Search results for: clinical simulation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8268

Search results for: clinical simulation

7938 CFD Simulation for Development of Cooling System in a Cooking Oven

Authors: V. Jagadish, Mathiyalagan V.

Abstract:

Prediction of Door Touch temperature of a Cooking Oven using CFD Simulation. Self-Clean cycle is carried out in Cooking ovens to convert food spilling into ashes which makes cleaning easy. During this cycle cavity of oven is exposed to high temperature around 460 C. At this operating point the user may prone to touch the Door surfaces, Side Shield, Control Panel. To prevent heat experienced by user, cooling system is built in oven. The most effective cooling system is developed with existing design constraints through CFD Simulations. Cross Flow fan is used for Cooling system due to its cost effectiveness and it can give more air flow with low pressure drop.

Keywords: CFD, MRF, RBM, RANS, new product development, simulation, thermal analysis

Procedia PDF Downloads 132
7937 (Re)Assessing Clinical Spaces: How Do We Critically Provide Mental Health and Disability Support and Effective Care for Young People Who Are Impacted by Structural Violence and Structural Racism?

Authors: Sireen Irsheid, Stephanie Keeney Parks, Michael A. Lindsey

Abstract:

The medical and mental health field have been organized as reactive systems to respond to symptoms of mental health problems and disability. This becomes problematic particularly for those harmed by structural violence and racism, typically pushing us in the direction of alleviating symptoms and personalizing structural problems. The current paper examines how we assess, diagnose, and treat mental health and disability challenges in clinical spaces. We provide the readers with some context to think about the problem of racism and mental health/disability, ways to deconstruct the problem through the lens of structural violence, and recommendations to critically engage in clinical assessments, diagnosis, and treatment for young people impacted by structural violence and racism.

Keywords: mental health, disability, race and ethnicity, structural violence, structural racism, young people

Procedia PDF Downloads 27
7936 Object-Oriented Modeling Simulation and Control of Activated Sludge Process

Authors: J. Fernandez de Canete, P. Del Saz Orozco, I. Garcia-Moral, A. Akhrymenka

Abstract:

Object-oriented modeling is spreading in current simulation of wastewater treatments plants through the use of the individual components of the process and its relations to define the underlying dynamic equations. In this paper, we describe the use of the free-software OpenModelica simulation environment for the object-oriented modeling of an activated sludge process under feedback control. The performance of the controlled system was analyzed both under normal conditions and in the presence of disturbances. The object-oriented described approach represents a valuable tool in teaching provides a practical insight in wastewater process control field.

Keywords: object-oriented programming, activated sludge process, OpenModelica, feedback control

Procedia PDF Downloads 361
7935 Dental Management Particularities of Werner Syndrome: A Report of Two Cases

Authors: Emna Abid, Linda Chebbi, Yosra Mabrouk, Amel Labidi, Lamia Mansour

Abstract:

Werner syndrome (WS) is a rare genetic disorder inherited in an autosomal recessive pattern characterized by accelerated aging. While extensive research has been conducted on its systemic manifestations, the specific dental implications of WS remain poorly understood. The medical history and the oral health status of two patients diagnosed with WS were detailed. Our findings revealed a high prevalence of dental problems in both patients, including periodontitis, xerostomia, and temporomandibular joint disorders. This article aims to investigate the dental challenges faced by individuals with WS as well as the prosthetic options envisaged through two clinical cases contributing to a deeper understanding of the dental implications of WS and to choose the appropriate prosthetic solution in this population. Future research should focus on larger scale studies and clinical trials to validate these proposed strategies.

Keywords: adult progeria, clinical symptoms, oral manifestations, dental care, prosthetic management

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7934 Advanced Mechatronic Design of Robot Manipulator Using Hardware-In-The-Loop Simulation

Authors: Reza Karami, Ali Akbar Ebrahimi

Abstract:

This paper discusses concurrent engineering of robot manipulators, based on the Holistic Concurrent Design (HCD) methodology and by using a hardware-in-the-loop simulation platform. The methodology allows for considering numerous design variables with different natures concurrently. It redefines the ultimate goal of design based on the notion of satisfaction, resulting in the simplification of the multi-objective constrained optimization process. It also formalizes the effect of designer’s subjective attitude in the process. To enhance modeling efficiency for both computation and accuracy, a hardware-in-the-loop simulation platform is used, which involves physical joint modules and the control unit in addition to the software modules. This platform is implemented in the HCD design architecture to reliably evaluate the design attributes and performance super criterion during the design process. The resulting overall architecture is applied to redesigning kinematic, dynamic and control parameters of an industrial robot manipulator.

