Search results for: medical tools

Authors: Isaac Benning

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Using technology to expand the learning space is critical for a productive mathematical discourse. This is a case study of two teachers who developed and enacted GeoGebra-based mathematics lessons following their engagement in a two-year professional development. The didactical and semiotic affordance of GeoGebra in widening the learning space for a productive mathematical discourse was explored. The approach of thematic analysis was used for lesson artefact, lesson observation, and interview data. The results indicated that constructing tools in GeoGebra provided a didactical milieu where students used them to explore mathematical concepts with little or no support from their teacher. The prompt feedback from the GeoGebra motivated students to practice mathematical concepts repeatedly in which they privately rethink their solutions before comparing their answers with that of their colleagues. The constructing tools enhanced self-discovery, team spirit, and dialogue among students. With regards to the semiotic construct, the tools widened the physical and psychological atmosphere of the classroom by providing animations that served as virtual concrete to enhance the recording, manipulation, testing of a mathematical idea, construction, and interpretation of geometric objects. These findings advance the discussion of widening the classroom for a productive mathematical discourse within the context of the mathematics curriculum of Ghana and similar Sub-Saharan African countries.

Keywords: GeoGebra, theory of didactical situation, semiotic mediation, mathematics laboratory, mathematical discussion

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Authors: Imme Petersen, Wiebke Sick, Regine Kollek

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In systems medicine, high-throughput technologies produce large amounts of data on different biological and pathological processes, including (disturbed) gene expressions, metabolic pathways and signaling. The large volume of data of different types, stored in separate databases and often located at different geographical sites have posed new challenges regarding data handling and processing. Tools based on bioinformatics have been developed to resolve the upcoming problems of systematizing, standardizing and integrating the various data. However, the heterogeneity of data gathered at different levels of biological complexity is still a major challenge in data analysis. To build multilayer disease modules, large and heterogeneous data of disease-related information (e.g., genotype, phenotype, environmental factors) are correlated. Therefore, a great deal of attention in systems medicine has been put on data standardization, primarily to retrieve and combine large, heterogeneous datasets into standardized and incorporated forms and structures. However, this data-centred concept of standardization in systems medicine is contrary to the debate in science and technology studies (STS) on standardization that rather emphasizes the dynamics, contexts and negotiations of standard operating procedures. Based on empirical work on research consortia that explore the molecular profile of diseases to establish systems medical approaches in the clinic in Germany, we trace how standardized data are processed and shaped by bioinformatics tools, how scientists using such data in research perceive such standard operating procedures and which consequences for knowledge production (e.g. modeling) arise from it. Hence, different concepts and meanings of standardization are explored to get a deeper insight into standard operating procedures not only in systems medicine, but also beyond.

Keywords: data, science and technology studies (STS), standardization, systems medicine

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Authors: Lucilla Crosta, Anthony Edwards

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Companies and the market place nowadays struggle to find employees with adequate skills in relation to anticipated growth of their businesses. At least half of workers will need to undertake some form of up-skilling process in the next five years in order to remain aligned with the requests of the market . In order to meet these challenges, there is a clear need to explore the potential uses of AI (artificial Intelligence) based tools in assessing transversal skills (critical thinking, communication and soft skills of different types in general) of workers and adult students while empowering them to develop those same skills in a reliable trustworthy way. Companies seek workers with key transversal skills that can make a difference between workers now and in the future. However, critical thinking seems to be the one of the most imprtant skill, bringing unexplored ideas and company growth in business contexts. What employers have been reporting since years now, is that this skill is lacking in the majority of workers and adult students, and this is particularly visible trough their writing. This paper investigates how critical thinking and communication skills are currently developed in Higher Education environments through use of AI tools at postgraduate levels. It analyses the use of a branch of AI namely Machine Learning and Big Data and of Neural Network Analysis. It also examines the potential effect the acquisition of these skills through AI tools and what kind of effects this has on employability This paper will draw information from researchers and studies both at national (Italy & UK) and international level in Higher Education. The issues associated with the development and use of one specific AI tool Edulai, will be examined in details. Finally comparisons will be also made between these tools and the more recent phenomenon of Chat GPT and forthcomings and drawbacks will be analysed.

