Search results for: patient monitoring

Authors: Sana Tahir, Haya Fatimah

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Sexuality is a social construct which is considered as the most confidential affair among individuals where women tend to refrain themselves more from sexually explicit behavior than men. Patriarchy has an elevated influence on the expression of female sexuality. While women’s sexual experiences are suppressed men are entitled to pleasure themselves according to their desire. The purpose of this study is to explore how the internalization of patriarchy affects women’s sexuality. Similarly, it was investigated how women sexuality is associated with psychological distress. The sample consisted of 100(age 20-40) married women. Participants were selected through a combination of convenient and snowball sampling. Women were asked to provide data regarding patriarchal beliefs, sexual awareness and DAS (depression, anxiety, and stress). Pearson Product Moment Correlation Analyze was conducted to examine the nature of the relationship between patriarchal beliefs, sexual awareness and psychological distress in married women. There is a significant negative relation between sexual awareness and patriarchal beliefs (r=-.391, p<.001). There also lies a significant negative relation between sexual awareness and depression, anxiety, stress (r=-.359, p<.001) (r=.301, p=.002) (r=-.221, p=.027). The results reveal that women with strong patriarchal beliefs have less sexual awareness in terms of sexual consciousness, sexual monitoring, sexual assertiveness and sexual appeal consciousness. Similarly, women with strong patriarchal beliefs and less sexual awareness have high levels of depression, anxiety, and stress.

Keywords: female sexuality, patriarchy, psychological distress, sexual awareness

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Authors: Dong-Hyun Kim, Wan-Ho Chung, Hak-Sung Kim

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In this work, non-destructive evaluation was conducted to measure the sheet resistance of silver nanowire coated film and find a damage of that film using terahertz (THz) wave. Pulse type THz instrument was used, and the measurement was performed under transmission and pitch-catch reflection modes with 30 degree of incidence angle. In the transmission mode, the intensity of the THz wave was gradually increased as the conductivity decreased. Meanwhile, the intensity of THz wave was decreased as the conductivity decreased in the pitch-catch reflection mode. To confirm the conductivity of the film, sheet resistance was measured by 4-point probe station. Interaction formula was drawn from a relation between the intensity and the sheet resistance. Through substituting sheet resistance to the formula and comparing the resultant value with measured maximum THz wave intensity, measurement of sheet resistance using THz wave was more suitable than that using 4-point probe station. In addition, the damage on the silver nanowire coated film was detected by applying the THz image system. Therefore, the reliability of the entire film can be also be ensured. In conclusion, real-time monitoring using the THz wave can be applied in the transparent electrodes with detecting the damaged area as well as measuring the sheet resistance.

Keywords: terahertz wave, sheet resistance, non-destructive evaluation, silver nanowire

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Authors: Sawan Kumar Jangid

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The paper attempts to study various facets of urbanization and regional planning in the framework of the present conditions and future needs. Urbanization is a dynamic system in which development and changes are prominent features; which implies population growth and changes in the primary, secondary and tertiary sector in the economy. Urban population is increasing day by day due to a natural increase in population and migration from rural areas, and the impact is bound to have in urban areas in terms of infrastructure, environment, water supply and other vital resources. For the organized way of planning and monitoring the implementation of Physical urban and regional plans high-resolution satellite imagery is the potential solution. Now the Remote Sensing data is widely used in urban as well as regional planning, infrastructure planning mainly telecommunication and transport network planning, highway development, accessibility to market area development in terms of catchment and population built-up area density. With Remote Sensing it is possible to identify urban growth, which falls outside the formal planning control. Remote Sensing and GIS technique combined together facilitate the planners, in making a decision, for general public and investors to have relevant data for their use in minimum time. This paper sketches out the Urbanization modal for the future development of Urban and Regional Planning. The paper suggests, a dynamic approach towards regional development strategy.

Keywords: development, dynamic, migration, resolution

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Authors: Kemka C. Ihemelandu, Chukwuemeka U. Ihemelandu

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The incidence of melanoma has been increasing rapidly over the past two decades, making melanoma a current public health crisis. Unfortunately, even as screening efforts continue to expand in an effort to ameliorate the death rate from melanoma, there is a need to improve diagnostic accuracy to decrease misdiagnosis. Artificial intelligence (AI) a new frontier in patient care has the ability to improve the accuracy of melanoma diagnosis. Convolutional neural network (CNN) a form of deep neural network, most commonly applied to analyze visual imagery, has been shown to outperform the human brain in pattern recognition. However, there are noted limitations with the accuracy of the CNN models. Our aim in this study was the optimization of convolutional neural network algorithms for the automated diagnosis of melanoma. We hypothesized that Optimal selection of the momentum and batch hyperparameter increases model accuracy. Our most successful model developed during this study, showed that optimal selection of momentum of 0.25, batch size of 2, led to a superior performance and a faster model training time, with an accuracy of ~ 83% after nine hours of training. We did notice a lack of diversity in the dataset used, with a noted class imbalance favoring lighter vs. darker skin tone. Training set image transformations did not result in a superior model performance in our study.

