Search results for: electrocardiological procedure

Authors: Marcin Jakiel, Maria Kurek, Karolina Gutkowska, Sylwia Sanakiewicz, Dominika Stolarczyk, Jakub Batko, Rafał Jakiel, Mateusz K. Hołda

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Proper imaging of the interventricular septum during endocavital lead implantation is essential for successful procedure. The interventricular septum is located oblique to the 3 main body planes and forms angles of 44.56° ± 7.81°, 45.44° ± 7.81°, 62.49° (IQR 58.84° - 68.39°) with the sagittal, frontal and transverse planes, respectively. The optimal left anterior oblique (LAO) projection is to have the septum aligned along the radiation beam and will be obtained for an angle of 53.24° ± 9,08°, while the best visualization of the septal surface in the right anterior oblique (RAO) projection is obtained by using an angle of 45.44° ± 7.81°. In addition, the RAO angle (p=0.003) and the septal slope to the transverse plane (p=0.002) are larger in the male group, but the LAO angle (p=0.003) and the dihedral angle that the septum forms with the sagittal plane (p=0.003) are smaller, compared to the female group. Analyzing the optimal RAO angle in cross-sections lying at the level of the connections of the septum with the free wall of the right ventricle from the front and back, we obtain slightly smaller angle values, i.e. 41.11° ± 8.51° and 43.94° ± 7.22°, respectively. As the septum is directed leftward in the apical region, the optimal RAO angle for this area decreases (16.49° ± 7,07°) and does not show significant differences between the male and female groups (p=0.23). Within the right ventricular apex, there is a cavity formed by the apical segment of the interventricular septum and the free wall of the right ventricle with a depth of 12.35mm (IQR 11.07mm - 13.51mm). The length of the septum measured in longitudinal section, containing 4 heart cavities, is 73.03mm ± 8.06mm. With the left ventricular septal wall formed by the interventricular septum in the apical region at a length of 10.06mm (IQR 8.86 - 11.07mm) already lies outside the right ventricle. Both mentioned lengths are significantly larger in the male group (p<0.001). For proper imaging of the septum from the right ventricular side, an oblique position of the visualization devices is necessary. Correct determination of the RAO and LAO angle during the procedure allows to improve the procedure performed, and possible modification of the visual field when moving in the anterior, posterior and apical directions of the septum will avoid complications. Overlooking the change in the direction of the interventricular septum in the apical region and a significant decrease in the RAO angle can result in implantation of the lead into the free wall of the right ventricle with less effective pacing and even complications such as wall perforation and cardiac tamponade. The demonstrated gender differences can also be helpful in setting the right projections. A necessary addition to the analysis will be a description of the area of the ventricular septum, which we are currently working on using autopsy material.

Keywords: anatomical variability, angle, electrocardiological procedure, intervetricular septum

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Authors: Tahir Mehmood, Pennung Warnitchai

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Simplified static analysis procedures such Nonlinear Static Procedure (NSP) are gaining popularity for the seismic evaluation of buildings. However, these simplified procedures accounts only for the seismic responses of the fundamental vibration mode of the structure. Some other procedures which can take into account the higher modes of vibration, lack in accuracy to determine the component responses. Hence, such procedures are not suitable for evaluating the structures where many vibration modes may participate significantly or where component responses are needed to be evaluated. Moreover, these procedures were found to either computationally expensive or tedious to obtain individual component responses. In this paper, a simplified but accurate procedure is studied. It is called the Uncoupled Modal Response History Analysis (UMRHA) procedure. In this procedure, the nonlinear response of each vibration mode is first computed, and they are later on combined into the total response of the structure. The responses of four tall buildings are computed by this simplified UMRHA procedure and compared with those obtained from the NLRHA procedure. The comparison shows that the UMRHA procedure is able to accurately compute the global responses, i.e., story shears and story overturning moments, floor accelerations and inter-story drifts as well as the component level responses of these tall buildings with heights varying from 20 to 44 stories. The required computational effort is also extremely low compared to that of the Nonlinear Response History Analysis (NLRHA) procedure.