Keywords: critical thinking, artificial intelligence, higher education, soft skills, chat GPT

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Authors: Ronald Blough

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Hospitals, clinics, and medical facilities are the core of the Health Services sector providing 24/7 medical care to those in need. Any disruption of these important medical services highlights the vulnerabilities in the medical system. An internal or external event can create a catastrophic incident paralyzing the medical services causing the facility to shift into emergency operations with the possibility of evacuation. The hospital administrator and government officials must decide in a very short amount of time whether to shelter in place or evacuate. This presentation will identify best practice recommendations regarding the hospital evacuation decision and response analyzing previous hospital evacuations to encourage hospitals in the region to review or develop their own emergency evacuation plans.

Keywords: disaster preparedness, hospital evacuation, shelter-in-place, incident containment, health services vulnerability, hospital resources

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Authors: Rafaella Nogaroli

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It is presented hypothetical cases in the context of AI algorithms to support clinical decisions, in order to discuss the importance of doctors to respect AI ethical principles. Regarding the principle of transparency and explanation, there is an impact on the new model of patient consent and on the understanding of qualified information. Besides, the human control of technology (AI as a tool) should guide the physician's activity; otherwise, he breaks the patient's legitimate expectation in a specific result, with the consequent transformation of the medical obligation nature.

Keywords: medical law, artificial intelligence, ethical principles, patient´s informed consent, medical obligations

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Authors: Irfan Anjum Manarvi, Fawzi Aljassir

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Human bones have been a keen area of research over a long time in the field of biomechanical engineering. Medical professionals, as well as engineering academics and researchers, have investigated various bones by using medical, mechanical, and materials approaches to discover the available body of knowledge. Their major focus has been to establish properties of these and ultimately develop processes and tools either to prevent fracture or recover its damage. Literature shows that mechanical professionals conducted a variety of tests for hardness, deformation, and strain field measurement to arrive at their findings. However, they considered these results accuracy to be insufficient due to various limitations of tools, test equipment, difficulties in the availability of human bones. They proposed the need for further studies to first overcome inaccuracies in measurement methods, testing machines, and experimental errors and then carry out experimental or theoretical studies. Finite Element analysis is a technique which was developed for the aerospace industry due to the complexity of design and materials. But over a period of time, it has found its applications in many other industries due to accuracy and flexibility in selection of materials and types of loading that could be theoretically applied to an object under study. In the past few decades, the field of biomechanical engineering has also started to see its applicability. However, the work done in the area of Tarsals, metatarsals and phalanges using this technique is very limited. Therefore, present research has been focused on using this technique for analysis of these critical bones of the human body. This technique requires a 3-dimensional geometric computer model of the object to be analyzed. In the present research, a 3d laser scanner was used for accurate geometric scans of individual tarsals, metatarsals, and phalanges from a typical human foot to make these computer geometric models. These were then imported into a Finite Element Analysis software and a length refining process was carried out prior to analysis to ensure the computer models were true representatives of actual bone. This was followed by analysis of each bone individually. A number of constraints and load conditions were applied to observe the stress and strain distributions in these bones under the conditions of compression and tensile loads or their combination. Results were collected for deformations in various axis, and stress and strain distributions were observed to identify critical locations where fracture could occur. A comparative analysis of failure properties of all the three types of bones was carried out to establish which of these could fail earlier which is presented in this research. Results of this investigation could be used for further experimental studies by the academics and researchers, as well as industrial engineers, for development of various foot protection devices or tools for surgical operations and recovery treatment of these bones. Researchers could build up on these models to carryout analysis of a complete human foot through Finite Element analysis under various loading conditions such as walking, marching, running, and landing after a jump etc.

Keywords: tarsals, metatarsals, phalanges, 3D scanning, finite element analysis

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Authors: Feng Wei, Lu Wenzhuang, Cai Wenjun, Yu Yaping, Basnet Rabin, Zuo Dunwen

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Diamond coatings were prepared on cemented carbide by hot filament chemical vapor deposition (HFCVD) method. Lapping experiment of single-crystal sapphire wafer was carried out using the prepared diamond coated tools. The diamond coatings and machined surface of the sapphire wafer were evaluated by SEM, laser confocal microscope and Raman spectrum. The results indicate that the lapping sapphire chips are small irregular debris and long thread-like debris. There is graphitization of diamond crystal during the lapping process. A low surface roughness can be obtained using a spherical grain diamond coated tool.

