Customer churn modeling in telecommunication using a novel multi-objective evolutionary clustering-based ensemble learning.

Customer churn prediction is vital for organizations to mitigate costs and foster growth. Ensemble learning models are commonly used for churn prediction. Diversity and prediction performance are two essential principles for constructing ensemble classifiers. Therefore, developing accurate ensemble learning models consisting of diverse base classifiers is a considerable challenge in this area. In this study, we propose two multi-objective evolutionary ensemble learning models based on clustering (MOEECs), which are include a novel diversity measure. Also, to overcome the data imbalance problem, another objective function is presented in the second model to evaluate ensemble performance. The proposed models in this paper are evaluated with a dataset collected from a mobile operator database. Our first model, MOEEC-1, achieves an accuracy of 97.30% and an AUC of 93.76%, outperforming classical classifiers and other ensemble models. Similarly, MOEEC-2 attains an accuracy of 96.35% and an AUC of 94.89%, showcasing its effectiveness in churn prediction. Furthermore, comparison with previous churn models reveals that MOEEC-1 and MOEEC-2 exhibit superior performance in accuracy, precision, and F-score. Overall, our proposed MOEECs demonstrate significant advancements in churn prediction accuracy and outperform existing models in terms of key performance metrics. These findings underscore the efficacy of our approach in addressing the challenges of customer churn prediction and its potential for practical application in organizational decision-making.

The impact of telecom industry employees' stress perception on job burnout: moderated mediation model.

BACKGROUND: The rapid development of the telecommunications industry in the post-COVID-19 era has brought tremendous pressure to employees making them a high-risk group for job burnout. However, prior research paid less attention to the burnout of employees. Furthermore, social support and gender have separate effects on job burnout. This study explores the mechanism of stress perception on job burnout and examines the roles of social support and gender amid it. METHOD: This cross-sectional study was conducted from June 2023 to August 2023 in mainland China. A total of 39,507 were recruited by random sampling and online questionnaires, and 28,204 valid questionnaires were retained. SPSS (version 26.0) and PROCESS (Model 4 & 7) were used for correlation analysis, mediation analysis, and mediated moderation analysis. RESULT: Stress perception can positively predict the level of job burnout of employees in the telecommunications industry, and social support plays a partial mediating role, accounts for 8.01% of the total effect, gender moderates the first half of the path in this mediation model. At the same pressure level, female can perceive more social support than male. CONCLUSIONS: Under high pressure background, employees' job burnout varies depending on gender and the perception of social support. Therefore, telecommunications industry managers should adopt decompression measures and targeted social support resources for different groups.

The role of information industry convergence in energy transition.

To cope with global climate risks, promoting energy transformation has become a global consensus. China issued a reform policy in 2010 to promote the convergence of the three major information industries, namely broadcasting and television networks, telecommunications networks and the Internet (TPR policy). However, is the convergence of information industries able to promote energy transition? This study constructs a quasi-natural experimental framework using China's TPR policy as a representative case of industrial convergence. Using city-level panel data between 2003 and 2016 in China and a multi-period difference-in-differences model, this study examines the impact of TPR policy on energy transition. The results show that TPR policy positively contributes to energy transition at a 1% significance level. Extensive robustness tests support this finding. This positive effect is particularly evident in regions with less developed communications infrastructure and stricter environmental regulations. Mechanism analysis suggests that TPR policy promotes energy transition by improving the level of information networks, promoting technological innovation, and optimizing industrial structure. The findings of this paper emphasize the importance of information industry convergence in facilitating energy transformation.

A Randomized Trial to Address Food Insecurity and Promote Smoking Cessation Among Low-Income Adults.

Many low-income adults who smoke also have unmet social needs, such as food insecurity, which can serve as a barrier to smoking cessation. We developed a novel intervention to jointly address smoking cessation and food insecurity and assessed its feasibility, acceptability, and preliminary outcomes. We enrolled participants who screened for food insecurity, reported smoking daily, and were ready to quit. All participants received 3 months of resources navigation from a community health worker through monthly telephone calls for referrals and check-ins for smoking cessation and food access resources. Participants randomized to the intervention group received an economic intervention equivalent to the cost of 1 week of groceries/month for 3 months. We randomized 55 participants who were smoking on average 13 cigarettes/day. The trial was feasible and acceptable based on 3-month retention rates (80%) and end-of-study qualitative feedback (91% would recommend the study to others). At 3 months, participants in the intervention versus control group reported a longer length of abstinence from smoking and had a higher proportion of serious quit attempts. Results from this pilot study suggest the importance of attending to social needs, particularly food insecurity, as a strategy to promote smoking cessation among low-income adults who smoke.

