Search results for: rating tool
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5476

Search results for: rating tool

5206 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

Procedia PDF Downloads 426
5205 Spectral Coherence Analysis between Grinding Interaction Forces and the Relative Motion of the Workpiece and the Cutting Tool

Authors: Abdulhamit Donder, Erhan Ilhan Konukseven

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Grinding operation is performed in order to obtain desired surfaces precisely in machining process. The needed relative motion between the cutting tool and the workpiece is generally created either by the movement of the cutting tool or by the movement of the workpiece or by the movement of both of them as in our case. For all these cases, the coherence level between the movements and the interaction forces is a key influential parameter for efficient grinding. Therefore, in this work, spectral coherence analysis has been performed to investigate the coherence level between grinding interaction forces and the movement of the workpiece on our robotic-grinding experimental setup in METU Mechatronics Laboratory.

Keywords: coherence analysis, correlation, FFT, grinding, hanning window, machining, Piezo actuator, reverse arrangements test, spectral analysis

Procedia PDF Downloads 405
5204 Improvement in Tool Life Through Optimizing Cutting Parameters Using Cryogenic Media in Machining of Aerospace Alloy Steel

Authors: Waseem Tahir, Syed Hussain Imran Jaffery, Mohammad Azam

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In this research work, liquid nitrogen gas (LN2) is used as a cryogenic media to optimize the cutting parameters for evaluation of tool flank wear width of Tungsten Carbide Insert (CNMG 120404-WF 4215) while turning a high strength alloy steel. Robust design concept of Taguchi L9 (34) method is applied to determine the optimum conditions. The analysis is revealed that cryogenic impact is more significant in reduction of the tool flank wear. However, High Speed Machining is shown most significant as compare to cooling media on work piece surface roughness.

Keywords: turning, cryogenic cooling, liquid nitrogen, flank wear, surface finish

Procedia PDF Downloads 512
5203 Application of Particle Swarm Optimization to Thermal Sensor Placement for Smart Grid

Authors: Hung-Shuo Wu, Huan-Chieh Chiu, Xiang-Yao Zheng, Yu-Cheng Yang, Chien-Hao Wang, Jen-Cheng Wang, Chwan-Lu Tseng, Joe-Air Jiang

Abstract:

Dynamic Thermal Rating (DTR) provides crucial information by estimating the ampacity of transmission lines to improve power dispatching efficiency. To perform the DTR, it is necessary to install on-line thermal sensors to monitor conductor temperature and weather variables. A simple and intuitive strategy is to allocate a thermal sensor to every span of transmission lines, but the cost of sensors might be too high to bear. To deal with the cost issue, a thermal sensor placement problem must be solved. This research proposes and implements a hybrid algorithm which combines proper orthogonal decomposition (POD) with particle swarm optimization (PSO) methods. The proposed hybrid algorithm solves a multi-objective optimization problem that concludes the minimum number of sensors and the minimum error on conductor temperature, and the optimal sensor placement is determined simultaneously. The data of 345 kV transmission lines and the hourly weather data from the Taiwan Power Company and Central Weather Bureau (CWB), respectively, are used by the proposed method. The simulated results indicate that the number of sensors could be reduced using the optimal placement method proposed by the study and an acceptable error on conductor temperature could be achieved. This study provides power companies with a reliable reference for efficiently monitoring and managing their power grids.

Keywords: dynamic thermal rating, proper orthogonal decomposition, particle swarm optimization, sensor placement, smart grid

Procedia PDF Downloads 432
5202 Automatic Tofu Stick Cutter to Increase the Production Capacity of Small and Medium Enterprises

Authors: Chaca Nugraha Zaid, Hikmat Ronaldo, Emerald Falah Brayoga, Azizah Eddy Setiawati, Soviandini Dwiki Kartika Putri, Novita Wijayanti

Abstract:

In the tofu stick production, the manual cutting process takes a half of working day or 4 hours for 21 kg of tofu. This issue has hampered the small and medium enterprises (SMEs) to increase the capacity of production to fulfill the market demand. In order to address the issue, the cutting process should be automized to create fast, efficient, and effective tools. This innovation to tackle this problem is an automatic cutter tool that is able to move continuously to cut the tofu into stick size. The tool uses the 78,5-watt electric motor and automatic sensors to drive the cutting tool automatically, resulting faster process time with more uniform size compared to the manual cutter. The component of this tool, i.e., cutting knife and the driver, electric motor, limit switch sensors, riley, Arduino nano, and power supply. The cutting speed cutting speed of this tool is 101,25 mm/s producing 64 tofu sticks. Benefits that can be obtained from the use of automatic tofu stick cutter, i.e. (1) Faster process (2) More uniform cutting result; (3) The quality of the tofu stick is maintained due to minimal contact with humans so that contamination can be suppressed; (4) The cutting knife can be modified to the desired size of the owner.

