Search results for: clinical simulation

Authors: Virginia Guillén Cañas, Miren Agurtzane Ortiz-Jauregi, Sonia Ruiz De Azua, Naiara Ozamiz

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We want to focus on relationship of the communicational skills in several key aspects of medicine. The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes’ improvement and efficiency of health services. We define empathy as it as Sympathy and connection to others and capability to communicate this understanding. Some outcomes favoring empathy are female gender, younger age, and specialty choice. Third gender or third sex is a concept in which allows a person not to be categorized in a dual way but as a continuous variable, giving the choice of moving along it. This point of view recognizes three or more genders. The subject of Ethics and Clinical Communication is dedicated to sensitizing students about the importance and effectiveness of a good therapeutic relationship. We are also interested in other communicational aspects related to empathy as active listening, assertivity and basic and advanced Social Skills. Objectives: 1. To facilitate the approach of the student in the Medicine Degree to the reality of the medical profession 2. Analyze interesting outcome variables in communication 3. Interactive process to detect the areas of improvement in the learning process of the Physician throughout his professional career needs. Design: A comparative study with a cross-sectional approach was conducted in successive academic year cohorts of health professional students at a public Basque university. Four communicational aspects were evaluated through these questionnaires in Basque, Spanish and English: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. Types of interventions for improving skills: Interpersonal skills training intervention, Empathy intervention, Writing about experiential learning, Drama through role plays, Communicational skills training, Problem-based learning, Patient interviews ´videos, Empathy-focused training, Discussion. Results: It identified the need for a cross cultural adaptation and no gender distinction. The students enjoyed all the techniques in comparison to the usual master class. There was medium participation but these participative methodologies are not so usual in the university. According to empathy, men have a greater empathic capacity to fully understand women (p < 0.05) With regard to assertiveness there have been no differences between men and women in self-assertiveness but nevertheless women are more heteroassertive than men. Conclusions: These findings suggest that educational interventions with adequate feedback can be effective in maintaining and enhancing empathy in undergraduate medical students.

Keywords: physician's communicational skills, patient satisfaction, third gender, cross cultural adaptation

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Authors: Seham A. S. Mohamed, Sarah R. Baker, Christopher Deery, Mario V. Vettore

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Background: The link between oral health conditions and school performance and attendance remain unclear among Middle Eastern children. The association has been studied extensively in the Western region; however, several concerns have been raised regarding the reliability and validity of measures, low quality of studies, inadequate inclusion of potential confounders, and the lack of a conceptual framework. These limitations have meant that, to date, there has been no detailed understanding of the association or of the key social, clinical, behavioural and parental factors which may impact the association. Aim: To examine the association between oral health conditions and children’s school performance and attendance at Grade 2 in Muharraq city in the Kingdom of Bahrain using Heilmann et al.’s (2015) life course framework for oral health. Objectives: To (1) describe the prevalence of oral health conditions among 7-8 years old schoolchildren in the city of Muharraq; (2) analyse the social, biological, behavioural, and parental pathways that link early and current life exposures with children’s current oral health status; (3) examine the association between oral health conditions and school performance and attendance among schoolchildren; (4) explore the early and current life course social, biological, behavioural and parental factors associated with children’s school outcomes. Design: A time-ordered-cross-sectional study was conducted with 466 schoolchildren aged 7-8 years and their parents from Muharraq city in KoB. Data were collected through parents’ self-administered questionnaires, children’s face-face interviews, and dental clinical examinations. Outcome variables, including school performance and school attendance data, were obtained from the parents and school records. The data were analysed using structural equation modelling (SEM). Results: Dental caries, the consequence of dental caries (PUFA/pufa), and enamel developmental defects (EDD) prevalence were 93.4%, 25.7%, and 17.2%, respectively. The findings from the SEM showed that children born in families with high SES were less likely to suffer from dentine dental caries (β= -0.248) and more likely to earn high school performance (β= 0.136) at 7-8 years of age in Muharraq. From the current life course of children, the dental plaque was associated significantly and directly with enamel caries (β= 0.094), dentine caries (β= 0.364), treated teeth (filled or extracted because of dental caries) (β= 0.121), and indirectly associated with dental pain (β= 0.057). Further, dentine dental caries was associated significantly and directly with low school performance (β= -0.155). At the same time, the dental plaque was indirectly associated with low school performance via dental caries (β = −0.044). Conversely, treated teeth were associated directly with high school performance (β= 0.100). Notably, none of the OHCs, biological, SES, behavioural, or parental conditions was related to school attendance in children. Conclusion: The life course approach was adequate to examine the role of OHCs on children’s school performance and attendance. Birth and current (7-8-year-olds) social factors were significant predictors of poor OH and poor school performance.

Keywords: dental caries, life course, Bahrain, school outcomes

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Authors: Hae-Yeoun Lee

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Quantification of cardiac function is performed by calculating blood volume and ejection fraction in routine clinical practice. However, these works have been performed by manual contouring,which requires computational costs and varies on the observer. In this paper, an automatic left ventricle segmentation algorithm on cardiac magnetic resonance images (MRI) is presented. Using knowledge on cardiac MRI, a K-mean clustering technique is applied to segment blood region on a coil-sensitivity corrected image. Then, a graph searching technique is used to correct segmentation errors from coil distortion and noises. Finally, blood volume and ejection fraction are calculated. Using cardiac MRI from 15 subjects, the presented algorithm is tested and compared with manual contouring by experts to show outstanding performance.

