Search results for: patient safety incidents

Authors: Vathsala Kaluarachchi, Oshani Wimalarathna, Charith Vandebona, Gayani Chandrarathna, Lakmal Rupasinghe, Windhya Rankothge

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It is the fundamental function of a monitoring system to allow users to collect and process data. A worldwide threat, the corona outbreak has wreaked havoc in Sri Lanka, and the situation has gotten out of hand. Since the epidemic, the Sri Lankan government has been unable to establish a systematic system for monitoring corona patients and providing emergency care in the event of an outbreak. Most patients have been held at home because of the high number of patients reported in the nation, but they do not yet have access to a functioning medical system. It has resulted in an increase in the number of patients who have been left untreated because of a lack of medical care. The absence of competent medical monitoring is the biggest cause of mortality for many people nowadays, according to our survey. As a result, a smartphone app for analyzing the patient's state and determining whether they should be hospitalized will be developed. Using the data supplied, we are aiming to send an alarm letter or SMS to the hospital once the system recognizes them. Since we know what those patients need and when they need it, we will put up a desktop program at the hospital to monitor their progress. Deep learning, image processing and application development, natural language processing, and blockchain management are some of the components of the research solution. The purpose of this research paper is to introduce a mechanism to connect hospitals and patients even when they are physically apart. Further data security and user-friendliness are enhanced through blockchain and NLP.

Keywords: blockchain, deep learning, NLP, monitoring system

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Authors: Ibtisam Al-Zaru

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Background: Worldwide, depression among coronary artery disease (CAD) patients is considered a serious problem that may cause many complications and negative consequences; particularly serious being increased mortality and morbidity rate. Studying depression among CAD patients in Jordan has not been investigated thoroughly and thus a need for further studies has been a priority. Aims: To assess depression in non-hospitalized Jordanian patients with CAD; to describe the relationship between socio-demographic data, health related factors, and depression; and to examine the best predictors of depression in non-hospitalized Jordanian patients with CAD. Method: A cross-sectional-descriptive design was used to collect data from 174 non-hospitalized Jordanian patients diagnosed with CAD in outpatients’ cardiac clinics, using a self- administered questionnaires and Cardiac Depression Scale. Results: 53.4% of CAD patients reported mild/moderate, and severe depressive symptoms. Significant relationships between depressive symptoms and some demo-clinical characteristics (i.e. being female gender; having of chronic disease and surgical history; being physically inactive, and perceived their sexual activity, physical and psychological as poor). The preceding factors are also found to be statistically significant predictors for depression among this patients’ group. Conclusion: Jordanian patients with CAD had various levels of severity regarding their depressive symptoms. Therefore, health care providers need to introduce depression assessment and treatment in cardiac rehabilitation to control depression and its impact on the patient. Consequently, such control will reduce co-morbidity, mortality, complications and health costs among CAD patients and enhance the quality of their lives.

Keywords: coronary artery disease, predictors, depression, prevalence

Procedia PDF Downloads 274

Authors: Sadeq Al Yaari, Fayza Alhammadi, Ayman Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Saleh Al Yami

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Background: A rapidly increasing number of studies that focus on the relationship between language and cortical (CD) and subcortical dementias (SCD) have recently shown that such correlation is existent. Mounting evidence suggests that cognitive impairments should be investigated against language disorders. Aims: This study aims at investigating how language is associated with dementia diseases namely CD &SCD in light of psychoneurolinguistic approach. Method: Data from multiple sources (e.g., theses, dissertations, articles, research, medical records, direct testing, staff reports, and client observations) have been integrated to provide a detailed analysis of the relationship between language and CD&SCD. The researchers identified over 20 most of dementia types, and described them. Having collected and described data, the researchers then analyzed these data independently to see to what extent CD&SCD are involved in matters concerning language. Results: Results of the present study demonstrate that language and CD&SCD are undoubtedly correlated with each other. The loss of the ability of some organs to perform certain functions (due to any of the dementia diseases) results in no way to the loss of some language aspects and /or speech skills. In clearer terms, it is rare to find a patient with dementia who is not suffering from partial or complete linguistic difficulties. Many deficits run through the current interpretation of linguistic disorders: language disorders, speech disorders, articulation disorders, or voice disorders.