Keywords: melanoma, convolutional neural network, momentum, batch hyperparameter

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Authors: Abdullah Tahir

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The omission of regular medications in surgical patients poses a significant challenge in healthcare settings and is associated with increased morbidity during hospital stays. Human factors such as high workload, poor communication, and emotional stress are known to contribute to these omissions, particularly evident in the surgical assessment unit (SAU) due to its high patient burden and long wait times. This study aimed to quantify and address the issue by implementing targeted interventions to enhance compliance in prescribing regular medications for surgical patients at Stoke Mandeville Hospital, United Kingdom. Data were collected on 14 spontaneous days between April and May 2023, and the frequency of prescription omissions was recorded using a tally chart. Subsequently, informative posters were introduced in the SAU, and presentations were given to the surgical team to emphasize the importance of compliance in this area. The interventions were assessed using a second data collection cycle, again over 14 spontaneous days in May 2023. Results demonstrated an improvement from 40% (60 out of 150) to 74% (93 out of 126) of patients having regular medications prescribed at the point of clerking. These findings highlight the efficacy of frequent prompts and awareness-raising interventions in increasing workforce compliance and addressing the issue of prescription omissions in the SAU.

Keywords: prescription omissions, quality improvement, regular medication, surgical assessment unit

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Authors: Auwal Mustapha Imam

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The aim of the energy management system is to monitor and control utilization, access, optimize and manage energy availability. This can be realized through real-time analyses and energy sources and loads data control in a predictive way. Smart-home monitoring and control provide convenience and cost savings by controlling appliances, lights, thermostats and other loads. There may be different categories of loads in the various homes, and the homeowner may wish to control access to solar-generated energy to protect the storage from draining completely. Controlling the power system operation by managing the converter output power and controlling how it feeds the appliances will satisfy the residential load demand. The Internet of Things (IoT) provides an attractive technological platform to connect the two and make home automation and domestic energy utilization easier and more attractive. This paper presents the use of IoT-based control topology to monitor and control power distribution and consumption by DC loads connected to single-input multiple outputs (SIMO) DC-DC converter, thereby reducing leakages, enhancing performance and reducing human efforts. A SIMO converter was first developed and integrated with the IoT/Raspberry Pi control topology, which enables the user to monitor and control power scheduling and load forecasting via an Android app.

Keywords: flyback, converter, DC-DC, photovoltaic, SIMO

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Authors: Mina Beheshti, Vida Shams, Mojtaba Esfandiari, Farzaneh Abdollahi, Abdolreza Ohadi

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Most of the people who survive a stroke need rehabilitation tools to regain their mobility. The core function of these devices is a brake actuator. The goal of this study is to design and control a magnetorheological brake which can be used as a rehabilitation tool. In fact, the fluid used in this brake is called magnetorheological fluid or MR that properties can change by variation of the magnetic field. The braking properties can be set as control by using this feature of the fluid. In this research, different MR brake designs are first introduced in each design, and the dimensions of the brake have been determined based on the required torque for foot movement. To calculate the brake dimensions, it is assumed that the shear stress distribution in the fluid is uniform and the fluid is in its saturated state. After designing the rehabilitation brake, the mathematical model of the healthy movement of a healthy person is extracted. Due to the nonlinear nature of the system and its variability, various adaptive controllers, neural networks, and robust have been implemented to estimate the parameters and control the system. After calculating torque and control current, the best type of controller in terms of error and control current has been selected. Finally, this controller is implemented on the experimental data of the patient's movements, and the control current is calculated to achieve the desired torque and motion.

Keywords: rehabilitation, magnetorheological fluid, knee, brake, adaptive control, robust control, neural network control, torque control

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Authors: Loretta Ichim, Dan Popescu, Grigore Stamatescu