Keywords: cardiac MRI, graph searching, left ventricle segmentation, K-means clustering

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Authors: Abhisek Chakrabarty, Subhraprakash Mandal

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Flash flood is one of the catastrophic natural hazards in the mountainous region of India. The recent flood in the Mandakini River in Kedarnath (14-17th June, 2013) is a classic example of flash floods that devastated Uttarakhand by killing thousands of people.The disaster was an integrated effect of high intensityrainfall, sudden breach of Chorabari Lake and very steep topography. Every year in Himalayan Region flash flood occur due to intense rainfall over a short period of time, cloud burst, glacial lake outburst and collapse of artificial check dam that cause high flow of river water. In Sikkim-Derjeeling Himalaya one of the probable flash flood occurrence zone is Teesta Watershed. The Teesta River is a right tributary of the Brahmaputra with draining mountain area of approximately 8600 Sq. km. It originates in the Pauhunri massif (7127 m). The total length of the mountain section of the river amounts to 182 km. The Teesta is characterized by a complex hydrological regime. The river is fed not only by precipitation, but also by melting glaciers and snow as well as groundwater. The present study describes an attempt to model surface runoff in upper Teesta basin, which is directly related to catastrophic flood events, by creating a system based on GIS technology. The main object was to construct a direct unit hydrograph for an excess rainfall by estimating the stream flow response at the outlet of a watershed. Specifically, the methodology was based on the creation of a spatial database in GIS environment and on data editing. Moreover, rainfall time-series data collected from Indian Meteorological Department and they were processed in order to calculate flow time and the runoff volume. Apart from the meteorological data, background data such as topography, drainage network, land cover and geological data were also collected. Clipping the watershed from the entire area and the streamline generation for Teesta watershed were done and cross-sectional profiles plotted across the river at various locations from Aster DEM data using the ERDAS IMAGINE 9.0 and Arc GIS 10.0 software. The analysis of different hydraulic model to detect flash flood probability ware done using HEC-RAS, Flow-2D, HEC-HMS Software, which were of great importance in order to achieve the final result. With an input rainfall intensity above 400 mm per day for three days the flood runoff simulation models shows outbursts of lakes and check dam individually or in combination with run-off causing severe damage to the downstream settlements. Model output shows that 313 Sq. km area were found to be most vulnerable to flash flood includes Melli, Jourthang, Chungthang, and Lachung and 655sq. km. as moderately vulnerable includes Rangpo,Yathang, Dambung,Bardang, Singtam, Teesta Bazarand Thangu Valley. The model was validated by inserting the rain fall data of a flood event took place in August 1968, and 78% of the actual area flooded reflected in the output of the model. Lastly preventive and curative measures were suggested to reduce the losses by probable flash flood event.

Keywords: flash flood, GIS, runoff, simulation model, Teesta river basin

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Authors: Alicia Yanadira Nava Fuentes, Ilse Cervantes Camacho, Amadeo José Argüelles Cruz, Ana María Balboa Verduzco

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Augmented reality promises being present in future driving, with its immersive technology let to show directions and maps to identify important places indicating with graphic elements when the car driver requires the information. On the other side, driving is considered a multitasking activity and, for some people, a complex activity where different situations commonly occur that require the immediate attention of the car driver to make decisions that contribute to avoid accidents; therefore, the main aim of the project is the instrumentation of a platform with biometric sensors that allows evaluating the performance in driving vehicles with the influence of augmented reality devices to detect the level of attention in drivers, since it is important to know the effect that it produces. In this study, the physiological sensors EPOC X (EEG), ECG06 PRO and EMG Myoware are joined in the driving test platform with a Logitech G29 steering wheel and the simulation software City Car Driving in which the level of traffic can be controlled, as well as the number of pedestrians that exist within the simulation obtaining a driver interaction in real mode and through a MSP430 microcontroller achieves the acquisition of data for storage. The sensors bring a continuous analog signal in time that needs signal conditioning, at this point, a signal amplifier is incorporated due to the acquired signals having a sensitive range of 1.25 mm/mV, also filtering that consists in eliminating the frequency bands of the signal in order to be interpretative and without noise to convert it from an analog signal into a digital signal to analyze the physiological signals of the drivers, these values are stored in a database. Based on this compilation, we work on the extraction of signal features and implement K-NN (k-nearest neighbor) classification methods and decision trees (unsupervised learning) that enable the study of data for the identification of patterns and determine by classification methods different effects of augmented reality on drivers. The expected results of this project include are a test platform instrumented with biometric sensors for data acquisition during driving and a database with the required variables to determine the effect caused by augmented reality on people in simulated driving.