Keywords: cortical dementia, subcortical dementia, diseases, psychoneurolinguistics, language, impairments, relationship

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Authors: Ali Abdi Kordani, Meysam Rooyintan, Sid Mohammad Boroomandrad

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Nowadays, one the most important problems in megacities is public transportation and satisfying citizens from this system in order to decrease the traffic congestions and air pollution. Accordingly, to improve the transit passengers and increase the travel safety, new transportation systems such as Bus Rapid Transit (BRT), tram, and monorail have expanded that each one has different merits and demerits. That is why comparing different systems for a systematic selection of public transportation systems in a big city like Tehran, which has numerous problems in terms of traffic and pollution, is essential. In this paper, it is tried to investigate the advantages and feasibility of using monorail, tram and BRT systems, which are widely used in most of megacities in all over the world. In Tehran, by using SPSS statistical analysis software and TOPSIS method, these three modes are compared to each other and their results will be assessed. Experts, who are experienced in the transportation field, answer the prepared matrix questionnaire to select each public transportation mode (tram, monorail, and BRT). The results according to experts’ judgments represent that monorail has the first priority, Tram has the second one, and BRT has the third one according to the considered indices like execution costs, wasting time, depreciation, pollution, operation costs, travel time, passenger satisfaction, benefit to cost ratio and traffic congestion.

Keywords: BRT, costs, monorail, pollution, tram

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Authors: Geetakshi Arora, Danish Malhotra

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Diabetic wounds are serious health issues and often fail to heal, leading to limb amputation that makes the life of the patient miserable. Delayed wound healing has been characterized by an increase in matrix metalloproteinase-9 (MMP-9). Thus research throughout the world has been going on to develop selective MMP-9 inhibitors for aiding diabetic wound healing. Bioactive constituents from natural sources always served as potential leads in drug development with high rates of success. Considering the need for novel selective MMP-9 inhibitors and the importance of natural bioactive compounds in drug development, we have screened a library of bioactive constituents from plant sources that were effective in diabetic wound healing on human MMP-9 (hMMP-9) using molecular docking studies. Screened constituents are ranked according to their dock score, ∆G value (binding affinity), and Ligand efficiency evaluated from FleXX docking and Hyde scoring modules available with drug designing platform LeadIT. Rhamnocitrin showed the highest correlation between dock score, ∆G value (binding affinity), and Ligand efficiency was further explored for binding interactions with hMMP-9. The overall study suggest that Rhamnocitrin is sufficiently decorated with both hydrophilic and hydrophobic substitutions that perfectly block hMMP-9 and act as a potential lead in the design and development of selective hMMP-9 inhibitors.

Keywords: MMP-9, diabetic wound, molecular docking, phytoconstituents

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Authors: Itamir de Morais Barroca Filho, Cephas A. S. Barreto, Ramon Malaquias, Cezar Miranda Paula de Souza, Arthur Costa Gorgônio, João C. Xavier-Júnior, Mateus Firmino, Fellipe Matheus Costa Barbosa

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Information and Communication Technologies (ICT) in healthcare are crucial for efficiently delivering medical healthcare services to patients. These ICTs are also known as e-health and comprise technologies such as electronic record systems, telemedicine systems, and personalized devices for diagnosis. The focus of e-health is to improve the quality of health information, strengthen national health systems, and ensure accessible, high-quality health care for all. All the data gathered by these technologies make it possible to help clinical staff with automated decisions using machine learning. In this context, we collected patient data, such as heart rate, oxygen saturation (SpO2), blood pressure, respiration, and others. With this data, we were able to develop machine learning models for patients’ risk of death and estimate the length of stay in ICU beds. Thus, this paper presents the methodology for applying machine learning techniques to develop these models. As a result, although we implemented these models on an IoT healthcare platform, helping clinical staff in healthcare in an ICU, it is essential to create a robust clinical validation process and monitoring of the proposed models.

Keywords: ICT, e-health, machine learning, ICU, healthcare

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Authors: Branimir Skoric

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Over the past two decades, number of international travels rose significantly in the United Kingdom and Worldwide in the shape of business travels and holiday travels as well. The fact that elderly people travel a lot, more than ever before increased the needs for medical evacuations (repatriations) back home if they fell ill abroad or had any kind of accident. This paper concerns medical evacuations of patients on the way back home to the United Kingdom (United Kingdom Residents) and their specific medical needs during short-haul or long-haul commercial scheduled flight and ground transportation to the final destination regardless whether it was hospital or usual place of residence. Particular medical need during medical evacuations is oxygen supply and it can be supplied via portable oxygen concentrator, pulse flow oxygenator or continuous free flow oxygenator depending on the main diagnosis and patient’s comorbidities. In this retrospective study, patients were divided into two groups. One group was consisted of patients suffering from cardio-respiratory diagnoses as primary illness. Another Group consisted of patients suffering from noncardiac illnesses who have other problems including any kind of physical injury. Needs for oxygen and type of supply were carefully considered in regards of duration of the flight, standard airline cabin pressure and results described in this retrospective study.