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The paper reports the collaboration between a top university from Romania and three companies for the implementation of a research project in a multidisciplinary domain, focusing on the impact and benefits both for the education and industry. The joint activities were developed under the Space Technology and Advanced Research Program (STAR), funded by the Romanian Space Agency (ROSA) for a university-industry partnership. The context was defined by linking the European Space Agency optional programs, with the development and promotion national research, with the educational and industrial capabilities in the aeronautics, security and related areas by increasing the collaboration between academic and industrial entities as well as by realizing high-level scientific production. The project name is Multisensory Robotic System for Aerial Monitoring of Critical Infrastructure Systems (MUROS), which was carried 2013-2016. The project included the University POLITEHNICA of Bucharest (coordinator) and three companies, which manufacture and market unmanned aerial systems. The project had as main objective the development of an integrated system for combined ground wireless sensor networks and UAV monitoring in various application scenarios for critical infrastructure surveillance. This included specific activities related to fundamental and applied research, technology transfer, prototype implementation and result dissemination. The core area of the contributions laid in distributed data processing and communication mechanisms, advanced image processing and embedded system development. Special focus is given by the paper to analyzing the impact the project implementation in the educational process, directly or indirectly, through the faculty members (professors and students) involved in the research team. Three main directions are discussed: a) enabling students to carry out internships at the partner companies, b) handling advanced topics and industry requirements at the master's level, c) experiments and concept validation for doctoral thesis. The impact of the research work (as the educational component) developed by the faculty members on the increasing performances of the companies’ products is highlighted. The collaboration between university and companies was well balanced both for contributions and results. The paper also presents the outcomes of the project which reveals the efficient collaboration between high education and industry: master thesis, doctoral thesis, conference papers, journal papers, technical documentation for technology transfer, prototype, and patent. The experience can provide useful practices of blending research and education within an academia-industry cooperation framework while the lessons learned represent a starting point in debating the new role of advanced research and development performing companies in association with higher education. This partnership, promoted at UE level, has a broad impact beyond the constrained scope of a single project and can develop into long-lasting collaboration while benefiting all stakeholders: students, universities and the surrounding knowledge-based economic and industrial ecosystem. Due to the exchange of experiences between the university (UPB) and the manufacturing company (AFT Design), a new project, SIMUL, under the Bridge Grant Program (Romanian executive agency UEFISCDI) was started (2016 – 2017). This project will continue the educational research for innovation on master and doctoral studies in MUROS thematic (collaborative multi-UAV application for flood detection).

Keywords: education process, multisensory robotic system, research and innovation project, technology transfer, university-industry partnership

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Authors: Saad Khalid Niaz, Arif Mahmood Siddiqui, Afzal Haqi

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Background: Estimated prevalence of Hepatitis C in Pakistan is 5% of which 78 % are Genotype 3, in which Response to conventional interferon is reported to be 70%. Objective: To determine the efficacy of pegylated interferon 20 kDa (Unipeg) plus ribavirin (Ribazole) in HCV genotype 3 patients who relapsed to conventional interferon. Methods: This is an ongoing study of 20 enrolled patients. Pegylated interferon alfa-2a 20 kDa 180 mcg weekly with ribavirin, were administered for a period of 24 weeks. Virological Responses were measured by Qualitative HCV RNA at weeks 4, 12, 24 and 48 to determine Rapid Virological Response (RVR), Early Virological Response (EVR), End of Treatment (ETR) and Sustained Virological Response (SVR), respectively. EVR was done for those who didn’t achieve RVR. Results: Males were 12 (60%) and mean age was 38.5 ±7.62 years. Out of 20 recruited patients, all completed 4 weeks therapy; RVR was achieved in 8 (40%) patients. One patient was lost to follow up and one yet to visit at 12 weeks. From 10 patients, 8 (80%) patients achieved EVR. Out of intent-to-treat patients, 15 completed 24 weeks therapy, ETR was achieved in 14 (93%) patients and 9 patients completed post therapy follow-up, of which, 8 (89%) patients achieved SVR. Conclusion: Our interim data demonstrates that Pegylated Interferon alfa-2a 20 kDa 180 mcg (Unipeg) in combination with Ribavirin (Ribazole) has shown promising results in treating HCV Genotype 3 patients who relapsed to conventional interferon. We recommend use of Pegylated Interferon in Relapsers with Genotype 3 when financial constraints limit the use of oral antivirals.

Keywords: pegylated interferon (unipeg), hepatitis c, relapsers, Pakistan

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Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan

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Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).

Keywords: cardiopulmonary disease, bipolar disorder, SJS, therapy

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Authors: T. L. Granzyk, S. Scarborough, J. DeCosmo

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The use of health-related or medical narratives has gained increasing anecdotal and research-based support as a successful device for changing health behavior and outcomes. These narratives, in the form of oral storytelling, short films, and educational documentaries, for example, are most effective when including empathetic characters that transport viewers into the story and command both their attention and emotional response. This case study outlines how and why one large health system created a short narrative film for their internal Sepsis Awareness campaign, which told the dramatic story of a patient recovering from a missed sepsis diagnosis, leaving her a quad-amputee. Results include positive global anecdotal response to the film from healthcare professionals and patients, as well as use of the film to support legislation, ultimately passed in favor of the formation of Sepsis Awareness Workgroups in Maryland. Authors conclude that narrative films can be used successfully to initiate healthcare legislation and to increase internal and external awareness of health-related areas in need of greater improvement and support. As such, healthcare leaders and stakeholders would benefit from learning how to intentionally create, cultivate, and curate narratives from within their own health systems that elicit an empathetic response.