Keywords: concurrent engineering, hardware-in-the-loop simulation, robot manipulator, multidisciplinary systems, mechatronics

Procedia PDF Downloads 424
7933 The Safety of Microbiologically Prepared Fructooligosaccharide on White Albino Rats

Authors: Olayinka Risiquat Raimi

Abstract:

FOS was produced from FTase of Aspergillus niger. HPLC analysis showed 32.24%. Consisting of 28.57% ketose and 4.67% nystose. Effects of FOS were studied on 12 weeks old albino rats. All animals survived until scheduled euthanasia. A low incidence of clinical sign and no toxicological effect were observed. Male rats fed with 2500mg/kg fructooligosaccharides had the highest weight. Male and female rat showed a significant increase in weight from first week to the fifth week. All haematological parameters examined were normal in male and female rats. Mean haematological and haemoglobin values for 2500mg/kg bw FOS fed male rats were the highest. Clinical chemistry test, glucose, albumin, and cholesterol were within normal laboratory values for a rat. The mean glucose value was lower for FOS fed male and female rats compared to those fed with honey and 60% sucrose. Gross necropsy observation showed no remarkable internal gross abnormalities for any of the animals.

Keywords: fructooligosaccharide, white albino rat, haematology values, clinical chemistry values

Procedia PDF Downloads 377
7932 The Importance of Introducing New Academic Programs in ‎Egyptian National Cancer ‎Institute

Authors: Mohammed S. Mohammed, Asmaa M. S. Mohammed

Abstract:

Background: To achieve the quality of cancer care, the oncologic academic programs should be continuously developed with establishing new ones. We highlighted three disciplines, Clinical nutrition, medical biophysics and radiobiology and Psycho-oncology programs; without a doubt, the Egyptian National Cancer Institute, in ‎the accreditation era, will be establishing them ‎ due to their importance in improving the skills of cancer practitioners. Methods: The first suggested program in Clinical Nutrition that is dealing with the assessment of the patient's well-being before, during and after treatment to avoid the defects in the metabolism resulting from the cancer disease and its treatment by giving the supplements in the patient's diet. The second program is Medical Biophysics and Radiobiology, which there's no denying that it ‎is ‎provided ‎in Cairo University as a good program in the faculty of science but lacks the clinical ‎practice. Hence, it is probably better to establish this program in our institute to ‎improve the ‎practitioner skills and introduce a tailored radiation therapy regimen for every patient according to ‎their characteristic profile.‎ While patients are receiving their treatment, the risk of post-traumatic stress disorder arises, so the importance of the third program, Psycho-Oncology, is clearly obtained. This program is concerned with the psychological, social, behavioral, and ethical aspects of cancer. The area of multi-disciplinary interest has boundaries with the major specialties in oncology: the clinical disciplines (surgery, medicine, pediatrics, and radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. Results: It is a prospective academic plan which is compatible with the institutional vision and its strategic plan. Conclusion: In this context, evaluating and understanding the suggested academic programs has become a mandatory part of cancer care. And it is essential to be provided by the NCI.

Keywords: clinical nutrition, psycho-oncology, medical biophysics and radiobiology, medical education

Procedia PDF Downloads 201
7931 An Investigation into the Isolation and Bandwidth Characteristics of X-Band Chireix Power Amplifier Combiners

Authors: Daniel P. Clayton, Edward A. Ball

Abstract:

This paper describes an investigation into the isolation characteristics and bandwidth performance of RF combiners that are used as part of Chireix PA architectures, designed for use in the X-Band range of frequencies. Combiner designs investigated are the typical Chireix and Wilkinson configurations which also include simulation of the Wilkinson using manufacturer’s data for the isolation resistor. Another simulation was the less common approach of using a Branchline coupler to form the combiner, as well as simulation results from adding an additional stage. This paper presents the findings of this investigation and compares the bandwidth performance and isolation characteristics to determine suitability.

