Search results for: heart failure patient

Authors: Gangacharyulu Dasaroju, Sumeet Sharma, Sanjay Singh

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Heat pipe is characterised as superconductor of heat because of its excellent heat removal ability. The operation of several engineering system results in generation of heat. This may cause several overheating problems and lead to failure of the systems. To overcome this problem and to achieve desired rate of heat dissipation, there is need to study the performance of heat pipe with annular fins under free convection at different inclinations. This study demonstrates the effect of different mass flow rate of hot fluid into evaporator section on the condenser side heat transfer coefficient with annular fins under natural convection at different inclinations. In this study annular fins are used for the experimental work having dimensions of length of fin, thickness of fin and spacing of fin as 10 mm, 1 mm and 6 mm, respectively. The main aim of present study is to discover at what inclination angles the maximum heat transfer coefficient shall be achieved. The heat transfer coefficient on the external surface of heat pipe condenser section is determined by experimental method and then predicted by empirical correlations. The results obtained from experimental and Churchill and Chu relation for laminar are in fair agreement with not more than 22% deviation. It is elucidated the maximum heat transfer coefficient of 31.2 W/(m²-K) at 25˚ tilt angle and minimal condenser heat transfer coefficient of 26.4 W/(m²-K) is seen at 45˚ tilt angle and 200 ml/min mass flow rate. Inclination angle also affects the thermal performance of heat pipe. Beyond 25^o inclination, heat transport rate starts to decrease.

Keywords: heat pipe, annular fins, natural convection, condenser heat transfer coefficient, tilt angle

Procedia PDF Downloads 154

Authors: Minna Chang

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Introduction: M. pneumoniae is a respiratory pathogen, which commonly causes upper and lower respiratory infections. It primarily affects children and young adults. Respiratory symptoms are well recognized, but extrapulmonary involvement is also common. Other systems that have been implicated in the disease include: skin, mucus membranes, central, peripheral nervous systems, cardiovascular, haematological, renal, and musculoskeletal systems. Here, we report a case of an otherwise healthy, young female with M. pneumonia, who presented with right upper quadrant abdominal pain. Case presentation: a healthy 25-year-old female was referred to A&E by her general practitioner, after presenting with fever, malaise, and right upper quadrant pain. M. pneumoniae was confirmed retrospectively by serology. The patient made a full recovery after a six-day course of doxycycline 100mg. Conclusion: M. pneumonia is a well-established cause of respiratory infections in children and young adults. Febrile illness with multisystem involvement, even in the absence of respiratory symptoms, should raise suspicion of M. pneumoniae infection in healthy, young adults. Our case illustrates the multi-system involvement of M. pneumoniae, which was initially missed, due to paucity of respiratory symptoms at presentation.

Keywords: infectious diseases, mycoplasma pneumoniae, respiratory infections, extra-pulmonary manifestations

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Authors: Muzamir Hasan, Anas Bazirgan

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Granular columns is a technique that has the properties of improving bearing capacity, accelerating the dissipation of excess pore water pressure and reducing settlement in a weak soft soil. This research aims to investigate the role of Polypropylene column in improving the shear strength and compressibility of soft reconstituted kaolin clay by determining the effects of area replacement ratio, height penetrating ratio and volume replacement ratio of a singular Polypropylene column on the strength characteristics. Reinforced kaolin samples were subjected to Unconfined Compression (UCT) and Unconsolidated Undrained (UU) triaxial tests. The kaolin samples were 50 mm in diameter and 100 mm in height. Using the PP column reinforcement, with an area replacement ratio of 0.8, 0.5 and 0.3, shear strength increased approximately 5.27%, 26.22% and 64.28%, and 37.14%, 42.33% and 51.17%, for area replacement ratios of 25% and 10.24%. Meanwhile, UU testing showed an increase in shear strength of 24.01%, 23.17% and 23.49% and 28.79%, 27.29 and 30.81% for the same ratios. Based on the UCT results, the undrained shear strength generally increased with the decrease in height penetration ratio. However, based on the UU test results Mohr-Coulomb failure criteria, the installation of Polypropylene columns did not show any significant difference in effective friction angle. However, there was an increase in the apparent cohesion and undrained shear strength of the kaolin clay. In conclusion, Polypropylene column greatly improved the shear strength; and could therefore be implemented in reducing the cost of soil improvement as a replacement for non-renewable materials.

Keywords: polypropylene, UCT, UU test, Kaolin S300, ground improvement

Procedia PDF Downloads 329

Authors: Shaker Alsharif, Xavier Banquy

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Controlled drug delivery technology represents one of the most rapidly advancing areas of science in which chemists and chemical engineers are contributing to human health care. Such delivery systems provide numerous advantages compared to conventional dosage forms including improved efficacy, and improved patient compliance and convenience. Such systems often use synthetic polymers as carriers for the drugs. As a result, treatments that would not otherwise be possible are now in conventional use. The role of bilayered vesicles as efficient carriers for drugs, vaccines, diagnostic agents and other bioactive agents have led to a rapid advancement in the liposomal drug delivery system. Moreover, the site avoidance and site-specific drug targeting therapy could be achieved by formulating a liposomal product, so as to reduce the cytotoxicity of many potent therapeutic agents. Our project focuses on developing and building hydrogel with nanoinclusion of liposomes loaded with active compounds such as proteins and growth factors able to release them in a controlled fashion. In order to achieve that, we synthesize several liposomes of two different phospholipids concentrations encapsulating model drug. Then, formulating hydrogel with specific mechanical properties embedding the liposomes to manage the release of active compound.