Keywords: healthcare policy, healthcare narratives, sepsis awareness, short films

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Authors: M. Saifudin Ahmed Atique, Santosh Paudyal, Caixia Yang

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In an aircraft, a great portion of energy is wasted due to its inflight structural vibration. Structural components vibrate due to aeroelastic instabilities, gust perturbations and engine rotation at very high rpm. Energy losses due to mechanical vibration can be utilized by harvesting energy from aircraft structure as electrical energy. This harvested energy can be stored in battery panels built into aircraft fuselage and can be used to power inflight auxiliary accessories i.e., lighting and entertainment systems. Moreover, this power can be used for wireless Structural Health Monitoring System (SHM) for aircraft and as an excellent replacement of aircraft Ground Power Unit (GPU)/Auxiliary Power Unit (APU) during passenger onboard time to power aircraft cabin accessories to reduce aircraft ground operation cost significantly. In this paper, we propose the design of a noble aircraft wing in which Piezoelectric panels placed under the composite skin of aircraft wing will generate electrical charges from any inflight aerodynamics or mechanical vibration and store it into battery to power auxiliary inflight systems/accessories as per requirement. Experimental results show that a well-engineered piezoelectric energy harvester based aircraft wing can produce adequate energy to support in-flight lighting and auxiliary cabin accessories.

Keywords: vibration energy, aircraft wing, piezoelectric material, inflight accessories

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Authors: Ananya Pappu, Sneha Mishra

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Introduction: The South Asian population experiences unique health challenges that predisposes this demographic to cardiometabolic diseases at lower BMIs. South Asians may therefore benefit from recommendations specific to their cultural needs. Here, we focus on current BMI guidelines for Asians with a discussion of South Asian dietary practices and culturally tailored interventions. By integrating traditional dietary practices with modern nutritional recommendations, this manuscript aims to highlight effective strategies to improving health outcomes among South Asians. Background: The South Asian community, including individuals from India, Pakistan, Bangladesh, and Sri Lanka, experiences high rates of cardiovascular diseases, cancers, diabetes, and strokes. Notably, the prevalence of diabetes and cardiovascular disease among Asians is elevated at BMIs below the WHO's standard overweight threshold. As it stands, a BMI of 25-30 kg/m² is considered overweight in non-Asians, while this cutoff is reduced to 23-27.4 kg/m² in Asians. This discrepancy can be attributed to studies which have shown different associations between BMI and health risks in Asians compared to other populations. Given these significant challenges, optimizing lifestyle management for cardiometabolic risk factors is crucial. Tailored interventions that consider cultural context seem to be the best approach for ensuring the success of both dietary and physical activity interventions in South Asian patients. Adopting a whole food, plant-based diet (WFPD) is one such strategy. The WFPD suggests that half of one meal should consist of non-starchy vegetables. In the South Asian diet, this includes traditional vegetables such as okra, tindora, eggplant, and leafy greens including amaranth, collards, chard, and mustards. A quarter of the meal should include plant-based protein sources like cooked beans, lentils, and paneer, with the remaining quarter comprising healthy grains or starches such as whole wheat breads, millets, tapioca, and barley. Adherence to the WFPD has been shown to improve cardiometabolic risk factors including weight, BMI, total cholesterol, HbA1c, and reduces the risk of developing non-alcoholic fatty liver disease (NAFLD). Another approach to improving dietary habits is timing meals. Many of the major cultures and religions in the Indian subcontinent incorporate religious fasting. Time-restricted eating (TRE), also known as intermittent fasting, is a practice akin to traditional fasting, which involves consuming all daily calories within a specific window. TRE has been shown to improve insulin resistance in prediabetic and diabetic patients. Common regimens include completing all meals within an 8-hour window, consuming a low-calorie diet every other day, and the 5:2 diet, which involves fasting twice weekly. These fasting practices align with the natural circadian rhythm, potentially enhancing metabolic health and reducing obesity and diabetes risks. Conclusion: South Asians develop cardiometabolic disease at lower BMIs; hence, it is important to counsel patients about lifestyle interventions that decrease their risk. Traditional South Asian diets can be made more nutrient-rich by incorporating vegetables, plant proteins like lentils and beans, and substituting refined grains for whole grains. Ultimately, the best diet is one to which a patient can adhere. It is therefore important to find a regimen that aligns with a patient’s cultural and traditional food practices.

Keywords: BMI, diet, obesity, South Asian, time-restricted eating

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Authors: Palash Dey, Sudip Talukdar

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In this work, a cross-breed approach is presented for obtaining both the amount of the damage intensity and location of damage existing in thin-walled members. This cross-breed approach is developed based on response surface methodology (RSM) and genetic algorithm (GA). Theoretical finite element (FE) model of cracked angle section thin walled curved beam has been linked to the developed approach to carry out trial experiments to generate response surface functions (RSFs) of free, forced and heterogeneous dynamic response data. Subsequently, the error between the computed response surface functions and measured dynamic response data has been minimized using GA to find out the optimum damage parameters (amount of the damage intensity and location). A single crack of varying location and depth has been considered in this study. The presented approach has been found to reveal good accuracy in prediction of crack parameters and possess great potential in crack detection as it requires only the current response of a cracked beam.