Communication and coordination of care for people living with HIV: a qualitative study of the patient perspective.

BACKGROUND: There is growing consensus that primary health care (PHC) providers have an important role in providing holistic, preventative care for people living with human immunodeficiency virus (PLHIV). In regional Australia, HIV care is primarily delivered through specialist services, thus adequate coordination and communication between specialist and PHC professionals is crucial. This study aimed to explore patient experiences of the coordination of care and health care professional communication for PLHIV in regional Australia. METHODS: Semi-structured interviews with PLHIV in a regional area of Australia were conducted in March to April 2022. Interviews were conducted via video conferencing, face-to-face, or via telephone call. Interviews were audio-recorded and manually transcribed. Transcripts were coded inductively and thematic analysis was conducted to explore perspectives on communication and coordination. RESULTS: Thirteen participants were interviewed. Most participants were male, aged 50-70, were diagnosed with HIV more than ten years ago, and had been living in regional Australia long-term. Through qualitative analysis, themes emerged in the following areas: (1) Patient perception of care coordination; (2) Patient understanding of modality of communication; (3) Positive attitudes towards communication between healthcare professionals; and (4) Concerns for information sharing between healthcare professionals. Many participants highlighted lack of clarity around care coordination as a key issue in their healthcare, with some citing themselves as the primary care coordinator. Participants identified that coordination and communication between PHC professionals and specialist services are essential in the delivery of their health care, but some were hesitant for this to occur. Hesitancy was entrenched in some patients' distrust of healthcare due to previous experiences of confidentiality breaches and stigma. CONCLUSION: This study identifies the need for clarity in coordination between health care professionals to deliver safe and effective HIV care, which may occur through care plans. Patient support for communication between healthcare providers may be strengthened by ensuring trust in the people and systems involved. Eliminating stigma in healthcare as well as building more trustworthy electronic-based communication technologies are essential components to trust-building between PLHIV and healthcare systems.

Does ICT influence carbon emissions in the context of universal connectivity: a global perspective?

The Connect 2030 initiative, launched by the International Telecommunication Union, is in alignment with the Sustainable Development Goals (SDGs) of the United Nations Agenda 2030. Its main objective is to achieve universal connectivity, a goal that is closely related to environmental issues. This topic currently receives attention from researchers and policymakers. Given these considerations, our study investigates the impact of information and communication technologies on carbon dioxide emissions for a panel of 84 countries spanning the years 2009 to 2020. Using principal component analysis, we construct an ICT index that encompasses international bandwidth, reflecting the universal connectivity, and participation in international data exchanges. The empirical analysis applies the pooled mean group-panel autoregressive distributive lag (PMG-ARDL) approach to estimate both the long-run and short-run coefficients of CO2 emissions' determinants. Our findings show that ICT and renewable energy mitigate CO2 emissions, unlike financial development, GDP, and non-renewable energy, which contribute significantly to emissions for the full sample. These outcomes suggest that promoting ICTs in general and international bandwidth in particular, as part of universal connectivity, improves the quality of the global environment.

Implementing and Enhancing Social and Economic Needs Screening at a Federally Qualified Health Center.

BACKGROUND: Programs to screen for social and economic needs (SENs) are challenging to implement. AIM: To describe implementation of an SEN screening program for patients obtaining care at a federally qualified health center (FQHC). SETTING: Large Chicago-area FQHC where many patients are Hispanic/Latino and insured through Medicaid. PROGRAM DESCRIPTION: In the program's phase 1 (beginning April 2020), a prescreening question asked about patients' interest in receiving community resources; staff then called interested patients. After several refinements (e.g., increased staffing, tailored reductions in screening frequency) to address challenges such as a large screening backlog, program phase 2 began in February 2021. In phase 2, a second prescreening question asked about patients' preferred modality to learn about community resources (text/email versus phone calls). PROGRAM EVALUATION: During phase 1, 8925 of 29,861 patients (30%) expressed interest in community resources. Only 40% of interested patients were successfully contacted and screened. In phase 2, 5781 of 21,737 patients (27%) expressed interest in resources; 84% of interested patients were successfully contacted by either text/email (43%) or phone (41%). DISCUSSION: Under one-third of patients obtaining care at an FQHC expressed interest in community resources for SENs. After program refinements, rates of follow-up with interested patients substantially increased.