Keywords: augmented reality, driving, physiological signals, test platform

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Authors: Morteza Esfandiari, Shabnam Jabari, Heather MacGrath, David Coleman

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Flood is a severe issue in different places in the world as well as the city of Fredericton, New Brunswick, Canada. The downtown area of Fredericton is close to the Saint John River, which is susceptible to flood around May every year. Recently, the frequency of flooding seems to be increased, especially after the fact that the downtown area and surrounding urban/agricultural lands got flooded in two consecutive years in 2018 and 2019. In order to have an explicit vision of flood span and damage to affected areas, it is necessary to use either flood inundation modelling or satellite data. Due to contingent availability and weather dependency of optical satellites, and limited existing data for the high cost of hydrodynamic models, it is not always feasible to rely on these sources of data to generate quality flood maps after or during the catastrophe. Height Above the Nearest Drainage (HAND), a state-of-the-art topo-hydrological index, normalizes the height of a basin based on the relative elevation along with the stream network and specifies the gravitational or the relative drainage potential of an area. HAND is a relative height difference between the stream network and each cell on a Digital Terrain Model (DTM). The stream layer is provided through a multi-step, time-consuming process which does not always result in an optimal representation of the river centerline depending on the topographic complexity of that region. HAND is used in numerous case studies with quite acceptable and sometimes unexpected results because of natural and human-made features on the surface of the earth. Some of these features might cause a disturbance in the generated model, and consequently, the model might not be able to predict the flow simulation accurately. We propose to include a previously existing stream layer generated by the province of New Brunswick and benefit from culvert maps to improve the water flow simulation and accordingly the accuracy of HAND model. By considering these parameters in our processing, we were able to increase the accuracy of the model from nearly 74% to almost 92%. The improved model can be used for generating highly accurate flood maps, which is necessary for future urban planning and flood damage estimation without any need for satellite imagery or hydrodynamic computations.

Keywords: HAND, DTM, rapid floodplain, simplified conceptual models

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Authors: Alireza Nikbakht Shahbazi, Emadeddin Shirali

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Since optimization issues of water resources are complicated due to the variety of decision making criteria and objective functions, it is sometimes impossible to resolve them through regular optimization methods or, it is time or money consuming. Therefore, the use of modern tools and methods is inevitable in resolving such problems. An accurate and essential utilization policy has to be determined in order to use natural resources such as water reservoirs optimally. Water reservoir programming studies aim to determine the final cultivated land area based on predefined agricultural models and water requirements. Dam utilization rule curve is also provided in such studies. The basic information applied in water reservoir programming studies generally include meteorological, hydrological, agricultural and water reservoir related data, and the geometric characteristics of the reservoir. The system of Dez dam water resources was simulated applying the basic information in order to determine the capability of its reservoir to provide the objectives of the performed plan. As a meta-exploratory method, genetic algorithm was applied in order to provide utilization rule curves (intersecting the reservoir volume). MATLAB software was used in order to resolve the foresaid model. Rule curves were firstly obtained through genetic algorithm. Then the significance of using rule curves and the decrease in decision making variables in the system was determined through system simulation and comparing the results with optimization results (Standard Operating Procedure). One of the most essential issues in optimization of a complicated water resource system is the increasing number of variables. Therefore a lot of time is required to find an optimum answer and in some cases, no desirable result is obtained. In this research, intersecting the reservoir volume has been applied as a modern model in order to reduce the number of variables. Water reservoir programming studies has been performed based on basic information, general hypotheses and standards and applying monthly simulation technique for a statistical period of 30 years. Results indicated that application of rule curve prevents the extreme shortages and decrease the monthly shortages.

Keywords: optimization, rule curve, genetic algorithm method, Dez dam reservoir

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Authors: A. Daftari, W. Kudla

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Liquefaction is a phenomenon in which the strength and stiffness of a soil is reduced by earthquake shaking or other rapid cyclic loading. Liquefaction and related phenomena have been responsible for huge amounts of damage in historical earthquakes around the world. Modelling of soil behaviour is the main step in soil liquefaction prediction process. Nowadays, several constitutive models for sand have been presented. Nevertheless, only some of them can satisfy this mechanism. One of the most useful models in this term is UBCSAND model. In this research, the capability of this model is considered by using PLAXIS software. The real data of superstition hills earthquake 1987 in the Imperial Valley was used. The results of the simulation have shown resembling trend of the UBC3D-PLM model.

Keywords: liquefaction, plaxis, pore-water pressure, UBC3D-PLM

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Authors: Chebaani Mohamed, Gplea Amar, Benchouia Mohamed Toufik

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Direct torque control is characterized by the merits of fast response, simple structure and strong robustness to the motor parameters variations. This paper proposes the implementation of DTC-SVM of an induction motor drive using Predictive controller. The principle of the method is explained and the system mathematical description is provided. The derived control algorithm is implemented both in the simulation software MatLab/Simulink and on the real induction motor drive with dSPACE control system. Simulated and measured results in steady states and transients are presented.

Keywords: induction motor, DTC-SVM, predictive controller, implementation, dSPACE, Matlab, Simulink

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Authors: Jun Tian, Yu Yang, Liping Zhang, Qianhua Kan

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Experimental results show that SA 508-3 steel exhibits temperature dependent cyclic softening characteristic and obvious ratcheting behaviors, and dynamic strain age was observed at temperature range of 200 ºC to 350 ºC. Based on these observations, a temperature dependent cyclic plastic constitutive model was proposed by introducing the nonlinear cyclic softening and kinematic hardening rules, and the dynamic strain age was also considered into the constitutive model. Comparisons between experiments and simulations were carried out to validate the proposed model at elevated temperature.

