Search results for: automatic emergency braking system
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18311

Search results for: automatic emergency braking system

18041 Predicting Factors for Occurrence of Cardiac Arrest in Critical, Emergency and Urgency Patients in an Emergency Department

Authors: Angkrit Phitchayangkoon, Ar-Aishah Dadeh

Abstract:

Background: A key aim of triage is to identify the patients with high risk of cardiac arrest because they require intensive monitoring, resuscitation facilities, and early intervention. We aimed to identify the predicting factors such as initial vital signs, serum pH, serum lactate level, initial capillary blood glucose, and Modified Early Warning Score (MEWS) which affect the occurrence of cardiac arrest in an emergency department (ED). Methods: We conducted a retrospective data review of ED patients in an emergency department (ED) from 1 August 2014 to 31 July 2016. Significant variables in univariate analysis were used to create a multivariate analysis. Differentiation of predicting factors between cardiac arrest patient and non-cardiac arrest patients for occurrence of cardiac arrest in an emergency department (ED) was the primary outcome. Results: The data of 527 non-trauma patients with Emergency Severity Index (ESI) 1-3 were collected. The factors found to have a significant association (P < 0.05) in the non-cardiac arrest group versus the cardiac arrest group at the ED were systolic BP (mean [IQR] 135 [114,158] vs 120 [90,140] mmHg), oxygen saturation (mean [IQR] 97 [89,98] vs 82.5 [78,95]%), GCS (mean [IQR] 15 [15,15] vs 11.5 [8.815]), normal sinus rhythm (mean 59.8 vs 30%), sinus tachycardia (mean 46.7 vs 21.7%), pH (mean [IQR] 7.4 [7.3,7.4] vs 7.2 [7,7.3]), serum lactate (mean [IQR] 2 [1.1,4.2] vs 7 [5,10.8]), and MEWS score (mean [IQR] 3 [2,5] vs 5 [3,6]). A multivariate analysis was then performed. After adjusting for multiple factors, ESI level 2 patients were more likely to have cardiac arrest in the ER compared with ESI 1 (odds ratio [OR], 1.66; P < 0.001). Furthermore, ESI 2 patients were more likely than ESI 1 patients to have cardiovascular disease (OR, 1.89; P = 0.01), heart rate < 55 (OR, 6.83; P = 0.18), SBP < 90 (OR, 3.41; P = 0.006), SpO2 < 94 (OR, 4.76; P = 0.012), sinus tachycardia (OR, 4.32; P = 0.002), lactate > 4 (OR, 10.66; P = < 0.001), and MEWS > 4 (OR, 4.86; P = 0.028). These factors remained predictive of cardiac arrest at the ED. Conclusion: The factors related to cardiac arrest in the ED are ESI 1 patients, ESI 2 patients, patients diagnosed with cardiovascular disease, SpO2 < 94, lactate > 4, and a MEWS > 4. These factors can be used as markers in the event of simultaneous arrival of many patients and can help as a pre-state for patients who have a tendency to develop cardiac arrest. The hemodynamic status and vital signs of these patients should be closely monitored. Early detection of potentially critical conditions to prevent critical medical intervention is mandatory.

Keywords: cardiac arrest, predicting factor, emergency department, emergency patient

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18040 Confidence Levels among UK Emergency Medicine Doctors in Performing Emergency Lateral Canthotomy: Should it be a Key Skill in the ED

Authors: Mohanad Moustafa, Julia Sieberer, Rhys Davies

Abstract:

Background: Orbital compartment syndrome (OCS) is a sight-threatening Ophthalmologic emergency caused by rapidly increasing intraorbital pressure. It is usually caused by a retrobulbar hemorrhage as a result of trauma. If not treated in a timely manner, permanent vision loss can occur. Lateral canthotomy and cantholysis are minor procedures that can be performed bedside with equipment available in the emergency department. The aim of the procedure is to release the attachments between the suspensory ligaments of the eye and the bony orbital wall, leading to a decrease in intraorbital pressure and preventing irreversible loss of vision. As most Ophthalmologists across the UK provide non-resident on-call service, this may lead to a delay in the treatment of OCS and stresses the need for Emergency medical staff to be able to provide this sight-saving procedure independently. Aim: To survey current training, experience, and confidence levels among Emergency Medicine doctors in performing emergency lateral canthotomy and to establish whether these variables change the following teaching from experienced ophthalmologists. RESULTS: Most EM registrars had little to no experience in performing lateral canthotomy and cantholysis. The majority of them showed a significant increase in their confidence to perform the procedure following ophthalmic-led teaching. The survey also showed that the registrars felt such training should be added to/part of the EM curriculum. Conclusion: The involvement of Ophthalmologists in the teaching of EM doctors to recognise and treat OCS independently may prevent delays in treatment and reduce the risk of permanent sight loss. This project showed potential in improving patient care and will lead to a National Survey of EM doctors across the UK.