Keywords: damage parameters, finite element, genetic algorithm, response surface methodology, thin walled curved beam

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Authors: Andrii Shalaginov, Katrin Franke, Xiongwei Huang

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One of the leading problems in Cyber Security today is the emergence of targeted attacks conducted by adversaries with access to sophisticated tools. These attacks usually steal senior level employee system privileges, in order to gain unauthorized access to confidential knowledge and valuable intellectual property. Malware used for initial compromise of the systems are sophisticated and may target zero-day vulnerabilities. In this work we utilize common behaviour of malware called ”beacon”, which implies that infected hosts communicate to Command and Control servers at regular intervals that have relatively small time variations. By analysing such beacon activity through passive network monitoring, it is possible to detect potential malware infections. So, we focus on time gaps as indicators of possible C2 activity in targeted enterprise networks. We represent DNS log files as a graph, whose vertices are destination domains and edges are timestamps. Then by using four periodicity detection algorithms for each pair of internal-external communications, we check timestamp sequences to identify the beacon activities. Finally, based on the graph structure, we infer the existence of other infected hosts and malicious domains enrolled in the attack activities.

Keywords: malware detection, network security, targeted attack, computational intelligence

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Authors: Z. Ezzouine, A. Nakheli

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This paper presents a high position electromagnetic sensor system (HPESS) that is applicable for moving object detection. The authors have developed a high-performance position sensor prototype dedicated to students’ laboratory. The challenge was to obtain a highly accurate and real-time sensor that is able to calculate position, length or displacement. An electromagnetic solution based on a two coil induction principal was adopted. The HPESS converts mechanical motion to electric energy with direct contact. The output signal can then be fed to an electronic circuit. The voltage output change from the sensor is captured by data acquisition system using LabVIEW software. The displacement of the moving object is determined. The measured data are transmitted to a PC in real-time via a DAQ (NI USB -6281). This paper also describes the data acquisition analysis and the conditioning card developed specially for sensor signal monitoring. The data is then recorded and viewed using a user interface written using National Instrument LabVIEW software. On-line displays of time and voltage of the sensor signal provide a user-friendly data acquisition interface. The sensor provides an uncomplicated, accurate, reliable, inexpensive transducer for highly sophisticated control systems.

Keywords: electromagnetic sensor, accurately, data acquisition, position measurement

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Authors: Mugabe Nzarama Gabriel

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In Rwanda, many healthcare organizations are still using a paper based patients’ data record system although it still present weaknesses to share health patients’ information across different services when necessary. In developed countries, the EHR has been put in place to revolutionize the paper based record system but still the EHR has some challenges related to privacy, security, or interoperability. The purpose of this research was to assess the existing patients’ data record system in healthcare sector in Rwanda, see what an EHR can improve to the system in place and assess the acceptance of EHR as system which is interoperable, very secure and interoperable and see whether stakeholders are ready to adopt the system. The case based methodology was used and TAM theoretical framework to design the questionnaire for the survey. A judgmental sample across two cases, CHUB and Hopital de Nemba, has been selected and SPSS has been used for descriptive statistics. After a qualitative analysis, the findings showed that the paper based record is useful, gives complete information about the patient, protects the privacy of patients but it is still less secure and less interoperable. The respondents shown that they are ready to use the proposed EHR System and want it secure, capable of enforcing the privacy but still they are not all ready for the interoperability. A conclusion has been formulated; recommendations and further research have been proposed.

Keywords: EHR system, healthcare service, TAM, privacy, interoperability

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Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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Authors: Ria M. Caramoan, Analiza P. Rollon, Karl N. Vergel

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The Simple Interactive Models for Better Air Quality (SIM-air) is an integrated approach model that allows the available information to support the integrated urban air quality management. This study utilized the vehicular air pollution information system module of SIM-air for the assessment of vehicular emissions in Commonwealth Avenue, Quezon City, Philippines. The main objective of the study is to assess and predict the contribution of different types of vehicles to the vehicular emissions in terms of PM₁₀, SOₓ, and NOₓ at different policy and technology scenarios. For the base year 2017, the results show vehicular emissions of 735.46 tons of PM₁₀, 108.90 tons of SOₓ, and 2,101.11 tons of NOₓ. Motorcycle is the major source of particulates contributing about 52% of the PM₁₀ emissions. Meanwhile, Public Utility Jeepneys contribute 27% of SOₓ emissions and private cars using gasoline contribute 39% of NOₓ emissions. Ambient air quality monitoring was also conducted in the study area for the standard parameters of PM₁₀, S0₂, and NO₂. Results show an average of 88.11 µg/Ncm, 47.41 µg/Ncm and 22.54 µg/Ncm for PM₁₀, N0₂, and SO₂, respectively, all were within the DENR National Ambient Air Quality Guideline Values. Future emissions of PM₁₀, NOₓ, and SOₓ are estimated at different scenarios. Results show that in the year 2030, PM₁₀ emissions will be increased by 186.2%. NOₓ emissions and SOₓ emissions will also be increased by 38.9% and 5.5%, without the implementation of the scenarios.