Keywords: higher mode effects, seismic evaluation procedure, tall buildings, component responses

Procedia PDF Downloads 342

Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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Authors: Aigin Bashti

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Preparation of multicomponent reactions (MCRs) via a simple one-pot strategy is considered a novel procedure which has attracted a lot of interest from organic and medicinal chemists. Due to the great importance of phthalazide triones, it was decided to introduce a novel and cost-effective green procedure for the preparation of these derivatives. In this methodology, an efficient 4,4ʹ-Bipyridinium Dichloride Ordered Mesoporous Silica functionalized catalyst (BP-SBA-15) was utilized. The catalyst was characterized by X-ray diffraction analysis (XRD), field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), thermo-gravimetric analysis (TGA), and Fourier-transform infrared spectroscopy (FT-IR) analysis. In conclusion, it should be mentioned that this methodology has some advantages, including short reaction time, high yield of the products, recyclable catalyst, green procedure, and facile work-up procedure. The catalyst was successfully utilized for the one-pot preparation of various phthalazinetrione derivatives.

Keywords: dimedone, green procedure, multicomponent reactions, phthalhydrazide

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Authors: E. L. Elghazy, A. M. Sanad, M. G. Ghoneim

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Over the past two decades research has shown that fiber reinforced polymers can be efficiently, economically and safely used for strengthening and rehabilitation of reinforced concrete (RC) structures. Designing FRP confined concrete columns requires reliable analytical tools that predict the level of performance and ductility enhancement. A numerical procedure is developed aiming at determining the type and thickness of FRP jacket needed to achieve a certain level of ductility enhancement. The procedure starts with defining the stress strain curve, which is used to obtain moment curvature relationship then displacement ductility ratio of reinforced concrete cross-sections subjected to bending moment and axial force. Three sets of published experimental tests were used to validate the numerical procedure. Comparisons between predicted results obtained by using the proposed procedure and actual results of experimental tests proved the reliability of the proposed procedure.

Keywords: columns, confinement, ductility, FRP, numerical

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Authors: Jirawan Jitthavech, Vichit Lorchirachoonkul

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A statistical procedure using multiple comparisons test for proportions is proposed for variable selection in a data envelopment analysis (DEA) model. The test statistic in the multiple comparisons is the proportion of efficient decision making units (DMUs) in a DEA model. Three methods of multiple comparisons test for proportions: multiple Z tests with Bonferroni correction, multiple tests in 2Xc crosstabulation and the Marascuilo procedure, are used in the proposed statistical procedure of iteratively eliminating the variables in a backward manner. Two simulation populations of moderately and lowly correlated variables are used to compare the results of the statistical procedure using three methods of multiple comparisons test for proportions with the hypothesis testing of the efficiency contribution measure. From the simulation results, it can be concluded that the proposed statistical procedure using multiple Z tests for proportions with Bonferroni correction clearly outperforms the proposed statistical procedure using the remaining two methods of multiple comparisons and the hypothesis testing of the efficiency contribution measure.

Keywords: Bonferroni correction, efficient DMUs, Marascuilo procedure, Pastor et al. method, 2xc crosstabulation

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Authors: Alldila Hendy, Agi Satria

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Background: A colostomy procedure is an important part in the management of surgical procedures in some diseases involving the gastrointestinal tract. So it is necessary to find the factors that influence the occurrence of complications. Methods: This is a retrospective cross-sectional analytic study in Cipto Mangunkusumo Hospital noting medical records of patients after the colostomy from January 2012 to December 2014 at the Division of Digestive Surgery. Results: In 136 cases of post-colostomy, 66 cases have complications, 14 is early-onset, and 52 is late-onset. 70 is without complications. Most complications are dermatitis, which is 31 (22.8%), cases of infection/abscess/fistula and intestinal obstruction are 13 (9.6%) and 5 patients (4.4%). A rare complication is colostomy retraction by 2 patients (1.5%), colostomy prolapse and necrosis/gangrene, which is only 3 patients (2.2%). A colostomy procedure in emergency surgery is riskier than elective surgery for complications after colostomy (p < 0.007, OR 2.85), Based on the operator who performs a colostomy procedure, the consultant had a lower risk of complications than fellow or resident (p < 0.0001). Based on the age factor, where the age of about 50 years has a risk of complications after colostomy (p < 0.018). Conclusion: The timing of operation (emergency or elective), age, and operator who perform a colostomy procedure have a significant relationship with an increased prevalence of complications after colostomy in RSCM.