Keywords: lapping, nano-micro crystalline diamond coating, Raman spectrum, sapphire

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Authors: Melvin Ouma

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Language is one of the most crucial tools in medical interaction. Its importance is as great today as it was many decades ago. Difficulty in openly discussing certain diseases and body parts is one of the challenges in language use in medical contexts. Guided by H. P. Grice’s Cooperative Principle, this paper explores the flouting of the cooperative principles in Swahili speaking medical setting. The paper examines how men flout the maxims using the Swahili language when reporting reproductive health problems to the doctor. The data used was gathered from a qualitative study carried out in a reproductive health clinic in a public facility in Nakuru County, Kenya. All the research protocols were observed by acquiring all the research permits. Respondents' ethical considerations of consent, privacy, and confidentiality were observed. The respondents recruited were men who visited the reproductive health clinic and voluntarily agreed to participate in the study without coercion or compensation. Participant observation was the key data collection tool, with the doctor and patient conversation digitally recorded. The researcher was allowed into the clinic in a socially acceptable role. Male patients flouted the maxims of quantity, quality, relation, and manner in order to describe their reproductive health problems without embarrassment using the Swahili language. The flouting was done through the discursive strategies of narration and circumlocution. Flouting of the maxims was acceptable to the doctor and patient due to the fact that sexual intercourse and private body parts are taboo topics and uncomfortable to talk about. The quality of health care received by the patient depended on the doctor’s patience when all the maxims were flouted. In the reproductive health clinic, flouting of maxims hindered communication and, at the same time, enhanced communication between the doctor and patient.

Keywords: cooperative principle, doctor, men, reproductive health

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Authors: Sahar Heidary

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Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

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Authors: Mohamed Elshal, Hazim El-Mounayri, Omar El-Mounayri

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Emergency department (ED) is considered as a complex system of interacting entities: patients, human resources, software and hardware systems, interfaces, and other systems. This paper represents a research for implementing a detailed Systems Engineering (SE) approach in a mid-size hospital in central Indiana. This methodology will be applied by “The Initiative for Product Lifecycle Innovation (IPLI)” institution at Indiana University to study and solve the crowding problem with the aim of increasing throughput of patients and enhance their treatment experience; therefore, the nature of crowding problem needs to be investigated with all other problems that leads to it. The presented SE methods are workflow analysis and systems modeling where SE tools such as Microsoft Visio are used to construct a group of system-level diagrams that demonstrate: patient’s workflow, documentation and communication flow, data systems, human resources workflow and requirements, leadership involved, and integration between ER different systems. Finally, the ultimate goal will be managing the process through implementation of an executable model using commercialized software tools, which will identify bottlenecks, improve documentation flow, and help make the process faster.

Keywords: systems modeling, ED operation, workflow modeling, systems analysis

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Authors: Nasrudin Andi Mappaware, Muh. Wirawan Harahap, Erlin Syahril, Farah Ekawati Mulyadi

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The increasing trend of cesarean sections, especially those performed on self-request without medical indications, presents complex dilemmas related to medical aspects, professionalism, and bioethics. This study aims to investigate the medical, professional, and bioethical considerations surrounding anesthesia in cesarean sections performed on self-request without medical indications. We report the case of a 27-year-old woman, G1P0A0 gravid 38 weeks, admitted to the hospital for a planned cesarean section on request for the reason that she could not tolerate pain and requested on a date that corresponded to the date and month of her mother's birth. Cesarean section on patient request fulfills the principle of autonomy, which states that patients have the right to themselves. However, this medical procedure is still considered no safer and riskier even though medical technology has developed rapidly. Furthermore, anesthesia during cesarean section at self-request without medical indications is a dilemma for anesthesiologists considering the risks and complications of anesthesia for both the fetus and the mother. The trend in increasing the number of cesarean sections is influenced by patient reasons such as not being able to tolerate pain, trust factors, and worry about damage to the birth canal.

Keywords: anesthesia, bioethics, cesarean section, self-request, professionalism

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Authors: Hromada Martin

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Risk analysis is considered as a fundamental aspect relevant for ensuring the level of critical infrastructure protection, where the critical infrastructure is seen as system, asset or its part which is important for maintaining the vital societal functions. Article actually discusses and analyzes the potential application of selected tools of information support for the implementation and within the framework of risk analysis and critical infrastructure protection. Use of the information in relation to their risk analysis can be viewed as a form of simplifying the analytical process. It is clear that these instruments (information support) for these purposes are countless, so they were selected representatives who have already been applied in the selected area of critical infrastructure, or they can be used. All presented fact were the basis for critical infrastructure resilience evaluation methodology development.