Keywords: commercial flight, elderly travellers, medical evacuations, oxygen

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Authors: Marzie Shahini, Rasoul Mirghaderi

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This paper describes collapse assessments of a steel moment-frame high-rise tower with setback irregularity, designed per the 2010 ASCE7 code, under spectral-matched ground motion records. To estimate a safety margin against life-threatening collapse, an analytical model of the tower is subjected to a suite of ground motions with incremental intensities from maximum considered earthquake hazard level to the incipient collapse level. Capability of the structural system to collapse prevention is evaluated based on the similar methodology reported in FEMA P695. Structural performance parameters in terms of maximum/mean inter-story drift ratios, residual drift ratios, and maximum plastic hinge rotations are also compared to the acceptance criteria recommended by the TBI Guidelines. The results demonstrate that the structural system satisfactorily safeguards the building against collapse. Moreover, for this tower, the code-specified requirements in ASCE7-10 are reasonably adequate to satisfy seismic performance criteria developed in the TBI Guidelines for the maximum considered earthquake hazard level.

Keywords: high-rise buildings, set back, residual drift, seismic performance

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Authors: Hua Chai, Qiangling Duan, Huiqi Cao, Mi Li, Jinhua Sun

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Nitrocellulose (NC), a kind of energetic material, has been widely used in the industrial and military fields. However, this material can also cause serious social disasters due to storage conditions. Thermal hazard of nitrocellulose (NC) was experimentally investigated using the CALVET heat flux calorimeter C80, and three kinds of storage conditions were considered in the experiments: (1) drying time, (2) moisture content, (3) cycles. The results showed that the heat flow curves of NC moved to the low-temperature direction firstly and then slightly moved back by increasing the drying hours. Moisture that was responsible for the appearance of small exothermic peaks was proven to be the unfavorable safety factor yet it could increase the onset temperature of the main peak to some extent. And cycles could both lower the onset temperature and the maximum heat flow but enlarged the peak temperature. Besides, relevant kinetic parameters such as the heat of reaction (ΔH) and the activation energy (Ea) were obtained and compared. It was found that all the three conditions could reduce the values of Ea and most of them produced larger reaction heat. In addition, the critical explosion temperature (Tb) of the NC samples were derived. It was clear that not only the drying time but also the cycles would increase the thermal hazard of the NC. Yet, the right amount of water helped to reduce the thermal hazard.

Keywords: C80, nitrocellulose, storage conditions, the critical explosion temperature, thermal hazard

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Authors: Kina Kim

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Background: There are two types of interferon-gamma release assays (IGRAs) in use for the detection of latent tuberculosis infection (LTBI), QuantiFERON-TB Gold In-tube (QFT-GIT) and T-SPOT.TB. There are some reports that IGRA results are affected by the patient's age. This study aims to compare the results of both IGRA tests according to age groups. Methods: We reviewed 54,882 samples referred to an independent reference laboratory (Seegene Medical Foundation, Seoul, Korea) for the diagnosis of LTBI from January 1, 2021, to December 31, 2021. This retrospective study enrolled 955 patients tested using QFT-GIT and 53,927 patients tested using T-SPOT.TB. The results of both IGRAs were divided in three age groups (0-9, 10-17, and ≥18-year old). The positive rates and the indeterminate rates between QFT-GIT and T-SPOT.TB were compared. We also evaluated the differences in positive and indeterminate rates by age-group. Results: The positive rate of QFT-GIT was 20.1% (192/955) and that of T-SPOT.TB was 8.7% (4704/53927) in overall patients. The positive rates of QFT-GIT in individuals aged 0-9, 10-17, and over 18-year old were 15.4%, 13.3%, and 22.0%, respectively. The positive rates of T-SPOT.TB were 8.9%, 2.0% and 8.8%,in each agegroup, respectively.The overall prevalence of indeterminate results was 2.1% (20/955) of QFT-GIT and 0.5% (270/53927) of T-SPOT.TB. The indeterminate rates of QFT-GIT in individuals aged 0-9, 10-17, and over 18 years were 0.4%, 6.7%, and 2.6%, respectively. The indeterminate rate of T-SPOT.TB were 0.5%, 0.7% and 0.5%,in each age group, respectively. Conclusion: Our findings suggest that T-SPOT.TB has a lower rate of positive results in overall patients and a lower rate of indeterminate results than those of QFT-GIT. The highest positive rate was found in the over 18 years group for QFT-GIT, but the positive rates of T-SPOT.TB was not significantly different among groups by age. QFT-GIT showed variable and higher indeterminate rates according to age group, but T-SPOT.TB showed lower rates in all age groups(<1%).