Keywords: bandwidth, Chireix, couplers, outphasing, power amplifiers, Wilkinson, X-Band

Procedia PDF Downloads 233
7930 Comparative Study of IC and Perturb and Observe Method of MPPT Algorithm for Grid Connected PV Module

Authors: Arvind Kumar, Manoj Kumar, Dattatraya H. Nagaraj, Amanpreet Singh, Jayanthi Prattapati

Abstract:

The purpose of this paper is to study and compare two maximum power point tracking (MPPT) algorithms in a photovoltaic simulation system and also show a simulation study of maximum power point tracking (MPPT) for photovoltaic systems using perturb and observe algorithm and Incremental conductance algorithm. Maximum power point tracking (MPPT) plays an important role in photovoltaic systems because it maximize the power output from a PV system for a given set of conditions, and therefore maximize the array efficiency and minimize the overall system cost. Since the maximum power point (MPP) varies, based on the irradiation and cell temperature, appropriate algorithms must be utilized to track the (MPP) and maintain the operation of the system in it. MATLAB/Simulink is used to establish a model of photovoltaic system with (MPPT) function. This system is developed by combining the models established of solar PV module and DC-DC Boost converter. The system is simulated under different climate conditions. Simulation results show that the photovoltaic simulation system can track the maximum power point accurately.

Keywords: incremental conductance algorithm, perturb and observe algorithm, photovoltaic system, simulation results

Procedia PDF Downloads 535
7929 Dose Profiler: A Tracking Device for Online Range Monitoring in Particle Therapy

Authors: G. Battistoni, F. Collamati, E. De Lucia, R. Faccini, C. Mancini-Terracciano, M. Marafini, I. Mattei, S. Muraro, V. Patera, A. Sarti, A. Sciubba, E. Solfaroli Camillocci, M. Toppi, G. Traini, S. M. Valle, C. Voena

Abstract:

Accelerated charged particles, mainly protons and carbon ions, are presently used in Particle Therapy (PT) to treat solid tumors. The precision of PT exploiting the charged particle high localized dose deposition in tissues and biological effectiveness in killing cancer cells demands for an online dose monitoring technique, crucial to improve the quality assurance of treatments: possible patient mis-positionings and biological changes with respect to the CT scan could negatively affect the therapy outcome. In PT the beam range confined in the irradiated target can be monitored thanks to the secondary radiation produced by the interaction of the projectiles with the patient tissue. The Dose Profiler (DP) is a novel device designed to track charged secondary particles and reconstruct their longitudinal emission distribution, correlated to the Bragg peak position. The feasibility of this approach has been demonstrated by dedicated experimental measurements. The DP has been developed in the framework of the INSIDE project, MIUR, INFN and Centro Fermi, Museo Storico della Fisica e Centro Studi e Ricerche 'E. Fermi', Roma, Italy and will be tested at the Proton Therapy center of Trento (Italy) within the end of 2017. The DP combines a tracker, made of six layers of two-view scintillating fibers with square cross section (0.5 x 0.5 mm2) with two layers of two-view scintillating bars (section 12.0 x 0.6 mm2). The electronic readout is performed by silicon photomultipliers. The sensitive area of the tracking planes is 20 x 20 cm2. To optimize the detector layout, a Monte Carlo (MC) simulation based on the FLUKA code has been developed. The complete DP geometry and the track reconstruction code have been fully implemented in the MC. In this contribution, the DP hardware will be described. The expected detector performance computed using a dedicated simulation of a 220 MeV/u carbon ion beam impinging on a PMMA target will be presented, and the result will be discussed in the standard clinical application framework. A possible procedure for real-time beam range monitoring is proposed, following the expectations in actual clinical operation.