Keywords: critical infrastructure, protection, resilience, risk analysis

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Authors: S. Valarmathi, P. B. Harathi, R. Sridhar, S. Balasubramanian

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Machine learning tools in medical diagnosis is increasing due to the improved effectiveness of classification and recognition systems to help medical experts in diagnosing breast cancer. In this study, ID3 chooses the splitting attribute with the highest gain in information, where gain is defined as the difference between before the split versus after the split. It is applied for age, location, taluk, stage, year, period, martial status, treatment, heredity, sex, and habitat against Very Serious (VS), Very Serious Moderate (VSM), Serious (S) and Not Serious (NS) to calculate the gain of information. The ranked histogram gives the gain of each field for the breast cancer data. The doctors use TNM staging which will decide the risk level of the breast cancer and play an important decision making field in fuzzy logic for perception based measurement. Spatial risk area (taluk) of the breast cancer is calculated. Result clearly states that Coimbatore (North and South) was found to be risk region to the breast cancer than other areas at 20% criteria. Weighted value of taluk was compared with criterion value and integrated with Map Object to visualize the results. ID3 algorithm shows the high breast cancer risk regions in the study area. The study has outlined, discussed and resolved the algorithms, techniques / methods adopted through soft computing methodology like ID3 algorithm for prognostic decision making in the seriousness of the breast cancer.

Keywords: ID3 algorithm, breast cancer, fuzzy logic, MATLAB

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Authors: M. Sandhya, R. M. Madhumitha, Sharmila Sankar

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Interoperable medical devices (IMDs) face threats due to the increased attack surface accessible by interoperability and the corresponding infrastructure. Initiating networking and coordination functionalities primarily modify medical systems' security properties. Understanding the threats is a vital first step in ultimately crafting security solutions for such systems. The key to this problem is coming up with some common types of threats or attacks with those of security and privacy, and providing this information as a roadmap. This paper analyses the security issues in interoperability of devices and presents the main types of threats that have to be considered to build a secured system.

Keywords: interoperability, threats, attacks, medical devices

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Authors: Nadir A. Carreon, Christa Sonderer, Aakarsh Rao, Roman Lysecky

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With the advent of complex software and increased connectivity, the security of life-critical medical devices is becoming an increasing concern, particularly with their direct impact on human safety. Security is essential, but it is impossible to develop completely secure and impenetrable systems at design time. Therefore, it is important to assess the potential impact on the security and safety of exploiting a vulnerability in such critical medical systems. The common vulnerability scoring system (CVSS) calculates the severity of exploitable vulnerabilities. However, for medical devices it does not consider the unique challenges of impacts to human health and privacy. Thus, the scoring of a medical device on which human life depends (e.g., pacemakers, insulin pumps) can score very low, while a system on which human life does not depend (e.g., hospital archiving systems) might score very high. In this paper, we propose a medical vulnerability scoring system (MVSS) that extends CVSS to address the health and privacy concerns of medical devices. We propose incorporating two new parameters, namely health impact, and sensitivity impact. Sensitivity refers to the type of information that can be stolen from the device, and health represents the impact on the safety of the patient if the vulnerability is exploited (e.g., potential harm, life-threatening). We evaluate fifteen different known vulnerabilities in medical devices and compare MVSS against two state-of-the-art medical device-oriented vulnerability scoring systems and the foundational CVSS.

Keywords: common vulnerability system, medical devices, medical device security, vulnerabilities

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Authors: Binita Shah, Seema Unnikrishnan

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In the recent time, an increasing interest in the analysis and efforts to reduce the environmental impacts generated by man-made activities has been seen widely being discussed and implemented by the society. The industrial processes are expressing their concern and showing keen interest in redesigning and amending the operation process leading to better environmental performance by upgrading technologies and adjusting the financial inputs. There are various tools available for the assessment of process and production of goods on the environment. Most methods look at a particular impact on the ecosystem. Life Cycle Assessment (LCA) is one of the most widely accepted and scientifically founded methodologies to assess the overall environmental impacts of products and processes. This paper looks at the tools used in India for environmental impact assessment.

Keywords: life cycle assessment, ecological footprint, measuring sustainability, India

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Authors: Azzeddine Atibi, Khadija El Kababi, Salim Ahmed, Mohamed Radid

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Teaching and learning occupy a significant position globally, as the sustainable development of all sectors is intrinsically linked to the improvement of the educational system. The COVID-19 pandemic demonstrated that the integration of Information and Communication Technology (ICT) in the learning process is not optional but essential, and that proficiency in computer tools is an asset that will enhance pedagogy and ensure the continuity of learning under any circumstances. The objective of our study is to evaluate the impact of introducing computer tools on the quality of learning and the realization of conceptual change in learners. To this end, a learning situation was meticulously prepared, targeting first-year baccalaureate students in experimental sciences at a public high school, "Khadija Oum Almouminin," focusing on the chapter on glycemia regulation in the Moroccan Life and Earth Sciences (LES) curriculum. The learning situation was implemented with a pilot group that utilized computer tools and a control group that studied the same chapter without using ICT. The analysis and comparison of the results allowed us to verify the research question posed and to propose perspectives to ensure conceptual change in learners.