Keywords: colostomy, complications, factors, procedure

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Authors: L. Hamra, J. F. Demonceau, V. Denoël

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The aim of this paper is to study a beam extracted from a frame and subjected to blast loading. The demand of ductility depends on six dimensionless parameters: two related to the blast loading, two referring to the bending behavior of the beam and two corresponding to the dynamic behavior of the rest of the structure. We develop a full analytical procedure that provides the ductility demand as a function of these six dimensionless parameters.

Keywords: analytical procedure, blast loading, membrane force, P-I diagram

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Authors: Shunpu Zhang

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We propose a new multiple test called the minPOP test for testing multiple hypotheses simultaneously. Under the assumption that the test statistics are independent, we show that the minPOP test has higher global power than the existing multiple testing methods. We further propose a stepwise multiple-testing procedure based on the minPOP test and two of its modified versions (the Double Truncated and Left Truncated minPOP tests). We show that these multiple tests have strong control of the family-wise error rate (FWER). A method for finding the p-values of the proposed tests after adjusting for multiplicity is also developed. Simulation results show that the Double Truncated and Left Truncated minPOP tests, in general, have a higher number of rejections than the existing multiple testing procedures.

Keywords: multiple test, single-step procedure, stepwise procedure, p-value for multiple testing

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Authors: Bonchan Koo, Junhee Han, Dohyung Lee

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The research attempts to evaluate the accuracy and efficiency of a design optimization procedure which combines wavelets-based solution algorithm and proper orthogonal decomposition (POD) database management technique. Aerodynamic design procedure calls for high fidelity computational fluid dynamic (CFD) simulations and the consideration of large number of flow conditions and design constraints. Even with significant computing power advancement, current level of integrated design process requires substantial computing time and resources. POD reduces the degree of freedom of full system through conducting singular value decomposition for various field simulations. For additional efficiency improvement of the procedure, adaptive wavelet technique is also being employed during POD training period. The proposed design procedure was applied to the optimization of wing aerodynamic performance. Throughout the research, it was confirmed that the POD/wavelets design procedure could significantly reduce the total design turnaround time and is also able to capture all detailed complex flow features as in full order analysis.

Keywords: POD (Proper Orthogonal Decomposition), wavelets, CFD, design optimization, ROM (Reduced Order Model)

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Authors: Chang-Bin Ha, Yong-Jun Kim, Dong-Hyun Ha, Hyoung-Kyu Song

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The conventional Wi-Fi back scatter system can only process one-to-one communication between the Wi-Fi reader and the Wi-Fi tag. For improvement of throughput of the conventional system, this paper proposes the multi-to-multi communication system. In the proposed system, the interference by the multi-to-multi communication is effectively cancelled by the orthogonal multiple access based on the identification code of the tag. Although the overhead is generated by the procedure for the multi-to-multi communication, because the procedure is processed by the Wi-Fi protocol, the overhead is insignificant for the entire communication procedure. From the numerical results, it is confirmed that the proposed system has nearly proportional increased throughput in according to the number of the tag that simultaneously participates in communication.

Keywords: backscatter, multi-to-multi communication, orthogonality, Wi-Fi

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Authors: Anita Afriana, Efa Laela Fakhriah

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The law of civil procedure which is currently in effect in Indonesia is still referring to the rules applicable at the time of the Dutch East Indies, that is Het Herziene Indonesisch Reglement (HIR) and Reglement Tot Regeling Van Het Rechtswezen In De gewesten Buiten Java En Madura (RBg). With the fact that the enactment of this has been very long, there are some things that are no longer suitable with the circumstances and needs of the community in seeking justice today. Therefore, a new regulation on the law of civil procedure is required and the discussions of the draft are currently being carried out. The fast examination of dispute in civil procedure is required to accelerate the growth of Indonesia’s economy by accelerating the dispute resolution method (time efficiency). With the provision of the quick examination on commercial disputes mentioned above, it is expected to benefit the community in order to obtain a tool of dispute resolution efficiently and effectively, so as making justice fast and inexpensive, especially for the resolution of commercial disputes.