Keywords: automatic, cutter, small and medium enterprise, tofu stick

Procedia PDF Downloads 166
5201 Developing a Web GIS Tool for the Evaluation of Soil Erosion of a Watershed

Authors: Y. Fekir, K. Mederbal, M. A. Hamadouche, D. Anteur

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The soil erosion by water has become one of the biggest problems of the environment in the world, threatening the majority of countries. There are several models to evaluate erosion. These models are still a simplified representation of reality. They permit the analysis of complex systems, measurements are complementary to allow an extrapolation in time and space and may combine different factors. The empirical model of soil loss proposed by Wischmeier and Smith (Universal Soil Loss Equation), is widely used in many countries. He considers that erosion is a multiplicative function of five factors: rainfall erosivity (the R factor) the soil erodibility factor (K), topography (LS), the erosion control practices (P) and vegetation cover and agricultural practices (C). In this work, we tried to develop a tool based on Web GIS functionality to evaluate soil losses caused by erosion taking into account five factors. This tool allows the user to integrate all the data needed for the evaluation (DEM, Land use, rainfall ...) in the form of digital layers to calculate the five factors taken into account in the USLE equation (R, K, C, P, LS). Accordingly, and after treatment of the integrated data set, a map of the soil losses will be achieved as a result. We tested the proposed tool on a watershed basin located in the weste of Algeria where a dataset was collected and prepared.

Keywords: USLE, erosion, web gis, Algeria

Procedia PDF Downloads 330
5200 Case Study of Mechanised Shea Butter Production in South-Western Nigeria Using the LCA Approach from Gate-to-Gate

Authors: Temitayo Abayomi Ewemoje, Oluwamayowa Oluwafemi Oluwaniyi

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Agriculture and food processing, industry are among the largest industrial sectors that uses large amount of energy. Thus, a larger amount of gases from their fuel combustion technologies is being released into the environment. The choice of input energy supply not only directly having affects the environment, but also poses a threat to human health. The study was therefore designed to assess each unit production processes in order to identify hotspots using life cycle assessments (LCA) approach in South-western Nigeria. Data such as machine power rating, operation duration, inputs and outputs of shea butter materials for unit processes obtained at site were used to modelled Life Cycle Impact Analysis on GaBi6 (Holistic Balancing) software. Four scenarios were drawn for the impact assessments. Material sourcing from Kaiama, Scenarios 1, 3 and Minna Scenarios 2, 4 but different heat supply sources (Liquefied Petroleum Gas ‘LPG’ Scenarios 1, 2 and 10.8 kW Diesel Heater, scenarios 3, 4). Modelling of shea butter production on GaBi6 was for 1kg functional unit of shea butter produced and the Tool for the Reduction and Assessment of Chemical and other Environmental Impacts (TRACI) midpoint assessment was tool used to was analyse the life cycle inventories of the four scenarios. Eight categories in all four Scenarios were observed out of which three impact categories; Global Warming Potential (GWP) (0.613, 0.751, 0.661, 0.799) kg CO2¬-Equiv., Acidification Potential (AP) (0.112, 0.132, 0.129, 0.149) kg H+ moles-Equiv., and Smog (0.044, 0.059, 0.049, 0.063) kg O3-Equiv., categories had the greater impacts on the environment in Scenarios 1-4 respectively. Impacts from transportation activities was also seen to contribute more to these environmental impact categories due to large volume of petrol combusted leading to releases of gases such as CO2, CH4, N2O, SO2, and NOx into the environment during the transportation of raw shea kernel purchased. The ratio of transportation distance from Minna and Kaiama to production site was approximately 3.5. Shea butter unit processes with greater impacts in all categories was the packaging, milling and with the churning processes in ascending order of magnitude was identified as hotspots that may require attention. From the 1kg shea butter functional unit, it was inferred that locating production site at the shortest travelling distance to raw material sourcing and combustion of LPG for heating would reduce all the impact categories assessed on the environment.

Keywords: GaBi6, Life cycle assessment, shea butter production, TRACI

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5199 CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire

Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

Procedia PDF Downloads 409
5198 A Microsurgery-Specific End-Effector Equipped with a Bipolar Surgical Tool and Haptic Feedback

Authors: Hamidreza Hoshyarmanesh, Sanju Lama, Garnette R. Sutherland

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In tele-operative robotic surgery, an ideal haptic device should be equipped with an intuitive and smooth end-effector to cover the surgeon’s hand/wrist degrees of freedom (DOF) and translate the hand joint motions to the end-effector of the remote manipulator with low effort and high level of comfort. This research introduces the design and development of a microsurgery-specific end-effector, a gimbal mechanism possessing 4 passive and 1 active DOFs, equipped with a bipolar forceps and haptic feedback. The robust gimbal structure is comprised of three light-weight links/joint, pitch, yaw, and roll, each consisting of low-friction support and a 2-channel accurate optical position sensor. The third link, which provides the tool roll, was specifically designed to grip the tool prongs and accommodate a low mass geared actuator together with a miniaturized capstan-rope mechanism. The actuator is able to generate delicate torques, using a threaded cylindrical capstan, to emulate the sense of pinch/coagulation during conventional microsurgery. While the tool left prong is fixed to the rolling link, the right prong bears a miniaturized drum sector with a large diameter to expand the force scale and resolution. The drum transmits the actuator output torque to the right prong and generates haptic force feedback at the tool level. The tool is also equipped with a hall-effect sensor and magnet bar installed vis-à-vis on the inner side of the two prongs to measure the tooltip distance and provide an analogue signal to the control system. We believe that such a haptic end-effector could significantly increase the accuracy of telerobotic surgery and help avoid high forces that are known to cause bleeding/injury.