Keywords: information and communication technology, conceptual change, continuity of learning, life and earth sciences, glycemia regulation

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Authors: S. K. Ashiquer Rahman

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The paper concentrates on the importance of Sustainable Campus Strategies, emphasizing the significance of mobilizing Innovative technological tools for constructing effectiveness of higher education strategy and institutional cooperation for sustainable campus at the university level and preparing the university’s authority to face the upcoming higher education strategy and institutional cooperation difficulties to the Sustainable Campus Plan. Within a framework of Sustainable Campus Strategies and institutional cooperation, the paper discusses the significance of a set of reference points that will lead to operational activities for multi-stakeholder multi-criteria evaluation of Higher Education and Research Institutions relative to the Sustainable Campus criteria and potential action plan for the University’s Strategy and Institutional Cooperation. It makes mention of the emergence of the effectiveness of Higher Education Strategy and Institutional Cooperation as well as the necessity of mobilizing innovative technological methods and tools for constructing the effectiveness of this Process. The paper outlines the conceptual framing of a Sustainable Campus Strategy, Institutional Cooperation and Action Plan for a sustainable campus. Optimistically, these will be a milestone in higher education, a pathway to meet the imminent Sustainable Campus Strategy and Institutional Cooperation of the completive world, and be able to manage the required criteria for a Sustainable University.

Keywords: higher education strategy, institutional cooperation, sustainable campus, multi-criteria evaluation, innovative method and tools

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Authors: Zeineb Ben Azzouz, Wahiba Ben Abdessalem Karaa

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The automated extraction of UML class diagram from natural language requirements is a highly challenging task. Many approaches, frameworks and tools have been presented in this field. Nonetheless, the experiments of these tools have shown that there is no approach that can work best all the time. In this context, we propose a new accurate approach to facilitate the automatic mapping from textual requirements to UML class diagram. Our new approach integrates the best properties of statistical Natural Language Processing (NLP) techniques to reduce ambiguity when analysing natural language requirements text. In addition, our approach follows the best practices defined by conceptual modelling experts to determine some patterns indispensable for the extraction of basic elements and concepts of the class diagram. Once the relevant information of class diagram is captured, a XMI document is generated and imported with a CASE tool to build the corresponding UML class diagram.

Keywords: class diagram, user’s requirements, XMI, software engineering

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Authors: Mohammed Saeed Jawad

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Metaverse involves the convergence of three major technologies trends of AI, VR, and AR. Together these three technologies can provide an entirely new channel for delivering healthcare with great potential to lower costs and improve patient outcomes on a larger scale. Telepresence is the technology that allows people to be together even if they are physically apart. Medical doctors can be symbolic as interactive avatars developed to have smart conversations and medical recommendations for patients at the different stages of the treatment. Medical digital assets such as Medical IoT for real-time remote healthcare monitoring as well as the symbolic doctors’ avatars as well as the hospital and clinical physical constructions and layout can be immersed in extended realities 3D metaverse environments where doctors, nurses, and patients can interact and socialized with the related digital assets that facilitate the data analytics of the sensed and collected personal medical data with visualized interaction of the digital twin of the patient’s body as well as the medical doctors' smart conversation and consultation or even in a guided remote-surgery operation.

Keywords: personal healthcare, metaverse, telemedicine, telepresence, avatar, medical consultation, remote-surgery

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Authors: Najrullah Khan, Athar Ali Khan

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The Topp-Leone distribution was introduced by Topp- Leone in 1955. In this paper, an attempt has been made to fit Topp-Leone Generalized exponential (TPGE) distribution. A real survival data set is used for illustrations. Implementation is done using R and JAGS and appropriate illustrations are made. R and JAGS codes have been provided to implement censoring mechanism using both optimization and simulation tools. The main aim of this paper is to describe and illustrate the Bayesian modelling approach to the analysis of survival data. Emphasis is placed on the modeling of data and the interpretation of the results. Crucial to this is an understanding of the nature of the incomplete or 'censored' data encountered. Analytic approximation and simulation tools are covered here, but most of the emphasis is on Markov chain based Monte Carlo method including independent Metropolis algorithm, which is currently the most popular technique. For analytic approximation, among various optimization algorithms and trust region method is found to be the best. In this paper, TPGE model is also used to analyze the lifetime data in Bayesian paradigm. Results are evaluated from the above mentioned real survival data set. The analytic approximation and simulation methods are implemented using some software packages. It is clear from our findings that simulation tools provide better results as compared to those obtained by asymptotic approximation.