Keywords: controlled release, hydrogel, liposomes, active compounds

Procedia PDF Downloads 447

Authors: Griaznova Svetlana, Umedov Mekhroz

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The current healthcare facilities trend is the creation of multidisciplinary large-scale centers to provide the maximum possible services in one place, minimizing the number of possible instances in the path of patient treatment. The multifunctional medical centers are mainly designed in urban infrastructure for good accessibility. However, many functions and connections define the building shape, often make it inharmonious, that greatly destroys the city's appearance. The purpose of the research is to scientifically substantiate the factors influencing the shaping, the formation of architectural solutions principles, the formation of recommendations and principles for the multifunctional medical centers' design. The result of the research is the elaboration of architectural and planning solutions principles and the determination of factors affecting the multifunctional healthcare facilities shaping. Research method: Study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research. An integrated approach to the study of existing international experience of multidisciplinary medical centers. Elaboration of graphical analysis and diagrams based on the system analysis of the processed information. Identification of methods and principles of functional zoning of nuclear medicine centers.

Keywords: health care, multifunctionality, form, medical center, hospital, PET, CT scan

Procedia PDF Downloads 104

Authors: Mohamed N. Al-Arifi, Hessa Othman Al-Husein, Mostafa Q. Al Shamiri, Ragab Said, Syed Wajid, Salmeen D. Babelghaith

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Polypharmacy was defined as a taking more than 4 medications per single patients (minor polypharmacy), patients who are taking more than 10 medications we considered as a major polypharmacy. This study was aimed to evaluate the prevalence of polypharmacy in elderly Saudi cardiac patient. A retrospective observational study was carried out at the department of CCU and cardiology unit of the King Fahad cardiac centre (KFCC) in King Khalid university hospital from May 2012 to October 2012. All Parameters was analyzed by using Statistical Packages for Social Science (SPSS) to conclude the result; tests of association were performed using the chi-square statistic. The mean age of patients was 70.1 ± 7.75 years, more than half 83 (51.6%) were males. The highest frequency of chronic diseases found were hypertension (91.0%) followed by, dyslipidemia (74.9%), and diabetes mellitus. Results showed that 82% had polypharmacy (>4 drugs) during the study period, and 47.9% had major polypharmacy. The incidence of inappropriate drug use was found to be higher with men than female (p = 0.984). In conclusion, this study revealed that high prevalence of polypharmacy and potentially inappropriate medications in elderly Saudi cardiac inpatients.

Keywords: cardiac inpatients, medications, polypharmacy, prevalence

Procedia PDF Downloads 734

Authors: Nuhi Arslani, Aleks Brumec

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Adhesive small bowel obstruction (ASBO) accounts for 20% of emergency surgical procedures and intraabdominal adhesions account for 65% of such cases. In a 10-year post-operative period of abdominal surgery patients, around 35% of them will be readmitted because of ASBO. The first step in approaching ASBOs is using the Bologna guidelines, which include a thorough initial evaluation to diagnose or rule out an ASBO and then proceed with either further imaging studies or emergency surgery, which can be either open or laparoscopic. The contraindications for a laparoscopic approach include hemodynamic instability of the patient and infections in the peritoneum or port sites. Studies have shown that a laparoscopic approach to adhesiolysis is linked with a significantly smaller risk of readmissions and reoperations as well as with faster recovery time and fewer postoperative infections, but has a higher risk of bowel injuries, so a careful selection of patients is required. Although studies favor a laparoscopic approach, many countries still prefer a laparotomy, often because a laparoscopic approach requires surgeons to be highly skilled in the procedure. In the US and UK, between 50 and 60% of surgeons would approach an ASBO with laparoscopy, while in Italy, this number is around 15% and it is most likely similar in Slovenia. We believe that in the right cases and in the right patients, a laparoscopic approach can be equally feasible for treating ASBOs and is associated with fewer intraoperative and postoperative complications.