Keywords: lateral canthotomy, retrobulbar hemorrhage, Ophthalmology, orbital compartment syndrome, sight loss, blindness

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18039 Barriers to Health Promotion Advice Delivered by Paramedics and Emergency Department Nurses – Promoted Study

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

Abstract:

Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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18038 Wolof Voice Response Recognition System: A Deep Learning Model for Wolof Audio Classification

Authors: Krishna Mohan Bathula, Fatou Bintou Loucoubar, FNU Kaleemunnisa, Christelle Scharff, Mark Anthony De Castro

Abstract:

Voice recognition algorithms such as automatic speech recognition and text-to-speech systems with African languages can play an important role in bridging the digital divide of Artificial Intelligence in Africa, contributing to the establishment of a fully inclusive information society. This paper proposes a Deep Learning model that can classify the user responses as inputs for an interactive voice response system. A dataset with Wolof language words ‘yes’ and ‘no’ is collected as audio recordings. A two stage Data Augmentation approach is adopted for enhancing the dataset size required by the deep neural network. Data preprocessing and feature engineering with Mel-Frequency Cepstral Coefficients are implemented. Convolutional Neural Networks (CNNs) have proven to be very powerful in image classification and are promising for audio processing when sounds are transformed into spectra. For performing voice response classification, the recordings are transformed into sound frequency feature spectra and then applied image classification methodology using a deep CNN model. The inference model of this trained and reusable Wolof voice response recognition system can be integrated with many applications associated with both web and mobile platforms.

Keywords: automatic speech recognition, interactive voice response, voice response recognition, wolof word classification

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18037 An Automatic Speech Recognition Tool for the Filipino Language Using the HTK System

Authors: John Lorenzo Bautista, Yoon-Joong Kim

Abstract:

This paper presents the development of a Filipino speech recognition tool using the HTK System. The system was trained from a subset of the Filipino Speech Corpus developed by the DSP Laboratory of the University of the Philippines-Diliman. The speech corpus was both used in training and testing the system by estimating the parameters for phonetic HMM-based (Hidden-Markov Model) acoustic models. Experiments on different mixture-weights were incorporated in the study. The phoneme-level word-based recognition of a 5-state HMM resulted in an average accuracy rate of 80.13 for a single-Gaussian mixture model, 81.13 after implementing a phoneme-alignment, and 87.19 for the increased Gaussian-mixture weight model. The highest accuracy rate of 88.70% was obtained from a 5-state model with 6 Gaussian mixtures.

Keywords: Filipino language, Hidden Markov Model, HTK system, speech recognition

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18036 Design and Implementation of Automated Car Anti-Collision System Device Using Distance Sensor

Authors: Mehrab Masayeed Habib, Tasneem Sanjana, Ahmed Amin Rumel

Abstract:

Automated car anti-collision system is a trending technology of science. A car anti-collision system is an automobile safety system. The aim of this paper was to describe designing a car anti-collision system device to reduce the severity of an accident. The purpose of this device is to prevent collision among cars and objects to reduce the accidental death of human. This project gives an overview of secure & smooth journey of car as well as the certainty of human life. This system is controlled by microcontroller PIC. Sharp distance sensor is used to detect any object within the danger range. A crystal oscillator is used to produce the oscillation and generates the clock pulse of the microcontroller. An LCD is used to give information about the safe distance and a buzzer is used as alarm. An actuator is used as automatic break and inside the actuator; there is a motor driver that runs the actuator. For coding ‘microC PRO for PIC’ was used and ’Proteus Design Suite version 8 Software’ was used for simulation.

Keywords: sharp distance sensor, microcontroller, MicroC PRO for PIC, proteus, actuator, automobile anti-collision system

Procedia PDF Downloads 441
18035 Sustainability through Resilience: How Emergency Responders Cope with Stressors

Authors: Sophie Kroeling, Agnetha Schuchardt

Abstract:

Striving for sustainability brings a lot of challenges for different fields of interest, e. g. security or health concerns. In Germany, civil protection is predominantly carried out by emergency responders who perform essential tasks of civil protection. Based on theoretical concepts of different psychological stress theories this contribution focuses on the question, how the resilience of emergency responders can be improved. The goal is to identify resources and successful coping strategies that help to prevent and reduce negative outcomes during or after stressful events. The paper will present results from a qualitative analysis of semi-structured qualitative interviews with 20 emergency responders. These results provide insights into the complexity of coping processes (e. g. controlling the situation, downplaying perceived personal threats through humor) and show the diversity of stressors (like complexity of the disastrous situation, intrusive press and media, or lack of social support within the organization). Self-efficacy expectation was a very important resource for coping with stressful situations. The results served as a starting point for a quantitative survey (that was conducted in March 2017), the development of education and training tools for emergency responders and the improvement of critical incident stress management processes. First results from the quantitative study with more than 700 participants show that, e. g., the emergency responders use social coping within their private social network and also within their aid organization and that both are correlated to resilience. Moreover, missing information, bureaucratic problems and social conflicts within the organization are events that the majority of the participants considered very onerous. Further results from regression analysis will be presented. The proposed paper will combine findings from the qualitative study with the quantitative results, illustrating figures and correlations with respective statements from the interviews. At the end, suggestions for the improvement of the emergency responder’s resilience are given and it is discussed how this can make a contribution to strive for civil security and furthermore a sustainable development.

Keywords: civil security, emergency responders, stress, resilience, resources

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18034 Automatic Verification Technology of Virtual Machine Software Patch on IaaS Cloud

Authors: Yoji Yamato

Abstract:

In this paper, we propose an automatic verification technology of software patches for user virtual environments on IaaS Cloud to decrease verification costs of patches. In these days, IaaS services have been spread and many users can customize virtual machines on IaaS Cloud like their own private servers. Regarding to software patches of OS or middleware installed on virtual machines, users need to adopt and verify these patches by themselves. This task increases operation costs of users. Our proposed method replicates user virtual environments, extracts verification test cases for user virtual environments from test case DB, distributes patches to virtual machines on replicated environments and conducts those test cases automatically on replicated environments. We have implemented the proposed method on OpenStack using Jenkins and confirmed the feasibility. Using the implementation, we confirmed the effectiveness of test case creation efforts by our proposed idea of 2-tier abstraction of software functions and test cases. We also evaluated the automatic verification performance of environment replications, test cases extractions and test cases conductions.

Keywords: OpenStack, cloud computing, automatic verification, jenkins

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18033 Recognition of Arrest Patients and Application of Basic Life Support by Bystanders in the Field

Authors: Behcet Al, Mehmet Murat Oktay, Suat Zengin, Mustafa Sabak, Cuma Yildirim

Abstract:

Objective: Th Recognition of arrest patients and application of basic life support (BLS) by bystanders in the field and the activation of emergency serves were evaluated in present study. Methodology: The present study was carried out by Emergency Department of Medicine Faculty of Gaziantep University at 33 of Emergency Health center in Gaziantep between December 2012- April 2014 prospectively. Of 539 arrested patients, 171 patients were included in study. Results: 118 (69%) male, and 53 31(%) female with a totlay of 171 patients were included in this study. Of patients, 32.2% had syncope and 24% had shorth breathing just befor being arrested. The majority of arrest cases had occured at home (61.4%) and rural area (11.7%) respectively. Of asking help, %48.5 were constructed by family members. Of announcement, only 15.2% occured within first minute of arrest. The BLS ratio that was applied by bystanders was 22.2%. Of bystanders, 47.4% had a course experience of BLS. The emergency serve had reached to the field with a mean of 8.43 min. Of cases, 55% (n=94) were evaluated as exitus firstly bu emergency staff. The most noticed rythim was asystol (73.1%). BLS and advanced life support (ALS) were applied to 98.8% and 60% respectively at the field. 10.5% (n=18) of cases were defibrilated, and 45 (26.3%) were intubated endotrecealy. The majority (48.5%) of staff who applied BLS and ALS at the fied were emergency medicine technicians. CPR was performed to 86.5% (n=148) cases in ambulance while they were transported. The mean arrival time to mergency department was 9.13 min. When the patients arrived to ED 15.2% needed defirlitation. 91.2% (n =156) of patients resulted in exitus in ED. 15 (8.8%) patients were discharged (9 with recovery, six patients with damage). Conclusion: The ratio of inntervention for arrest patients by bystanders is still low. To optain a high percentage of survival, BLS training should be widened among the puplic especiallyamong the caregivers.

Keywords: arrest patients, cardiopulmonary resuscitation, bystanders, chest compressions, prehospital

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18032 Fuzzy Multi-Objective Approach for Emergency Location Transportation Problem

Authors: Bidzina Matsaberidze, Anna Sikharulidze, Gia Sirbiladze, Bezhan Ghvaberidze

Abstract:

In the modern world emergency management decision support systems are actively used by state organizations, which are interested in extreme and abnormal processes and provide optimal and safe management of supply needed for the civil and military facilities in geographical areas, affected by disasters, earthquakes, fires and other accidents, weapons of mass destruction, terrorist attacks, etc. Obviously, these kinds of extreme events cause significant losses and damages to the infrastructure. In such cases, usage of intelligent support technologies is very important for quick and optimal location-transportation of emergency service in order to avoid new losses caused by these events. Timely servicing from emergency service centers to the affected disaster regions (response phase) is a key task of the emergency management system. Scientific research of this field takes the important place in decision-making problems. Our goal was to create an expert knowledge-based intelligent support system, which will serve as an assistant tool to provide optimal solutions for the above-mentioned problem. The inputs to the mathematical model of the system are objective data, as well as expert evaluations. The outputs of the system are solutions for Fuzzy Multi-Objective Emergency Location-Transportation Problem (FMOELTP) for disasters’ regions. The development and testing of the Intelligent Support System were done on the example of an experimental disaster region (for some geographical zone of Georgia) which was generated using a simulation modeling. Four objectives are considered in our model. The first objective is to minimize an expectation of total transportation duration of needed products. The second objective is to minimize the total selection unreliability index of opened humanitarian aid distribution centers (HADCs). The third objective minimizes the number of agents needed to operate the opened HADCs. The fourth objective minimizes the non-covered demand for all demand points. Possibility chance constraints and objective constraints were constructed based on objective-subjective data. The FMOELTP was constructed in a static and fuzzy environment since the decisions to be made are taken immediately after the disaster (during few hours) with the information available at that moment. It is assumed that the requests for products are estimated by homeland security organizations, or their experts, based upon their experience and their evaluation of the disaster’s seriousness. Estimated transportation times are considered to take into account routing access difficulty of the region and the infrastructure conditions. We propose an epsilon-constraint method for finding the exact solutions for the problem. It is proved that this approach generates the exact Pareto front of the multi-objective location-transportation problem addressed. Sometimes for large dimensions of the problem, the exact method requires long computing times. Thus, we propose an approximate method that imposes a number of stopping criteria on the exact method. For large dimensions of the FMOELTP the Estimation of Distribution Algorithm’s (EDA) approach is developed.

Keywords: epsilon-constraint method, estimation of distribution algorithm, fuzzy multi-objective combinatorial programming problem, fuzzy multi-objective emergency location/transportation problem

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18031 Automatic Approach for Estimating the Protection Elements of Electric Power Plants

Authors: Mahmoud Mohammad Salem Al-Suod, Ushkarenko O. Alexander, Dorogan I. Olga

Abstract:

New algorithms using microprocessor systems have been proposed for protection the diesel-generator unit in autonomous power systems. The software structure is designed to enhance the control automata of the system, in which every protection module of diesel-generator encapsulates the finite state machine.

Keywords: diesel-generator unit, protection, state diagram, control system, algorithm, software components

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18030 Decision Support System for Hospital Selection in Emergency Medical Services: A Discrete Event Simulation Approach

Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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18029 Automatic and High Precise Modeling for System Optimization

Authors: Stephanie Chen, Mitja Echim, Christof Büskens

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To describe and propagate the behavior of a system mathematical models are formulated. Parameter identification is used to adapt the coefficients of the underlying laws of science. For complex systems this approach can be incomplete and hence imprecise and moreover too slow to be computed efficiently. Therefore, these models might be not applicable for the numerical optimization of real systems, since these techniques require numerous evaluations of the models. Moreover not all quantities necessary for the identification might be available and hence the system must be adapted manually. Therefore, an approach is described that generates models that overcome the before mentioned limitations by not focusing on physical laws, but on measured (sensor) data of real systems. The approach is more general since it generates models for every system detached from the scientific background. Additionally, this approach can be used in a more general sense, since it is able to automatically identify correlations in the data. The method can be classified as a multivariate data regression analysis. In contrast to many other data regression methods this variant is also able to identify correlations of products of variables and not only of single variables. This enables a far more precise and better representation of causal correlations. The basis and the explanation of this method come from an analytical background: the series expansion. Another advantage of this technique is the possibility of real-time adaptation of the generated models during operation. Herewith system changes due to aging, wear or perturbations from the environment can be taken into account, which is indispensable for realistic scenarios. Since these data driven models can be evaluated very efficiently and with high precision, they can be used in mathematical optimization algorithms that minimize a cost function, e.g. time, energy consumption, operational costs or a mixture of them, subject to additional constraints. The proposed method has successfully been tested in several complex applications and with strong industrial requirements. The generated models were able to simulate the given systems with an error in precision less than one percent. Moreover the automatic identification of the correlations was able to discover so far unknown relationships. To summarize the above mentioned approach is able to efficiently compute high precise and real-time-adaptive data-based models in different fields of industry. Combined with an effective mathematical optimization algorithm like WORHP (We Optimize Really Huge Problems) several complex systems can now be represented by a high precision model to be optimized within the user wishes. The proposed methods will be illustrated with different examples.