Keywords: LTBI, IGRA, QFT-GIT, T-SPOT. TB

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Authors: Mireille Elhajj, Washington Ochieng, Deeph Chana

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The challenges of the rapid growth in the demand for transport has traditionally been seen within the context of the problems of congestion, air quality, climate change, safety, and affordability. However, there are increasing threats including those related to crime such as cyber-attacks that threaten the security of the transport of people and goods. To the best of the authors’ knowledge, this paper presents for the first time, a comprehensive framework for the assessment of the current and future security issues of multi-modal transport systems. The approach or method proposed is based on a structured framework starting with a detailed specification of the transport asset map (transport system architecture), followed by the identification of vulnerabilities. The asset map and vulnerabilities are used to identify the various approaches for exploitation of the vulnerabilities, leading to the creation of a set of threat scenarios. The threat scenarios are then transformed into risks and their categories, and include insights for their mitigation. The consideration of the mitigation space is holistic and includes the formulation of appropriate policies and tactics and/or technical interventions. The quality of the framework is ensured through a structured and logical process that identifies the stakeholders, reviews the relevant documents including policies and identifies gaps, incorporates targeted surveys to augment the reviews, and uses subject matter experts for validation. The approach to categorising security risks is an extension of the current methods that are typically employed. Specifically, the partitioning of risks into either physical or cyber categories is too limited for developing mitigation policies and tactics/interventions for transport systems where an interplay between physical and cyber processes is very often the norm. This interplay is rapidly taking on increasing significance for security as the emergence of cyber-physical technologies, are shaping the future of all transport modes. Examples include: Connected Autonomous Vehicles (CAVs) in road transport; the European Rail Traffic Management System (ERTMS) in rail transport; Automatic Identification System (AIS) in maritime transport; advanced Communications, Navigation and Surveillance (CNS) technologies in air transport; and the Internet of Things (IoT). The framework adopts a risk categorisation scheme that considers risks as falling within the following threat→impact relationships: Physical→Physical, Cyber→Cyber, Cyber→Physical, and Physical→Cyber). Thus the framework enables a more complete risk picture to be developed for today’s transport systems and, more importantly, is readily extendable to account for emerging trends in the sector that will define future transport systems. The framework facilitates the audit and retro-fitting of mitigations in current transport operations and the analysis of security management options for the next generation of Transport enabling strategic aspirations such as systems with security-by-design and co-design of safety and security to be achieved. An initial application of the framework to transport systems has shown that intra-modal consideration of security measures is sub-optimal and that a holistic and multi-modal approach that also addresses the intersections/transition points of such networks is required as their vulnerability is high. This is in-line with traveler-centric transport service provision, widely accepted as the future of mobility services. In summary, a risk-based framework is proposed for use by the stakeholders to comprehensively and holistically assess the security of transport systems. It requires a detailed understanding of the transport architecture to enable a detailed vulnerabilities analysis to be undertaken, creates threat scenarios and transforms them into risks which form the basis for the formulation of interventions.

Keywords: mitigations, risk, transport, security, vulnerabilities

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Authors: A. Cagnacci, D. F. Barattini, E. Casolati, M. Mangrella, E. Piccolo, S. Rosu, L. C. Pătrașcu

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This Triple study aimed to evaluate the efficacy of polycarbophil vaginal gel (PCV) in treating symptoms of vaginal atrophy (VA) in peri- and post-menopausal women. Women in peri- (n=29) and postmenopause (n=54) diagnosed with VA were progressively enrolled and treated once a day for 30 days. Thereafter, those wishing to continue (n=73) received the PCV treatment for an additional 180 days. The vaginal health index (VHI) and vaginal dryness, irritation, and pain at intercourse, along with treatment safety, were evaluated at baseline, 30 days of treatment, and after additional 180 days. At baseline, the VHI (p<0.056) and VAS of vaginal dryness (p=0.0001,) irritation (p=0.002), and pain at intercourse (p=0.0001) were worse in postmenopausal women than in perimenopausal women. VHI and VA symptoms improved in all women, and after 30 days of PCV administration, they were similar between peri-and postmenopausal women. After an additional 180 days of treatment, VHI further increased (p=0.0001), VAS of all symptoms (P=0.0001) and the Global Symptom Score (P=0.0001) further decreased. The treatment was safe. Treatment with PCV improves VA symptoms in both peri- and post-menopausal women. Prolongation of treatment up to 6 months increases the efficacy of treatment with no side effects.