Keywords: adhesive small bowel obstruction, laparoscopy, adhesions, adhesiolysis

Procedia PDF Downloads 86

Authors: V. Howard, R. Maguire, S. Corrigan

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Background: Type 1 Diabetes (T1D) is a chronic autoimmune disease, typically diagnosed in childhood. T1D puts an enormous strain on families; controlling blood-glucose in children is difficult and the consequences of poor control for patient health are significant. Successful illness management and better health outcomes can be dependent on quality of caregiving. On diagnosis, parent-caregivers face a steep learning curve as T1D care requires a significant level of knowledge to inform complex decision making throughout the day. The majority of illness management is carried out in the home setting, independent of clinical health providers. Parent-caregivers vary in their level of knowledge and their level of engagement in applying this knowledge in the practice of illness management. Enabling researchers to quantify these aspects of the caregiver experience is key to identifying targets for psychosocial support interventions, which are desirable for reducing stress and anxiety in this highly burdened cohort, and supporting better health outcomes in children. Currently, there are limited tools available that are designed to capture this information. Where tools do exist, they are not comprehensive and do not adequately capture the lived experience. Objectives: Development of quantitative tools, informed by lived experience, to enable researchers gather data on parent-caregiver knowledge and engagement, which accurately represents the experience/cohort and enables exploration of questions that are of real-world value to the cohort themselves. Methods: This research employed an engaged approach to address the problem of quantifying two key aspects of caregiver diabetes management: Knowledge and engagement. The research process was multi-staged and iterative. Stage 1: Working from a constructivist standpoint, literature was reviewed to identify relevant questionnaires, scales and single-item measures of T1D caregiver knowledge and engagement, and harvest candidate questionnaire items. Stage 2: Aggregated findings from the review were circulated among a PPI (patient and public involvement) expert panel of caregivers (n=6), for discussion and feedback. Stage 3: In collaboration with the expert panel, data were interpreted through the lens of lived experience to create a long-list of candidate items for novel questionnaires. Items were categorized as either ‘knowledge’ or ‘engagement’. Stage 4: A Delphi-method process (iterative surveys) was used to prioritize question items and generate novel questions that further captured the lived experience. Stage 5: Both questionnaires were piloted to refine wording of text to increase accessibility and limit socially desirable responding. Stage 6: Tools were piloted using an online survey that was deployed using an online peer-support group for caregivers for Juveniles with T1D. Ongoing Research: 123 parent-caregivers completed the survey. Data analysis is ongoing to establish face and content validity qualitatively and through exploratory factor analysis. Reliability will be established using an alternative-form method and Cronbach’s alpha will assess internal consistency. Work will be completed by early 2024. Conclusion: These tools will enable researchers to gain deeper insights into caregiving practices among parents of juveniles with T1D. Development was driven by lived experience, illustrating the value of engaged research at all levels of the research process.

Keywords: caregiving, engaged research, juvenile type 1 diabetes, quantified engagement and knowledge

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Authors: Raj Banerjee, Y. M. Parulekar, Aniruddha Sengupta, J. Chattopadhyay

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This study proposes a Discrete Element Method (DEM) simulation using a commercial software PFC 2D (2019) for quantitatively simulating the monotonic and cyclic behaviour of sand using irregular shapes of sand grains. A preliminary analysis of the number of particles for optimal Representative Element Volume (REV) simulation of dimension 35mm x 35mm x 70mm using the scaled Grain Size Distribution (GSD) of sand is carried out. Subsequently, the effect of particle shape on the performance of sand during monotonic and cyclic bi-axial tests is assessed using numerical simulation. The validation of the numerical simulation for one case is carried out using the test results from the literature. Further numerical studies are performed in which the particles in REV are simulated by mixing round discs with irregular clumps (100% round disc, 75% round disc 25% irregular clump, 50% round disc 50% irregular clump, 25% round disc 75% irregular clump, 100% irregular clump) in different proportions using Dry Deposition (DD) method. The macro response for monotonic loading shows that irregular sand has a higher strength than round particles and that the Mohr-Coulomb failure envelope depends on the shape of the grains. During cyclic loading, it is observed that the liquefaction resistance curve (Cyclic Stress Ratio (CSR)-Number of cycles (N)) of sand is dependent on the combination of particle shapes with different proportions.

Keywords: biaxial test, particle shape, monotonic, cyclic

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Authors: Asiri Wijesinghe, N. D. Kodikara, Damitha Sandaruwan

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The Diabetic Retinopathy (DR) is a rapidly growing interrogation around the world which can be annotated by abortive metabolism of glucose that causes long-term infection in human retina. This is one of the preliminary reason of visual impairment and blindness of adults. Information on retinal pathological mutation can be recognized using ocular fundus images. In this research, we are mainly focused on resurrecting an automated diagnosis system to detect DR anomalies such as severity level classification of DR patient (Non-proliferative Diabetic Retinopathy approach) and vessel tortuosity measurement of untwisted vessels to assessment of vessel anomalies (Proliferative Diabetic Retinopathy approach). Severity classification method is obtained better results according to the precision, recall, F-measure and accuracy (exceeds 94%) in all formats of cross validation. In ROC (Receiver Operating Characteristic) curves also visualized the higher AUC (Area Under Curve) percentage (exceeds 95%). User level evaluation of severity capturing is obtained higher accuracy (85%) result and fairly better values for each evaluation measurements. Untwisted vessel detection for tortuosity measurement also carried out the good results with respect to the sensitivity (85%), specificity (89%) and accuracy (87%).

Keywords: fundus image, exudates, microaneurisms, hemorrhages, tortuosity, diabetic retinopathy, optic disc, fovea

Procedia PDF Downloads 342

Authors: Imali T. Jayamanne, K. P. Asoka Ramanayake

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Transition from tertiary level education to employment is one of the challenges that many fresh university graduates face after graduation. The transition period or the waiting time to obtain the first employment varies with the socio-economic factors and the general characteristics of a graduate. Compared to other fields of study, Arts graduates in Sri Lanka, have to wait a long time to find their first employment. The objective of this study is to identify the determinants of the transition from higher education to employment of these graduates using survival models. The study is based on a survey that was conducted in the year 2016 on a stratified random sample of Arts graduates from Sri Lankan universities who had graduated in 2012. Among the 469 responses, 36 (8%) waiting times were interval censored and 13 (3%) were right censored. Waiting time for the first employment varied between zero to 51 months. Initially, the log-rank and the Gehan-Wilcoxon tests were performed to identify the significant factors. Gender, ethnicity, GCE Advanced level English grade, civil status, university, class received, degree type, sector of first employment, type of first employment and the educational qualifications required for the first employment were significant at 10%. The Cox proportional hazards model was fitted to model the waiting time for first employment with these significant factors. All factors, except ethnicity and type of employment were significant at 5%. However, since the proportional hazard assumption was violated, the lognormal Accelerated failure time (AFT) model was fitted to model the waiting time for the first employment. The same factors were significant in the AFT model as in Cox proportional model.