Assessing Patient-Reported Outcomes in Routine Cancer Clinical Care Using Electronic Administration and Telehealth Technologies: Realist Synthesis of Potential Mechanisms for Improving Health Outcomes.

BACKGROUND: The routine measurement of patient-reported outcomes in cancer clinical care using electronic patient-reported outcome measures (ePROMs) is gaining momentum worldwide. However, a deep understanding of the mechanisms underpinning ePROM interventions that could inform their optimal design to improve health outcomes is needed. OBJECTIVE: This study aims to identify the implicit mechanisms that underpin the effectiveness of ePROM interventions and develop program theories about how and when ePROM interventions improve health outcomes. METHODS: A realist synthesis of the literature about ePROM interventions in cancer clinical care was performed. A conceptual framework of ePROM interventions was constructed to define the scope of the review and frame the initial program theories. Literature searches of Ovid MEDLINE, Ovid Embase, Scopus, and CINAHL, supplemented by citation tracking, were performed to identify relevant literature to develop, refine, and test program theories. Quality appraisal of relevant studies was performed using the Mixed Methods Appraisal Tool. RESULTS: Overall, 61 studies were included in the realist synthesis: 15 (25%) mixed methods studies, 9 (15%) qualitative studies, 13 (21%) descriptive studies, 21 (34%) randomized controlled trials, and 3 (5%) quasi-experimental studies. In total, 3 initial program theories were developed regarding the salient components of ePROM interventions-remote self-reporting, real-time feedback to clinicians, and clinician-patient telecommunication. The refined theories posit that remote self-reporting enables patients to recognize and report symptoms accurately and empowers them to communicate these to clinicians, real-time feedback prompts clinicians to manage symptoms proactively, and clinician-patient telephone interactions and e-interactions between clinic encounters improve symptom management by reshaping how clinicians and patients communicate. However, the intervention may not achieve the intended benefit if ePROMs become a reminder to patients of their illness and are not meaningful to them and when real-time feedback to clinicians lacks relevance and increases the workload. CONCLUSIONS: The key to improving health outcomes through ePROM interventions is enabling better symptom reporting and communication through remote symptom self-reporting, promoting proactive management of symptoms through real-time clinician feedback, and facilitating clinician-patient interactions. Patient engagement with self-reporting and clinician engagement in responding to feedback are vital and may reinforce each other in improving outcomes. Effective ePROM interventions might fundamentally alter how clinicians and patients interact between clinic encounters.

Focus group in the development of concepts for a Nursing model: experience report.

OBJECTIVE: To communicate the experience of developing concepts for the construction of a care model through focus groups. METHODS: An experience report on the development of concepts through remote focus groups with members of a research group from a public university in southern Brazil. RESULTS: Focus groups were developed in which homogeneity and heterogeneity criteria were observed among participants. In addition to the concepts of the nursing metaparadigm, the concepts of care and family-centered care were developed, relevant to the nursing care model in question. FINAL CONSIDERATIONS: Despite the challenges of conducting remote focus groups, they were suitable for the collective construction of concepts for a nursing care model, allowing the interaction of participants from different locations.

Telemedicine: The Situation in Morocco.

The Moroccan healthcare system is facing several challenges in ensuring equitable access to quality services and reducing or at least controlling their rising cost. Telemedicine can address these two needs by optimizing the use of existing human and material resources through telecommunications. Today, the gradual increase in the population's healthcare needs poses a major challenge to the Moroccan healthcare system, given the shortage of personnel in healthcare facilities and the persistent difficulties in accessing certain regions. In this regard, Morocco has established a regulatory framework defining the rules for the practice of telemedicine. Several initiatives have been launched, particularly in the public sector, aiming to cover 80% of medical deserts in Morocco by 2025.