Keywords: commercial dispute, civil law procedure, court, Indonesia

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Authors: Guilherme Gomes, Jose Lebre de Freitas

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The rules of Civil Procedure that are defined in the Portuguese Civil Procedure Code of 2013 particularly their articles 552 to 626- represent the model that the legislator thought that would be more suitable for national civil litigation, from the moment the action is brought by the plaintiff to the moment when the sentence is issued. However, procedural legalism is no longer a reality in the Portuguese Civil Procedural Law. According to the article 547 of the code of 2013, the civil judge has a duty to adopt the procedure that better suits the circumstances of the case, whether or not it is the one defined by law. The main goal of our paper is to answer the question whether the formal adequation imposed by this article diminishes the importance of the Portuguese rules of Civil Procedure and their daily application by national civil judges. We will start by explaining the appearance of the abovementioned rules in the Civil Procedure Code of 2013. Then we will analyse, using specific examples that were obtained by the books we read, how the legal procedure defined in the abovementioned code does not suit the circumstances of some specific cases and is totally inefficient in some situations. After that, we will, by using the data obtained in the practical research that we are conducting in the Portuguese civil courts within the scope of our Ph.D. thesis (until now, we have been able to consult 150 civil lawsuits), verify whether and how judges and parties make the procedure more efficient and effective in the case sub judice. In the scope of our research, we have already reached some preliminary findings: 1) despite the fact that the legal procedure does not suit the circumstances of some civil lawsuits, there are only two situations of frequent use of formal adequation (the judge allowing the plaintiff to respond to the procedural exceptions deduced in the written defense and the exemption from prior hearing for the judges who never summon it), 2) the other aspects of procedural adequation (anticipation of the production of expert evidence, waiving of oral argument at the final hearing, written allegations, dismissal of the dispatch on the controversial facts and the examination of witnesses at the domicile of one of the lawyers) are still little used and 3) formal adequation tends to happen by initiative of the judge, as plaintiffs and defendants are afraid of celebrating procedural agreements in most situations. In short, we can say that, in the Portuguese legal order of the 21st century, the flexibility of the legal procedure, as it is defined in the law and applied by procedural subjects, does not affect the importance of the rules of Civil Procedure of the code of 2013.

Keywords: casuistic adequation, civil procedure code of 2013, procedural subjects, rules of civil procedure

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Authors: Rahma Fitriani, Zerlita Fahdha Pusdiktasari, Herman Cahyo Diartho

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Spatial panel model is commonly used to specify more complicated behavior of economic agent distributed in space at an individual-spatial unit level. There are several spatial panel models which can be adapted based on certain assumptions. A package called splm in R has several functions, ranging from the estimation procedure, specification tests, and model selection tests. In the absence of prior assumptions, a comprehensive procedure which utilizes the available functions in splm must be formed, which is the objective of this study. In this way, the best specification and model can be fitted based on data. The implementation of the procedure works well. It specifies SARAR-FE as the best model for agricultural productivity growth of the 38 East Java’s Regencies/Municipalities.

Keywords: spatial panel, specification, splm, agricultural productivity growth

Procedia PDF Downloads 171

Authors: Hayder Shanbara, Felicite Ruddock, William Atherton, Ali Al-Rifaie

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In highways construction, Hot Mix Asphalt (HMA) is used predominantly as a paving material from many years. Around 90 percent of the world road network is laid by flexible pavements. However, there are some restrictions on paving hot mix asphalt such as immoderate greenhouse gas emission, rainy season difficulties, fuel and energy consumption and cost. Therefore, Cold Bitumen Emulsion Mixture (CBEM) is considered an alternative mix to the HMA. CBEM is the popular type of Cold Mix Asphalt (CMA). It is unheated emulsion, aggregate and filler mixtures, which can be prepared and mixed at ambient temperature. This research presents a simple and more practicable design procedure of CBEM and discusses limitations of this design. CBEM is a mixture of bitumen emulsion and aggregates that mixed and produced at ambient temperature. It is relatively easy to produce, but the design procedure that provided by Asphalt Institute (Manual Series 14 (1989)) pose some issues in its practical application.