Keywords: ambient air quality, emissions inventory, mobile air pollution, vehicular emissions

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Authors: S. Benessam, T. H. Debieche, S. Amiour, A. Chine, S. Khelili

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Iron is naturally present in groundwater, it comes from the dissolution of the geological formations (clay, schist, mica-schist, gneiss…). Its chemical form and mobility in water are controlled mainly by two physicochemical parameters (Eh and pH). In order to determine its spatiotemporal evolution in groundwater, a two-monthly monitoring of the physicochemical parameters and major elements in the water of the alluvial sheet of Nil river (North-eastern Algerian) was carried out during the period from November 2013 to January 2015. The results show that iron is present in weak concentrations in the upstream part of the alluvial sheet and with raised concentrations, which can exceed the standard of potable drinking water (0.2 mg/L), in the central and downstream parts of the alluvial sheet. This variation of the concentrations is related to the important variation of Eh between the upstream part (200 mV) where the aquiver is unconfined (oxidizing medium) and the central and downstream parts (-100 mV) where the aquifer is confined (reducing medium). Iron in the oxidizing part is presented with the complexes form, where it precipitates or/and adsorbed by the geological formations. On the other hand in the reducing parts, it is released in water. In this study, one will discuss also the mobility and the chemical forms of iron according to the rains and pumping.

Keywords: groundwater, iron, mobility, speciation

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Authors: Tayyaba Hussain, Sobia Jangsher, Saqib Ali, Saqib Ejaz

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Unmanned Aerial vehicles (UAV’s) have gained great popularity due to their remoteness, ease of deployment and high maneuverability in different applications like real-time surveillance, image capturing, weather atmospheric studies, disaster site monitoring and mapping. These applications can involve a real-time communication with the ground station. However, altitude and mobility possess a few challenges for the communication. UAV’s at high altitude usually require more transmit power. One possible solution can be with the use of multi hops (UAV’s acting as relays) and exploiting the mobility pattern of the UAV’s. In this paper, we studied a relay (UAV’s acting as relays) selection for a reliable transmission to a destination UAV. We exploit the mobility information of the UAV’s to propose a Mobility-Aware Relay Selection (MARS) algorithm with the objective of giving improved data rates. The results are compared with Non Mobility-Aware relay selection scheme and optimal values. Numerical results show that our proposed MARS algorithm gives 6% better achievable data rates for the mobile UAV’s as compared with Non MobilityAware relay selection scheme. On average a decrease of 20.2% in data rate is achieved with MARS as compared with SDP solver in Yalmip.

Keywords: mobility aware, relay selection, time division multiple acess, unmanned aerial vehicle

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Authors: Khaliun Nyambayar, Nomindari Azzaya, Batkhuyag Purevjav

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Pharmacovigilance was officially introduced in Mongolia in 2003, in accordance with the Health Minister Order 183 for the registry of adverse drug reactions (ADR), approved in 2006 and was reviewed in 2010. This study was designed to evaluate the incidence and common types of adverse drug reactions among hospitalized children, the frequency of adverse drug reaction reported by health care providers, and the follow-up processes resulting from adverse drug reactions. A retrospective study of paediatric patients who experienced an adverse drug reaction from 2015 to 2019, extracted from the “yellow” card at the State Research Center for Maternal and Child Health, (city). A total of 417 adverse drug reactions were reported with an overall incidence was 80 (21.5%). Adverse reactions resulting from the use of antibiotics (particularly gentamycin, cephalosporins, and vancomycin) were usually mild. ADR’s were reported by physicians and nurses (93.8%), pharmacists (6.25%). Although documentation of physician notification occurred for 93% of adverse drug reactions, only 29% of cases were documented in the patient's medical chart, 13% included follow-up education for individuals involved, and 10% were updated in the allergy profile of the hospital computer system. Measures to improve the detection and reporting of adverse drug reactions by all health care professionals should be improved, to enhance our understanding of the nature and impact of these reactions in children.

Keywords: adverse drug reaction, pediatric, yellow card, Mongolia

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Authors: Laila Ozola, Evita Straumite

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Celiac disease is a permanent enteropathy caused by the ingestion of gluten, a protein occurring in wheat, rye and barley. The only way of the effective daily treatment is a strict gluten-free diet. From the investigation of products available in the local market, it was found that Latvian producers do not offer gluten-free products. The aim of this research was to study and analyze changes of celiac patient’s attitude to gluten-free product quality and availability in the Latvian market and purchasing habits. The survey was designed using website www.visidati.lv, and a questionnaire was sent to people suffering from celiac disease. The first time the respondents were asked to fill in the questionnaire in 2011, but now repeatedly from the beginning of September 2013 till the end of January 2014. The questionnaire was performed with 75 celiac patients, respondents were from all Latvian regions and they answered 16 questions. One of the most important questions was aimed to find out consumers’ opinion about quality of gluten-free products, consumption patterns of gluten-free products, and, moreover, their interest in products made in Latvia. Respondents were asked to name gluten-free products they mainly buy and give specific purchase locations, evaluate the quality of products and necessity for products produced in Latvia. The results of questionnaire show that the consumers are satisfied with the quality of gluten-free flour, flour blends, sweets and pasta, but are not satisfied with the quality of bread and confectionery available in the Latvian markets.