Keywords: AFT model, first employment, proportional hazard, survey design, waiting time

Procedia PDF Downloads 312

Authors: Junior Nomani

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This paper presents a novel approach to modelling the metal cutting of duplex stainless steels, a two-phase alloy regarded as a difficult-to-machine material. Calculation and control of shear strain and stresses during cutting are essential to achievement of ideal cutting conditions. Too low or too high leads to higher required cutting force or excessive heat generation causing premature tool wear failure. A 2D finite element cutting model was created based on electron backscatter diffraction (EBSD) data imagery of duplex microstructure. A mesh was generated using ‘object-oriented’ software OOF2 version V2.1.11, converting microstructural images to quadrilateral elements. A virtual workpiece was created on ABAQUS modelling software where a rigid body toolpiece advanced towards workpiece simulating chip formation, generating serrated edge chip formation cutting. Model results found calculated stress strain contour plots correlated well with similar finite element models tied with austenite stainless steel alloys. Virtual chip form profile is also similar compared experimental frozen machining chip samples. The output model data provides new insight description of strain behavior of two phase material on how it transitions from workpiece into the chip.

Keywords: Duplex stainless steel, ABAQUS, OOF2, Chip formation

Procedia PDF Downloads 100

Authors: Suppawan Lertpongpakpoom, Anongnat Boonrat, Kunya BoontummoSuppawan

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This descriptive cost analysis aimed to analyze the unit cost of patients in medical intensive care unit. Purposive sampling was used to select 20 nurses, 6 practical nurses, 5 nurses aid and select samples 30 patients. Data were collected from both primary source (activity and average time of nursing care) and secondary source Z bill of payment and patient record). Instruments were cost recording form, activity observation form, and service recording form. Content validity of all instruments were evaluated by three experts (CVI = 0.87). Descriptive statistics was employed for data analysis. The results of the Activity-Based Costing Analysis showed that total activity cost of 4 service types for the patients was 14,776.92 Bath. The highest cost was nursing record was 5,674.78 Bath, followed direct nursing activity was 5,176.18 Bath, medical treatment was 1,976.6 Bath. The lowest cost was management activity was 1,003.64 Bath per visit. The result suggested that Activity-Base Costing Analysis could be applied to give better understanding of cost structure, enabling better consideration wasted expense and non-value-added activity, and improvement of effective utilization.

Keywords: activity-based costing, medical intensive care, nursing care, cost analysis

Procedia PDF Downloads 403

Authors: Živilė Jurgelėnė, Vitalijus Karabanovas, Augustas Morkvėnas, Reda Dzingelevičienė, Nerijus Dzingelevičius, Saulius Raugelė, Boguslaw Buszewski

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The short- and long-term effects of COVID-19 antiviral drug molnupiravir and micro/nanoplastics on the early development of Salmo trutta were investigated using accumulation and exposure studies. Salmo trutta were used as standardized test organisms in toxicity studies of COVID-19 waste contaminants. The 2D/3D imaging was performed using confocal fluorescence spectral imaging microscopy to assess the uptake, bioaccumulation, and distribution of molnupiravir and micro/nanoplastics complex in live fish. Our study results demonstrated that molnupiravir may interact with a micro/nanoplastics and modify their spectroscopic parameters and toxicity to S. trutta embryos and larvae. The 0.2 µm size microplastics at a concentration of 10 mg/L were found to be stable in aqueous media than 0.02 µm, and 2 µm sizes polymeric particles. This study demonstrated that polymeric particles can adsorb molnupiravir that are present in mixtures and modify the accumulation of molnupiravir in Salmo trutta embryos and larvae. In addition, 2D/3D confocal fluorescence imaging showed that the single polymeric particle hardly accumulates and couldn't penetrate outer tissues of the tested organism. However, co-exposure micro/nanoplastics and molnupiravir could significantly enhance the polymeric particles capability of accumulating on surface tissues and penetrating surface tissue of fish in early development. Exposure to molnupiravir at 2 g/L concentration and co-exposure to micro/nanoplastics and molnupiravir did not bring about survival changes in in the early stages of Salmo trutta development, but we observed the reduction in heart rate and decrease in gill ventilation. The statistical analysis confirmed that micro/nanoplastics used in combination with molnupiravir enhance the toxicity of the latter micro/nanoplastics to embryos and larvae. This research has received funding from the European Regional Development Fund (project No 13.1.1-LMT-K-718-05-0014) under a grant agreement with the Research Council of Lithuania (LMTLT), and it was funded as part of the European Union’s measure in response to the COVID-19 pandemic.