Keywords: late menopausal transition, postmenopause, polycarbophil, sexuality, vaginal dryness

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Authors: David W. Farler, Perry Haan

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This paper explores what effective leadership is being employed in the engineering, technology, and construction (ETC) industry. Organizations need to understand what character traits are being used and what leadership styles work to promote sustainability and improve the triple bottom line. This paper looks at multiple publications on leadership and character traits effective for managers and leaders in the ETC industry. The ETC industry is a trillion-dollar industry, and understanding ways to improve leadership is vital for organizations' successful outcomes. With improvements to the managerial and leadership, there could be ways for organizations to profit more and cut down on cost costs. Finding ways to improve motivation can help organizations improve safety, improve culture, and increase employee motivation. From the research, this paper has found that situational leadership, transformational, and transactional are the most effective leadership styles that individuals can use in the ETC industry for leadership. Character traits that are the most effective have been identified in this research paper. This research has contributed to the ways individuals who start in the engineering and technology industry can improve upon their leadership skills as they are promoted into managerial and leadership roles. The need for managerial positions in the ETC industry, such as project and construction managers, to improve is vital for successful outcomes and creating a high-level performance. The study helps provide a gap in the limited research available to improve ETC leadership for all organizations' present and future.

Keywords: construction, effective leadership, engineering, technology

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Authors: Dilson Subedi

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Current transformers are an integral part of power system because it provides a proportional safe amount of current for protection and measurement applications. However, due to upgradation of electromechanical relays to numerical relays and electromechanical energy meters to digital meters, the connected burden, which defines some of the CT characteristics, has drastically reduced. This has led to the system experiencing high currents damaging the connected relays and meters. Since the protection and metering equipment's are designed to withstand only certain amount of current with respect to time, these high currents pose a risk to man and equipment. Therefore, during such instances, the CT saturation characteristics have a huge influence on the safety of both man and equipment and on the reliability of the protection and metering system. This paper shows the effectiveness of a bank of parallel connected resistors, as a burden compensation technique, in compensating the burden of under-burdened CT’s. The response of the CT in the case of failure of one or more resistors at different levels of overcurrent will be captured using the LabVIEWTM data acquisition hardware (DAQ). The analysis is done on the real-time data gathered using LabVIEWTM. Variation of current transformer saturation characteristics with changes in burden will be discussed.

Keywords: accuracy limiting factor, burden, burden compensation, current transformer

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Authors: Maria Malliarou, Efrossini Lyraraki, Pavlos Sarafis, Theodosios Paralikas, Styliani Kotrotsiou, Evangelia Kotrotsiou, Mairy Gouva

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Women with breast cancer have to adapt to physical malformations, side effects of chemotherapy, emotional insecurity, and changes in social roles. Inability to recognize the co-morbidity of psychiatric conditions can have an aggravating effect on patient compliance in therapeutic interventions, resulting in treatment delays and an impact on overall survival. The purpose of this study was to identify the quality of life of breast cancer patients undergoing external radiation therapy and to correlate it with depression and anxiety. Patients were asked to respond to an anonymous questionnaire with general demographic and clinical questions, followed by the EORTCQLQ-C30 questionnaire for assessing the quality of life of patients with breast cancer. Hospital Anxiety and Depression Scale (HADS) as well as the Depression, Anxiety and Stress Scale (DASS-21) was also administered. The statistical analysis of the data was done in IBM SPSS. Results indicated that the incidence of anxiety and depression in breast cancer patients is high both in HADS (37.5 % with mild to moderate depression and 62.5 % with significant to severe depression) and DASS - 21 (39.2 % mild to moderate depression and 60.8 % significant to severe) scales. The correlation of anxiety and depression with life quality was negative for HADS (r = -, 810, p = .000) as well as for DASS-21 (r = -, 682, p = .000). The psychological impact of breast cancer on patients is important. Its correlation with the quality of life may lead to better tolerance to treatment and better effectiveness of the therapeutic approach.

Keywords: anxiety, breast cancer, depression, quality of life

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Authors: Sakinah Abdullah, Rosna Mat Taha

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Antioxidants are compounds that protect cells against the damaging effects of reactive oxygen species such as singlet oxygen, superoxide, peroxyl radicals, and peroxynitrite which result in oxidative stress leading to cellular damage. Natural antioxidant are in high demand because of their potential in health promotion and disease prevention and their improved safety and consumer acceptability. Plants are rich sources of natural antioxidant. Dioscorea alata L. known as 'ubi badak' in Malaysia were well known for their antioxidant content, but this plant was seasonal. Thus, tissue culture technique was used to mass propagate this plant. In the present work, a comparative study between in vitro (from tissue culture) and in vivo (from intact plant) samples of Dioscorea alata L. for their antioxidant potential by 2,2-diphenil -1- picrylhydrazyl (DPPH) radical scavenging activity method and their total phenolic and flavonoid contents were carried out. All samples had better radical scavenging activity but in vivo samples had the strongest radical scavenging activity compared to in vitro samples. Furthermore, tubers from in vivo samples showed the greatest free radical scavenging effect and comparatively greater phenolic content than in vitro samples.