Keywords: online range monitoring, particle therapy, quality assurance, tracking detector

Procedia PDF Downloads 225
7928 Assessing the Impact of Pharmacist-Led Medication Therapy Management on Treatment Adherence and Clinical Outcomes in Cancer Patients: A Prospective Intervention Study

Authors: Omer Ibrahim Abdallh Omer

Abstract:

Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

Procedia PDF Downloads 34
7927 Variation of Clinical Manifestations of COVID-19 Over Time of Pandemic

Authors: Mahdi Asghari Ozma, Fatemeh Aghamohammadzadeh, Mahin Ahangar Oskouee

Abstract:

In late 2019, the people of the world were involved with a new infection by the coronavirus, named SARS-COV-2 (COVID-19), which disseminated around the world quickly. This infection has the ability to affect various systems of the body, including respiratory, gastrointestinal, urinary, and hematology, which can be transmitted by various body samples in different ways. To control this fast-transmitted infection by preventing its transmission to other people, rapid diagnosis is vital, which can be done by examining the patient's clinical symptoms and also using various serological, molecular, and radiological methods. Symptoms caused by COVID-19 in patients include fever, cough, sore throat, headache, fatigue, shortness of breath, loss of taste or smell, skin rash, myalgia, and conjunctivitis. These clinical features were appearing gradually in different time periods from the onset of the infection, and patients showed varied and new symptoms at different times, which show the variety of symptoms over time during the spread of the infection.

Keywords: COVID-19, diagnosis, symptom, variation, novel coronavirus

Procedia PDF Downloads 60
7926 Model-Based Process Development for the Comparison of a Radial Riveting and Roller Burnishing Process in Mechanical Joining Technology

Authors: Tobias Beyer, Christoph Friedrich

Abstract:

Modern simulation methodology using finite element models is nowadays a recognized tool for product design/optimization. Likewise, manufacturing process design is increasingly becoming the focus of simulation methodology in order to enable sustainable results based on reduced real-life tests here as well. In this article, two process simulations -radial riveting and roller burnishing- used for mechanical joining of components are explained. In the first step, the required boundary conditions are developed and implemented in the respective simulation models. This is followed by process space validation. With the help of the validated models, the interdependencies of the input parameters are investigated and evaluated by means of sensitivity analyses. Limit case investigations are carried out and evaluated with the aid of the process simulations. Likewise, a comparison of the two joining methods to each other becomes possible.

Keywords: FEM, model-based process development, process simulation, radial riveting, roller burnishing, sensitivity analysis

Procedia PDF Downloads 86
7925 Transition 1970 Volkswagen Beetle from Internal Combustion Engine Vehicle to Electric Vehicle, Modeling and Simulation

Authors: Jamil Khalil Izraqi

Abstract:

This paper investigates the transition of a 1970 Volkswagen Beetle from an internal combustion engine (ICE) to an EV using Matlab/Simulink modeling and simulation. The performance of the EV drivetrain system was simulated under various operating conditions, including standard and custom driving cycles in Turkey and Jordan (Amman), respectively. The results of this paper indicate that the transition is viable and that modeling and simulation can help in understanding the performance and efficiency of the electric drivetrain system, including battery pack, power electronics, and brushless direct current (BLDC) Motor.

Keywords: BLDC, buck-boost, inverter, SOC, drive-cycle

Procedia PDF Downloads 76
7924 IT-Aided Business Process Enabling Real-Time Analysis of Candidates for Clinical Trials

Authors: Matthieu-P. Schapranow

Abstract:

Recruitment of participants for clinical trials requires the screening of a big number of potential candidates, i.e. the testing for trial-specific inclusion and exclusion criteria, which is a time-consuming and complex task. Today, a significant amount of time is spent on identification of adequate trial participants as their selection may affect the overall study results. We introduce a unique patient eligibility metric, which allows systematic ranking and classification of candidates based on trial-specific filter criteria. Our web application enables real-time analysis of patient data and assessment of candidates using freely definable inclusion and exclusion criteria. As a result, the overall time required for identifying eligible candidates is tremendously reduced whilst additional degrees of freedom for evaluating the relevance of individual candidates are introduced by our contribution.