Keywords: fish, micro/nanoplastics, molnupiravir, toxicity

Procedia PDF Downloads 95

Authors: N. Boutaghane, F. Z. Tounsi

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Many physical and technological factors degrade the SPECT images, both qualitatively and quantitatively. For this, it is not always put into leading technological advances to improve the performance of tomographic gamma camera in terms of detection, collimation, reconstruction and correction of tomographic images methods. We have to master firstly the choice of various acquisition and reconstruction parameters, accessible to clinical cases and using the attenuation and scatter correction methods to always optimize quality image and minimized to the maximum dose received by the patient. In this work, an evaluation of qualitative and quantitative tomographic images is performed based on the acquisition parameters (counts per projection) and reconstruction parameters (filter type, associated cutoff frequency). In addition, methods for correcting physical effects such as attenuation and scatter degrading the image quality and preventing precise quantitative of the reconstructed slices are also presented. Two approaches of attenuation and scatter correction are implemented: the attenuation correction by CHANG method with a filtered back projection reconstruction algorithm and scatter correction by the subtraction JASZCZAK method. Our results are considered as such recommandation, which permits to determine the origin of the different artifacts observed both in quality control tests and in clinical images.

Keywords: attenuation, scatter, reconstruction filter, image quality, acquisition and reconstruction parameters, SPECT

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Authors: Sanjeeb Sutradhar, Archita Patnaik

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Histidine is one of the twenty-two naturally occurring essential amino acids exhibiting two conformations, L-histidine and D-histidine. D-Histidine is biologically inert, while L-histidine is bioactive because of its conversion to neurotransmitter or neuromodulator histamine in both brain as well as central nervous system. The deficiency of L-histidine causes serious diseases like Parkinson’s disease, epilepsy and the failure of normal erythropoiesis development. Gold nanocomposites are attractive materials due to their excellent biocompatibility and are easy to adsorb on the electrode surface. In the present investigation, hydrophobic fullerene-C60 was functionalized with homocysteine via nucleophilic addition reaction to make it hydrophilic and to successively make the nanocomposite with in-situ prepared gold nanoparticles with ascorbic acid as reducing agent. The electronic structure calculations of the AuNPs@Hcys-C60 nanocomposite showed a drastic reduction of HOMO-LUMO gap compared to the corresponding molecules of interest, indicating enhanced electron transportability to the electrode surface. In addition, the electrostatic potential map of the nanocomposite showed the charge was distributed over either end of the nanocomposite, evidencing faster direct electron transfer from nanocomposite to the electrode surface. This nanocomposite showed catalytic activity; the nanocomposite modified glassy carbon electrode showed a tenfold higher kₑt, the electron transfer rate constant than the bare glassy carbon electrode. Significant improvement in its sensing behavior by square wave voltammetry was noted.

Keywords: fullerene-C60, gold nanocomposites, L-Histidine, square wave voltammetry

Procedia PDF Downloads 250

Authors: Wisit Wichitkosoom

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Objectives: To find out the more effect of early cardiologist consultation using a simple technology on the diagnosis and early proper management of patients with Non-STEMI at emergency department of district hospitals without cardiologist on site before transferred. Methods: A cohort study was performed in Udonthani general hospital at Udonthani province. From 1 October 2012–30 September 2013 with 892 patients diagnosed with Non-STEMI. All patients mean aged 46.8 years of age who had been transferred because of Non-STEMI diagnosed, over a 12 week period of studied. Patients whose transferred, in addition to receiving proper care, were offered a cardiologist consultation with average time to Udonthani hospital 1.5 hour. The main outcome measure was length of hospital stay, mortality at 3 months, inpatient investigation, and transfer rate to the higher facilitated hospital were also studied. Results: Hospital stay was significantly shorter for those didn’t consult cardiologist (hazard ratio 1.19; approximate 95% CI 1.001 to 1.251; p = 0.039). The 136 cases were transferred to higher facilitated hospital. No statistically significant in overall mortality between the groups (p=0.068). Conclusions: Early cardiologist consultant can reduce length of hospital stay for patients with cardiovascular conditions outside of cardiac center. The new basic technology can apply for the safety patient.

Keywords: critical, telemedicine, safety, non STEMI

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Authors: Ahmed Hamzi, Bryan Norman

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Having scribes help document patient records in electronic health record systems can improve hospitalists’ productivity. But hospitals need to determine the optimum number of scribes to hire to maximize scribe cost effectiveness. Scribe attendance uncertainty due to planned and unplanned absences is a primary challenge. This paper presents simulation and analytical models to determine the optimum number of scribes for a hospital to hire. Scribe staffing practices vary from one context to another; different staffing scenarios are considered where having extra attending scribes provides or does not provide additional value and utilizing on-call scribes to fill in for potentially absent scribes. These staffing scenarios are assessed for different scribe revenue ratios (ratio of the value of the scribe relative to scribe costs) ranging from 100% to 300%. The optimum solution depends on the absenteeism rate, revenue ratio, and desired service level. The analytical model obtains solutions easier and faster than the simulation model, but the simulation model is more accurate. Therefore, the analytical model’s solutions are compared with the simulation model’s solutions regarding both the number of scribes hired and cost-effectiveness. Additionally, an Excel tool has been developed to facilitate decision-makers in easily obtaining solutions using the analytical model.

