Search results for: clinical simulation
5130 Evaluation of the Elastic Mechanical Properties of a Hybrid Adhesive Material
Authors: Moudar H. A. Zgoul, Amin Al Zamer
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Adhesive materials and adhesion have been the focal point of multiple research works related to numerous applications, particularly, aerospace, and aviation industries. To enhance the properties of conventional adhesive materials, additives have been introduced to the mix in order to enhance their mechanical and physical properties by creating a hybrid adhesive material. The evaluation of the mechanical properties of such hybrid adhesive materials is thus of an essential requirement for the purpose of properly modeling their behavior accurately. This paper presents an approach/tool to simulate the behavior such hybrid adhesives in a way that will allow researchers to better understand their behavior while in service.Keywords: adhesive materials, analysis, hybrid adhesives, mechanical properties, simulation
Procedia PDF Downloads 4235129 Numerical Study on the Hazards of Gravitational Forces on Cerebral Aneurysms
Authors: Hashem M. Alargha, Mohammad O. Hamdan, Waseem H. Aziz
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Aerobatic and military pilots are subjected to high gravitational forces that could cause blackout, physical injuries or death. A CFD simulation using fluid-solid interactions scheme has been conducted to investigate the gravitational effects and hazards inside cerebral aneurysms. Medical data have been used to derive the size and geometry of a simple aneurysm on a T-shaped bifurcation. The results show that gravitational force has no effect on maximum Wall Shear Stress (WSS); hence, it will not cause aneurysm initiation/formation. However, gravitational force cause causes hypertension which could contribute to aneurysm rupture.Keywords: aneurysm, cfd, wall shear stress, gravity, fluid dynamics, bifurcation artery
Procedia PDF Downloads 3725128 Using Gaussian Process in Wind Power Forecasting
Authors: Hacene Benkhoula, Mohamed Badreddine Benabdella, Hamid Bouzeboudja, Abderrahmane Asraoui
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The wind is a random variable difficult to master, for this, we developed a mathematical and statistical methods enable to modeling and forecast wind power. Gaussian Processes (GP) is one of the most widely used families of stochastic processes for modeling dependent data observed over time, or space or time and space. GP is an underlying process formed by unrecognized operator’s uses to solve a problem. The purpose of this paper is to present how to forecast wind power by using the GP. The Gaussian process method for forecasting are presented. To validate the presented approach, a simulation under the MATLAB environment has been given.Keywords: wind power, Gaussien process, modelling, forecasting
Procedia PDF Downloads 4205127 Hot Forging Process Simulation of Outer Tie Rod to Reduce Forming Load
Authors: Kyo Jin An, Bukyo Seo, Young-Chul Park
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The current trend in car market is increase of parts of automobile and weight in vehicle. It comes from improvement of vehicle performance. Outer tie rod is a part of component of steering system and it is lighter than the others. But, weight lightening is still required for improvement of car mileage. So, we have presented a model of aluminized outer tie rod, but the process of fabrication has to be checked to manufacture the product. Therefore, we have anticipated forming load, die stress and abrasion to use the program of forging interpretation in the part of hot forging process of outer tie rod in this study. Also, we have implemented the experiments design to use the table of orthogonal arrays to reduce the forming load.Keywords: forming load, hot forging, orthogonal array, outer tie rod (OTR), multi–step forging
Procedia PDF Downloads 4355126 Acute Phase Proteins as Biomarkers of Urinary Tract Infection (UTI) in Dairy Cattle
Authors: Wael El-Deeb
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The present study aimed to investigate the diagnostic importance of acute phase proteins in urinary tract infection (UTI) in cattle. We describe the clinical, bacteriological and biochemical findings in 99 lactating cows. Blood and urine samples from diseased (n=84) and control healthy cows (n=15) were submitted to laboratory investigations. The urine analysis revealed hematuria and pyuria in UTI group. The isolated bacteria were E.coli (43/84) Corynebacterium spp, (31/84), Proteus spp. (6/84) and Streptococcus spp (4/84). The concentrations of Haptoglobin (Hp), serum amyloid A (SAA), α1-Acid glycoprotein (AGP), fibrinogen (Fb), total protein, albumen, and globulin were higher in cows with UTI when compared to healthy ones. Fifty-one of 84 cows with UTI were successfully treated. The levels of Hp, SAA, AGP, total protein, and globulin were associated with the odds of treatment failure. Conclusively, acute phase proteins could be used as diagnostic and prognostic biomarkers in cows with UTI.Keywords: cows, urinary, infections, haptoglobin, serum Amyloid A
Procedia PDF Downloads 7265125 Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Service Provision and Pre-Service Training of Health Care Providers
Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie
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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.Keywords: abortion, contraception, quality improvement, service provision