Keywords: cold bitumen, emulsion mixture, design procedure, pavement

Procedia PDF Downloads 251

Authors: L. Roseiro, C. Veiga, V. Maranha, A. Neto, N. Laraqi, A. Baïri, N. Alilat

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In orthopedic surgery there are various situations in which the surgeon needs to implement methods of cutting and drilling the bone. With this type of procedure the generated friction leads to a localized increase in temperature, which may lead to the bone necrosis. Recognizing the importance of studying this phenomenon, an experimental evaluation of the temperatures developed during the procedure of drilling bone has been done. Additionally the influence of the use of the procedure with / without additional lubrication during drilling of bone has also been done. The obtained results are presented and discussed and suggests an advantage in using additional lubrication as a way to minimize the appearance of bone tissue necrosis during bone drilling procedures.

Keywords: bone necrosis, bone drilling, thermography, surgery

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Authors: David Halley, Tyra Oseng-Rees, Luca Pagano, Juan A Ferriz-Papi

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Recycled glass material is made from 100% recycled bottle glass and consumes less energy than re-melt technology. It also uses no additives in the manufacturing process allowing the recycled glass material, in principal, to go back to the recycling stream after end-of-use, contributing to the circular economy with a low ecological impact. The aim of this paper is to investigate the procedure for testing the recycled glass material for impact resistance, so it can be applied to pavements and other surfaces which are at risk of impact during service. A review of different impact test procedures for construction materials was undertaken, comparing methodologies and international standards applied to other materials such as natural stone, ceramics and glass. A drop weight impact testing machine was designed and manufactured in-house to perform these tests. As a case study, samples of the recycled glass material were manufactured with two different thicknesses and tested. The impact energy was calculated theoretically, obtaining results with 5 and 10 J. The results on the material were subsequently discussed. Improvements on the procedure can be made using high speed video technology to calculate velocity just before and immediately after the impact to know the absorbed energy. The initial results obtained in this procedure were positive although repeatability needs to be developed to obtain a correlation of results and finally be able to validate the procedure. The experiment with samples showed the practicality of this procedure and application to the recycled glass material impact testing although further research needs to be developed.

Keywords: construction materials, drop weight impact, impact testing, recycled glass

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Authors: Lars Laußat, Manfred Helmus, Kamil Szczesny, Markus König

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As one result of the project “Reactive Construction Project Scheduling using Real Time Construction Logistic Data and Simulation”, a procedure for using data about uncertain resource availability assumptions in reactive scheduling processes has been developed. Prediction data about resource availability is generated in a formalized way using real-time monitoring data e.g. from auto-ID systems on the construction site and in the supply chains. The paper focuses on the formalization of the procedure for monitoring construction logistic processes, for the detection of disturbance and for generating of new and uncertain scheduling assumptions for the reactive resource constrained simulation procedure that is and will be further described in other papers.

Keywords: auto-ID, construction logistic, fuzzy, monitoring, RFID, scheduling

Procedia PDF Downloads 513

Authors: Oleg Sapelnikov, Ruslan Latypov, Darina Ardus, Samvel Aivazian, Andrey Shiryaev, Renat Akchurin

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OBJECTIVE: MAZE procedure is one of the most effective surgical methods in atrial fibrillation (AF) treatment. Nowadays we are all aware of its modifications. In our study we conducted clinical analysis of “Box lesion+” approach during MAZE procedure in two-year follow-up. METHODS: We studied the results of the open-heart on-pump procedures performed in our hospital from 2017 to 2018 years. Thirty-two (32) patients with atrial fibrillation (AF) were included in this study. Fifteen (15) patients had concomitant coronary bypass grafting and seventeen (17) patients had mitral valve repair. Mean age was 62.3±8.7 years; prevalence of men was admitted (56.1%). Mean duration of AF was 4.75±5.44 and 7.07±8.14 years. In all cases, we performed endocardial Cryo-MAZE procedure with one-time myocardium revascularization or mitral-valve surgery. All patients of this study underwent pulmonary vein (PV) isolation and ablation of mitral isthmus with additional isolation of LA posterior wall (Box-lesion+ procedure). Mean follow-up was 2 years. RESULTS: All cases were performed without any complications. Additional isolation of posterior wall did not prolong the operative time and artificial circulation significantly. Cryo-MAZE procedure directly lasted 20±2.1 min, the whole operation time was 192±24 min and artificial circulation time was 103±12 min. According to design of the study, we performed clinical investigation of the patients in 12 months and in 2 years from the initial procedure. In 12 months, the number of AF free patients 81.8% and 75.8% in two years of follow-up. CONCLUSIONS: Isolation of the left atrial posterior wall and perimitral area may considerably improve the efficacy of surgical treatment, which was demonstrated in significant decrease of AF recurrences during the whole period of follow-up.