Keywords: Bayesian Inference, JAGS, Laplace Approximation, LaplacesDemon, posterior, R Software, simulation

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Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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Authors: Palash Dutta

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More frequently uncertainties are encountered in medical diagnosis and therefore it is the most important and interesting area of applications of fuzzy set theory. In this present study, an attempt has been made to extend Sanchez’s approach for medical diagnosis via interval valued picture fuzzy sets and exhibit the technique with suitable case studies. In this article, it is observed that a refusal can be expressed in the databases concerning the examined objects. The technique is performing diagnosis on the basis of distance measures and as a result, this approach makes it possible to introduce weights of all symptoms and consequently patient can be diagnosed directly.

Keywords: medical diagnosis, uncertainty, fuzzy set, picture fuzzy set, interval valued picture fuzzy set

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Authors: Magdalena Chrabąszcz, Teresa Wolniewicz, Cezary Maciejewski, Joanna Czuwara

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BACKGROUND: Dermoscopy is a clinical tool known to improve the early detection of melanoma and other malignancies of the skin. Over the past few years melanoma has grown into a disease of socio-economic importance due to the increasing incidence and persistently high mortality rates. Early diagnosis remains the best method to reduce melanoma and non-melanoma skin cancer– related mortality and morbidity. Dermoscopy is a noninvasive technique that consists of viewing pigmented skin lesions through a hand-held lens. This simple procedure increases melanoma diagnostic accuracy by up to 35%. Dermoscopy is currently the standard for clinical differential diagnosis of cutaneous melanoma and for qualifying lesion for the excision biopsy. Like any clinical tool, training is required for effective use. The introduction of small and handy dermoscopes contributed significantly to the switch of dermatoscopy toward a first-level useful tool. Non-dermatologist physicians are well positioned for opportunistic melanoma detection; however, education in the skin cancer examination is limited during medical school and traditionally lecture-based. AIM: The aim of this randomized study was to determine whether the adjunct of dermoscopy to the standard fourth year medical curriculum improves the ability of medical students to distinguish between benign and malignant lesions and assess acceptability and satisfaction with the intervention. METHODS: We performed a prospective study in 2 cohorts of fourth-year medical students at Medical University of Warsaw. Groups having dermatology course, were randomly assigned to:  cohort A: with limited access to dermatoscopy from their teacher only – 1 dermatoscope for 15 people  Cohort B: with a full access to use dermatoscopy during their clinical classes:1 dermatoscope for 4 people available constantly plus 15-minute dermoscopy tutorial. Students in both study arms got an image-based test of 10 lesions to assess ability to differentiate benign from malignant lesions and postintervention survey collecting minimal background information, attitudes about the skin cancer examination and course satisfaction. RESULTS: The cohort B had higher scores than the cohort A in recognition of nonmelanocytic (P < 0.05) and melanocytic (P <0.05) lesions. Medical students who have a possibility to use dermatoscope by themselves have also a higher satisfaction rates after the dermatology course than the group with limited access to this diagnostic tool. Moreover according to our results they were more motivated to learn dermatoscopy and use it in their future everyday clinical practice. LIMITATIONS: There were limited participants. Further study of the application on clinical practice is still needed. CONCLUSION: Although the use of dermatoscope in dermatology as a specialty is widely accepted, sufficiently validated clinical tools for the examination of potentially malignant skin lesions are lacking in general practice. Introducing medical students to dermoscopy in their fourth year curricula of medical school may improve their ability to differentiate benign from malignant lesions. It can can also encourage students to use dermatoscopy in their future practice which can significantly improve early recognition of malignant lesions and thus decrease melanoma mortality.