Keywords: end-effector, force generation, haptic interface, robotic surgery, surgical tool, tele-operation

Procedia PDF Downloads 118
5197 Utilization of a Telepresence Evaluation Tool for the Implementation of a Distant Education Program

Authors: Theresa Bacon-Baguley, Martina Reinhold

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Introduction: Evaluation and analysis are the cornerstones of any successful program in higher education. When developing a program at a distant campus, it is essential that the process of evaluation and analysis be orchestrated in a timely manner with tools that can identify both the positive and negative components of distant education. We describe the utilization of a newly developed tool used to evaluate and analyze the successful expansion to a distant campus using Telepresence Technology. Like interactive television, Telepresence allows live interactive delivery but utilizes broadband cable. The tool developed is adaptable to any distant campus as the framework for the tool was derived from a systematic review of the literature. Methodology: Because Telepresence is a relatively new delivery system, the evaluation tool was developed based on a systematic review of literature in the area of distant education and ITV. The literature review identified four potential areas of concern: 1) technology, 2) confidence in the system, 3) faculty delivery of the content and, 4) resources at each site. Each of the four areas included multiple sub-components. Benchmark values were determined to be 80% or greater positive responses to each of the four areas and the individual sub-components. The tool was administered each semester during the didactic phase of the curriculum. Results: Data obtained identified site-specific issues (i.e., technology access, student engagement, laboratory access, and resources), as well as issues common at both sites (i.e., projection screen size). More specifically, students at the parent location did not have adequate access to printers or laboratory space, and students at the distant campus did not have adequate access to library resources. The evaluation tool identified that both sites requested larger screens for visualization of the faculty. The deficiencies were addressed by replacing printers, including additional orientation for students on library resources and increasing the screen size of the Telepresence system. When analyzed over time, the issues identified in the tool as deficiencies were resolved. Conclusions: Utilizing the tool allowed adjustments of the Telepresence delivery system in a timely manner resulting in successful implementation of an entire curriculum at a distant campus.

Keywords: physician assistant, telepresence technology, distant education, assessment

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5196 Analytical Study: An M-Learning App Reflecting the Factors Affecting Student’s Adoption of M-Learning

Authors: Ahmad Khachan, Ahmet Ozmen

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This study aims to introduce a mobile bite-sized learning concept, a mobile application with social networks motivation factors that will encourage students to practice critical thinking, improve analytical skills and learn knowledge sharing. We do not aim to propose another e-learning or distance learning based tool like Moodle and Edmodo; instead, we introduce a mobile learning tool called Interactive M-learning Application. The tool reconstructs and strengthens the bonds between educators and learners and provides a foundation for integrating mobile devices in education. The application allows learners to stay connected all the time, share ideas, ask questions and learn from each other. It is built on Android since the Android has the largest platform share in the world and is dominating the market with 74.45% share in 2018. We have chosen Google-Firebase server for hosting because of flexibility, ease of hosting and real time update capabilities. The proposed m-learning tool was offered to four groups of university students in different majors. An improvement in the relation between the students, the teachers and the academic institution was obvious. Student’s performance got much better added to better analytical and critical skills advancement and moreover a willingness to adopt mobile learning in class. We have also compared our app with another tool in the same class for clarity and reliability of the results. The student’s mobile devices were used in this experimental study for diversity of devices and platform versions.

Keywords: education, engineering, interactive software, undergraduate education

Procedia PDF Downloads 155
5195 The Development of a Cyber Violence Measurement Tool for Youths: A Multi-Reporting of Ecological Factors

Authors: Jong-Hyo Park, Eunyoung Choi, Jae-Yeon Lim, Seon-Suk Lee, Yeong-Rong Koo, Ji-Ung Kwon, Kyung-Sung Kim, Jong-Ik Lee, Juhan Park, Hyun-Kyu Lee, Won-Kyoung Oh, Jisang Lee, Jiwon Choe

Abstract:

Due to COVID-19, cyber violence among youths has soared as they spend more time online than before. In contrast to the deepening concerns, measurement tools that can assess the vulnerability of cyber violence in individual youths still need to be supplemented. The measurement tools lack consideration of various factors related to cyber violence among youths. Most of the tools are self-report questionnaires, and these adolescents' self-report questionnaire forms can underestimate the harmful behavior and overestimate the damage experience. Therefore, this study aims to develop a multi-report measurement tool for youths that can reliably measure individuals' ecological factors related to cyber violence. The literature review explored factors related to cyber violence, and the questions were constructed. The face validity of the questions was confirmed by conducting focus group interviews. Exploratory and confirmatory factor analyses (N=671) were also conducted for statistical validation. This study developed a multi-report measurement tool for cyber violence with 161 questions, consisting of six domains: online behavior, cyber violence awareness, victimization-perpetration-witness experience, coping efficacy (individuals, peers, teachers, and parents), psychological characteristics, and pro-social capabilities. In addition to self-report from a youth respondent, this measurement tool includes peers, teachers, and parents reporting for the respondent. It is possible to reliably measure the ecological factors of individual youths who are vulnerable or highly resistant to cyber violence. In schools, teachers could refer to the measurement results for guiding students, better understanding their cyber violence conditions, and assessing their pro-social capabilities. With the measurement results, teachers and police officers could detect perpetrators or victims and intervene immediately. In addition, this measurement tool could analyze the effects of the prevention and intervention programs for cyber violence and draw appropriate suggestions.