Evaluating the impact of e-registration and mHealth on institutional delivery in hazard-prone areas of Bangladesh: A protocol for a non-randomized controlled cluster trial.

Despite substantial progress, Bangladesh still has a high rate of maternal deaths owing to difficulties during pregnancy, delivery, and the postpartum period. Increasing facility delivery is mandatory to reach the goal of bringing down the MMR to <70 deaths/100,000 live births by 2030. In the era of digitalization, the introduction of e-registration and mHealth may aid the government in reaching this target. The southern part of Bangladesh is a hazard-prone area, where service uptake from institutions is low. This study aims to determine the effect of an e-registration tracking system and mHealth counseling on institutional deliveries to pregnant mothers in hazard-prone areas of southern Bangladesh. We will conduct an open-label, two-arm, non-randomized controlled cluster trial for six months and use three hazard-prone areas for intervention and another three hazard-prone areas for control. We will collect data at baseline and end-line of the study period using a structured questionnaire. We will enroll at least 268 pregnant mothers from the intervention and 268 pregnant mothers from the control areas after screening based on the inclusion and exclusion criteria. Pregnancy information will be obtained from the Family Welfare Assistant register. The respondents of the intervention arm will be registered in the e-Registration system, and receive voice call and text messages from the midwives to have their deliveries done in healthcare facilities. We will follow the participants until their delivery and exclude those respondents from the study who will have post-dated delivery, migrate out, lost to follow-up, or die during the study period. Random-intercept mixed-effect logistic regression will be performed to explain the relationship of e-registration and mHealth package with institutional delivery. Institutional delivery is still uncommon in Southern Bangladesh despite several interventions. Innovative approaches like e-registration and mHealth counseling may be helpful to bring women to health facilities. The findings from the study might enable the policy makers of Bangladesh to integrate the intervention package into the existing healthcare system. This experiment is registered in the open science framework. Clinical trial registration: Registration number: DOI 10.17605/OSF.IO/YZE5C) and https://www.clinicaltrials.gov/ (registration number: NCT05398978.

Human Exposure to Non-Ionizing Radiation from Indoor Distributed Antenna System: Shopping Mall Measurement Analysis.

It is crucial to monitor the levels of Non-Ionizing Radiation (NIR) to which the general population may be exposed and compare them to the limits defined in the current standards, in view of the rapid rise of communication services and the prospects of a connected society. A high number of people visits shopping malls and since these locations usually have several indoor antennas close to the public, it is therefore a kind of place that must be evaluated. Thus, this work presents measurements of the electric field in a shopping mall located in Natal, Brazil. We proposed a set of six measurement points, following two criteria: places with great the flow of people and the presence of one or more Distributed Antenna System (DAS), co-sited or not with WiFi access points. Results are presented and discussed in terms of the distance to DAS (conditions: near and far) and flow density of people in the mall (scenarios: low and high number of people). The highest peaks of electric field measured were 1.96 and 3.26 V/m, respectively corresponding to 5% and 8% of the limits defined by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) and the Brazilian National Telecommunication Agency (ANATEL).

Two-Channel OTDM System for Data-Center Interconnects: A Review.

It has been proposed to implement the >100 Gb/s data-center interconnects using a two-channel optical time-division multiplexed system with multilevel pulse-amplitude modulation. Unlike the conventional four-channel optical time-division multiplexed system which requires an expensive narrow pulse, the two-channel system can be implemented cost-effectively using a wide pulse (which can be simply generated using a single modulator). The two-channel system is expected to be practically available using an integrated transmitter in a chip due to the recent advances in photonics-integrated circuits. This paper reviews the current stage of research on a two-channel optical time-division multiplexed system and discusses possible research directions. Furthermore, it has been demonstrated that 200 Gb/s signals can be generated by using modulators with only 17.2 GHz bandwidth. Therefore, the use of the phase-alternating pulse can make the multiplexed signal robust to chromatic dispersion, enabling the 200 Gb/s 4-level pulse-amplitude-modulated signal to be transmitted over 1.9 km of standard single-mode fiber.

Feasibility and acceptability of a remote, hands-free cognitive battery for adults with traumatic spinal cord injury.