Keywords: in-memory technology, clinical trials, screening, eligibility metric, data analysis, clustering

Procedia PDF Downloads 467
7923 Simulation and Experimental Study on Tensile Force Measurement of PS Tendons Using an Embedded EM Sensor

Authors: ByoungJoon Yu, Junkyeong Kim, Seunghee Park

Abstract:

The tensile force estimation PS tendons is in great demand on monitoring the structural health condition of PSC girder bridges. Measuring the tensile force of the PS tendons inside the PSC girder using conventional methods is hard due to its location. In this paper, an embedded EM sensor based tensile force estimation of PS tendon was carried out by measuring the permeability of the PS tendons in PSC girder. The permeability is changed due to the induced tensile force by the magneto-elastic effect and the effect then lead to the gradient change of the B-H curve. An experiment was performed to obtain the signals from the EM sensor using three down-scaled PSC girder models. The permeability of PS tendons was proportionally decreased according to the increase of the tensile forces. To verify the experiment results, a simulation of tensile force estimation will be conducted in further study. Consequently, it is expected that both the experiment results and the simulation results increase the accuracy of the tensile force estimation, and then it could be one of the solutions for evaluating the performance of PSC girder.

Keywords: tensile force estimation, embedded EM sensor, PSC girder, EM sensor simulation, cross section loss

Procedia PDF Downloads 449
7922 Improving Healthcare Readiness to Respond to Human Trafficking: A Case Study

Authors: Traci A. Hefner

Abstract:

Limited research exists on the readiness of emergency departments to respond to human trafficking (HT). The purpose of this qualitative case study was to improve the readiness of a Department of Emergency Medicine (ED), located in the southeast region of the United States, in identifying, assessing, and responding to trafficked individuals. The research objectives were to 1) provide an organizing framework to understand the ED’s readiness to respond to HT, using the Transtheoretical Model’s stages of change construct, 2) explain the readiness of the ED through a three-pronged contextual approach that included policies and procedures, patient data collection processes, and clinical practice methods, and 3) develop recommendations to respond to HT. Content analysis was used for document reviews and on-site observations, while thematic analysis identified themes of staff perceptions of the ED’s readiness in interviews of over 30 clinical and non-clinical healthcare professionals. Results demonstrated low levels of readiness to identify HT through the ED’s policies and procedures, data collection processes, and clinical practice methods. Clinical practice-related factors consisted of limited awareness of HT warning signs and low-levels of knowledge about community resources for possible HT referrals. Policy and practice recommendations to increase the ED’s readiness to respond to HT included: developing staff trainings across the ED system to enhance awareness of HT warning signs, incorporating HT into current policies and procedures for vulnerable patient populations as well as creating a HT protocol that addresses policies and procedures, screening tools, and community referrals.

Keywords: emergency medicine, human trafficking, organizational assessment, stages of change

Procedia PDF Downloads 125
7921 Qualitative Detection of HCV and GBV-C Co-infection in Cirrhotic Patients Using a SYBR Green Multiplex Real Time RT-PCR Technique

Authors: Shahzamani Kiana, Esmaeil Lashgarian Hamed, Merat Shahin

Abstract:

HCV and GBV-C belong to the Flaviviridae family of viruses and GBV-C is the closest virus to HCV genetically. Accumulative research is in progress all over the world to clarify clinical aspects of GBV-C. Possibility of interaction between HCV and GBV-C and also its consequence with other liver diseases are the most important clinical aspects which encourage researchers to develop a technique for simultaneous detection of these viruses. In this study a SYBR Green multiplex real time RT-PCR technique as a new economical and sensitive method was optimized for simultaneous detection of HCV/GBV-C in HCV positive plasma samples. After designing and selection of two pairs of specific primers for HCV and GBV-C, SYBR Green Real time RT-PCR technique optimization was performed separately for each virus. Establishment of multiplex PCR was the next step. Finally our technique was performed on positive and negative plasma samples. 89 cirrhotic HCV positive plasma samples (29 of genotype 3 a and 27 of genotype 1a) were collected from patients before receiving treatment. 14% of genotype 3a and 17.1% of genotype 1a showed HCV/GBV-C co-infection. As a result, 13.48% of 89 samples had HCV/GBV-C co-infection that was compatible with other results from all over the world. Data showed no apparent influence of HGV co-infection on the either clinical or virological aspect of HCV infection. Furthermore, with application of multiplex Real time RT-PCR technique, more time and cost could be saved in clinical-research settings.