Keywords: adaptive modeling, automatic identification of correlations, data based modeling, optimization

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18028 Residual Evaluation by Thresholding and Neuro-Fuzzy System: Application to Actuator

Authors: Y. Kourd, D. Lefebvre, N. Guersi

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The monitoring of industrial processes is required to ensure operating conditions of industrial systems through automatic detection and isolation of faults. In this paper we propose a method of fault diagnosis based on neuro-fuzzy technique and the choice of a threshold. The validation of this method on a test bench "Actuator Electro DAMADICS Benchmark". In the first phase of the method, we construct a model represents the normal state of the system to fault detection. With residuals analysis generated and the choice of thresholds for signatures table. These signatures provide us with groups of non-detectable faults. In the second phase, we build faulty models to see the flaws in the system that are not located in the first phase.

Keywords: residuals analysis, threshold, neuro-fuzzy system, residual evaluation

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18027 Autopsy-Based Study of Abdominal Traffic Trauma Death after Emergency Room Arrival

Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

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We experience the autopsy cases that the deceased was alive in emergency room on arrival. Bleeding is the leading cause of preventable death after injury. This retrospective study aimed to characterize opportunities for performance improvement identified in patients who died from traffic trauma and were considered by the quality improvement of education system. The Japan Advanced Trauma Evaluation and Care (JATEC) education program was introduced in 2002. We focused the abdominal traffic trauma injury. An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 41 post-mortems of road traffic accident between April 1999 and March 2014 subjected to medico-legal autopsy at the department of Forensic Medicine, Shiga University of Medical Science. 16 patients (39.0%) were abdominal trauma injury. The mean period of survival after meet with accident was 13.5 hours, compared abdominal trauma death was 27.4 hours longer. In road traffic accidents, the most injured abdominal organs were liver followed by mesentery. We thought delayed treatment was associated with immediate diagnostic imaging, and so expected to expand trauma management examination.

Keywords: abdominal traffic trauma, preventable death, autopsy, emergency medicine

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18026 Humanitarian Emergency of the Refugee Condition for Central American Immigrants in Irregular Situation

Authors: María de los Ángeles Cerda González, Itzel Arriaga Hurtado, Pascacio José Martínez Pichardo

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In México, the recognition of refugee condition is a fundamental right which, as host State, has the obligation of respect, protect, and fulfill to the foreigners – where we can find the figure of immigrants in irregular situation-, that cannot return to their country of origin for humanitarian reasons. The recognition of the refugee condition as a fundamental right in the Mexican law system proceeds under these situations: 1. The immigrant applies for the refugee condition, even without the necessary proving elements to accredit the humanitarian character of his departure from his country of origin. 2. The immigrant does not apply for the recognition of refugee because he does not know he has the right to, even if he has the profile to apply for. 3. The immigrant who applies fulfills the requirements of the administrative procedure and has access to the refugee recognition. Of the three situations above, only the last one is contemplated for the national indexes of the status refugee; and the first two prove the inefficiency of the governmental system viewed from its lack of sensibility consequence of the no education in human rights matter and which results in the legal vulnerability of the immigrants in irregular situation because they do not have access to the procuration and administration of justice. In the aim of determining the causes and consequences of the no recognition of the refugee status, this investigation was structured from a systemic analysis which objective is to show the advances in Central American humanitarian emergency investigation, the Mexican States actions to protect, respect and fulfil the fundamental right of refugee of immigrants in irregular situation and the social and legal vulnerabilities suffered by Central Americans in Mexico. Therefore, to achieve the deduction of the legal nature of the humanitarian emergency from the Human Rights as a branch of the International Public Law, a conceptual framework is structured using the inductive deductive method. The problem statement is made from a legal framework to approach a theoretical scheme under the theory of social systems, from the analysis of the lack of communication of the governmental and normative subsystems of the Mexican legal system relative to the process undertaken by the Central American immigrants to achieve the recognition of the refugee status as a human right. Accordingly, is determined that fulfilling the obligations of the State referent to grant the right of the recognition of the refugee condition, would mean a guideline for a new stage in Mexican Law, because it would enlarge the constitutional benefits to everyone whose right to the recognition of refugee has been denied an as consequence, a great advance in human rights matter would be achieved.