Keywords: constitutive model, elevated temperature, ratcheting, SA 508-3

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Authors: Seongsoo Lee

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IP reuse is an effective design methodology for modern SoC design to reduce effort and time. However, description and modeling methods of IP interfaces are different due to different IP designers. In this paper, standardized description and modeling methods of IP interfaces are proposed. It consists of 11 items such as IP information, model provision, data type, description level, interface information, port information, signal information, protocol information, modeling level, modeling information, and source file. The proposed description and modeling methods enables easy understanding, simulation, verification, and modification in IP reuse.

Keywords: interface, standardization, description, modeling, semiconductor IP

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Authors: Bassma A. Abdelhaleem, Mamdouh A. Abdulrhman, Nagwa I. Mohamed

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Malnutrition in children is an increasing problem worldwide which may result in both short and long-term irreversible negative health outcomes. Severe Acute Malnutrition (SAM) affects more than 18 million children each year, mostly living in low-income settings. SAM contributes to 45% of all deaths in children less than five years of age. Honey is a natural sweetener, containing mainly monosaccharides (up to 80%), disaccharides (3–5%), water (17–20%), and a wide range of minor constituents such as vitamins, minerals, proteins, amino acids, enzymes, and phytochemicals, mainly phenolic acids, and flavonoids. Honey has been used in many cultures around the world due to its known nutritional and medicinal benefits including the treatment of hypercholesterolemia. Despite its use since ancient times yet little is known about its potential benefits for malnourished children. Honey has the potential to be an affordable solution for malnourished low-income children as it is nutrient-dense and calorie dense food, easily absorbed, highly palatable, enhances appetite, and boosts immunity. This study assessed the effect of clover honey supplementation on the anthropometric measurements and lipid profile of malnourished infants and children. A prospective interventional clinical trial was conducted between November 2019 to November 2020, on 40 malnourished infants and children divided into two groups: Group A (20 children; 11 males and 9 females) received honey in a dose of 1.75ml/kg/dose, twice weekly for 12 weeks and Group B (20 children; 6 males and 14 females) received placebo. Written informed consent was obtained for parents/guardians. Patients were recruited from the Pediatric Nutrition Clinic at Ain Shams University. Anthropometric measurements (weight, height, body mass index, head circumference, and mid-arm circumference) and fasting serum cholesterol levels were measured at baseline and after 3 months. The 3-month honey consumption had a statistically highly significant effect on increasing weight, height, and body mass index and lowering fasting serum cholesterol levels in primary malnourished infants and children. Weight, height, body mass index, and fasting serum cholesterol level before honey consumption were (9.49 ± 2.03, 81.45 ± 8.31, 14.24 ± 2.15, 178.00 ± 20.91) and after 3 months of honey consumption were (10.91 ± 2.11, 84.80 ± 8.23, 15.07 ± 2.05, 162.45 ± 19.73) respectively with P-value < 0.01. Our results showed a significant desirable effect of honey consumption on changes in nutritional status based on weight, height, and body mass index, and has a favourable effect on lowering fasting serum cholesterol levels. These results propose the use of honey as an affordable solution to improve malnutrition, particularly in low-income countries. However, further research needs to weigh benefits against potential harms including the risk of botulinum toxin that is historically associated with honey consumption in early childhood.

Keywords: clinical trial, dyslipidemia, honey, malnutrition

Procedia PDF Downloads 111

Authors: Liqin Zhang, Liang Yan

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This paper addresses the speed synchronization control problem for a network-based multi-motor system from the perspective of cluster consensus theory. Each motor is considered as a single agent connected through fixed and undirected network. This paper presents an improved control protocol from three aspects. First, for the purpose of improving both tracking and synchronization performance, this paper presents a distributed leader-following method. The improved control protocol takes the importance of each motor’s speed into consideration, and all motors are divided into different groups according to speed weights. Specifically, by using control parameters optimization, the synchronization error and tracking error can be regulated and decoupled to some extent. The simulation results demonstrate the effectiveness and superiority of the proposed strategy. In practical engineering, the simplified models are unrealistic, such as single-integrator and double-integrator. And previous algorithms require the acceleration information of the leader available to all followers if the leader has a varying velocity, which is also difficult to realize. Therefore, the method focuses on an observer-based variable structure algorithm for consensus tracking, which gets rid of the leader acceleration. The presented scheme optimizes synchronization performance, as well as provides satisfactory robustness. What’s more, the existing algorithms can obtain a stable synchronous system; however, the obtained stable system may encounter some disturbances that may destroy the synchronization. Focus on this challenging technological problem, a state-dependent-switching approach is introduced. In the presence of unmeasured angular speed and unknown failures, this paper investigates a distributed fault-tolerant consensus tracking algorithm for a group non-identical motors. The failures are modeled by nonlinear functions, and the sliding mode observer is designed to estimate the angular speed and nonlinear failures. The convergence and stability of the given multi-motor system are proved. Simulation results have shown that all followers asymptotically converge to a consistent state when one follower fails to follow the virtual leader during a large enough disturbance, which illustrates the good performance of synchronization control accuracy.