PURPOSE/OBJECTIVE: To evaluate the acceptability and feasibility of testing the cognitive abilities of adults with traumatic spinal cord injury (TSCI) via teleconference. RESEARCH DESIGN: Data were collected prospectively at two study sites from 75 adults living with TSCI. Participants completed a series of self-report measures via an online survey platform, in addition to a brief battery of cognitive testing administered via audio-video teleconference. Modifications were made to select measures to allow for hands-free administration of all tasks. RESULTS: Feasibility was demonstrated by a 97.4% completion rate among the 77 participants who began the cognitive testing and approximately normal distributions for nearly all cognitive testing variables examined. No ceiling or floor effects were observed across cognitive testing variables. Review of acceptability ratings indicated that participants found this approach to cognitive testing to be highly acceptable. CONCLUSION/IMPLICATIONS: Our findings provide evidence for the feasibility and acceptability of administering cognitive testing via teleconference to adults living with TSCI. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Simple polarization-insensitive coherent RoF link with increased capacity.

A simple polarization-insensitive coherent radio-over-fiber (RoF) link with increased spectrum efficiency and transmission capacity is proposed and demonstrated. Instead of using two polarization splitters (PBSs), two 90° hybrids, and four pairs of balanced photodetectors (PDs) in a conventional polarization-diversity coherent receiver (PDCR), a simplified PDCR with only one PBS, one optical coupler (OC), and two PDs is employed in the coherent RoF link. At the simplified receiver, a novel, to the best of our knowledge, digital signal processing (DSP) algorithm is proposed to achieve polarization-insensitive detection and demultiplexing of two spectrally overlapping microwave vector signals as well as the elimination of the joint phase noise originating from the transmitter and the local oscillator (LO) laser sources. An experiment is performed. The transmission and detection of two independent 16QAM microwave vector signals at identical microwave carrier frequencies of 3 GHz with a symbol rate of 0.5 GSym/s over a 25-km single-mode fiber (SMF) is demonstrated. Thanks to the spectrum superposition of the two microwave vector signals, the spectral efficiency as well as the data transmission capacity is increased.

Rural-Urban Differences in Telehealth Utilization and Delayed Care During the COVID-19 Pandemic.

Purpose: Use of telehealth among older adults increased during the COVID-19 pandemic, but patterns and correlates of its use are poorly understood. The present study uses a representative sample of Medicare beneficiaries to examine rural-urban differences in telehealth utilization during the pandemic and to investigate the associations between the number and type of telehealth services utilized and delayed in-person care. Methods: The study sample (N = 3,257) came from Round 10 of the National Health and Aging Trends Study. Telehealth was measured in three modalities: phone calls, e-mails or portal messages, and video calls. Multivariable Poisson and logistic regressions were performed to test the study aims, adjusting for sociodemographic and health controls. Analytic weights and survey design factors were incorporated to generate population estimates. Findings: Results show that rurality is associated with lower rates (incidence rate ratio = 0.78, p < 0.001) and lower odds of telehealth use compared with urban older adults. Specifically, rural older adults were less likely to use e-mail or portal messages (adjusted odds ratio [AOR] = 0.43, p < 0.001) and video calls (AOR = 0.57, p = 0.004) to communicate with their usual health care provider. Use of any 2 forms of telehealth was associated with greatest increased odds of delayed in-person care among rural and urban populations during the pandemic. Conclusions: Future efforts are needed to expand the utilization of e-mail/portal messages and video call telehealth services among rural older adults. Telehealth may be an important mechanism to support care continuity during and beyond the COVID-19 pandemic for both urban and rural older adults when in-person modalities of care are not feasible.

The tragic paradoxical effect of telemedicine on healthcare disparities- a time for redemption: a narrative review.

BACKGROUND: Telemedicine has become more convenient and advantageous due to the rapid development of the internet and telecommunications. A growing number of patients are turning to telemedicine for health consultations and health-related information. Telemedicine can increase access to medical care by removing geographical and other barriers. In most nations, the COVID-19 pandemic imposed social isolation. This has accelerated the transition to telemedicine, which has become the most commonly utilized method of outpatient care in many places. Telehealth can assist resolve gaps in access to healthcare services and health outcomes, in addition to its primary function of boosting accessibility to remote health services. However, as the benefits of telemedicine become more apparent, so do the limitations of serving vulnerable groups. Some populations may lack digital literacy or internet access. Homeless persons, the elderly, and people with inadequate language skills are also affected. In such circumstances, telemedicine has the potential to exacerbate health inequities. AIM AND METHODS: In this narrative review (using the PubMed and Google scholar database), the different benefits and drawbacks of telemedicine are discussed, both globally and in Israel, with particular focus paid to special populations and to the telehealth usage during the Covid-19 period. FINDINGS: The contradiction and paradox of using telemedicine to address health inequities yet sometimes making them worse is highlighted. The effectiveness of telemedicine in bridging access to healthcare inequities is explored along with a number of potential solutions. CONCLUSIONS: Policy makers should identify barriers among special populations to using telemedicine. They should initiate interventions to overcome these barriers, while adapting them to the needs of these groups.