Keywords: HCV, GBV-C, cirrhotic patients, multiplex real time RT- PCR

Procedia PDF Downloads 273
7920 The Use of Building Energy Simulation Software in Case Studies: A Literature Review

Authors: Arman Ameen, Mathias Cehlin

Abstract:

The use of Building Energy Simulation (BES) software has increased in the last two decades, parallel to the development of increased computing power and easy to use software applications. This type of software is primarily used to simulate the energy use and the indoor environment for a building. The rapid development of these types of software has raised their level of user-friendliness, better parameter input options and the increased possibility of analysis, both for a single building component or an entire building. This, in turn, has led to many researchers utilizing BES software in their research in various degrees. The aim of this paper is to carry out a literature review concerning the use of the BES software IDA Indoor Climate and Energy (IDA ICE) in the scientific community. The focus of this paper will be specifically the use of the software for whole building energy simulation, number and types of articles and publications dates, the area of application, types of parameters used, the location of the studied building, type of building, type of analysis and solution methodology. Another aspect that is examined, which is of great interest, is the method of validations regarding the simulation results. The results show that there is an upgoing trend in the use of IDA ICE and that researchers use the software in their research in various degrees depending on case and aim of their research. The satisfactory level of validation of the simulations carried out in these articles varies depending on the type of article and type of analysis.

Keywords: building simulation, IDA ICE, literature review, validation

Procedia PDF Downloads 114
7919 Checking Energy Efficiency by Simulation Tools: The Case of Algerian Ksourian Models

Authors: Khadidja Rahmani, Nahla Bouaziz

Abstract:

Algeria is known for its rich heritage. It owns an immense historical heritage with a universal reputation. Unfortunately, this wealth is withered because of abundance. This research focuses on the Ksourian model, which constitutes a large portion of this wealth. In fact, the Ksourian model is not just a witness to a great part of history or a vernacular culture, but also it includes a panoply of assets in terms of energetic efficiency. In this context, the purpose of our work is to evaluate the performance of the old techniques which are derived from the Ksourian model , and that using the simulation tools. The proposed method is decomposed in two steps; the first consists of isolate and reintroduce each device into a basic model, then run a simulation series on acquired models. And this in order to test the contribution of each of these dialectal processes. In another scale of development, the second step consists of aggregating all these processes in an aboriginal model, then we restart the simulation, to see what it will give this mosaic on the environmental and energetic plan .The model chosen for this study is one of the ksar units of Knadsa city of Bechar (Algeria). This study does not only show the ingenuity of our ancestors in their know-how, and their adapting power to the aridity of the climate, but also proves that their conceptions subscribe in the current concerns of energy efficiency, and respond to the requirements of sustainable development.

Keywords: dialectal processes, energy efficiency, evaluation, Ksourian model, simulation tools

Procedia PDF Downloads 173
7918 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai

Abstract:

Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.

Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis

Procedia PDF Downloads 119
7917 Composing Method of Decision-Making Function for Construction Management Using Active 4D/5D/6D Objects

Authors: Hyeon-Seung Kim, Sang-Mi Park, Sun-Ju Han, Leen-Seok Kang

Abstract:

As BIM (Building Information Modeling) application continually expands, the visual simulation techniques used for facility design and construction process information are becoming increasingly advanced and diverse. For building structures, BIM application is design - oriented to utilize 3D objects for conflict management, whereas for civil engineering structures, the usability of nD object - oriented construction stage simulation is important in construction management. Simulations of 5D and 6D objects, for which cost and resources are linked along with process simulation in 4D objects, are commonly used, but they do not provide a decision - making function for process management problems that occur on site because they mostly focus on the visual representation of current status for process information. In this study, an nD CAD system is constructed that facilitates an optimized schedule simulation that minimizes process conflict, a construction duration reduction simulation according to execution progress status, optimized process plan simulation according to project cost change by year, and optimized resource simulation for field resource mobilization capability. Through this system, the usability of conventional simple simulation objects is expanded to the usability of active simulation objects with which decision - making is possible. Furthermore, to close the gap between field process situations and planned 4D process objects, a technique is developed to facilitate a comparative simulation through the coordinated synchronization of an actual video object acquired by an on - site web camera and VR concept 4D object. This synchronization and simulation technique can also be applied to smartphone video objects captured in the field in order to increase the usability of the 4D object. Because yearly project costs change frequently for civil engineering construction, an annual process plan should be recomposed appropriately according to project cost decreases/increases compared with the plan. In the 5D CAD system provided in this study, an active 5D object utilization concept is introduced to perform a simulation in an optimized process planning state by finding a process optimized for the changed project cost without changing the construction duration through a technique such as genetic algorithm. Furthermore, in resource management, an active 6D object utilization function is introduced that can analyze and simulate an optimized process plan within a possible scope of moving resources by considering those resources that can be moved under a given field condition, instead of using a simple resource change simulation by schedule. The introduction of an active BIM function is expected to increase the field utilization of conventional nD objects.