Keywords: dermatoscopy, early detection of melanoma, medical education, skin cancer

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Authors: Guillaume Mullier, Jean François Chatelain

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Carbon Fiber Reinforced Plastics (CFRPs) are widely used for advanced applications, in particular in aerospace, automotive and wind energy industries. Once cured to near net shape, CFRP parts need several finishing operations such as trimming, milling or drilling in order to accommodate fastening hardware and meeting the final dimensions. The present research aims to study the effect of the cutting temperature in trimming on the mechanical strength of high performance CFRP laminates used for aeronautics applications. The cutting temperature is of great importance when dealing with trimming of CFRP. Temperatures higher than the glass-transition temperature (Tg) of the resin matrix are highly undesirable: they cause degradation of the matrix in the trimmed edges area, which can severely affect the mechanical performance of the entire component. In this study, a 9.50 mm diameter CVD diamond coated carbide tool with six flutes was used to trim 24-plies CFRP laminates. A 300 m/min cutting speed and 1140 mm/min feed rate were used in the experiments. The tool was heated prior to trimming using a blowtorch, for temperatures ranging from 20°C to 300°C. The temperature at the cutting edge was measured using embedded K-Type thermocouples. Samples trimmed for different cutting temperatures, below and above Tg, were mechanically tested using three-points bending short-beam loading configurations. New cutting tools as well as worn cutting tools were utilized for the experiments. The experiments with the new tools could not prove any correlation between the length of cut, the cutting temperature and the mechanical performance. Thus mechanical strength was constant, regardless of the cutting temperature. However, for worn tools, producing a cutting temperature rising up to 450°C, thermal damage of the resin was observed. The mechanical tests showed a reduced mean resistance in short beam configuration, while the resistance in three point bending decreases with increase of the cutting temperature.

Keywords: composites, trimming, thermal damage, surface quality

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Authors: Catherine Bernard

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The maldistribution of clinicians within countries is well documented. It is a common theme throughout the world that rural areas often struggle to recruit and retain health workers resulting in inadequate healthcare for many. This paper will concentrate on the responsibilities that medical schools may have in addressing this shortage of rural health workers. Recommendations are made with regards to targeted rural student admissions, rurally-based medical schools, rural clinical rotations and a curriculum orientated towards rural health issues. The evidence gathered suggests that individual factors are positive in encouraging health workers to practice in rural locations. However, there is strength in numbers, and combining all the recommendations will likely result in a synergistic effect, thereby increasing numbers of rural health workers and achieving accessible healthcare for those living in rural populations.

Keywords: medical education, medical education design, public health, rural health

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Authors: Elżbieta Cygan, Bączek, Piotr Wyżga

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This paper presents the results of research on the physical, mechanical, and tribological properties of materials constituting the matrix in sintered metallic-diamond tools. The ground powders based on the Fe-Mn-Cu-Sn-C system were modified with micro-sized particles of the ceramic phase: SiC, Al₂O₃ and consolidated using the SPS (spark plasma sintering) method to a relative density of over 98% at 850-950°C, at a pressure of 35 MPa and time 10 min. After sintering, an analysis of the microstructure was conducted using scanning electron microscopy. The resulting materials were tested for the apparent density determined by Archimedes’ method, Rockwell hardness (scale B), Young’s modulus, as well as for technological properties. The performance results of obtained diamond composites were compared with the base material (Fe–Mn–Cu–Sn–C) and the commercial alloy Co-20% WC. The hardness of composites has achieved the maximum at a temperature of 900°C; therefore, it should be considered that at this temperature it was obtained optimal physical and mechanical properties of the subjects' composites were. Research on tribological properties showed that the composites modified with micro-sized particles of the ceramic phase are characterized by more than twice higher wear resistance in comparison with base materials and the commercial alloy Co-20% WC. Composites containing Al₂O₃ phase particles in the matrix material were composites containing Al₂O₃ phase particles in the matrix material were characterized by the lowest abrasion wear resistance. The manufacturing technology presented in the paper is economically justified and can be successfully used in the production process of the matrix in sintered diamond-impregnated tools used for the machining of an industrial floor system. Acknowledgment: The study was performed under LIDER IX Research Project No. LIDER/22/0085/L-9/17/NCBR/2018 entitled “Innovative metal-diamond tools without the addition of critical raw materials for applications in the process of grinding industrial floor systems” funded by the National Centre for Research and Development of Poland, Warsaw.