Keywords: Dioscorea alata, tissue culture, antioxidant, in vivo, in vitro, DPPH

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Authors: Joel A. Gordon, Nazmiye Balta-Ozkan, Seyed Ali Nabavi

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Hydrogen-fueled technologies are rapidly advancing as a critical component of the low-carbon energy transition. In countries historically reliant on natural gas for home heating, such as the UK, hydrogen may prove fundamental for decarbonizing the residential sector, alongside other technologies such as heat pumps and district heat networks. While the UK government is set to take a long-term policy decision on the role of domestic hydrogen by 2026, there are considerable uncertainties regarding consumer preferences for ‘hydrogen homes’ (i.e., hydrogen-fueled appliances for space heating, hot water, and cooking. In comparison to other hydrogen energy technologies, such as road transport applications, to date, few studies have engaged with the social acceptance aspects of the domestic hydrogen transition, resulting in a stark knowledge deficit and pronounced risk to policymaking efforts. In response, this study aims to safeguard against undesirable policy measures by revealing the underlying relationships between the factors of domestic hydrogen acceptance and their respective dimensions: attitudinal, socio-political, community, market, and behavioral acceptance. The study employs an online survey (n=~2100) to gauge how different UK householders perceive the proposition of switching from natural gas to hydrogen-fueled appliances. In addition to accounting for housing characteristics (i.e., housing tenure, property type and number of occupants per dwelling) and several other socio-structural variables (e.g. age, gender, and location), the study explores the impacts of consumer heterogeneity on hydrogen acceptance by recruiting respondents from across five distinct groups: (1) fuel poor householders, (2) technology engaged householders, (3) environmentally engaged householders, (4) technology and environmentally engaged householders, and (5) a baseline group (n=~700) which filters out each of the smaller targeted groups (n=~350). This research design reflects the notion that supporting a socially fair and efficient transition to hydrogen will require parallel engagement with potential early adopters and demographic groups impacted by fuel poverty while also accounting strongly for public attitudes towards net zero. Employing a second-order multigroup confirmatory factor analysis (CFA) in Mplus, the proposed hydrogen acceptance model is tested to fit the data through a partial least squares (PLS) approach. In addition to testing differences between and within groups, the findings provide policymakers with critical insights regarding the significance of knowledge and awareness, safety perceptions, perceived community impacts, cost factors, and trust in key actors and stakeholders as potential explanatory factors of hydrogen acceptance. Preliminary results suggest that knowledge and awareness of hydrogen are positively associated with support for domestic hydrogen at the household, community, and national levels. However, with the exception of technology and/or environmentally engaged citizens, much of the population remains unfamiliar with hydrogen and somewhat skeptical of its application in homes. Knowledge and awareness present as critical to facilitating positive safety perceptions, alongside higher levels of trust and more favorable expectations for community benefits, appliance performance, and potential cost savings. Based on these preliminary findings, policymakers should be put on red alert about diffusing hydrogen into the public consciousness in alignment with energy security, fuel poverty, and net-zero agendas.

Keywords: hydrogen homes, social acceptance, consumer heterogeneity, heat decarbonization

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Authors: Walid Moudani

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The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the coronary heart disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts’ knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: multi-classifier decisions tree, features reduction, dynamic programming, rough sets

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Authors: Siyuan Cai

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This paper takes community segregation during major infectious diseases as the background, based on the physiological needs and safety needs of citizens during home segregation, and based on the selection of convenient facilities and medical facilities as the main research objects. Based on the POI data of public facilities in Chongqing, the spatial distribution characteristics of the convenience and medical facilities in the 15-minute living circle centered on three neighborhoods in Shapingba, namely Shengwei Community, Anju Commmunity and Fengtian Garden Community, were explored by means of GIS spatial analysis. The results show that the spatial distribution of convenience and medical facilities in this area has significant clustering characteristics, with a point-like distribution pattern of "dense in the west and sparse in the east", and a grouped and multi-polar spatial structure. The spatial structure is multi-polar and has an obvious tendency to the intersections and residential areas with dense pedestrian flow. This study provides a preliminary exploration of the distribution of medical and convenience facilities within the 15-minute living circle of a segregated community, which makes up for the lack of spatial research in this area.

