing their patients with respiratory diseases rather than as a stand-alone substitute to traditional medical care. As such, TM is a means rather than an end.

Process Simulation of Oxy-Fuel Combustion for A 120 MW Coal-Fired Power Plant Using Aspen Plus

Oxy-fuel Combustion is a technology with the potential of drastically reducing the amount of CO2 emission, it relies on the use of oxygen and recycled CO2 instead of air as the oxidant. This helps to reduce the amount of the CO2 and NOx emissions. This study focuses on the components of flue gas produced and their amounts for oxy-fuel combustion in a coal-fired power plant (CFPP) and also the boiler efficiency using the direct (input-output) method. The combustion process of pulverized coal in a 120MW power plant is studied using Aspen Plus 11. The amount of each component in flue gas in coal-fired processes with air or O2/ CO2 (using recycle of 20%, 40%, 60% and 80% of CO2) as oxidizer was obtained. From the process simulation, as the recycle % of CO2 was increased, the flame temperature, CO and NOx emissions were reduced. The simulation results of air combustion were compared with that of oxy-fuel combustion with 80% recycle and it was seen that the flame temperature dropped from 1894oC when air was used as oxidizer to 1679oC for oxy-fuel combustion with 80% recycle. Also, there was a reduction in the amount of NOx produced, but the SOx levels were constant for both combustion processes. The Gross Calorific Value (GCV) of the coal was calculated from its Proximate Analysis using Dulong’s formula and it was used to estimate the Boiler Efficiency using the Direct (Input-Output) method and a value of 83.6% was obtained.

Strategi Komunikasi Pemasaran PT. Allianz Life Indonesia Dalam Pengambilan Keputusan Nasabah

This article contains the correspondence system of PT. Allianz Life Indonesia in the client's independent direction focuses on the means of creating an appropriate exchange, specifically distinguishing interest groups, selecting correspondence targets, planning messages, deciding on media, selecting message beginnings, gathering input, selecting complete progress rules, selecting mixed progress, and choose an ad mix strategy. The exploration strategy is a subjective story strategy using information checking methods such as Interactive Matthew B. Miles and A. Michael Huberman. Due to exploration, the depiction shows that the correspondence technique displays PT. Allianz focuses on 2-way correspondence for clients to sell their goods so that they can provide effects, beliefs and activities that are taken as direct input. good use.

Control device synthesis by polynomial matrix fractional descriptions method with limitation on controller structure

Modification of the algorithm for the polynomial synthesis of a multi-channel controller was proposed to preserve all control channels in this article. In order to test the functionality of the proposed modification, an example of a linear model of an unstable multi-channel plant is considered. The choice of the plant was determined by the possibility of a visual algorithm demonstration for polynomial synthesis of the controller, taking into account the proposed modifications.The plant was represented as three series-connected standard links: an aperiodic link of the first order, an unstable link, and an integrator, and has three input and two output channels. The control in the system is carried out in the feedback of the system and is summed up with the input impact. The feature of the plant is to limit the task to the second output, since it is essentially a derivative of the first output. In addition, the plant has a direct input–output channel. That is, the traversal matrix of the system is nonzero (when described through the state space). The synthesis task was set as follows: it is necessary to achieve certain quality indicators of the output vector value while maintaining all three control channels of the plant.

Morphological Significance and Relation of Ecosystems of Submarine Canyons off SW Taiwan

There are four shelf-incising submarine canyons off SW Taiwan. They are distributed along the active continental margin, which is periodically flushed by gravity flows. Shelf-incising canyons, such as Kaoping Canyon, may not only be affected by oceanographic conditions but also by extreme climate change due to the direct input of river sediment. In the canyons along the SW margin of Taiwan, strong sedimentary flows are reflected in highly abundant nutrient input and physical disturbances. The Kaoping Canyon possesses habitats that promote biodiversity but that are sensitive to environmental change. The aims of this study are to review the canyons along the SW margin of Taiwan and to present their geomorphological features and associated ecosystems.