Keywords: consensus control, distributed follow, fault-tolerant control, multi-motor system, speed synchronization

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Authors: Christine F. Boos, Fernando M. Azevedo

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Electroencephalogram (EEG) is a record of the electrical activity of the brain that has many applications, such as monitoring alertness, coma and brain death; locating damaged areas of the brain after head injury, stroke and tumor; monitoring anesthesia depth; researching physiology and sleep disorders; researching epilepsy and localizing the seizure focus. Epilepsy is a chronic condition, or a group of diseases of high prevalence, still poorly explained by science and whose diagnosis is still predominantly clinical. The EEG recording is considered an important test for epilepsy investigation and its visual analysis is very often applied for clinical confirmation of epilepsy diagnosis. Moreover, this EEG analysis can also be used to help define the types of epileptic syndrome, determine epileptiform zone, assist in the planning of drug treatment and provide additional information about the feasibility of surgical intervention. In the context of diagnosis confirmation the analysis is made using long term EEG recordings with at least 24 hours long and acquired by a minimum of 24 electrodes in which the neurophysiologists perform a thorough visual evaluation of EEG screens in search of specific electrographic patterns called epileptiform discharges. Considering that the EEG screens usually display 10 seconds of the recording, the neurophysiologist has to evaluate 360 screens per hour of EEG or a minimum of 8,640 screens per long term EEG recording. Analyzing thousands of EEG screens in search patterns that have a maximum duration of 200 ms is a very time consuming, complex and exhaustive task. Because of this, over the years several studies have proposed automated methodologies that could facilitate the neurophysiologists’ task of identifying epileptiform discharges and a large number of methodologies used neural networks for the pattern classification. One of the differences between all of these methodologies is the type of input stimuli presented to the networks, i.e., how the EEG signal is introduced in the network. Five types of input stimuli have been commonly found in literature: raw EEG signal, morphological descriptors (i.e. parameters related to the signal’s morphology), Fast Fourier Transform (FFT) spectrum, Short-Time Fourier Transform (STFT) spectrograms and Wavelet Transform features. This study evaluates the application of these five types of input stimuli and compares the classification results of neural networks that were implemented using each of these inputs. The performance of using raw signal varied between 43 and 84% efficiency. The results of FFT spectrum and STFT spectrograms were quite similar with average efficiency being 73 and 77%, respectively. The efficiency of Wavelet Transform features varied between 57 and 81% while the descriptors presented efficiency values between 62 and 93%. After simulations we could observe that the best results were achieved when either morphological descriptors or Wavelet features were used as input stimuli.

Keywords: Artificial neural network, electroencephalogram signal, pattern recognition, signal processing

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Authors: Bao Li, Aike Qiao, Gaoyang Li, Youjun Liu

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Background: Lumped parameter model (LPM) is a common numerical model for hemodynamic calculation. LPM uses circuit elements to simulate the human blood circulatory system. Physiological indicators and characteristics can be acquired through the model. However, due to the different physiological indicators of each individual, parameters in LPM should be personalized in order for convincing calculated results, which can reflect the individual physiological information. This study aimed to develop an automatic and effective optimization method to personalize the parameters in LPM of the blood circulatory system, which is of great significance to the numerical simulation of individual hemodynamics. Methods: A closed-loop LPM of the human blood circulatory system that is applicable for most persons were established based on the anatomical structures and physiological parameters. The patient-specific physiological data of 5 volunteers were non-invasively collected as personalized objectives of individual LPM. In this study, the blood pressure and flow rate of heart, brain, and limbs were the main concerns. The collected systolic blood pressure, diastolic blood pressure, cardiac output, and heart rate were set as objective data, and the waveforms of carotid artery flow and ankle pressure were set as objective waveforms. Aiming at the collected data and waveforms, sensitivity analysis of each parameter in LPM was conducted to determine the sensitive parameters that have an obvious influence on the objectives. Simulated annealing was adopted to iteratively optimize the sensitive parameters, and the objective function during optimization was the root mean square error between the collected waveforms and data and simulated waveforms and data. Each parameter in LPM was optimized 500 times. Results: In this study, the sensitive parameters in LPM were optimized according to the collected data of 5 individuals. Results show a slight error between collected and simulated data. The average relative root mean square error of all optimization objectives of 5 samples were 2.21%, 3.59%, 4.75%, 4.24%, and 3.56%, respectively. Conclusions: Slight error demonstrated good effects of optimization. The individual modeling algorithm developed in this study can effectively achieve the individualization of LPM for the blood circulatory system. LPM with individual parameters can output the individual physiological indicators after optimization, which are applicable for the numerical simulation of patient-specific hemodynamics.

Keywords: blood circulatory system, individual physiological indicators, lumped parameter model, optimization algorithm

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Authors: Ilona Krone

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Maternal smoking during pregnancy increases the risk of perinatal/postnatal negative health outcomes; however, only 1 in 5 pregnant smokers quit smoking. That is a clinical and public health problem. Pregnant smokers have negative paternal support, and higher levels of perceived stress than non-smokers and quitters return to smoking in a stressful situation. A crisis like the COVID-19 outbreak causes significant uncertainty and stress. For pregnant women, additional stress may increase due to concerns for their fetus. Strategies targeting maternal stress and isolation may be particularly useful to prevent negative outcomes for women and their fetuses. Within the post-doctoral study, cooperating with leading specialists, an innovative program for pregnant smokers will be developed. Feasibility for reducing craving, distress intolerance, Covid 19 related stress, and fear in pregnant women in Latvia will be assessed.