Keywords: ArcGIS, community segregation, convenient facilities; distribution pattern, medical facilities, POI, 15-minute community life circle

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Authors: Dada Kolawole Segun

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Transdermal drug delivery has gained popularity as a non-invasive method for controlled drug release compared to traditional delivery routes. Dissolvable transdermal patches have emerged as a promising platform for delivering a variety of drugs due to their ease of use. The objective of this research was to create and characterize dissolvable transdermal patches using various compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. A micromolding technique was utilized to fabricate the patches, which were subsequently characterized using scanning electron microscopy, atomic force microscopy, and tensile strength testing. In vitro drug release studies were conducted to evaluate the drug release kinetics of the patches. The study found that the mechanical strength and dissolution properties of the patches were influenced by the hyaluronic acid and zinc oxide nanoparticle ratios used in the fabrication process. Moreover, the patches demonstrated controlled delivery of model drugs through the skin, highlighting their potential for transdermal drug delivery applications. The results suggest that dissolvable transdermal patches can be tailored to meet specific requirements for drug delivery applications using different compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. This development has the potential to improve treatment outcomes and patient compliance in various therapeutic areas.

Keywords: transdermal drug delivery, characterization, skin permeation, biodegradable materials

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Authors: Kelsi Hagerty, Ami Rosen, Aaliyah Heyward, Nadia Ali, Emily Brown, Erin Demo, Yue Guan, Modele Ogunniyi, Brianna McDaniels, Alanna Morris, Kunal Bhatt

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Hereditary transthyretin amyloidosis (hATTR) is a progressive, multi-systemic, and life-threatening disease caused by a disruption in the TTR protein that delivers thyroxine and retinol to the liver. This disruption causes the protein to misfold into amyloid fibrils, leading to the accumulation of the amyloid fibrils in the heart, nerves, and GI tract. Over 130 variants in the TTR gene are known to cause hATTR. The Val122Ile variant is the most common in the United States and is seen almost exclusively in people of African descent. TTR variants are inherited in an autosomal dominant fashion and have incomplete penetrance and variable expressivity. Individuals with hATTR may exhibit symptoms from as early as 30 years to as late as 80 years of age. hATTR is characterized by a wide range of clinical symptoms such as cardiomyopathy, neuropathy, carpal tunnel syndrome, and GI complications. Without treatment, hATTR leads to progressive disease and can ultimately lead to heart failure. hATTR disproportionately affects individuals of African descent; the estimated prevalence of hATTR among Black individuals in the US is 3.4%. Unfortunately, hATTR is often underdiagnosed and misdiagnosed because many symptoms of the disease overlap with other cardiac conditions. Due to the progressive nature of the disease, multi-systemic manifestations that can lead to a shortened lifespan, and the availability of free genetic testing and promising FDA-approved therapies that enhance treatability, early identification of individuals with a pathogenic hATTR variant is important, as this can significantly impact medical management for patients and their relatives. Furthermore, recent literature suggests that TTR genetic testing should be performed in all patients with suspicion of TTR-related cardiomyopathy, regardless of age, and that follow-up with genetic counseling services is recommended. Relatives of patients with hATTR benefit from genetic testing because testing can identify carriers early and allow relatives to receive regular screening and management. Despite the striking prevalence of hATTR among Black individuals, hATTR remains underdiagnosed in this patient population, and germline genetic testing for hATTR in Black individuals seems to be underrepresented, though the reasons for this have not yet been brought to light. Historically, Black patients experience a number of barriers to seeking healthcare that has been hypothesized to perpetuate the underdiagnosis of hATTR, such as lack of access and mistrust of healthcare professionals. Prior research has described a myriad of factors that shape an individual’s decision about whether to pursue presymptomatic genetic testing for a familial pathogenic variant, such as family closeness and communication, family dynamics, and a desire to inform other family members about potential health risks. This study explores these factors through 10 in-depth interviews with patients with hATTR about what factors may be contributing to the underdiagnosis of hATTR in the Black population. Participants were selected from the Emory University Amyloidosis clinic based on having a molecular diagnosis of hATTR. Interviews were recorded and transcribed verbatim, then coded using MAXQDA software. Thematic analysis was completed to draw commonalities between participants. Upon preliminary analysis, several themes have emerged. Barriers identified include i) Misdiagnosis and a prolonged diagnostic odyssey, ii) Family communication and dynamics surrounding health issues, iii) Perceptions of healthcare and one’s own health risks, and iv) The need for more intimate provider-patient relationships and communication. Overall, this study gleaned valuable insight from members of the Black community about possible factors contributing to the underdiagnosis of hATTR, as well as potential solutions to go about resolving this issue.