Comparison of different New Radio (NR) waveforms for wireless communications.

New Radio (NR) waveforms of existing wireless communication systems need further improvement in order to support future wireless communications. NR is the radio interface technology proposed by the 3rd Generation Partnership Project (3GPP) for 5G. Prototype Filter (PF) of NR plays a vital role in performance improvement of wireless systems. NR waveforms can adapt in a better way to different channel conditions. Some of the NR filtering techniques are Filtered-OFDM (F-OFDM), Filter Bank Multi-Carrier (FBMC), and Universal Filtered Multi-Carrier (UFMC). NR waveforms require performance improvement when high reliability, massive connectivity, lower power consumption, and time-critical applications are required. Areas of improvement are Power Spectral Density (PSD), Bit Error Rate (BER), Signal to Interference Ratio (SIR), Doppler Diversity, and Peak to Average Power Ratio (PAPR). This paper compares different performance parameters of Filtered-OFDM, FBMC, and UFMC using existing proto-type filters and novel proto-type filters. The novel and better PFs, described in the paper, were proposed first time by the authors and his research group. Proposed novel prototype filters for FBMC, Filtered-OFDM, and UFMC are respectively Binomial filter and Fractional Powered Binomial Filter (FPBF). With FPBF based OFDM, PSD improvement was 97.5 dB, and BER improvement was 0.07 at 0 dB SNR. With Binomial filter based FBMC, OOBE improvement was 19.7 dB and BER improvement was 0.03 at 0 dB SNR. PAPR improvement with Binomial filter based FBMC was 1.16 dB at 64-QAM and 1.1 dB at 256-QAM. With FPBF based UFMC, improvement of interference level was 122 dB within 3rd~52th sub-bands due to 1st sub-band. BER improvement was 0.09 at 0 dB SNR. SIR improvement was 5. 27 dB with 15 KHz sub-carrier spacing and 16.55 dB with 30 KHz sub-carrier spacing of UFMC. Novel NR filters, discussed in the paper, are good candidates for future 6G wireless systems.

Experiences and support needs of informal long-distance caregivers at the end of life: a scoping review.

OBJECTIVES: There is a lack of research on the specific experiences and needs of geographically distant kin caregivers in end-of-life situations. Clinicians and researchers would benefit from a systematic overview. The scoping review aimed at examining the international literature on the experiences and needs of informal long-distance (LD) caregivers at the end of life, to address gaps in the evidence base, and to make recommendations for further research. DESIGN: The scoping review was conducted according to the methodological framework of Arksey and O'Malley. Studies of various designs involving kin caregivers were analysed narratively. DATA SOURCES: A highly sensitive strategy was used to search CINAHL, Google Scholar, PsycInfo, PubMed and Web of Science Core Collection, from inception to 8 November 2021, with searches rerun in CINAHL, PsycInfo and PubMed on 31 January 2023. An additional hand search of the reference lists of the identified articles was performed. RESULTS: Two authors independently assessed the titles and abstracts of 3827 scientific papers. As a result, 89 full texts were reviewed and 20 articles plus one review were included in the review. Five major themes were identified: (1) LD as a barrier to caregiving, (2) communication difficulties and the role of video and telephone calls, (3) the burdens and benefits of LD caregiving, (4) interaction and conflict with local caregivers and (5) LD caregivers' wishes and needs for support. CONCLUSIONS: Further quantitative and mixed-methods studies should be undertaken to improve our understanding of LD caregiving for relatives at the end of life. Studies to explore the feasibility and implementation of communication technologies in end-of-life LD caregiving are also needed.