Keywords: COVID 19, mindfulness, motivation, pregnancy, smoking cessation

Procedia PDF Downloads 224

Authors: Balthazar Temu, Zhao Yan, Bogdan-Petrin Ratiu, Sang Soon Oh, Qiang Li

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Photonic crystal surface emitting lasers (PCSELs) has recently become an area of active research because of the advantages these lasers have over the edge emitting lasers and vertical cavity surface emitting lasers (VCSELs). PCSELs can emit laser beams with high power (from the order of few milliwatts to Watts or even tens of Watts) which scales with the emission area while maintaining single mode operation even at large emission areas. Most PCSELs reported in the literature are air-hole based, with only few demonstrations of nanowire based PCSELs. We previously reported an optically pumped, nanowire based PCSEL operating in the O band by using the honeycomb lattice. The nanowire based PCSELs have the advantage of being able to grow on silicon platform without threading dislocations. It is desirable to extend their operating wavelength to C band to open more applications including eye-safe sensing, lidar and long haul optical communications. In this work we first analyze how the lattice constant , nanowire diameter, nanowire height and side length of the hexagon in the honeycomb pattern can be changed to increase the operating wavelength of the honeycomb based PCSELs to the C band. Then as an attempt to make our device electrically pumped, we present the finite-difference time-domain (FDTD) simulation results with metals on the nanowire. The results for different metals on the nanowire are presented in order to choose the metal which gives the device with the best quality factor. The metals under consideration are those which form good ohmic contact with p-type doped InGaAs with low contact resistivity and decent sticking coefficient to the semiconductor. Such metals include Tungsten, Titanium, Palladium and Platinum. Using the chosen metal we demonstrate the impact of thickness of the metal for a given nanowire height on the quality factor of the device. We also investigate how the height of the nanowire affects the quality factor for a fixed thickness of the metal. Finally, the main steps in making the practical device are discussed.

Keywords: designing nanowire PCSEL, designing PCSEL on silicon substrates, low threshold nanowire laser, simulation of photonic crystal lasers.

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Authors: Agus Hariyadi, Hiroatsu Fukuda

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In tropical country like Indonesia, especially in Jakarta, most of the energy consumption on building is for the cooling system, the second one is from lighting electric consumption. One of the passive design strategy that can be done is optimizing the use of natural light from the sun. In this area, natural light is always available almost every day around the year. Natural light have many effect on building. It can reduce the need of electrical lighting but also increase the external load. Another thing that have to be considered in the use of natural light is the visual comfort from occupant inside the room. To optimize the effectiveness of natural light need some modification of façade design. By using external shading device, it can minimize the external load that introduces into the room, especially from direct solar radiation which is the 80 % of the external energy load that introduces into the building. It also can control the distribution of natural light inside the room and minimize glare in the perimeter zone of the room. One of the horizontal blind that can be used for that purpose is Sudare. It is traditional Japanese blind that have been used long time in Japanese traditional house especially in summer. In its original function, Sudare is used to prevent direct solar radiation but still introducing natural ventilation. It has some physical characteristics that can be utilize to optimize the effectiveness of natural light. In this research, different scale of Sudare will be simulated using EnergyPlus and DAYSIM simulation software. EnergyPlus is a whole building energy simulation program to model both energy consumption—for heating, cooling, ventilation, lighting, and plug and process loads—and water use in buildings, while DAYSIM is a validated, RADIANCE-based daylighting analysis software that models the annual amount of daylight in and around buildings. The modelling will be done in Ladybug and Honeybee plugin. These are two open source plugins for Grasshopper and Rhinoceros 3D that help explore and evaluate environmental performance which will directly be connected to EnergyPlus and DAYSIM engines. Using the same model will maintain the consistency of the same geometry used both in EnergyPlus and DAYSIM. The aims of this research is to find the best configuration of façade design which can reduce the external load from the outside of the building to minimize the need of energy for cooling system but maintain the natural light distribution inside the room to maximize the visual comfort for occupant and minimize the need of electrical energy consumption.

Keywords: façade, natural light, blind, energy

Procedia PDF Downloads 349

Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

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Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

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Authors: William Gallagher, Harriet Bothwell, Lowri Evans, Kevin Jones

Abstract:

Background: Worldwide, a third of adult deaths are caused by cardiovascular disease, a high proportion occurring in the developing world. Contributing to these poor outcomes are suboptimal assessments, treatments and monitoring of the acutely unwell patient. Successful training in trauma and neonates is recognised in the developing world but there is little literature supporting adult resuscitation. As far as the authors are aware no literature has been published on resuscitation training in Uganda since 2000 when a resuscitation training officer ran sessions in neonatal and paediatric resuscitation. The aim of this project was to offer training in Basic Life Support ( BLS) to staff and healthcare students based at Villa Maria Hospital in the Kalungu District, Central Uganda. This project was undertaken as a student selected component (SSC) offered by Swindon Academy, based at the Great Western Hospital, to medical students in their fourth year of the undergraduate programme. Methods: Semi-structured, informal interviews and focus groups were conducted with different clinicians in the hospital. These interviews were designed to focus on the level of training and understanding of BLS. A training session was devised which focused on BLS (excluding the use of an automatic external defribrillator) involving pre and post-training questionnaires and clinical assessments. Three training sessions were run for different cohorts: a pilot session for 5 Ugandan medical students, a second session for a group of 8 nursing and midwifery students and finally, a third was devised for physicians. The data collected was analysed in excel. Paired T-Tests determined statistical significance between pre and post-test scores and confidence before and after the sessions. Average clinical skill assessment scores were converted to percentages based on the area of BLS being assessed. Results: 27 participants were included in the analysis. 14 received ‘small group training’ whilst 13 received’ large group training’ 88% of all participants had received some form of resuscitation training. Of these, 46% had received theory training, 27% practical training and only 15% received both. 12% had received no training. On average, all participants demonstrated a significant increase of 5.3 in self-assessed confidence (p <0.05). On average, all participants thought the session was very useful. Analysis of qualitative date from clinician interviews in ongoing but identified themes identified include rescue breaths being considered the most important aspect resuscitation and doubts of a ‘good’ outcome from resuscitation. Conclusions: The results of this small study reflect the need for regular formal training in BLS in low resource settings. The active engagement and positive opinions concerning the utility of the training are promising as well as the evidence of improvement in knowledge.