Keywords: consumers, gluten-free products, quality, survey

Procedia PDF Downloads 279

Authors: Avram Irina, Coiciu Eugenia-Mihaela, Popovici Mara-Georgiana, Mitu Iani Octavian

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ELI-NP stands as a cutting-edge facility globally, hosting unique radiological setups. It conducts experiments leveraging high-power lasers capable of producing extremely brief 10 PW pulses on two fronts. Moreover, it houses an exceptional gamma beam system with distinctive spectral characteristics. The facility hosts various experiments across designated experimental areas, encompassing ultra-short high-power laser tests, high-intensity gamma beam trials, and combined experiments utilizing both setups. The facility hosts a dosimetry laboratory, which recently obtained accreditation, where the radiation safety group employs a host of different types of detectors for monitoring the personnel, environment, and public exposure to ionizing radiation generated in experiments performed. ELI-NP's design was shaped by radiological protection assessments conducted through Monte Carlo simulations. The poster exemplifies an assessment conducted using the FLUKA code in an experimental area where a high-power laser system is implemented, and the future diagnostic system for variable energy gamma beams will soon be operational.

Keywords: radiation protection, Monte Carlo simulation, FLUKA, dosimetry

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Authors: Magda Olesiuk-Okomska

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The degree of international interdependence has grown significantly. Poland is a party to nearly 1000 binding multilateral treaties, including international legal instruments devoted to criminal matters and obliging the state to penalize certain crimes. The paper presents results of a theoretical research conducted as a part of doctoral research. The main hypothesis assumed that there was a separate category of crimes to penalization of which Poland was obliged under international legal instruments; that a catalogue of such crimes and a catalogue of international legal instruments providing for Poland’s international obligations had never been compiled in the domestic doctrine, thus there was no mechanism for monitoring implementation of such obligations. In the course of the research, a definition of transnational crimes was discussed and confronted with notions of international crimes, treaty crimes, as well as cross-border crimes. A list of transnational crimes penalized in the Polish Penal Code as well as in non-code criminal law regulations was compiled; international legal instruments, obliging Poland to criminalize and penalize specific conduct, were enumerated and catalogued. It enabled the determination whether Poland’s international obligations were implemented in domestic legislation, as well as the formulation of de lege lata and de lege ferenda postulates. Implemented research methods included inter alia a dogmatic and legal method, an analytical method and desk research.

Keywords: international criminal law, transnational crimes, transnational criminal law, treaty crimes

Procedia PDF Downloads 219

Authors: M. Mert, M. T. Ozkan

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Pile load tests should be applied to check the bearing capacity calculations and to determine the settlement of the pile corresponding to test load. Strain gauges can be installed into pile in order to determine the shaft resistance of the piles for every soil layer respectively. Detailed results can be obtained by means of strain gauges placed at certain levels into test piles. In the scope of this study, pile load test data obtained from two different projects are examined.  Instrumented static pile load tests were applied on totally 7 test bored piles of different diameters (80 cm, 150 cm, and 200 cm) and different lengths (between 30-76 m) in two different project site. Settlement analysis of test piles is done by using some of load transfer methods and finite element method. Plaxis 3D which is a three-dimensional finite element program is also used for settlement analysis of the test piles. In this study, firstly bearing capacity of test piles are determined and compared with strain gauge data which is required for settlement analysis. Then, settlement values of the test piles are estimated by using load transfer methods developed in recent years and finite element method. The aim of this study is to show similarities and differences between the results obtained from settlement analysis methods and instrumented pile load tests.

Keywords: failure, finite element method, monitoring and instrumentation, pile, settlement

Procedia PDF Downloads 165

Authors: Monika Lipska

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Drinking water is water with a very high quality, and as such represents only 2.5% of the total quantity of all water in the world. For many years we have observed continuous increase in its consumption as a result of many factors such as: Growing world population (7 billion in 2011r.), increase of human lives comfort and – above all – the economic growth. Due to the rocketing consumption and growing costs of production of water with such high-quality parameters, we experience accelerating interest in alternative sources of obtaining potable water. One of the ways of saving this valuable material is using rainwater in the Urban Building. With an exponentially growing demand, the acquisition of additional sources of water is necessary to maintain the proper balance of all ecosystems. The first part of the paper describes what rainwater is and what are its potential sources and means of use, while the main part of the article focuses on the description of the methods of obtaining water from rain on the example of new urban building in Poland. It describes the method and installations of rainwater in the new urban building (“MBJ2030”). The paper addresses also the issue of monitoring of the whole recycling systems as well as the particular quality indicators important because of identification of the potential risks to human health. The third part describes the legal arrangements concerning the recycling of rainwater existing in different European Union countries with particular reference to Poland on example the new urban building in Warsaw.