Procedia PDF Downloads 2295124 Three-Stage Multivariate Stratified Sample Surveys with Probabilistic Cost Constraint and Random Variance
Authors: Sanam Haseen, Abdul Bari
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In this paper a three stage multivariate programming problem with random survey cost and variances as random variables has been formulated as a non-linear stochastic programming problem. The problem has been converted into an equivalent deterministic form using chance constraint programming and modified E-modeling. An empirical study of the problem has been done at the end of the paper using R-simulation.Keywords: chance constraint programming, modified E-model, stochastic programming, stratified sample surveys, three stage sample surveys
Procedia PDF Downloads 4615123 Numerical Modelling of Effective Diffusivity in Bone Tissue Engineering
Authors: Ayesha Sohail, Khadija Maqbool, Anila Asif, Haroon Ahmad
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The field of tissue engineering is an active area of research. Bone tissue engineering helps to resolve the clinical problems of critical size and non-healing defects by the creation of man-made bone tissue. We will design and validate an efficient numerical model, which will simulate the effective diffusivity in bone tissue engineering. Our numerical model will be based on the finite element analysis of the diffusion-reaction equations. It will have the ability to optimize the diffusivity, even at multi-scale, with the variation of time. It will also have a special feature, with which we will not only be able to predict the oxygen, glucose and cell density dynamics, more accurately, but will also sort the issues arising due to anisotropy. We will fix these problems with the help of modifying the governing equations, by selecting appropriate spatio-temporal finite element schemes, by adaptive grid refinement strategy and by transient analysis.Keywords: scaffolds, porosity, diffusion, transient analysis
Procedia PDF Downloads 5455122 Failure Simulation of Small-scale Walls with Chases Using the Lattic Discrete Element Method
Authors: Karina C. Azzolin, Luis E. Kosteski, Alisson S. Milani, Raquel C. Zydeck
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This work aims to represent Numerically tests experimentally developed in reduced scale walls with horizontal and inclined cuts by using the Lattice Discrete Element Method (LDEM) implemented On de Abaqus/explicit environment. The cuts were performed with depths of 20%, 30%, and 50% On the walls subjected to centered and eccentric loading. The parameters used to evaluate the numerical model are its strength, the failure mode, and the in-plane and out-of-plane displacements.Keywords: structural masonry, wall chases, small scale, numerical model, lattice discrete element method
Procedia PDF Downloads 1815121 Implementation of Iterative Algorithm for Earthquake Location
Authors: Hussain K. Chaiel
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The development in the field of the digital signal processing (DSP) and the microelectronics technology reduces the complexity of the iterative algorithms that need large number of arithmetic operations. Virtex-Field Programmable Gate Arrays (FPGAs) are programmable silicon foundations which offer an important solution for addressing the needs of high performance DSP designer. In this work, Virtex-7 FPGA technology is used to implement an iterative algorithm to estimate the earthquake location. Simulation results show that an implementation based on block RAMB36E1 and DSP48E1 slices of Virtex-7 type reduces the number of cycles of the clock frequency. This enables the algorithm to be used for earthquake prediction.Keywords: DSP, earthquake, FPGA, iterative algorithm
Procedia PDF Downloads 3945120 Impact Analysis of a School-Based Oral Health Program in Brazil
Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha
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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.Keywords: primary care, public health, oral health, school-based oral health, data management
Procedia PDF Downloads 1395119 Some Generalized Multivariate Estimators for Population Mean under Multi Phase Stratified Systematic Sampling
Authors: Muqaddas Javed, Muhammad Hanif
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The generalized multivariate ratio and regression type estimators for population mean are suggested under multi-phase stratified systematic sampling (MPSSS) using multi auxiliary information. Estimators are developed under the two different situations of availability of auxiliary information. The expressions of bias and mean square error (MSE) are developed. Special cases of suggested estimators are also discussed and simulation study is conducted to observe the performance of estimators.Keywords: generalized estimators, multi-phase sampling, stratified random sampling, systematic sampling
Procedia PDF Downloads 7335118 Predicting Provider Service Time in Outpatient Clinics Using Artificial Intelligence-Based Models
Authors: Haya Salah, Srinivas Sharan
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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time
Procedia PDF Downloads 1255117 Design of a Rectifier with Enhanced Efficiency and a High-gain Antenna for Integrated and Compact-size Rectenna Circuit
Authors: Rawaa Maher, Ahmed Allam, Haruichi Kanaya, Adel B. Abdelrahman