Keywords: central American immigrants in irregular situation, humanitarian emergency, human rights, refugee

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18025 Assessing Suitability of Earthbag Technology for Temporary Housing: Sustainability Challenge

Authors: S. M. Amin Hosseini, Ana Blanco, Albert De La Fuente, Sergio Cavalaro

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In emergency situations, it is fundamental to provide with a safe shelter to the population affected. However, the lack of resources and short time often represent a barrier difficult to overcome. A sustainable, rapid and low-cost construction technique is earthbag construction. This technique has spread as an alternative to the construction of emergency shelter, social housing, and even ecovillages. The earthbag construction consists of introducing soil in degradable bags that are stacked to form adobe structures. The present study aims to assess characteristics of the earthbag construction technique based on sustainability requirements and features of other methods used for temporary housing. In this case, after defining the sustainability criteria and emergency situation necessities, this study compares earthbag construction with other types of prefabricated temporary housing. Finally, the most suitable conditions for applying this technique based on the particular local properties and second life scenarios of superadobe temporary housing. The results of the study contribute to promote the earthbag and superadobe techniques as sustainable alternatives for temporary housing. However, the sustainability index of this technology highly depends on affected local conditions and characteristics. Consequently, in order to achieve a high sustainability index, emergency managers need to decide about this technology based on the highlighted results of this study, attention to the importance of specific local conditions and next functions of temporary housing.

Keywords: temporary housing, temporary shelter, earthbag, superadobe, sustainability, emergency

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18024 Patients' Understanding of Their Treatment Plans and Diagnosis during Discharge in Emergency Ward at B. P. Koirala Institute of Health Sciences

Authors: Ajay Kumar Yadav, Masum Paudel, Ritesh Chaudhary

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Background: Understanding the diagnosis and the treatment plan is very important for the patient which reflects the effectiveness of the patient care as well as counseling. Large groups of patients do not understand their emergency care plan or their discharge instructions. With only a little more than 2/3ʳᵈ of the adult population is literate and poorly distributed health service institutions in Nepal, exploring the current status of patient understanding of their diagnosis and treatment would help identify interventions to improve patient compliance with the provided care and the treatment outcomes. Objectives: This study was conducted to identify and describe the areas of patients’ understanding and confusion regarding emergency care and discharge instructions at the Emergency ward of B. P. Koirala Institute of Health Sciences teaching hospital, Dharan, Nepal. Methods: A cross-sectional study was conducted among 426 patients discharged from the emergency unit of BPKIHS. Cases who are leaving against medical advice absconded cases and those patients who came just for vaccination are excluded from the study. Patients’ understanding of the treatment plan and diagnosis was measured. Results: There were 60% men in this study. More than half of the participants reported not being able to read English. More than 90% of the respondents reported they could not read their prescription at all. While patient could point out their understanding of their diagnosis at discharge, most of them could not tell the names and the dosage of all the drugs prescribed to them at discharge. More than 95% of the patients could not tell the most common side effects of the drugs that they are prescribed. Conclusions: There is a need to further explore the factors influencing the understanding of the patients regarding their treatment plan. Interventions to understand the health literacy needs and ways to improve the health literacy of the patients are needed.

Keywords: discharge instruction, emergency ward, health literacy, treatment plan

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18023 Comparison of Patient Stay at Withy Bush Same Day Emergency Care and Then Those at the Emergency Department

Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

Abstract:

Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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18022 Double Layer Security Authentication Model for Automatic Dependent Surveillance-Broadcast

Authors: Buse T. Aydin, Enver Ozdemir

Abstract:

An automatic dependent surveillance-broadcast (ADS-B) system has serious security problems. In this study, a double layer authentication scheme between the aircraft and ground station, aircraft to aircraft, ground station to ATC tower is designed to prevent any unauthorized aircrafts from introducing themselves as friends. This method can be used as a solution to the problem of authentication. The method is a combination of classical cryptographic methods and new generation physical layers. The first layer has employed the embedded key of the aircraft. The embedded key is assumed to installed during the construction of the utility. The other layer is a physical attribute (flight path, distance, etc.) between the aircraft and the ATC tower. We create a mathematical model so that two layers’ information is employed and an aircraft is authenticated as a friend or unknown according to the accuracy of the results of the model. The results of the aircraft are compared with the results of the ATC tower and if the values found by the aircraft and ATC tower match within a certain error margin, we mark the aircraft as friend. As a result, the ADS-B messages coming from this authenticated friendly aircraft will be processed. In this method, even if the embedded key is captured by the unknown aircraft, without the information of the second layer, the unknown aircraft can easily be determined. Overall, in this work, we present a reliable system by adding physical layer in the authentication process.

Keywords: ADS-B, authentication, communication with physical layer security, cryptography, identification friend or foe

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18021 Automatic Staging and Subtype Determination for Non-Small Cell Lung Carcinoma Using PET Image Texture Analysis

Authors: Seyhan Karaçavuş, Bülent Yılmaz, Ömer Kayaaltı, Semra İçer, Arzu Taşdemir, Oğuzhan Ayyıldız, Kübra Eset, Eser Kaya

Abstract:

In this study, our goal was to perform tumor staging and subtype determination automatically using different texture analysis approaches for a very common cancer type, i.e., non-small cell lung carcinoma (NSCLC). Especially, we introduced a texture analysis approach, called Law’s texture filter, to be used in this context for the first time. The 18F-FDG PET images of 42 patients with NSCLC were evaluated. The number of patients for each tumor stage, i.e., I-II, III or IV, was 14. The patients had ~45% adenocarcinoma (ADC) and ~55% squamous cell carcinoma (SqCCs). MATLAB technical computing language was employed in the extraction of 51 features by using first order statistics (FOS), gray-level co-occurrence matrix (GLCM), gray-level run-length matrix (GLRLM), and Laws’ texture filters. The feature selection method employed was the sequential forward selection (SFS). Selected textural features were used in the automatic classification by k-nearest neighbors (k-NN) and support vector machines (SVM). In the automatic classification of tumor stage, the accuracy was approximately 59.5% with k-NN classifier (k=3) and 69% with SVM (with one versus one paradigm), using 5 features. In the automatic classification of tumor subtype, the accuracy was around 92.7% with SVM one vs. one. Texture analysis of FDG-PET images might be used, in addition to metabolic parameters as an objective tool to assess tumor histopathological characteristics and in automatic classification of tumor stage and subtype.

Keywords: cancer stage, cancer cell type, non-small cell lung carcinoma, PET, texture analysis

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18020 Curvature Based-Methods for Automatic Coarse and Fine Registration in Dimensional Metrology

Authors: Rindra Rantoson, Hichem Nouira, Nabil Anwer, Charyar Mehdi-Souzani

Abstract:

Multiple measurements by means of various data acquisition systems are generally required to measure the shape of freeform workpieces for accuracy, reliability and holisticity. The obtained data are aligned and fused into a common coordinate system within a registration technique involving coarse and fine registrations. Standardized iterative methods have been established for fine registration such as Iterative Closest Points (ICP) and its variants. For coarse registration, no conventional method has been adopted yet despite a significant number of techniques which have been developed in the literature to supply an automatic rough matching between data sets. Two main issues are addressed in this paper: the coarse registration and the fine registration. For coarse registration, two novel automated methods based on the exploitation of discrete curvatures are presented: an enhanced Hough Transformation (HT) and an improved Ransac Transformation. The use of curvature features in both methods aims to reduce computational cost. For fine registration, a new variant of ICP method is proposed in order to reduce registration error using curvature parameters. A specific distance considering the curvature similarity has been combined with Euclidean distance to define the distance criterion used for correspondences searching. Additionally, the objective function has been improved by combining the point-to-point (P-P) minimization and the point-to-plane (P-Pl) minimization with automatic weights. These ones are determined from the preliminary calculated curvature features at each point of the workpiece surface. The algorithms are applied on simulated and real data performed by a computer tomography (CT) system. The obtained results reveal the benefit of the proposed novel curvature-based registration methods.

Keywords: discrete curvature, RANSAC transformation, hough transformation, coarse registration, ICP variant, point-to-point and point-to-plane minimization combination, computer tomography

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18019 Reducing System Delay to Definitive Care For STEMI Patients, a Simulation of Two Different Strategies in the Brugge Area, Belgium

Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

Abstract:

Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

Procedia PDF Downloads 296
18018 Opioid Administration on Patients Hospitalized in the Emergency Department

Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

Abstract:

Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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18017 Gamma-Hydroxybutyrate (GHB): A Review for the Prehospital Clinician

Authors: Theo Welch

Abstract:

Background: Gamma-hydroxybutyrate (GHB) is a depressant of the central nervous system with euphoric effects. It is being increasingly used recreationally in the United Kingdom (UK) despite associated morbidity and mortality. Due to the lack of evidence, healthcare professionals remain unsure as to the optimum management of GHB acute toxicity. Methods: A literature review was undertaken of its pharmacology and the emergency management of its acute toxicity.Findings: GHB is inexpensive and readily available over the Internet. Treatment of GHB acute toxicity is supportive. Clinicians should pay particular attention to the airway as emesis is common. Intubation is required in a minority of cases. Polydrug use is common and worsens prognosis. Conclusion: An inexpensive and readily available drug, GHB acute toxicity can be difficult to identify and treat. GHB acute toxicity is generally treated conservatively. Further research is needed to ascertain the indications, benefits, and risks of intubating patients with GHB acute toxicity. instructions give you guidelines for preparing papers for the conference.

Keywords: GHB, gamma-hydroxybutyrate, prehospital, emergency, toxicity, management

Procedia PDF Downloads 175
18016 Earphone Style Wearable Device for Automatic Guidance Service with Position Sensing

Authors: Dawei Cai

Abstract:

This paper describes a design of earphone style wearable device that may provide an automatic guidance service for visitors. With both position information and orientation information obtained from NFC and terrestrial magnetism sensor, a high level automatic guide service may be realized. To realize the service, a algorithm for position detection using the packet from NFC tags, and developed an algorithm to calculate the device orientation based on the data from acceleration and terrestrial magnetism sensors called as MEMS. If visitors want to know some explanation about an exhibit in front of him, what he has to do is only move to the object and stands for a moment. The identification program will automatically recognize the status based on the information from NFC and MEMS, and start playing explanation content about the exhibit. This service should be useful for improving the understanding of the exhibition items and bring more satisfactory visiting experience without less burden.