Keywords: adolescents, cyber violence, cyber violence measurement tool, measurement tool, multi-report measurement tool, youths

Procedia PDF Downloads 101
5194 Technological Tool-Use as an Online Learner Strategy in a Synchronous Speaking Task

Authors: J. Knight, E. Barberà

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Language learning strategies have been defined as thoughts and actions, consciously chosen and operationalized by language learners, to help them in carrying out a multiplicity of tasks from the very outset of learning to the most advanced levels of target language performance. While research in the field of Second Language Acquisition has focused on ‘good’ language learners, the effectiveness of strategy-use and orchestration by effective learners in face-to-face classrooms much less research has attended to learner strategies in online contexts, particular strategies in relation to technological tool use which can be part of a task design. In addition, much research on learner strategies and strategy use has been explored focusing on cognitive, attitudinal and metacognitive behaviour with less research focusing on the social aspect of strategies. This study focuses on how learners mediate with a technological tool designed to support synchronous spoken interaction and how this shape their spoken interaction in the opening of their talk. A case study approach is used incorporating notions from communities of practice theory to analyse and understand learner strategies of dyads carrying out a role play task. The study employs analysis of transcripts of spoken interaction in the openings of the talk along with log files of tool use. The study draws on results of previous studies pertaining to the same tool as a form of triangulation. Findings show how learners gain pre-task planning time through technological tool control. The strategies involving learners’ choices to enter and exit the tool shape their spoken interaction qualitatively, with some cases demonstrating long silences whilst others appearing to start the pedagogical task immediately. Who/what learners orientate to in the openings of the talk: an audience (i.e. the teacher), each other and/or screen-based signifiers in the opening moments of the talk also becomes a focus. The study highlights how tool use as a social practice should be considered a learning strategy in online contexts whereby different usages may be understood in the light of the more usual asynchronous social practices of the online community. The teachers’ role in the community is also problematised as the evaluator of the practices of that community. Results are pertinent for task design for synchronous speaking tasks. The use of community of practice theory supports an understanding of strategy use that involves both metacognition alongside social context revealing how tool-use strategies may need to be orally (socially) negotiated by learners and may also differ from an online language community.

Keywords: learner strategy, tool use, community of practice, speaking task

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5193 Shopping Tourism for Emerging Markets: Examining Shopping Tourism in the UK as an Attraction Tool for Wealthy Tourists

Authors: Ali Abdallah, Shaima Al Mohannadi

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This study explores shopping tourism in the UK and examines it as an attraction tool for wealthy tourists to the UK’s capital city London. The study aims to identify the scope of shopping tourism used by countries such as the UK as a tool for attracting wealthy tourists. This study adopts the quantitative research approach through surveys in attaining the results required. Results demonstrate how the UK tourism market is an experience-based market and has recently become an attraction for luxurious brand shoppers. The term Trexit is introduced as a new form of tourism generated by the Brexit. If addressed appropriately the Trexit can assist in any negative economic retaliations of the Brexit. The study concludes that shopping tourism is yet to further incline in years to come, however, government support and cooperative planning with the retail industry is required as a means of further strengthening this developing sector.

Keywords: Brexit tourism, luxury shopping, UK tourism, wealthy tourists

Procedia PDF Downloads 163
5192 BlueVision: A Visual Tool for Exploring a Blockchain Network

Authors: Jett Black, Jordyn Godsey, Gaby G. Dagher, Steve Cutchin

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Despite the growing interest in distributed ledger technology, many data visualizations of blockchain are limited to monotonous tabular displays or overly abstract graphical representations that fail to adequately educate individuals on blockchain components and their functionalities. To address these limitations, it is imperative to develop data visualizations that offer not only comprehensive insights into these domains but education as well. This research focuses on providing a conceptual understanding of the consensus process that underlies blockchain technology. This is accomplished through the implementation of a dynamic network visualization and an interactive educational tool called BlueVision. Further, a controlled user study is conducted to measure the effectiveness and usability of BlueVision. The findings demonstrate that the tool represents significant advancements in the field of blockchain visualization, effectively catering to the educational needs of both novice and proficient users.