Keywords: 4D, 5D, 6D, active BIM

Procedia PDF Downloads 253
7916 Numerical Simulation Using Lattice Boltzmann Technique for Mass Transfer Characteristics in Liquid Jet Ejector

Authors: K. S. Agrawal

Abstract:

The performance of jet ejector was studied in detail by different authors. Several authors have studied mass transfer characteristics like interfacial area, mass transfer coefficients etc. In this paper, we have made an attempt to develop PDE model by considering bubble properties and apply Lattice-Boltzmann technique for PDE model. We may present the results for the interfacial area which we have obtained from our numerical simulation. Later the results are compared with previous work.

Keywords: jet ejector, mass transfer characteristics, numerical simulation, Lattice-Boltzmann technique

Procedia PDF Downloads 340
7915 When and Why Unhappy People Avoid Enjoyable Experiences

Authors: Hao Shen, Aparna Labroo

Abstract:

Across four studies, we show people in a negative mood avoid anticipated enjoyable experiences because of the subjective difficulty in simulating those experiences, and they misattribute these feelings of difficulty to reduced pleasantness of the anticipated experience. We observe the avoidance of enjoyable experiences only for anticipated experiences that involve smile-like facial-muscular simulation. When the need for facial-muscular simulation is attenuated, or when the anticipated experience relies on facial-muscular simulation to a lesser extent, people in a negative mood no longer avoid enjoyable experiences, but rather seek such experiences because they fit better with their ongoing mood-repair goals.

Keywords: emotion regulation, mood repair, embodiment, anticipated experiences

Procedia PDF Downloads 398
7914 Artificial Intelligence in Disease Diagnosis

Authors: Shalini Tripathi, Pardeep Kumar

Abstract:

The method of translating observed symptoms into disease names is known as disease diagnosis. The ability to solve clinical problems in a complex manner is critical to a doctor's effectiveness in providing health care. The accuracy of his or her expertise is crucial to the survival and well-being of his or her patients. Artificial Intelligence (AI) has a huge economic influence depending on how well it is applied. In the medical sector, human brain-simulated intellect can help not only with classification accuracy, but also with reducing diagnostic time, cost and pain associated with pathologies tests. In light of AI's present and prospective applications in the biomedical, we will identify them in the paper based on potential benefits and risks, social and ethical consequences and issues that might be contentious but have not been thoroughly discussed in publications and literature. Current apps, personal tracking tools, genetic tests and editing programmes, customizable models, web environments, virtual reality (VR) technologies and surgical robotics will all be investigated in this study. While AI holds a lot of potential in medical diagnostics, it is still a very new method, and many clinicians are uncertain about its reliability, specificity and how it can be integrated into clinical practice without jeopardising clinical expertise. To validate their effectiveness, more systemic refinement of these implementations, as well as training of physicians and healthcare facilities on how to effectively incorporate these strategies into clinical practice, will be needed.

Keywords: Artificial Intelligence, medical diagnosis, virtual reality, healthcare ethical implications 

Procedia PDF Downloads 111
7913 Methods for Business Process Simulation Based on Petri Nets

Authors: K. Shoylekova, K. Grigorova

Abstract:

The Petri nets are the first standard for business process modeling. Most probably, it is one of the core reasons why all new standards created afterwards have to be so reformed as to reach the stage of mapping the new standard onto Petri nets. The paper presents a Business process repository based on a universal database. The repository provides the possibility the data about a given process to be stored in three different ways. Business process repository is developed with regard to the reformation of a given model to a Petri net in order to be easily simulated two different techniques for business process simulation based on Petri nets - Yasper and Woflan are discussed. Their advantages and drawbacks are outlined. The way of simulating business process models, stored in the Business process repository is shown.