Keywords: hospitalists, workload, optimization cost, economic analysis

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Authors: Aditya Karade, Sharada Falane, Dhananjay Deshmukh, Vijaykumar Mantri

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Brain tumors pose a significant challenge in healthcare due to their complex nature and impact on patient outcomes. The application of deep learning (DL) algorithms in medical imaging have shown promise in accurate and efficient brain tumour detection. This paper explores the performance of various pre-trained DL models ResNet50, Xception, InceptionV3, EfficientNetB0, DenseNet121, NASNetMobile, VGG19, VGG16, and MobileNet on a brain tumour dataset sourced from Figshare. The dataset consists of MRI scans categorizing different types of brain tumours, including meningioma, pituitary, glioma, and no tumour. The study involves a comprehensive evaluation of these models’ accuracy and effectiveness in classifying brain tumour images. Data preprocessing, augmentation, and finetuning techniques are employed to optimize model performance. Among the evaluated deep learning models for brain tumour detection, ResNet50 emerges as the top performer with an accuracy of 98.86%. Following closely is Xception, exhibiting a strong accuracy of 97.33%. These models showcase robust capabilities in accurately classifying brain tumour images. On the other end of the spectrum, VGG16 trails with the lowest accuracy at 89.02%.

Keywords: brain tumour, MRI image, detecting and classifying tumour, pre-trained models, transfer learning, image segmentation, data augmentation

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Authors: Kritika Kulhari, Aparna Sahu

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Test anxiety results from concerns about failure in examinations or evaluative situations. Attentional biases are known to pronounce the symptomatic expression of test anxiety. In recent times, the inattentional blindness (IB) paradigm has shown promise as an attention bias modification treatment (ABMT) for anxiety by overcoming practice and expectancy effects which preexisting paradigms fail to counter. The IB paradigm assesses the inability of an individual to attend to a stimulus that appears suddenly while indulging in a perceptual discrimination task. The present study incorporated an IB task with three critical items (book, face, and triangle) appearing randomly in the perceptual discrimination task. Attentional biases were assessed as detection and identification of the critical item. The sample (N = 50) consisted of low test anxiety (LTA) and high test anxiety (HTA) groups based on the reactions to tests scale scores. Test threat manipulation was done with pre- and post-test assessment of test anxiety using the State Test Anxiety Inventory. A mixed factorial design with gender, test anxiety, presence or absence of test threat, and critical items was conducted to assess their effects on attentional biases. Results showed only a significant main effect for test anxiety on detection with higher accuracy of detection of the critical item for the LTA group. The study presents promising results in the realm of ABMT for test anxiety.

Keywords: attentional bias, attentional bias modification treatment, inattentional blindness, test anxiety

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Authors: Albert Chang, Duncan Webster

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Streptococcus equi subspecies zooepidemicus infections in humans can be contracted through contact with domestic animals or unpasteurized dairy products. Although infection in humans is rare, the course can be fulminant. We describe the case of a 75-year-old, immunocompetent male, who developed disseminated disease with bacteremia, native aortic valve endocarditis, suppurative pericarditis with cardiac tamponade, meningitis and bilateral endopthalmitis. Despite treatment with pericardial drain placement, intravenous ceftriaxone and rifampin the patient, unfortunately, did not survive. To date, reported cases of disseminated infection by S. zooepidemicus are few. Furthermore, with the review of the literature, this case demonstrates the broadest organ system involvement reported. Of interest, previous studies have suggested an affinity of this organism for certain organ systems and this case corroborates an emerging association of S. zooepidemicus with endopthalmitis. In addition, this is the second Canadian case of documented human infection with both cases being similar in clinical features, presentation, and geographical location. A discussion regarding previous S. zooepidemicus outbreaks and the potential for zoonotic outbreaks to occur is included. In short, this case report should serve to warn clinicians regarding complications and sites of haematogenous seeding in the setting of disseminated S. zooepidemicus infections.

Keywords: endopthalmitis, endocarditis, meningitis, Streptococcus equi subspecies zooepidemicus

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Authors: Nader Khalafian, Mohsen Ghaderi

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Field observations have revealed many examples of structures which were damaged due to ground surface deformation caused by the faulting phenomena. In this paper some efforts were made in order to estimate the length and location of the ground surface where large displacements were created due to the reverse faulting. This research has conducted in two steps; (1) in the first step, a 2D explicit finite element model were developed using ABAQUS software. A subroutine for Mohr-Coulomb failure criterion with strain softening model was developed by the authors in order to properly model the stress strain behavior of the soil in the fault rapture zone. The results of the numerical analysis were verified with the results of available centrifuge experiments. Reasonable coincidence was found between the numerical and experimental data. (2) In the second step, the effects of the fault dip angle (δ), depth of soil layer (H), dilation and friction angle of sand (ψ and φ) and the amount of fault offset (d) on the soil surface displacement and fault rupture path were investigated. An artificial neural network-based model (ANN), as a powerful prediction tool, was developed to generate a general model for predicting faulting characteristics. A properly sized database was created to train and test network. It was found that the length and location of the zone of displaced ground surface can be accurately estimated using the proposed model.