Keywords: atrial fibrillation, cryoablation, left atrium isolation, open heart procedure

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Authors: I.-A. Ciobotaru, I.-E. Ciobotaru, D.-I. Vaireanu

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Currently, an ascending trend of battery use may be observed, together with an increase of the generated amount of waste. Efforts have been focused on the recycling of batteries; however, extending their lifetime may be a more adequate alternative, and the development of such methods may prove to be more cost efficient as compared to recycling. In this context, this paper presents the analysis of a proposed process for the reconditioning of some lithium-ions batteries. The analysis is performed based on two criteria, the first one referring to the technical aspect of the reconditioning process and the second to the economic aspects. The main technical parameters taken into consideration are the values of capacitance and internal resistance of the lithium-ion batteries. The economic criterion refers to the evaluation of the efficiency of the reconditioning procedure reported to its total cost for the investigated lithium-ion batteries. Based on the cost analysis, one introduced a novel coefficient that correlates the efficiency of the aforementioned process and its corresponding costs. The reconditioning procedure for the lithium-ion batteries proposed in this paper proved to be valid, efficient, and with reasonable costs.

Keywords: cost assessment, lithium-ion battery, reconditioning coefficient, reconditioning procedure

Procedia PDF Downloads 138

Authors: C. Catalina Zapata, Z. Claudia Montoya

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Transplant from hematopoietic parents (THP) or medulla (MT) is a procedure used to replace the medulla that does not work as part of a disease or when it is destroyed either by a treatment of high medication doses against cancer or by radiation. The transplant process has three stages, a stage prior to transplant, during and after the transplant. It is held with the help of an interdisciplinary team, including nursing, carrying out mainly educative procedures to warrant the adhesion and the changes in lifestyles needed to whom will undergo this procedure. The aim of the study was to assess the results of an educative procedure by nursing, on adult patients subjected to a transplant from hematopoietic parents at a high complexity institution of Medellin city, Colombia. This study had an observational longitudinal design. According to the rules of protocol, the educative activity must be held on all patients joining the procedure. Four instruments were designed in order to collect all the information. One of them to measure the sociodemographic variables, another one to measure self-care practices, another one to measure transplant knowledge and its cares and the other one to measure the 30-day post-transplant complications. The last three instruments were applied before and after the educative procedure. A univaried analysis was carried out but the bivaried analysis was not carried out since there were not statistically meaningful differences before and after. Within the results, ten patients were evaluated. The average age was 38.2 (13.38 SD – standard deviation), 8/10 were men. Some self-care practices such us having pets and plants and consuming some specific food as well as little use of UV protection are all present in this type of patients and are not modified after the procedure. In measuring the knowledge, something stands out among the answers. It is the fact that some patients do not know what the medulla is, the nature of separating wastes at home and the need to consult about vomit and nausea. The most frequent complications during the first thirty days were: nausea, vomit, fever, and rash. They are considered to be expected within this period. Patients do not exhibit differences in their level of knowledge before and after the educative procedure by nursing. The patients’ self-care practices do not involve all the necessary ones to avoid complications. During the first 30 days, most of the complications are typical of the transplant process from hematopoietic parents.

Keywords: bone marrow transplant, education, family, nursing, patients, Transplantation of hematopoietic progenitors

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Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: skeletal scintigraphy, SPECT/CT, imaging, procedure

Procedia PDF Downloads 152

Authors: Amaal Almigal

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Neurotypical children learn to ask questions from natural exposure and this skill is fundamental for their academic success. However, children with autism spectrum disorder may not learn to ask in the same way due to earlier communication impairments, and some may need to use Augmentative and Alternative Communication systems (AAC) to ask questions. This paper aims to highlight issues related to questioning skills in children with autism giving a specific attention to asking questions within preverbal or minimally verbal children. Different procedures have been employed to teach these children, including AAC users, to ask questions. Therefore, these procedures will also be discussed to administrate how they were used and what they were aimed to teach. This paper also provides a suggested procedure to assist preverbal or minimally verbal children to ask questions using an iPad application for communication (Proloquo2Go) as AAC. This suggested procedure was used with 3 children with autism. Initial results will be discussed to clarify ways in which this procedure was used with each child based on his skills and which questioning skills each child has acquired using this procedure.