Keywords: wearable device, MEMS sensor, ubiquitous computing, NFC

Procedia PDF Downloads 220
18015 Efficient Subsurface Mapping: Automatic Integration of Ground Penetrating Radar with Geographic Information Systems

Authors: Rauf R. Hussein, Devon M. Ramey

Abstract:

Integrating Ground Penetrating Radar (GPR) with Geographic Information Systems (GIS) can provide valuable insights for various applications, such as archaeology, transportation, and utility locating. Although there has been progress toward automating the integration of GPR data with GIS, fully automatic integration has not been achieved yet. Additionally, manually integrating GPR data with GIS can be a time-consuming and error-prone process. In this study, actual, real-world GPR applications are presented, and a software named GPR-GIS 10 is created to interactively extract subsurface targets from GPR radargrams and automatically integrate them into GIS. With this software, it is possible to quickly and reliably integrate the two techniques to create informative subsurface maps. The results indicated that automatic integration of GPR with GIS can be an efficient tool to map and view any subsurface targets in their appropriate location in a 3D space with the needed precision. The findings of this study could help GPR-GIS integrators save time and reduce errors in many GPR-GIS applications.

Keywords: GPR, GIS, GPR-GIS 10, drone technology, automation

Procedia PDF Downloads 59
18014 Design and Development of Data Mining Application for Medical Centers in Remote Areas

Authors: Grace Omowunmi Soyebi

Abstract:

Data Mining is the extraction of information from a large database which helps in predicting a trend or behavior, thereby helping management make knowledge-driven decisions. One principal problem of most hospitals in rural areas is making use of the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved; this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method, which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to easily retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: data mining, medical record system, systems programming, computing

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18013 Applying Spanning Tree Graph Theory for Automatic Database Normalization

Authors: Chetneti Srisa-an

Abstract:

In Knowledge and Data Engineering field, relational database is the best repository to store data in a real world. It has been using around the world more than eight decades. Normalization is the most important process for the analysis and design of relational databases. It aims at creating a set of relational tables with minimum data redundancy that preserve consistency and facilitate correct insertion, deletion, and modification. Normalization is a major task in the design of relational databases. Despite its importance, very few algorithms have been developed to be used in the design of commercial automatic normalization tools. It is also rare technique to do it automatically rather manually. Moreover, for a large and complex database as of now, it make even harder to do it manually. This paper presents a new complete automated relational database normalization method. It produces the directed graph and spanning tree, first. It then proceeds with generating the 2NF, 3NF and also BCNF normal forms. The benefit of this new algorithm is that it can cope with a large set of complex function dependencies.

Keywords: relational database, functional dependency, automatic normalization, primary key, spanning tree

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18012 Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in an Urgent Care Center in Saudi Arabia

Authors: Abdullah Arafat, Ali Al-Farhan, Amir Omair

Abstract:

Objectives: To review and assess the effectiveness of the implemented modified five-levels triage and acuity scale triage system in AL-Yarmook Urgent Care Center (UCC), King Abdulaziz Residential city, Riyadh, Saudi Arabia. Method: The applied study design was an observational cross sectional design. A data collection sheet was designed and distributed to triage nurses; the data collection was done during triage process and was directly observed by the co-investigator. Triage system was reviewed by measuring three time intervals as quality indicators: time before triage (TBT), time before being seen by physician (TBP) and total length of stay (TLS) taking in consideration timing of presentation and level of triage. Results: During the study period, a total of 187 patients were included in our study. 118 visits were at weekdays and 68 visits at weekends. Overall, 173 patients (92.5%) were seen by the physician in timely manner according to triage guidelines while 14 patients (7.5%) were not seen at appropriate time.Overall, The mean time before seen the triage nurse (TBT) was 5.36 minutes, the mean time to be seen by physician (TBP) was 22.6 minutes and the mean length of stay (TLS) was 59 minutes. The data didn’t showed significant increase in TBT, TBP, and number of patients not seen at the proper time, referral rate and admission rate during weekend. Conclusion: The CTAS is adaptable to countries beyond Canada and worked properly. The applied CTAS triage system in Al-Yarmook UCC is considered to be effective and well applied. Overall, urgent cases have been seen by physician in timely manner according to triage system and there was no delay in the management of urgent cases.

Keywords: CTAS, emergency, Saudi Arabia, triage, urgent care

Procedia PDF Downloads 295