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In this paper, a compact, high-efficiency integrated rectenna is presented to operate in the 2.45 GHz band. A comparison between two rectifier topologies is performed to verify the benefits of removing the matching network from the rectifier. A rectifier high conversion efficiency of 74.1% is achieved. To complete the rectenna system, a novel omnidirectional antenna with high gain (3.72 dB) and compact size (25 mm * 29 mm) is designed and fabricated. The same antenna is used with a reflector for raising the gain to nearly 8.3 dB. The simulation and measurement results of the antenna are in good agreement.Keywords: internet of things, integrated rectenna, rectenna, RF energy harvesting, wireless sensor networks(WSN)
Procedia PDF Downloads 1885116 Pattern of Stress Distribution in Different Ligature-Wire-Brackets Systems: A FE and Experimental Analysis
Authors: Afef Dridi, Salah Mezlini
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Since experimental devices cannot calculate stress and deformation of complex structures. The Finite Element Method FEM has been widely used in several fields of research. One of these fields is orthodontics. The advantage of using such a method is the use of an accurate and non invasive method that allows us to have a sufficient data about the physiological reactions can happening in soft tissues. Most of researches done in this field were interested in the study of stresses and deformations induced by orthodontic apparatus in soft tissues (alveolar tissues). Only few studies were interested in the distribution of stress and strain in the orthodontic brackets. These studies, although they tried to be as close as possible to real conditions, their models did not reproduce the clinical cases. For this reason, the model generated by our research is the closest one to reality. In this study, a numerical model was developed to explore the stress and strain distribution under the application of real conditions. A comparison between different material properties was also done.Keywords: visco-hyperelasticity, FEM, orthodontic treatment, inverse method
Procedia PDF Downloads 2615115 Repeated Suicidal Attempts in Foster Teenagers: Breaking the Cycle Using a Stepped Care Approach
Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister
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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care
Procedia PDF Downloads 395114 A Constitutive Model for Time-Dependent Behavior of Clay
Authors: T. N. Mac, B. Shahbodaghkhan, N. Khalili
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A new elastic-viscoplastic (EVP) constitutive model is proposed for the analysis of time-dependent behavior of clay. The proposed model is based on the bounding surface plasticity and the concept of viscoplastic consistency framework to establish continuous transition from plasticity to rate dependent viscoplasticity. Unlike the overstress based models, this model will meet the consistency condition in formulating the constitutive equation for EVP model. The procedure of deriving the constitutive relationship is also presented. Simulation results and comparisons with experimental data are then presented to demonstrate the performance of the model.Keywords: bounding surface, consistency theory, constitutive model, viscosity
Procedia PDF Downloads 4985113 Real-Time Detection of Space Manipulator Self-Collision
Authors: Zhang Xiaodong, Tang Zixin, Liu Xin
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In order to avoid self-collision of space manipulators during operation process, a real-time detection method is proposed in this paper. The manipulator is fitted into a cylinder enveloping surface, and then the detection algorithm of collision between cylinders is analyzed. The collision model of space manipulator self-links can be detected by using this algorithm in real-time detection during the operation process. To ensure security of the operation, a safety threshold is designed. The simulation and experiment results verify the effectiveness of the proposed algorithm for a 7-DOF space manipulator.Keywords: space manipulator, collision detection, self-collision, the real-time collision detection
Procedia PDF Downloads 4745112 Penguins Search Optimization Algorithm for Chaotic Synchronization System
Authors: Sofiane Bououden, Ilyes Boulkaibet
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In terms of security of the information signal, the meta-heuristic Penguins Search Optimization Algorithm (PeSOA) is applied to synchronize chaotic encryption communications in the case of sensitive dependence on initial conditions in chaotic generator oscillator. The objective of this paper is the use of the PeSOA algorithm to exploring search space with random and iterative processes for synchronization of symmetric keys in both transmission and reception. Simulation results show the effectiveness of the PeSOA algorithm in generating symmetric keys of the encryption process and synchronizing.Keywords: meta-heuristic, PeSOA, chaotic systems, encryption, synchronization optimization
Procedia PDF Downloads 2025111 Modal Analysis of Power System with a Microgrid
Authors: Burak Yildirim, Muhsin Tunay Gençoğlu