Keywords: basic life support, education, resuscitation, sub-Saharan Africa, training, Uganda

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Authors: Sara Mahmood, Omar Ahmed, Youssef Aladham, Moustafa Abdelnaby

Abstract:

The varied complications of COVID-19 present an ongoing challenge to healthcare professionals. A rare presentation of complicated sinusitis with pre-septal cellulitis and hard palatal necrosis in a COVID-19 patient, was reported. A 52-year-old male was admitted to the hospital with typical COVID manifestations where he had two successive COVID-19 positive swabs. During his admission, he developed symptoms of right orbital complications of sinusitis along with both clinical and radiological evidence of ipsilateral hard palatal necrosis. Imaging confirmed a diagnosis of right pan-sinusitis complicated with right pre-septal infection and hard palatal bony defect on the same side. Intra-operatively, the sphenopalatine artery was found to be thrombosed. This case focuses on the possible association between these manifestations and the known thromboembolic complications of COVID-19. Ongoing management of such complicated rare cases should be through a multidisciplinary team.

Keywords: COVID-19, sinusitis, sphenopalatine artery, thrombosis

Procedia PDF Downloads 183

Authors: C. S. Bianca Sabrina, N. Egidio Raimundo, L. Alexandre Baratella, C. H. João Paulo

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This paper aims to present a study, with the theoretical concepts and applications of the Quadcopter, using the MATLAB simulator. In order to use this tool, the study of the stability of the drone through a Proportional - Integral - Derivative (PID) controller will be presented. After the stability study, some tests are done on the simulator and its results will be presented. From the mathematical model, it is possible to find the Newton-Euler angles, so that it is possible to stabilize the quadcopter in a certain position in the air, starting from the ground. In order to understand the impact of the controllers gain values on the stabilization of the Euler-Newton angles, three conditions will be tested with different controller gain values.

Keywords: controllers, drones, quadcopter, stability

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Authors: Norma Binti Alias, Che Rahim Che The, Norfarizan Mohd Said, Sakinah Abdul Hanan, Akhtar Ali

Abstract:

This paper discusses on the transportation of magnetic drug targeting through blood within vessels, tissues and cells. There are three integrated mathematical models to be discussed and analyze the concentration of drug and blood flow through magnetic nanoparticles. The cell therapy brought advancement in the field of nanotechnology to fight against the tumors. The systematic therapeutic effect of Single Cells can reduce the growth of cancer tissue. The process of this nanoscale phenomena system is able to measure and to model, by identifying some parameters and applying fundamental principles of mathematical modeling and simulation. The mathematical modeling of single cell growth depends on three types of cell densities such as proliferative, quiescent and necrotic cells. The aim of this paper is to enhance the simulation of three types of models. The first model represents the transport of drugs by coupled partial differential equations (PDEs) with 3D parabolic type in a cylindrical coordinate system. This model is integrated by Non-Newtonian flow equations, leading to blood liquid flow as the medium for transportation system and the magnetic force on the magnetic nanoparticles. The interaction between the magnetic force on drug with magnetic properties produces induced currents and the applied magnetic field yields forces with tend to move slowly the movement of blood and bring the drug to the cancer cells. The devices of nanoscale allow the drug to discharge the blood vessels and even spread out through the tissue and access to the cancer cells. The second model is the transport of drug nanoparticles from the vascular system to a single cell. The treatment of the vascular system encounters some parameter identification such as magnetic nanoparticle targeted delivery, blood flow, momentum transport, density and viscosity for drug and blood medium, intensity of magnetic fields and the radius of the capillary. Based on two discretization techniques, finite difference method (FDM) and finite element method (FEM), the set of integrated models are transformed into a series of grid points to get a large system of equations. The third model is a single cell density model involving the three sets of first order PDEs equations for proliferating, quiescent and necrotic cells change over time and space in Cartesian coordinate which regulates under different rates of nutrients consumptions. The model presents the proliferative and quiescent cell growth depends on some parameter changes and the necrotic cells emerged as the tumor core. Some numerical schemes for solving the system of equations are compared and analyzed. Simulation and computation of the discretized model are supported by Matlab and C programming languages on a single processing unit. Some numerical results and analysis of the algorithms are presented in terms of informative presentation of tables, multiple graph and multidimensional visualization. As a conclusion, the integrated of three types mathematical modeling and the comparison of numerical performance indicates that the superior tool and analysis for solving the complete set of magnetic drug delivery system which give significant effects on the growth of the targeted cancer cell.