Keywords: business process repository, petri nets, simulation, Woflan, Yasper

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7912 Using a Simulated Learning Environment to Teach Pre-Service Special Educators Behavior Management

Authors: Roberta Gentry

Abstract:

A mixed methods study that examined candidate’s perceptions of the use of computerized simulation as an effective tool to learn classroom management will be presented. The development, implementation, and assessment of the simulation and candidate data on the feasibility of the approach in comparison to other methods will be presented.

Keywords: behavior management, simulations, teacher preparation, teacher education

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7911 Early Detection of Neuropathy in Leprosy-Comparing Clinical Tests with Nerve Conduction Study

Authors: Suchana Marahatta, Sabina Bhattarai, Bishnu Hari Paudel, Dilip Thakur

Abstract:

Background: Every year thousands of patients develop nerve damage and disabilities as a result of leprosy which can be prevented by early detection and treatment. So, early detection and treatment of nerve function impairment is of paramount importance in leprosy. Objectives: To assess the electrophysiological pattern of the peripheral nerves in leprosy patients and to compare it with clinical assessment tools. Materials and Methods: In this comparative cross-sectional study, 74 newly diagnosed leprosy patients without reaction were enrolled. They underwent thorough evaluation for peripheral nerve function impairment using clinical tests [i.e. nerve palpation (NP), monofilament (MF) testing, voluntary muscle testing (VMT)] and nerve conduction study (NCS). Clinical findings were compared with that of NCS using SPSS version 11.5. Results: NCS was impaired in 43.24% of leprosy patient at the baseline. Among them, sensory NCS was impaired in more patients (32.4%) in comparison to motor NCS (20.3%). NP, MF, and VMT were impaired in 58.1%, 25.7%, and 9.4% of the patients, respectively. Maximum concordance of monofilament testing and sensory NCS was found for sural nerve (14.7%). Likewise, the concordance of motor NP and motor NCS was the maximum for ulnar nerve (14.9%). When individual parameters of the NCS were considered, amplitude was found to be the most frequently affected parameter for both sensory and motor NCS. It was impaired in 100% of cases with abnormal NCS findings. Conclusion: Since there was no acceptable concordance between NCS findings and clinical findings, we should consider NCS whenever feasible for early detection of neuropathy in leprosy. The amplitude of both sensory nerve action potential (SNAP) and compound nerve action potential (CAMP) could be important determinants of the abnormal NCS if supported by further studies.

Keywords: leprosy, nerve function impairment, neuropathy, nerve conduction study

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7910 Utilization of Standard Paediatric Observation Chart to Evaluate Infants under Six Months Presenting with Non-Specific Complaints

Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

Abstract:

Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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7909 Investigation of Biofilm Formation in Clinical Strains of Klebsiella pneumoniae and Klebsiella rhinoscleromatis

Authors: Gulcan Sahal, Nermin Hande Avcioglu, Isil Seyis Bilkay

Abstract:

Klebsiella species which are natural colonizers of human upper respiratory and human gastrointestinal tracts are also responsible for every reoccurring nosocomial infections by means of having ability to form slimy layers known as biofilm on many surfaces. Therefore, in this study, investigation of biofilm formation in K. pneumoniae and K. rhinoscleromatis and examination of each Klebsiella strains’ clinical information in the light of their biofilm formation results were aimed. In this respect, biofilm formation of Klebsiella strains was analyzed via crystal violet binding assay. According to our results, biofilm formation levels of K. pneumoniae and K. rhinoscleromatis strains were different from each other. Additionally, in comparison to K. rhinoscleromatis strains, K. pneumoniae was observed to include higher amounts of strong biofilm forming strains. Besides, it was also seen that clinical information of patients from which strong biofilm forming Klebsiella strains were isolated were similar to each other. Our results indicate that there should be more precautions against K. pneumoniae which includes higher amount of strong biofilm forming strains.

Keywords: biofilm formation, Klebsiella pneumoniae, Klebsiella rhinoscleromatis, biosystems engineering

Procedia PDF Downloads 368