Keywords: AAC, autism, communication, information, iPad, requesting

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Authors: Afshan Saad, Muhammad Saad, Shah Muhammad Emaduddin

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Nowadays the business condition is so quick paced that enhancing ourselves consistently has turned into a huge factor for the presence of an undertaking. We can check this for structural building and significantly more so in the quick-paced universe of data innovation and programming designing. The lithe philosophies, similar to Scrum, have a devoted advance in the process that objectives the enhancement of the improvement procedure and programming items. Pivotal to process enhancement is to pick up data that grants you to assess the condition of the procedure and its items. From the status data, you can design activities for the upgrade and furthermore assess the accomplishment of those activities. This investigation builds a model that measures the product nature of the improvement procedure. The product quality is dependent on the useful and auxiliary nature of the product items, besides the nature of the advancement procedure is likewise vital to enhance programming quality. Utilitarian quality covers the adherence to client prerequisites, while the auxiliary quality tends to the structure of the product item's source code with reference to its practicality. The procedure quality is identified with the consistency and expectedness of the improvement procedure. The product quality model is connected in a business setting by social occasion the information for the product measurements in the model. To assess the product quality model, we investigate the information and present it to the general population engaged with the light-footed programming improvement process. The outcomes from the application and the client input recommend that the model empowers a reasonable evaluation of the product quality and that it very well may be utilized to help the persistent enhancement of the advancement procedure and programming items.

Keywords: Agile SDLC Tools, Agile Software development, business value, enterprise applications, IBM, IBM Rational Team Concert, RTC, software quality, software metrics

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Authors: Tarek Aly

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The shoulder is the most mobile joint whose stability requires the interaction of both dynamic and static stabilizers. Its wide range of movement predisposes to a high susceptibility to dislocation, accounting for nearly 50% of all dislocations. This trauma typically results in ligament injury (e.g., labral tear, capsular strain) or bony fracture (e.g., loss of glenoid or humeral head bone), which frequently causes recurrent instability. Patients with significant glenoid defects may require Latarjet procedure, which involves transferring the coracoid to the antero-inferior glenoid rim. In spite of outstanding results, 15 to 30% of cases suffer complications. In this article, we discuss the diagnosis of recurrent shoulder instability, the surgical technique and various complications of Latarjet procedure.

Keywords: recurrent, anterior gleno-humeral instability, latarjet, unstable shoulder

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Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

Procedia PDF Downloads 103

Authors: W. Hajuthman, R. Warner, S. Rahman, M. Abraham, H. Helliwell, D. Bodiwala

Abstract:

Context: Prostate cancer is a prevalent cancer in males in Europe and the US, with diagnosis primarily relying on PSA testing, mpMRI, and subsequent biopsies. However, this diagnostic strategy may lead to complications for patients. Research Aim: The aim of this study is to assess compliance with trust guidelines for antibiotic prophylaxis in patients undergoing transperineal template biopsies of the prostate and evaluate the rate of post-procedure complications. Methodology: This study is conducted retrospectively over an 8-month period. Data collection includes patient demographics, compliance with trust guidelines, associated risk factors, and post-procedure complications such as infection, haematuria, and urinary retention. Findings: The audit includes 100 patients with a median age of 66.11. The compliance with pre-procedure antibiotics was 98%, while compliance with antibiotic prophylaxis recommended by trust guidelines was 68%. Among the patients, 3% developed post-procedure sepsis, with 2 requiring admission for intravenous antibiotics. No evident risk factors were identified in these cases. Additionally, post-procedure urinary retention occurred in 3% of patients and post-procedure haematuria in 2%. Theoretical Importance: This study highlights the increasing use of transperineal template biopsies across UK centres and suggests that having a standardized protocol and compliance with guidelines can reduce confusion, ensure appropriate administration of antibiotics, and mitigate post-procedure complications. Data Collection and Analysis Procedures: Data for this study is collected retrospectively, involving the extraction and analysis of relevant information from patient records over the specified 8-month period. Question Addressed: This study addresses the following research questions: (1) What is the compliance rate with trust guidelines for antibiotic prophylaxis in transperineal template biopsies of the prostate? (2) What is the rate of post-procedure complications, such as infection, haematuria, and urinary retention? Conclusion: Transperineal template biopsies are becoming increasingly prevalent in the UK. Implementing a standardized protocol and ensuring compliance with guidelines can reduce confusion, ensure proper administration of antibiotics, and potentially minimize post-procedure complications. Additionally, considering that studies show no difference in outcomes when prophylactic antibiotics are not used, the reminder to follow trust guidelines may prompt a re-evaluation of antibiotic prescribing practices.