Keywords: reverse faulting, surface deformation, numerical, neural network

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Authors: Paulo H. R. G. Reis, Joana P. Maia, Davi Neiva Alves, Mariana R. C. Aquino, Igor B. Guimaraes, Anderson Horta, Thiago Santiago, Mariana Volpini

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Additive manufacturing is a manufacturing technique used in many fields as a tool for the production of complex parts accurately. This technique has a wide possibility of applications in bioengineering, mainly in the manufacture of orthopedic devices, thanks to the versatility of shapes and surface details. The present article aims to evaluate the mechanical viability of a wrist-hand orthosis made using additive manufacturing techniques with Nylon 12 polyamide and compare this device with the wrist-hand orthosis manufactured by the traditional process with thermoplastic Ezeform. The methodology used is based on the application of computational simulations of voltage and temperature, from finite element analysis, in order to evaluate the properties of displacement, mechanical stresses and thermal comfort in the two devices. The execution of this work was carried out through a case study with a 29-year-old male patient. The modeling software involved was Meshmixer from US manufacturer Autodesk and Fusion 360 from the same manufacturer. The results demonstrated that the orthosis developed by 3D printing, from Nylon 12, presents better thermal comfort and response to the mechanical stresses exerted on the orthosis.

Keywords: additive manufacturing, finite elements, hand orthosis, thermal comfort, neurorehabilitation

Procedia PDF Downloads 190

Authors: Fatma Sümer

Abstract:

Introduction: This case report aims to report myopic anisometropia with copy-image in monozygotic twins. Methods: In February 2021, a 6-year-old identical twin was seen, who was referred to us with the diagnosis of amblyopia in their left eye from an external center. Both twins had a full ophthalmic examination, which included visual acuity testing, ocular motility testing, cycloplegic refraction, and fundus examination. Results: On examination, “copy image” myopic anisometropia was discovered. Twin 1 had anisometropia with myopic astigmatism in the left eye. His cycloplegic refraction was +1.00 (-0.75x 75) in the right eye and -8.0 (-1.50x175) in the left eye. Similarly, twin 2 had anisometropia with myopic astigmatism in the left eye. His cycloplegic refraction was -7.75 (-1.50x180) in the left eye and +1.25 (-0.75x90 ) in the right eye. The best-corrected visual acuity was 20/60 in the amblyopic eyes and 20/20 in the unaffected eyes. There was no ocular deviation. In either patient, a slit-lamp microscopic examination revealed no abnormalities in the anterior parts of either eye. Fundoscopic examination revealed no abnormalities. No abnormal ocular movements were demonstrated. Conclusion: As far as we have reviewed in the literature, previous studies with twins were mostly concerned with mirror-effect myopic anisometropia and myopic anisometropia, whereas ipsilateral amblyopia and anisometropia were not reported in monozygotic twins. This case underscores the possible genetic basis of myopic anisometropia.

Keywords: amblyopia, anisometropia, myopia, twins

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Authors: Sally Hosny, Mona G. Ibrahim, N. K. Hassan

Abstract:

Fiber reinforced polymers (FRP) is one of the most environmentally method for strengthening and retrofitting steel structure buildings. The behaviour of flexural strengthened steel I-beams using FRP was investigated. The finite element (FE) models were developed using ANSYS® as verification cases to simulate the experimental behaviour of using FRP strips to flexure strengthen steel I-beam. Two experimental studies were selected for verification; first examined the effect of different thicknesses and modulus of elasticity while the second studied the effect of applying different carbon fiber reinforced polymers (CFRP) bond lengths. The proposed FE models were in good agreement with the experimental results in terms of failure modes, load bearing capacities and strain distribution on CFRP strips. The verified FE models can be utilized to conduct a parametric study where various widths (40, 50, 60, 70 and 80 mm), thickness (1.2, 2 and 4 mm) and lengths (1500, 1700 and 1800 mm) of CFRP were analyzed. The results presented clearly revealed that the load bearing capacity was significantly increased (+7%) when the width and thickness were increased. However, load bearing capacity was slightly affected using longer CFRP strips. Moreover, applying another glass fiber reinforced polymers (GFRP) of 1500 mm in length, 50 mm in width and thicknesses of 1.2, 2 and 4 mm were investigated. Load bearing capacity of strengthened I-beams using GFRP is less than CFRP by average 8%. Statistical analysis has been conducted using Minitab®.

Keywords: FRP, strengthened steel I-beams, flexural, FEM, ANSYS

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Authors: Hatim Laalej, Salvador Sumohano-Verdeja, Thomas McLeay

Abstract:

Monitoring of tool wear in milling operations is essential for achieving the desired dimensional accuracy and surface finish of a machined workpiece. Although there are numerous statistical models and artificial intelligence techniques available for monitoring the wear of cutting tools, these techniques cannot pin point which cutting edge of the tool, or which insert in the case of indexable tooling, is worn or broken. Currently, the task of monitoring the wear on the tool cutting edges is carried out by the operator who performs a manual inspection, causing undesirable stoppages of machine tools and consequently resulting in costs incurred from lost productivity. The present study is concerned with the development of a flute tracking system to segment signals related to each physical flute of a cutter with three flutes used in an end milling operation. The purpose of the system is to monitor the cutting condition for individual flutes separately in order to determine their progressive wear rates and to predict imminent tool failure. The results of this study clearly show that signals associated with each flute can be effectively segmented using the proposed flute tracking system. Furthermore, the results illustrate that by segmenting the sensor signal by flutes it is possible to investigate the wear in each physical cutting edge of the cutting tool. These findings are significant in that they facilitate the online condition monitoring of a cutting tool for each specific flute without the need for operators/engineers to perform manual inspections of the tool.