Keywords: rainwater, potable water, non-potable water, Poland

Procedia PDF Downloads 409

Authors: W. J. Zhang, Y. Q. Du, M. L. Wang

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Noninvasive diagnostics of diseases via breath analysis has attracted considerable scientific and clinical interest for many years and become more and more promising with the rapid advancement in nanotechnology and biotechnology. The volatile organic compounds (VOCs) in exhaled breath, which are mainly blood borne, particularly provide highly valuable information about individuals’ physiological and pathophysiological conditions. Additionally, breath analysis is noninvasive, real-time, painless and agreeable to patients. We have developed a wireless sensor array based on single-stranded DNA (ssDNA)-decorated single-walled carbon nanotubes (SWNT) for the detection of a number of physiological indicators in breath. Eight DNA sequences were used to functionalize SWNT sensors to detect trace amount of methanol, benzene, dimethyl sulfide, hydrogen sulfide, acetone and ethanol, which are indicators of heavy smoking, excessive drinking, and diseases such as lung cancer, breast cancer, cirrhosis and diabetes. Our tests indicated that DNA functionalized SWNT sensors exhibit great selectivity, sensitivity, reproducibility, and repeatability. Furthermore, different molecules can be distinguished through pattern recognition enabled by this sensor array. Thus, the DNA-SWNT sensor array has great potential to be applied in chemical or bimolecular detection for the noninvasive diagnostics of diseases and health monitoring.

Keywords: breath analysis, diagnosis, DNA-SWNT sensor array, noninvasive

Procedia PDF Downloads 345

Authors: Shan-Ying Wu, Sheng-Hui Lan, Xi-Zhang Lin, Ih-Jen Su, Ting-Fen Tsai, Chia-Jui Yen, Tsung-Hsueh Lu, Fu-Wen Liang, Huey-Jen Su, Chun-Li Su, Hsiao-Sheng Liu

Abstract:

In hepatocelluar carcinoma (HCC), dysregulated expression of cyclin D1 and impaired autophagy has been reported separately. However, the relationship between them has not been explored. In this study, we demonstrated that autophagy was inversely correlated with cyclin D1 expression in 147 paired HCC patient specimens. HCC specimen with highly expression of cyclin D1 shows correlation with poor overall survival rate. Furthermore, induction of autophagy by amiodarone (antiarrhythmic drug) in Hep 3B cells, cyclin D1 was recruited into autophagosomes demonstrated by immune-gold labeling of cyclin D1 after extraction of autophagosomes. We further demonstrated that autophagy suppresses Hep 3B cell proliferation, and further analysis revealed that cell cycle was arrested at G1 phase. The interaction between LC3 (maker of autophagy) and cyclin D1 was increased after autophagy induction. In addition, ubiquitinated-cyclin D1 was also increased after autophagy induction, which is selectively degraded by autophagosome through binding with SQSTM1/p62 (an adaptor protein). In vivo study showed that amiodarone induced autophagy suppresses liver tumor formation in xenograft mouse and orthotopic rat model through decreasing cyclin D1 expression and inhibition of cell proliferation. Altogether, we reveal a novel mechanism that ubiquitinated cyclin D1 degraded by autophagic pathway by p62 and amiodarone is a promising drug for targeting cyclin D1 in liver cancer therapy.

Keywords: autophagy, cyclin D1, hepatocellular carcinoma, amiodarone

Procedia PDF Downloads 293

Authors: Kave Moloudi, Heidi Abrahamse, Blassan P. George

Abstract:

Radiotherapy (RT) and photodynamic therapy (PDT) are both forms of cancer treatment that aim to kill cancer cells while minimizing damage to healthy tissue. The similarity between RT and PDT lies in their mechanism of action. Both treatments use energy to damage cancer cells. RT uses high-energy radiation to damage the DNA of cancer cells, while PDT uses light energy to activate a photosensitizing agent, which produces reactive oxygen species (ROS) that damage the cancer cells. Both treatments require careful planning and monitoring to ensure the correct dose is delivered to the tumor while minimizing damage to surrounding healthy tissue. They are also often used in combination with other treatments, such as surgery or chemotherapy, to improve overall outcomes. However, there are also significant differences between RT and PDT. For example, RT is a non-invasive treatment that can be delivered externally or internally, while PDT requires the injection of a photosensitizing agent and the use of a specialized light source to activate it. Additionally, the side effects and risks associated with each treatment can vary. In this review, we focus on generalizing the 6Rs of radiobiology in PDT, which can open a window for the clinical application of Radio-photodynamic therapy with minimum side effects. Furthermore, this review can open new insight to work on and design new radio-photosensitizer agents in Radio-photodynamic therapy.

Keywords: radiobiology, photodynamic therapy, radiotherapy, 6Rs in radiobiology, ROS, DNA damages, cellular and molecular mechanism, clinical application.

Procedia PDF Downloads 91