Keywords: blockchain, visualization, consensus, distributed network

Procedia PDF Downloads 62
5191 PhilSHORE: Development of a WebGIS-Based Marine Spatial Planning Tool for Tidal Current Energy Resource Assessment and Site Suitability Analysis

Authors: Ma. Rosario Concepcion O. Ang, Luis Caezar Ian K. Panganiban, Charmyne B. Mamador, Oliver Dan G. De Luna, Michael D. Bausas, Joselito P. Cruz

Abstract:

PhilSHORE is a multi-site, multi-device and multi-criteria decision support tool designed to support the development of tidal current energy in the Philippines. Its platform is based on Geographic Information Systems (GIS) which allows for the collection, storage, processing, analyses and display of geospatial data. Combining GIS tools with open source web development applications, PhilSHORE becomes a webGIS-based marine spatial planning tool. To date, PhilSHORE displays output maps and graphs of power and energy density, site suitability and site-device analysis. It enables stakeholders and the public easy access to the results of tidal current energy resource assessments and site suitability analyses. Results of the initial development shows PhilSHORE is a promising decision support tool for ORE project developments.

Keywords: gis, site suitability analysis, tidal current energy resource assessment, webgis

Procedia PDF Downloads 525
5190 EEG-Based Screening Tool for School Student’s Brain Disorders Using Machine Learning Algorithms

Authors: Abdelrahman A. Ramzy, Bassel S. Abdallah, Mohamed E. Bahgat, Sarah M. Abdelkader, Sherif H. ElGohary

Abstract:

Attention-Deficit/Hyperactivity Disorder (ADHD), epilepsy, and autism affect millions of children worldwide, many of which are undiagnosed despite the fact that all of these disorders are detectable in early childhood. Late diagnosis can cause severe problems due to the late treatment and to the misconceptions and lack of awareness as a whole towards these disorders. Moreover, electroencephalography (EEG) has played a vital role in the assessment of neural function in children. Therefore, quantitative EEG measurement will be utilized as a tool for use in the evaluation of patients who may have ADHD, epilepsy, and autism. We propose a screening tool that uses EEG signals and machine learning algorithms to detect these disorders at an early age in an automated manner. The proposed classifiers used with epilepsy as a step taken for the work done so far, provided an accuracy of approximately 97% using SVM, Naïve Bayes and Decision tree, while 98% using KNN, which gives hope for the work yet to be conducted.

Keywords: ADHD, autism, epilepsy, EEG, SVM

Procedia PDF Downloads 190
5189 Sustainability Assessment Tool for the Selection of Optimal Site Remediation Technologies for Contaminated Gasoline Sites

Authors: Connor Dunlop, Bassim Abbassi, Richard G. Zytner

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Life cycle assessment (LCA) is a powerful tool established by the International Organization for Standardization (ISO) that can be used to assess the environmental impacts of a product or process from cradle to grave. Many studies utilize the LCA methodology within the site remediation field to compare various decontamination methods, including bioremediation, soil vapor extraction or excavation, and off-site disposal. However, with the authors' best knowledge, limited information is available in the literature on a sustainability tool that could be used to help with the selection of the optimal remediation technology. This tool, based on the LCA methodology, would consider site conditions like environmental, economic, and social impacts. Accordingly, this project was undertaken to develop a tool to assist with the selection of optimal sustainable technology. Developing a proper tool requires a large amount of data. As such, data was collected from previous LCA studies looking at site remediation technologies. This step identified knowledge gaps or limitations within project data. Next, utilizing the data obtained from the literature review and other organizations, an extensive LCA study is being completed following the ISO 14040 requirements. Initial technologies being compared include bioremediation, excavation with off-site disposal, and a no-remediation option for a generic gasoline-contaminated site. To complete the LCA study, the modelling software SimaPro is being utilized. A sensitivity analysis of the LCA results will also be incorporated to evaluate the impact on the overall results. Finally, the economic and social impacts associated with each option will then be reviewed to understand how they fluctuate at different sites. All the results will then be summarized, and an interactive tool using Excel will be developed to help select the best sustainable site remediation technology. Preliminary LCA results show improved sustainability for the decontamination of a gasoline-contaminated site for each technology compared to the no-remediation option. Sensitivity analyses are now being completed on on-site parameters to determine how the environmental impacts fluctuate at other contaminated gasoline locations as the parameters vary, including soil type and transportation distances. Additionally, the social improvements and overall economic costs associated with each technology are being reviewed. Utilizing these results, the sustainability tool created to assist in the selection of the overall best option will be refined.

Keywords: life cycle assessment, site remediation, sustainability tool, contaminated sites

Procedia PDF Downloads 58
5188 Impact of Interdisciplinary Therapy Allied to Online Health Education on Cardiometabolic Parameters and Inflammation Factor Rating in Obese Adolescents

Authors: Yasmin A. M. Ferreira, Ana C. K. Pelissari, Sofia De C. F. Vicente, Raquel M. Da S. Campos, Deborah C. L. Masquio, Lian Tock, Lila M. Oyama, Flavia C. Corgosinho, Valter T. Boldarine, Ana R. Dâmaso

Abstract:

The prevalence of overweight and obesity is growing around the world and currently considered a global epidemic. Food and nutrition are essential requirements for promoting health and protecting non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate the inflammation and oxidative stress in obese individuals. Few studies have investigated the dietary Inflammation Factor Rating (IFR) in obese adolescents. The IFR was developed to characterize an individual´s diet on anti- to pro-inflammatory score. This evaluation contributes to investigate the effects of inflammatory diet in metabolic profile in several individual conditions. Objectives: The present study aims to investigate the effects of a multidisciplinary weight loss therapy on inflammation factor rating and cardiometabolic risk in obese adolescents. Methods: A total of 26 volunteers (14-19 y.o) were recruited and submitted to 20 weeks interdisciplinary therapy allied to health education website- Ciclo do Emagrecimento®, including clinical, nutritional, psychological counseling and exercise training. The body weight was monitored weekly by self-report and photo. The adolescents answered a test to evaluate the knowledge of the topics covered in the videos. A 24h dietary record was applied at the baseline and after 20 weeks to assess the food intake and to calculate IFR. A negative IFR suggests that diet may have inflammatory effects and a positive IFR indicates an anti-inflammatory effect. Statistical analysis was performed using the program STATISTICA version 12.5 for Windows. The adopted significant value was α ≤ 5 %. Data normality was verified with the Kolmogorov Smirnov test. Data were expressed as mean±SD values. To analyze the effects of intervention it was applied test t. Pearson´s correlations test was performed. Results: After 20 weeks of treatment, body mass index (BMI), body weight, body fat (kg and %), abdominal and waist circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. Moreover, it was found an improvement of inflammation factor rating from -427,27±322,47 to -297,15±240,01, suggesting beneficial effects of nutritional counselling. Considering the correlations analysis, it was found that pro-inflammatory diet is associated with increase in the BMI, very low-density lipoprotein cholesterol (VLDL), triglycerides, insulin and insulin resistance index (HOMA-IR); while an anti-inflammatory diet is associated with improvement of HDL-c and insulin sensitivity Check index (QUICKI). Conclusion: The 20-week blended multidisciplinary therapy was effective to reduce body weight, anthropometric circumferences and improve inflammatory markers in obese adolescents. In addition, our results showed that an increase in inflammatory profile diet is associated with cardiometabolic parameters, suggesting the relevance to stimulate anti-inflammatory diet habits as an effective strategy to treat and control of obesity and related comorbidities. Financial Support: FAPESP (2017/07372-1) and CNPq (409943/2016-9)

Keywords: cardiometabolic risk, inflammatory diet, multidisciplinary therapy, obesity

Procedia PDF Downloads 194
5187 Evaluating the Feasibility of Magnetic Induction to Cross an Air-Water Boundary

Authors: Mark Watson, J.-F. Bousquet, Adam Forget

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A magnetic induction based underwater communication link is evaluated using an analytical model and a custom Finite-Difference Time-Domain (FDTD) simulation tool. The analytical model is based on the Sommerfeld integral, and a full-wave simulation tool evaluates Maxwell’s equations using the FDTD method in cylindrical coordinates. The analytical model and FDTD simulation tool are then compared and used to predict the system performance for various transmitter depths and optimum frequencies of operation. To this end, the system bandwidth, signal to noise ratio, and the magnitude of the induced voltage are used to estimate the expected channel capacity. The models show that in seawater, a relatively low-power and small coils may be capable of obtaining a throughput of 40 to 300 kbps, for the case where a transmitter is at depths of 1 to 3 m and a receiver is at a height of 1 m.

Keywords: magnetic induction, FDTD, underwater communication, Sommerfeld

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5186 Effect of Taper Pin Ratio on Microstructure and Mechanical Property of Friction Stir Welded AZ31 Magnesium Alloy

Authors: N. H. Othman, N. Udin, M. Ishak, L. H. Shah

Abstract:

This study focuses on the effect of pin taper tool ratio on friction stir welding of magnesium alloy AZ31. Two pieces of AZ31 alloy with thickness of 6 mm were friction stir welded by using the conventional milling machine. The shoulder diameter used in this experiment is fixed at 18 mm. The taper pin ratio used are varied at 6:6, 6:5, 6:4, 6:3, 6:2 and 6:1. The rotational speeds that were used in this study were 500 rpm, 1000 rpm and 1500 rpm, respectively. The welding speeds used are 150 mm/min, 200 mm/min and 250 mm/min. Microstructure observation of welded area was studied by using optical microscope. Equiaxed grains were observed at the TMAZ and stir zone indicating fully plastic deformation. Tool pin diameter ratio 6/1 causes low heat input to the material because of small contact surface between tool surface and stirred materials compared to other tool pin diameter ratio. The grain size of stir zone increased with increasing of ratio of rotational speed to transverse speed due to higher heat input. It is observed that worm hole is produced when excessive heat input is applied. To evaluate the mechanical properties of this specimen, tensile test was used in this study. Welded specimens using taper pin ratio 6:1 shows higher tensile strength compared to other taper pin ratio up to 204 MPa. Moreover, specimens using taper pin ratio 6:1 showed better tensile strength with 500 rpm of rotational speed and 150mm/min welding speed.