Keywords: prostate, transperineal template biopsies of prostate, antibiotics, complications, microbiology, guidelines

Procedia PDF Downloads 79

Authors: Maryam Shayan

Abstract:

Programming frameworks have been utilized as a part of chemical industry process safety operation and configuration to enhance its effectiveness. This paper gives a brief survey and investigation of the best in class and effects of programming frameworks in process security. A study was completed by talking staff accountable for procedure wellbeing practices in the Iranian chemical process industry and diving into writing of innovation for procedure security. This article investigates the useful and operational attributes of programming frameworks for security and endeavors to sort the product as indicated by its level of effect in the administration chain of importance. The study adds to better comprehension of the parts of Information Communication Technology in procedure security, the future patterns and conceivable gaps for innovative work.

Keywords: programming frameworks, chemical industry process, process security, administration chain, information communication technology

Procedia PDF Downloads 373

Authors: Ki Hwa Lee, Eunsu Kang, Jae Hong Park

Abstract:

Background: Interventional neuroradiology (INR) has been a rapidly growing and evolving neurosurgical part during the past few decades. Sevoflurane and propofol are both suitable anesthetics for INR procedure. Monitoring of depth of anesthesia is being used very widely. SEDLine™ monitor, a 4-channel processed EEG monitor, uses a proprietary algorithm to analyze the raw EEG signal and displays the Patient State Index (PSI) values. There are only a fewer studies examining the PSI in the neuro-anesthesia. We aimed to investigate the difference of PSI values and hemodynamic variables between sevoflurane and propofol anesthesia during INR procedure. Methods: We reviewed the medical records of patients who scheduled to undergo embolization of non-ruptured intracranial aneurysm by a single operator from May 2013 to December 2014, retrospectively. Sixty-five patients were categorized into two groups; sevoflurane (n = 33) vs propofol (n = 32) group. The PSI values, hemodynamic variables, and the use of hemodynamic drugs were analyzed. Results: Significant differences were seen between PSI values obtained during different perioperative stages in both two groups (P < 0.0001). The PSI values of propofol group were lower than that of sevoflurane group during INR procedure (P < 0.01). The patients in propofol group had more prolonged time of extubation and more phenylephrine requirement than sevoflurane group (p < 0.05). Anti-hypertensive drug was more administered to the patients during extubation in sevoflurane group (p < 0.05). Conclusions: The PSI can detect depth of anesthesia and changes of concentration of anesthetics during INR procedure. Extubation was faster in sevoflurane group, but smooth recovery was shown in propofol group.

Keywords: interventional neuroradiology, patient state index, propofol, sevoflurane

Procedia PDF Downloads 180

Authors: Rebaz Sdiq Ismail

Abstract:

Organ donation and transplantation is one of the most debated topics in modern jurisprudence. It is a surgical procedure that aims to prolong a person’s life suffering from damaged or missing organs. This surgical procedure is carried out by removing an organ from a donor and transplanting it into the body of the recipient. As human life is of high value in Islamic Sharia, therefore, the donor and recipient should go through an intensive medical examination to remove any health risk associated with the organ and transplantation procedure. Thus, in carrying out the organ donation process, any violation of the Sharia decree that might cause harm to the human body is strictly prohibited. The researcher concludes that the former scholars of Islamic Sharia, along with some of the contemporary scholars, are against the entire concept of organ donation and transplant. However, the majority of contemporary scholars support organ donation.

Keywords: law, donation, organ, Kurdistan, sharia

Procedia PDF Downloads 29