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A microgrid (MG) is a small power grid composed of localized medium or low level power generation, storage systems, and loads. In this paper, the effects of a MG on power systems voltage stability are shown. The MG model, designed to demonstrate the effects of the MG, was applied to the IEEE 14 bus power system which is widely used in power system stability studies. Eigenvalue and modal analysis methods were used in simulation studies. In the study results, it is seen that MGs affect system voltage stability positively by increasing system voltage instability limit value for buses of a power system in which MG are placed.Keywords: eigenvalue analysis, microgrid, modal analysis, voltage stability
Procedia PDF Downloads 3755110 A Comparative and Critical Analysis of Some Routing Protocols in Wireless Sensor Networks
Authors: Ishtiaq Wahid, Masood Ahmad, Nighat Ayub, Sajad Ali
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Lifetime of a wireless sensor network (WSN) is directly proportional to the energy consumption of its constituent nodes. Routing in wireless sensor network is very challenging due its inherit characteristics. In hierarchal routing the sensor filed is divided into clusters. The cluster-heads are selected from each cluster, which forms a hierarchy of nodes. The cluster-heads are used to transmit the data to the base station while other nodes perform the sensing task. In this way the lifetime of the network is increased. In this paper a comparative study of hierarchal routing protocols are conducted. The simulation is done in NS-2 for validation.Keywords: WSN, cluster, routing, sensor networks
Procedia PDF Downloads 4835109 Effects of Level Densities and Those of a-Parameter in the Framework of Preequilibrium Model for 63,65Cu(n,xp) Reactions in Neutrons at 9 to 15 MeV
Authors: L. Yettou
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In this study, the calculations of proton emission spectra produced by 63Cu(n,xp) and 65Cu(n,xp) reactions are used in the framework of preequilibrium models using the EMPIRE code and TALYS code. Exciton Model predidtions combined with the Kalbach angular distribution systematics and the Hybrid Monte Carlo Simulation (HMS) were used. The effects of levels densities and those of a-parameter have been investigated for our calculations. The comparison with experimental data shows clear improvement over the Exciton Model and HMS calculations.Keywords: Preequilibrium models , level density, level density a-parameter., Empire code, Talys code.
Procedia PDF Downloads 1375108 Low Power, Highly Linear, Wideband LNA in Wireless SOC
Authors: Amir Mahdavi
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In this paper a highly linear CMOS low noise amplifier (LNA) for ultra-wideband (UWB) applications is proposed. The proposed LNA uses a linearization technique to improve second and third-order intercept points (IIP3). The linearity is cured by repealing the common-mode section of all intermodulation components from the cascade topology current with optimization of biasing current use symmetrical and asymmetrical circuits for biasing. Simulation results show that maximum gain and noise figure are 6.9dB and 3.03-4.1dB over a 3.1–10.6 GHz, respectively. Power consumption of the LNA core and IIP3 are 2.64 mW and +4.9dBm respectively. The wideband input impedance matching of LNA is obtained by employing a degenerating inductor (|S11|<-9.1 dB). The circuit proposed UWB LNA is implemented using 0.18 μm based CMOS technology.Keywords: highly linear LNA, low-power LNA, optimal bias techniques
Procedia PDF Downloads 2845107 Cost Based Analysis of Risk Stratification Tool for Prediction and Management of High Risk Choledocholithiasis Patients
Authors: Shreya Saxena
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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery
Procedia PDF Downloads 1035106 Translation and Validation of the Thai Version of the Japanese Sleep Questionnaire for Preschoolers
Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul
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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.Keywords: preschooler, questionnaire, validation, Thai version
Procedia PDF Downloads 1105105 Performance of LTE Multicast Systems in the Presence of the Colored Noise Jamming
Authors: S. Malisuwan, J. Sivaraks, N. Madan, N. Suriyakrai
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The ever going evolution of advanced wireless technologies makes it financially impossible for military operations to completely manufacture their own equipment. Therefore, Commercial-Off-The-Shelf (COTS) and Modified-Off-The-Shelf (MOTS) are being considered in military mission with low-cost modifications. In this paper, we focus on the LTE multicast systems for military communication systems under tactical environments with jamming condition. We examine the influence of the colored noise jamming on the performance of the LTE multicast systems in terms of the average throughput. The simulation results demonstrate the degradation of the average throughput for different dynamic ranges of the colored noise jamming versus average SNR.Keywords: performance, LTE, multicast, jamming, throughput
Procedia PDF Downloads 4225104 A Double Ended AC Series Arc Fault Location Algorithm Based on Currents Estimation and a Fault Map Trace Generation
Authors: Edwin Calderon-Mendoza, Patrick Schweitzer, Serge Weber