Keywords: friction stir welding, magnesium AZ31, cylindrical taper tool, taper pin ratio

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5185 Exploring the Motivations That Drive Paper Use in Clinical Practice Post-Electronic Health Record Adoption: A Nursing Perspective

Authors: Sinead Impey, Gaye Stephens, Lucy Hederman, Declan O'Sullivan

Abstract:

Continued paper use in the clinical area post-Electronic Health Record (EHR) adoption is regularly linked to hardware and software usability challenges. Although paper is used as a workaround to circumvent challenges, including limited availability of a computer, this perspective does not consider the important role paper, such as the nurses’ handover sheet, play in practice. The purpose of this study is to confirm the hypothesis that paper use post-EHR adoption continues as paper provides both a cognitive tool (that assists with workflow) and a compensation tool (to circumvent usability challenges). Distinguishing the different motivations for continued paper-use could assist future evaluations of electronic record systems. Methods: Qualitative data were collected from three clinical care environments (ICU, general ward and specialist day-care) who used an electronic record for at least 12 months. Data were collected through semi-structured interviews with 22 nurses. Data were transcribed, themes extracted using an inductive bottom-up coding approach and a thematic index constructed. Findings: All nurses interviewed continued to use paper post-EHR adoption. While two distinct motivations for paper use post-EHR adoption were confirmed by the data - paper as a cognitive tool and paper as a compensation tool - further finding was that there was an overlap between the two uses. That is, paper used as a compensation tool could also be adapted to function as a cognitive aid due to its nature (easy to access and annotate) or vice versa. Rather than present paper persistence as having two distinctive motivations, it is more useful to describe it as presenting on a continuum with compensation tool and cognitive tool at either pole. Paper as a cognitive tool referred to pages such as nurses’ handover sheet. These did not form part of the patient’s record, although information could be transcribed from one to the other. Findings suggest that although the patient record was digitised, handover sheets did not fall within this remit. These personal pages continued to be useful post-EHR adoption for capturing personal notes or patient information and so continued to be incorporated into the nurses’ work. Comparatively, the paper used as a compensation tool, such as pre-printed care plans which were stored in the patient's record, appears to have been instigated in reaction to usability challenges. In these instances, it is expected that paper use could reduce or cease when the underlying problem is addressed. There is a danger that as paper affords nurses a temporary information platform that is mobile, easy to access and annotate, its use could become embedded in clinical practice. Conclusion: Paper presents a utility to nursing, either as a cognitive or compensation tool or combination of both. By fully understanding its utility and nuances, organisations can avoid evaluating all incidences of paper use (post-EHR adoption) as arising from usability challenges. Instead, suitable remedies for paper-persistence can be targeted at the root cause.

Keywords: cognitive tool, compensation tool, electronic record, handover sheet, nurse, paper persistence

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5184 FEM Simulation of Tool Wear and Edge Radius Effects on Residual Stress in High Speed Machining of Inconel718

Authors: Yang Liu, Mathias Agmell, Aylin Ahadi, Jan-Eric Stahl, Jinming Zhou

Abstract:

Tool wear and tool geometry have significant effects on the residual stresses in the component produced by high-speed machining. In this paper, Coupled Eulerian and Lagrangian (CEL) model is adopted to investigate the residual stress in high-speed machining of Inconel718 with a CBN170 cutting tool. The result shows that the mesh with the smallest size of 5 um yields cutting forces and chip morphology in close agreement with the experimental data. The analysis of thermal loading and mechanical loading are performed to study the effect of segmented chip morphology on the machined surface topography and residual stress distribution. The effects of cutting edge radius and flank wear on residual stresses formation and distribution on the workpiece were also investigated. It is found that the temperature within 100um depth of the machined surface increases drastically due to the more friction heat generation with the contact area of tool and workpiece increasing when a larger edge radius and flank wear are used. With the depth further increasing, the temperature drops rapidly for all cases due to the low conductivity of Inconel718. Consequently, higher and deeper tensile residual stress is generated on the superficial. Furthermore, an increased depth of plastic deformation and compressive residual stress is noticed in the subsurface, which is attributed to the reduction of the yield strength under the thermal effect. Besides, the ploughing effect produced by a larger tool edge radius contributes more than flank wear. The magnitude variation of the compressive residual stress caused by various edge radius and flank wear have a totally opposite trend, which depends on the magnitude of the ploughing and friction pressure acting on the machined surface.

Keywords: Coupled Eulerian Lagrangian, segmented chip, residual stress, tool wear, edge radius, Inconel718

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5183 The Predictors of Head and Neck Cancer-Head and Neck Cancer-Related Lymphedema in Patients with Resected Advanced Head and Neck Cancer

Authors: Shu-Ching Chen, Li-Yun Lee

Abstract:

The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

Procedia PDF Downloads 258
5182 Engaging African Youth in Agribusiness through ICT

Authors: Adebola Adedugbe

Abstract:

Agriculture is the mainstay of most countries in Africa. It employs up to 90 per cent of the rural workforce, who are mostly youths and women. Engaging youths in Information and Communications Technology (ICT) in agriculture is critical to economic and agricultural development of the African continent. The objective of this paper is to identify and mobilize the potentials of young Africans in agriculture through ICT and recognize their role as the dominant driver for sustainable agricultural development in Africa. The youth is vibrant, energetic, creative, and innovative and has the potential to play a significant role sustainable agriculture. This paper identifies the role of ICT as a tool for attracting youths in agriculture. The development of ICT is important in stimulating youths in SME’s to compete favorably and effectively as a way to fight poverty through job and wealth creation. It is one of the strategies for promoting entrepreneurship by increasing the availability and diversity of online information. ICT has become a key factor in economic development in most developing countries. The exchange of information is essential for stakeholders in the agricultural sector, as it is the tool to establish, develop and manage efforts to improve performance, productivity and economic competitiveness in local and international markets. In this regard, Information and Communications Technology (ICT) is a powerful tool, fast and innovative to facilitate the exchange of information among all stakeholders in the agricultural sector.