Keywords: mathematical modeling, visualization, PDE models, magnetic nanoparticle drug delivery model, drug release model, single cell effects, avascular tumor growth, numerical analysis

Procedia PDF Downloads 432

Authors: Wang Zhulin, Min Fuhong, Peng Guangya, Wang Yaoda, Cao Yi

Abstract:

In this paper, a magnetron memristor model based on hyperbolic sine function is presented and the correctness proved by studying the trajectory of its voltage and current phase, and then a memristor chaotic system with the memristor model is presented. The phase trajectories and the bifurcation diagrams and Lyapunov exponent spectrum of the magnetron memristor system are plotted by numerical simulation, and the chaotic evolution with changing the parameters of the system is also given. The paper includes numerical simulations and mathematical model, which confirming that the system, has a wealth of dynamic behavior.

Keywords: memristor, chaotic circuit, dynamical behavior, chaotic system

Procedia PDF Downloads 507

Authors: M. Jalali Azizpour, V.Tavvaf, E. Akhlaghi, H. Mohammadi Majd, A. Shirani, S. M. Moravvej, M. Kazemi, A. R. Aboudi Asl, A. Jaderi

Abstract:

The static and corrosion behavior of the bridge using for pipelines in the south of country have been evaluated. The bridge was constructed more than 40 years ago on the Karoon River. Mentioned bridge is located in Khuzestan province and at a distance of 15 km east from the suburbs of Ahwaz. In order to determine the mechanical properties, the experimental tools such as measuring the thickness and static simulations based on the actual load were used. In addition, the metallurgical studies were used to achieve a rate of corrosion of pipes in the river and in the river bed. The aim of this project is to determine the remaining life of the bridge using mechanical and metallurgical studies.

Keywords: FEM, stress, corrosion, bridge

Procedia PDF Downloads 478

Authors: S. Movafagh, Y. Bakhshan

Abstract:

In this study, effect of adding Al2O3 nanoparticle to base fluid (water) in car radiator is investigated numerically. Radiators are compact heat exchangers optimized and evaluated by considering different working conditions. The cooling system of a car plays an important role in vehicle's performance, consists of two main parts, known as radiator and fan. Improving thermal efficiency of engine leads to increase the engine's performance, decline the fuel consumption and decrease the pollution emissions. In this study, the effects of fluid inlet flow rate and nanoparticle volume fraction on heat transfer and pressure drop of acar radiator are studied.

Keywords: forced convection, nanofluid, radiator, CFD simulation

Procedia PDF Downloads 346

Authors: James D. Beauchemin

Abstract:

This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

Procedia PDF Downloads 159

Authors: Jane Killough

Abstract:

A podcast series was developed to support learning amongst first-year undergraduate mental health nursing students. Many first-year students do not have any clinical experience and find it difficult to engage with theory, which can present as cumbersome. Further, it can be challenging to relate abstract concepts to everyday mental health practice. Mental health professionals and service users from practice were interviewed on a range of core topics that are key to year one learning. The podcasts were made available, and students could access these recordings at their convenience to fit in with busy daily routines. The aim was to enable meaningful learning by providing access to those who have lived experience and who can, in effect, bring to life the theory being taught in university and essentially bridge the theory and practice gap while fostering working relationships between practice and academics. The student experience will be evaluated using a logic model.

Keywords: education, mental health nursing students, podcast, practice, undergraduate

Procedia PDF Downloads 156

Authors: Teodora Mocan, Lucian Mocan, Cornel Iancu, Flaviu A. Tabaran, Bartos Dana, Matea Cristian

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Antimicrobial resistance, which threatens the efficacy of the existing antibiotics represents a worldwide public health issue. At the current time, vancomycin is the only responsive treatment although has significant cytotoxicity, is partially effective and it is poorly retained by infected tissues. From a clinical point of view, attractive alternative approaches for treating such Meticillin-Resistant Staphylococcus Aureus (MRSA) strains would be using agents that cause physical damage to the bacteria. Modular nanopharmaceuticals systems are being designed to address all of these multifunctional capabilities for the ideal bacterial treatment, with the ability to mix and match appropriate functions. Here we present a novel method of selective laser photothermal ablation of MRSA bacteria mediated by gold nanoparticles bound to PBP antibody against PBP protein located on the MRSA surface.

Keywords: MRSA, laser, nanoparticle, antibody

Procedia PDF Downloads 284

Authors: D. Habibinia, M. R. Feyzi

Abstract:

Nowadays, specialized software is vastly used to verify the performance of an electric machine prototype by evaluating a model of the system. These models mainly consist of electrical parameters such as inductances and resistances. However, when the operating frequency of the device is above one kHz, the effect of parasitic capacitances grows significantly. In this paper, a software-based procedure is introduced to model these capacitances within the electromagnetic simulation of the device. The case study is a high-frequency high-voltage pulse transformer. The Finite Element Analysis (FEA) software with coupled field analysis is used in this method.

Keywords: finite element analysis, parasitic capacitance, pulse transformer, high frequency

Procedia PDF Downloads 519