Keywords: abrasive wear resistance, metal matrix composites, sintered diamond tools, Spark Plasma Sintering

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Authors: Laura Rodriguez Amaya

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Advances in science, technology, engineering, and mathematics (STEM) are viewed as important to countries’ national economies and their capacities to be competitive in the global economy. However, many countries experience low numbers of students entering these disciplines. To strengthen the professional STEM pipelines, it is important that students are retained in these disciplines at universities. Scholars agree that to retain students in universities’ STEM degrees, it is necessary that STEM course content shows the relevance of these academic fields to their daily lives. By increasing students’ understanding on the importance of these degrees and careers, students’ motivation to remain in these academic programs can also increase. An effective way to make STEM content relevant to students’ lives is the use of geospatial technologies and geovisualization in the classroom. The Geospatial Revolution, and the science and technology associated with it, has provided scientists and engineers with an incredible amount of data about Earth and Earth systems. This data can be used in the classroom to support instruction and make content relevant to all students. The purpose of this study was to find out the prevalence use of geospatial technologies and geovisualization as teaching practices in a USA university. The Teaching Practices Inventory survey, which is a modified version of the Carl Wieman Science Education Initiative Teaching Practices Inventory, was selected for the study. Faculty in the STEM disciplines that participated in a summer learning institute at a 4-year university in the USA constituted the population selected for the study. One of the summer learning institute’s main purpose was to have an impact on the teaching of STEM courses, particularly the teaching of gateway courses taken by many STEM majors. The sample population for the study is 97.5 of the total number of summer learning institute participants. Basic descriptive statistics through the Statistical Package for the Social Sciences (SPSS) were performed to find out: 1) The percentage of faculty using geospatial technologies and geovisualization; 2) Did the faculty associated department impact their use of geospatial tools?; and 3) Did the number of years in a teaching capacity impact their use of geospatial tools? Findings indicate that only 10 percent of respondents had used geospatial technologies, and 18 percent had used geospatial visualization. In addition, the use of geovisualization among faculty of different disciplines was broader than the use of geospatial technologies. The use of geospatial technologies concentrated in the engineering departments. Data seems to indicate the lack of incorporation of geospatial tools in STEM education. The use of geospatial tools is an effective way to engage students in deep STEM learning. Future research should look at the effect on student learning and retention in science and engineering programs when geospatial tools are used.

Keywords: engineering education, geospatial technology, geovisualization, STEM

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Authors: Rashid Javed, Hardy Lehmkuehler, Franz Josef-Behr

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Web Processing Services (WPS) have up growing concern in geoinformation research. However, teaching about them is difficult because of the generally complex circumstances of their use. They limit the possibilities for hands- on- exercises on Web Processing Services. To support understanding however a Training Tools Collection was brought on the way at University of Applied Sciences Stuttgart (HFT). It is limited to the scope of Geostatistical Interpolation of sample point data where different algorithms can be used like IDW, Nearest Neighbor etc. The Tools Collection aims to support understanding of the scope, definition and deployment of Web Processing Services. For example it is necessary to characterize the input of Interpolation by the data set, the parameters for the algorithm and the interpolation results (here a grid of interpolated values is assumed). This paper reports on first experiences using a pilot installation. This was intended to find suitable software interfaces for later full implementations and conclude on potential user interface characteristics. Experiences were made with Deegree software, one of several Services Suites (Collections). Being strictly programmed in Java, Deegree offers several OGC compliant Service Implementations that also promise to be of benefit for the project. The mentioned parameters for a WPS were formalized following the paradigm that any meaningful component will be defined in terms of suitable standards. E.g. the data output can be defined as a GML file. But, the choice of meaningful information pieces and user interactions is not free but partially determined by the selected WPS Processing Suite.

Keywords: deegree, interpolation, IDW, web processing service (WPS)

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Authors: Fatemeh Noughani, Seyd Mehdi Sadat

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Medical tourism or travel therapy is travelling from one country to another to be under medical treatment, utilizing the health factors of natural sector like mineral water springs and so on. From 1990s medical tourism around the world developed and grew because of different factors like globalization and free trade in the fields of health services, changes in exchange rates in the world economy (which caused the desirability of Asian countries as a medical tourist attraction) in a way that currently there is a close competition in this field among famous countries in medical services to make them find a desirable place in medical tourism market of the world as a complicated and growing industry in a short time. Perhaps tourism is an attractive industry and a good support for the economy of Iran, if we try to merge oil earnings and tourism industry it would be better and more constructive than putting them in front of each other. Moving from oil toward tourism economy especially medical tourism, must be one of the prospects of Iran's government for the oil industry to provide a few percent of the yearly earnings of the country. Among the achievements in medical tourism we can name the prevention of brain drain to other countries and an increase in employment rate for healthcare staff, increase in foreign exchange earnings of the country because of the tourists' staying and followed by increasing the quality of life and cultural transmission as well as empowering the medical human resources.

Keywords: developing countries, health tourism, quality of life, cultural transmission

Procedia PDF Downloads 432