Keywords: machining, milling operation, tool condition monitoring, tool wear prediction

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Authors: Tsoi Kim Ming, Yu King Pong

Abstract:

Background: With powered wheelchair, patients can travel more easily and conveniently. However, some patients suffer from other difficulties, such as visual impairment, cognitive disorder, or psychological issues, which make them unable to control powered wheelchair safely. Purpose: Therefore, those patients are required to complete a comprehensive driving training by therapists on confined area, which simulates narrow paths in daily live. During the training, therapists will give series of driving instruction to patients, which may be unaware of patients crossing out the boundary of area. To facilitate the training, it is needed to develop a device to provide warning to patients during training Method: We adopt LIDAR for distance sensing started from center of confined area. Then, we program the LIDAR with linear geometry to remember each side of the area. The LIDAR will sense the location of wheelchair continuously. Once the wheelchair is driven out of the boundary, audio alert will be given to patient. Result: Patients can pay their attention to the particular driving situation followed by audio alert during driving training, which can learn how to avoid out of boundary in similar situation next time. Conclusion: Instead of only instructed by therapist, the LIDAR can facilitate the powered wheelchair training by patients actively pay their attention to driving situation. After training, they are able to control the powered wheelchair safely when facing difficult and narrow path in real life.

Keywords: PWC, training, rehab, AT

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Authors: Krzysztof Malczewski

Abstract:

PET is widely applied scanning procedure in medical imaging based research. It delivers measurements of functioning in distinct areas of the human brain while the patient is comfortable, conscious and alert. This article presents the new compression sensing based super-resolution algorithm for improving the image resolution in clinical Positron Emission Tomography (PET) scanners. The issue of motion artifacts is well known in Positron Emission Tomography (PET) studies as its side effect. The PET images are being acquired over a limited period of time. As the patients cannot hold breath during the PET data gathering, spatial blurring and motion artefacts are the usual result. These may lead to wrong diagnosis. It is shown that the presented approach improves PET spatial resolution in cases when Compressed Sensing (CS) sequences are used. Compressed Sensing (CS) aims at signal and images reconstructing from significantly fewer measurements than were traditionally thought necessary. The application of CS to PET has the potential for significant scan time reductions, with visible benefits for patients and health care economics. In this study the goal is to combine super-resolution image enhancement algorithm with CS framework to achieve high resolution PET output. Both methods emphasize on maximizing image sparsity on known sparse transform domain and minimizing fidelity.

Keywords: PET, super-resolution, image reconstruction, pattern recognition

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Authors: Rajnish Gourh, Nitesh Sharma, Nikhil Patil

Abstract:

Introduction: Adequate nutrition is essential for improving pregnancy and its outcomes. Failure to comply with the required daily intake of nutrition can lead to complications threatening both mother and child survival. Objectives: To provide access to nutritious diet to mothers in antenatal and post-natal stage for supporting a healthy progressive pregnancy, positive delivery outcome, and lactation and to promote regular consumption of the foods by the mothers and help overcome the dietary gap by nutrition education during pregnancy time. Methodology: Total of 95 ANC mothers were identified from Malvada PHC area, in Palghar district of Maharashtra. This short-term cohort intended for the proposed supplementation and education was targeted for follow-up until birth and six-months of post-natal period. In month of May 2016 to June 2017. Results: Average weight of women was observed 40.01kg, (SD- 5.024) at registered for ANC at Centre in the first month. In same month, average Haemoglobin level of women was observed 9.13gm/dl. Average increase in weight of women during pregnancy in month October 2016 was 48.83kg. Birth weight of 14 babies was less than 2 kgs. 13 babies with birth weight in range of 2.1kgs to 2.4kgs. 68 babies with birth weight in range of 2.5kg to 3kg and above. Conclusion: Importance of consumption of food, improving levels of nutrient intake and outcome of delivery was excellent.

Keywords: delivery status, nutrition, pregnancy, education

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Authors: Ibrahim Aydogdu, Alper Akin

Abstract:

In this study, the development of minimizing the cost and the CO2 emission of the RC retaining wall design has been performed by Biogeography Based Optimization (BBO) algorithm. This has been achieved by developing computer programs utilizing BBO algorithm which minimize the cost and the CO2 emission of the RC retaining walls. Objective functions of the optimization problem are defined as the minimized cost, the CO2 emission and weighted aggregate of the cost and the CO2 functions of the RC retaining walls. In the formulation of the optimum design problem, the height and thickness of the stem, the length of the toe projection, the thickness of the stem at base level, the length and thickness of the base, the depth and thickness of the key, the distance from the toe to the key, the number and diameter of the reinforcement bars are treated as design variables. In the formulation of the optimization problem, flexural and shear strength constraints and minimum/maximum limitations for the reinforcement bar areas are derived from American Concrete Institute (ACI 318-14) design code. Moreover, the development length conditions for suitable detailing of reinforcement are treated as a constraint. The obtained optimum designs must satisfy the factor of safety for failure modes (overturning, sliding and bearing), strength, serviceability and other required limitations to attain practically acceptable shapes. To demonstrate the efficiency and robustness of the presented BBO algorithm, the optimum design example for retaining walls is presented and the results are compared to the previously obtained results available in the literature.

Keywords: bio geography, meta-heuristic search, optimization, retaining wall

Procedia PDF Downloads 400