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Series arc faults appear frequently and unpredictably in low voltage distribution systems. Many methods have been developed to detect this type of faults and commercial protection systems such AFCI (arc fault circuit interrupter) have been used successfully in electrical networks to prevent damage and catastrophic incidents like fires. However, these devices do not allow series arc faults to be located on the line in operating mode. This paper presents a location algorithm for series arc fault in a low-voltage indoor power line in an AC 230 V-50Hz home network. The method is validated through simulations using the MATLAB software. The fault location method uses electrical parameters (resistance, inductance, capacitance, and conductance) of a 49 m indoor power line. The mathematical model of a series arc fault is based on the analysis of the V-I characteristics of the arc and consists basically of two antiparallel diodes and DC voltage sources. In a first step, the arc fault model is inserted at some different positions across the line which is modeled using lumped parameters. At both ends of the line, currents and voltages are recorded for each arc fault generation at different distances. In the second step, a fault map trace is created by using signature coefficients obtained from Kirchhoff equations which allow a virtual decoupling of the line’s mutual capacitance. Each signature coefficient obtained from the subtraction of estimated currents is calculated taking into account the Discrete Fast Fourier Transform of currents and voltages and also the fault distance value. These parameters are then substituted into Kirchhoff equations. In a third step, the same procedure described previously to calculate signature coefficients is employed but this time by considering hypothetical fault distances where the fault can appear. In this step the fault distance is unknown. The iterative calculus from Kirchhoff equations considering stepped variations of the fault distance entails the obtaining of a curve with a linear trend. Finally, the fault distance location is estimated at the intersection of two curves obtained in steps 2 and 3. The series arc fault model is validated by comparing current registered from simulation with real recorded currents. The model of the complete circuit is obtained for a 49m line with a resistive load. Also, 11 different arc fault positions are considered for the map trace generation. By carrying out the complete simulation, the performance of the method and the perspectives of the work will be presented.Keywords: indoor power line, fault location, fault map trace, series arc fault
Procedia PDF Downloads 1405103 Economic Analysis of Endogenous Growth Model with ICT Capital
Authors: Shoji Katagiri, Hugang Han
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This paper clarifies the role of ICT capital in Economic Growth. Albeit ICT remarkably contributes to economic growth, there are few studies on ICT capital in ICT sector from theoretical point of view. In this paper, production function of ICT which is used as input of intermediate good in final good and ICT sectors is incorporated into our model. In this setting, we analyze the role of ICT on balance growth path and show the possibility of general equilibrium solutions for this model. Through the simulation of the equilibrium solutions, we find that when ICT impacts on economy and economic growth increases, it is necessary that increases of efficiency at ICT sector and of accumulation of non-ICT and ICT capitals occur simultaneously.Keywords: endogenous economic growth, ICT, intensity, capital accumulation
Procedia PDF Downloads 4585102 An 8-Bit, 100-MSPS Fully Dynamic SAR ADC for Ultra-High Speed Image Sensor
Authors: F. Rarbi, D. Dzahini, W. Uhring
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In this paper, a dynamic and power efficient 8-bit and 100-MSPS Successive Approximation Register (SAR) Analog-to-Digital Converter (ADC) is presented. The circuit uses a non-differential capacitive Digital-to-Analog (DAC) architecture segmented by 2. The prototype is produced in a commercial 65-nm 1P7M CMOS technology with 1.2-V supply voltage. The size of the core ADC is 208.6 x 103.6 µm2. The post-layout noise simulation results feature a SNR of 46.9 dB at Nyquist frequency, which means an effective number of bit (ENOB) of 7.5-b. The total power consumption of this SAR ADC is only 1.55 mW at 100-MSPS. It achieves then a figure of merit of 85.6 fJ/step.Keywords: CMOS analog to digital converter, dynamic comparator, image sensor application, successive approximation register
Procedia PDF Downloads 4225101 Firesetting in a Male Prison; An Investigation into the Personality Differences in Firesetters and Non-firesetters
Authors: Elinor Bull, Faye Horsley
Abstract:
Abstract Objective: The current study investigated if there was a difference in personality factors in prisoners who had a recorded history of firesetting and who had no recorded history of firesetting. Participants: Participants were 64 male prisoners in a Category B male prison. Participants who had set a fire were identified through the prisons data base, and prisoners who had not set a fire were selected at random. Method: The study used the International Personality Item Pool-50 to measure personality factors, and prisoners who had set a fire were identified through a range of sources accessible to the prison. Analytical evaluation was done by the Multivariate Kruskal Wallis and Mann-Whitney tests. Findings: There was a significant difference between the the firesetting and non-firesetting group in the scores of the personality factor of Contentiousness. Contentiousness was significantly lower in the firesetting sample compared to the non-firesetting sample. Conclusions: Implications for clinical practice and future research are discussed.Keywords: firesetting, personality, arson, prison, prisoners
Procedia PDF Downloads 86