Keywords: Africa, agriculture, ICT, tool, youth

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5181 Efficient Pre-Processing of Single-Cell Assay for Transposase Accessible Chromatin with High-Throughput Sequencing Data

Authors: Fan Gao, Lior Pachter

Abstract:

The primary tool currently used to pre-process 10X Chromium single-cell ATAC-seq data is Cell Ranger, which can take very long to run on standard datasets. To facilitate rapid pre-processing that enables reproducible workflows, we present a suite of tools called scATAK for pre-processing single-cell ATAC-seq data that is 15 to 18 times faster than Cell Ranger on mouse and human samples. Our tool can also calculate chromatin interaction potential matrices, and generate open chromatin signal and interaction traces for cell groups. We use scATAK tool to explore the chromatin regulatory landscape of a healthy adult human brain and unveil cell-type specific features, and show that it provides a convenient and computational efficient approach for pre-processing single-cell ATAC-seq data.

Keywords: single-cell, ATAC-seq, bioinformatics, open chromatin landscape, chromatin interactome

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5180 Partnering With Key Stakeholders for Successful Implementation of Inhaled Analgesia for Specific Emergency Department Presentations

Authors: Sarah Hazelwood, Janice Hay

Abstract:

Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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5179 A Randomised Simulation Study to Assess the Impact of a Focussed Crew Resource Management Course on UK Medical Students

Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

Abstract:

Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

Procedia PDF Downloads 134
5178 Performance Evaluation of a Very High-Resolution Satellite Telescope

Authors: Walid A. Attia, Taher M. Bazan, Fawzy Eltohamy, Mahmoud Fathy

Abstract:

System performance evaluation is an essential stage in the design of high-resolution satellite telescopes prior to the development process. In this paper, a system performance evaluation of a very high-resolution satellite telescope is investigated. The evaluated system has a Korsch optical scheme design. This design has been discussed in another paper with respect to three-mirror anastigmat (TMA) scheme design and the former configuration showed better results. The investigated system is based on the Korsch optical design integrated with a time-delay and integration charge coupled device (TDI-CCD) sensor to achieve a ground sampling distance (GSD) of 25 cm. The key performance metrics considered are the spatial resolution, the signal to noise ratio (SNR) and the total modulation transfer function (MTF) of the system. In addition, the national image interpretability rating scale (NIIRS) metric is assessed to predict the image quality according to the modified general image quality equation (GIQE). Based on the orbital, optical and detector parameters, the estimated GSD is found to be 25 cm. The SNR has been analyzed at different illumination conditions of target albedos, sun and sensor angles. The system MTF has been computed including diffraction, aberration, optical manufacturing, smear and detector sampling as the main contributors for evaluation the MTF. Finally, the system performance evaluation results show that the computed MTF value is found to be around 0.08 at the Nyquist frequency, the SNR value was found to be 130 at albedo 0.2 with a nadir viewing angles and the predicted NIIRS is in the order of 6.5 which implies a very good system image quality.

Keywords: modulation transfer function, national image interpretability rating scale, signal to noise ratio, satellite telescope performance evaluation

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5177 Development of Trigger Tool to Identify Adverse Drug Events From Warfarin Administered to Patient Admitted in Medical Wards of Chumphae Hospital

Authors: Puntarikorn Rungrattanakasin

Abstract:

Objectives: To develop the trigger tool to warn about the risk of bleeding as an adverse event from warfarin drug usage during admission in Medical Wards of Chumphae Hospital. Methods: A retrospective study was performed by reviewing the medical records for the patients admitted between June 1st,2020- May 31st, 2021. ADEs were evaluated by Naranjo’s algorithm. The international normalized ratio (INR) and events of bleeding during admissions were collected. Statistical analyses, including Chi-square test and Reciever Operating Characteristic (ROC) curve for optimal INR threshold, were used for the study. Results: Among the 139 admissions, the INR range was found to vary between 0.86-14.91, there was a total of 15 bleeding events, out of which 9 were mild, and 6 were severe. The occurrence of bleeding started whenever the INR was greater than 2.5 and reached the statistical significance (p <0.05), which was in concordance with the ROC curve and yielded 100 % sensitivity and 60% specificity in the detection of a bleeding event. In this regard, the INR greater than 2.5 was considered to be an optimal threshold to alert promptly for bleeding tendency. Conclusions: The INR value of greater than 2.5 (>2.5) would be an appropriate trigger tool to warn of the risk of bleeding for patients taking warfarin in Chumphae Hospital.

Keywords: trigger tool, warfarin, risk of bleeding, medical wards

Procedia PDF Downloads 148