Using Customer Journey Mapping and Design Thinking to Understand the Library’s Role in Supporting the Research Data Lifecycle

Objective: Customer journey mapping and design thinking were identified as useful tools for identifying deeper insights into the research data service needs of researchers on our campus with their direct input. In this article we discuss ways to improve the process in order to identify data needs earlier in the project life and at a more granular level. Methods: Customer journey mapping and design thinking were employed to get direct input from researchers about their research processes and data management needs. Responses from mapping templates and follow-up interviews were then used to identify themes to be explored using design thinking. Finally, a toolkit was created in Open Science Framework to guide other libraries who wish to employ these techniques Results: Outcomes from the customer journey mapping and design thinking sessions identified needs in the areas of data storage, organization and sharing. We also identified project-management lessons learned. The first lesson was to ensure the researchers who participate adequately represent the range of data needs on campus. Another was that customer journey mapping would be more effective if the responses were collected in real time and researchers were allowed more flexibility in the mapping process. Conclusions: Modifications to the customer journey mapping and design thinking techniques will provide real-time responses and deeper insights into the research data service needs of researchers on our campus. Our pilot identified some important gaps but we felt that more subtle and useful outcomes were possible by making changes to our process.

Priming of Frames and Slots in Bilingual Children’s Code-Mixing: A Usage-Based Approach

This article investigates the role of direct input in the code-mixing of three bilingual children aged 2–4 years acquiring English as one language, and either German, Polish, or Finnish as the other. From a usage-based perspective, it is assumed that early children’s utterances are item-based and that they contain many lexically fixed patterns. To account for such patterns, the traceback method has been developed to test the hypothesis that children’s utterances are constructed on the basis of a limited inventory of chunks and frame-and-slot patterns. We apply this method to the code-mixed utterances, suggesting that much of the code-mixing occurs within frame-and-slot patterns, such as Was ist X? as in Was ist breakfast muesli? “What is breakfast muesli?” We further analyzed each code-mixed utterance in terms of priming. Our findings suggest that much of the early code-mixing is based on concrete lexically fixed patterns which are subject to input occurring in immediately prior speech, either the child’s own or that of her caregivers.

Livestock as vectors of organic matter and nutrient loading in aquatic ecosystems in African savannas

Populations of large wildlife have declined in many landscapes around the world, and have been replaced or displaced by livestock. The consequences of these changes on the transfer of organic matter (OM) and nutrients from terrestrial to aquatic ecosystems are not well understood. We used behavioural data, excretion and egestion rates and C: N: P stoichiometry of dung and urine of zebu cattle, to develop a metabolism-based estimate of loading rates of OM (dung), C, N and P into the Mara River, Kenya. We also directly measured the deposition of OM and urine by cattle into the river during watering. Per head, zebu cattle excrete and/or egest 25.6 g dry matter (DM, 99.6 g wet mass; metabolism) - 27.7 g DM (direct input) of OM, 16.0–21.8 g C, 5.9–9.6 g N, and 0.3–0.5 g P per day into the river. To replace loading rates OM of an individual hippopotamus by cattle, around 100 individuals will be needed, but much less for different elements. In parts of the investigated sub-catchments loading rates by cattle were equivalent to or higher than that of the hippopotamus. The patterns of increased suspended materials and nutrients as a result of livestock activity fit into historical findings on nutrients concentrations, dissolved organic carbon and other variables in agricultural and livestock areas in the Mara River basin. Changing these patterns of carbon and nutrient transport and cycling are having significant effects on the structure and functioning of both terrestrial and aquatic ecosystems.

Livestock as vectors of organic matter and nutrient loading in aquatic ecosystems in African savannas

Populations of large wildlife have declined in many landscapes around the world, and have been replaced or displaced by livestock. The consequences of these changes on the transfer of organic matter (OM) and nutrients from terrestrial to aquatic ecosystems are not well understood. We used behavioural data, excretion and egestion rates and C: N: P stoichiometry of dung and urine of zebu cattle, to develop a metabolism-based estimate of loading rates of OM (dung), C, N and P into the Mara River, Kenya. We also directly measured the deposition of OM and urine by cattle into the river during watering. Per head, zebu cattle excrete and/or egest 25.6 g dry matter (DM, 99.6 g wet mass; metabolism) - 27.7 g DM (direct input) of OM, 16.0-21.8 g C, 5.9-9.6 g N, and 0.3-0.5 g P per day into the river. To replace loading rates OM of an individual hippopotamus by cattle, around 100 individuals will be needed, but much less for different elements. In parts of the investigated sub-catchments loading rates by cattle were equivalent to or higher than that of the hippopotamus. The patterns of increased suspended materials and nutrients as a result of livestock activity fit into historical findings on nutrients concentrations, dissolved organic carbon and other variables in agricultural and livestock areas in the Mara River basin. Changing these patterns of OM and nutrients transport and cycling are having significant effects on the structure and functioning of both terrestrial and aquatic ecosystems.