Keywords: cardiac amyloidosis, heart failure, TTR, genetic testing

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Authors: Animesh Gupta

Abstract:

Objective: The purpose of this study is to evaluate the versatility and outcome of lateral supra malleolar flap (LSMF) in soft tissue reconstruction of the regions including the distal leg, ankle, dorsal foot and heel. Methods: From March 2021 to April 2023, 18 patients with soft tissue defects in the regions, including the distal leg, ankle, dorsal foot and heel, who underwent LSMF repair for lower limb wound reconstruction were analyzed. The location, size of the defects, etiology, outcome, complications, and other alternative options were studied and presented. Results: The follow-up period of the cases was 3-6 months after surgery. All flaps were successful; however, one flap was complicated by venous congestion and was managed by loosening a few sutures and the patient was required to elevate the affected limb to resolve the issue. Conclusion: The LSMF has numerous advantages in repairing soft tissue defects in areas involving the ankle, distal leg, heel and dorsum of the foot. In comparison to reverse sural flaps for repairing defects in the heel and lower leg, LSMF offers shorter operation time, shorter hospitalization, lower cost, and fewer postoperative complications.

Keywords: lateral supra malleolar flap, LSMF, soft tissue reconstruction, lower leg defect

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Authors: Farnoosh Faal

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The excessive reliance on private cars has led to a range of problems, such as traffic congestion, air pollution, and carbon emissions, which have significant impacts on public health and the environment. Public open spaces have the potential to promote sustainable transportation and reduce dependence on cars by providing alternative mobility options, including walking, cycling, and public transit. This paper examines the existing research on the relationship between public open spaces and sustainable transportation. It discusses the key design principles and planning strategies that can enhance the accessibility and safety of public open spaces, particularly for pedestrians and cyclists. The paper also explores the role of public open spaces in promoting active mobility and reducing car use in urban and suburban contexts. Finally, the paper highlights the policy and institutional barriers that hinder the integration of public open spaces with sustainable transportation systems and suggests some potential solutions to overcome these barriers. Overall, the paper argues that public open spaces have immense potential to facilitate sustainable transportation and reduce car dependence, and therefore, it is important to prioritize the development and maintenance of public open spaces as a key component of sustainable urban and regional planning.

Keywords: public open space, sustainable transportation, active mobility, car dependence, urban and regional planning, traffic congestion

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Authors: Ali Heidari

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This paper presents the principles for improving flood mitigation operation in multipurpose dams and maximizing reservoir performance during flood occurrence with a focus on the real-time operation of gated spillways. The criteria of operation include the safety of dams during flood management, minimizing the downstream flood risk by decreasing the flood hazard and fulfilling water supply and other purposes of the dam operation in mid and long terms horizons. The parameters deemed to be important include flood inflow, outlet capacity restrictions, downstream flood inundation damages, economic revenue of dam operation, and environmental and sedimentation restrictions. A simulation model was used to determine the real-time release of the Dez dam located in the Dez rivers in southwest Iran, considering the gate regulation curves for the gated spillway. The results of the simulation model show that there is a possibility to improve the current procedures used in the real-time operation of the dams, particularly using gate regulation curves and early flood forecasting system results. The Dez dam operation data shows that in one of the best flood control records, % 17 of the total active volume and flood control pool of the reservoir have not been used in decreasing the downstream flood hazard despite the availability of a flood forecasting system.

Keywords: dam operation, flood control criteria, Dez dam, Iran

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Authors: Surajit Chakrabarty, Piyush Chauhan, Subhasis Panda, Sujoy Bhattacharya

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A large proportion of roads in India are not well maintained as per the laid down public safety guidelines leading to loss of direction control and fatal accidents. We propose a technique to detect speed breakers and potholes using mobile sensor data captured from multiple vehicles and provide a profile of the road. This would, in turn, help in monitoring roads and revolutionize digital maps. Incorporating randomness in the model formulation for detection of speed breakers and potholes is crucial due to substantial heterogeneity observed in data obtained using a mobile application from multiple vehicles driven by different drivers. This is accomplished with Hidden Markov Models, whose hidden state sequence is found for each time step given the observables sequence, and are then fed as input to LSTM network with peephole connections. A precision score of 0.96 and 0.63 is obtained for classifying bumps and potholes, respectively, a significant improvement from the machine learning based models. Further visualization of bumps/potholes is done by converting time series to images using Markov Transition Fields where a significant demarcation among bump/potholes is observed.

Keywords: deep learning, hidden Markov model, pothole, speed breaker

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Authors: Bharti Arora, Michael Chen, Steven Lun

Abstract:

Plasmacytoid urothelial carcinoma (PUC) of the bladder is a rare and aggressive subtype of urothelial carcinoma that usually presents at an advanced clinical stage, has a predilection for early metastatic potential and is associated with poor prognosis. The first reported case of PUC was in 1991 and approximately 100 cases were reported in the literature worldwide. We present a case of a 43 year old female presenting with a 3-month history of urgency and frequency. Failing medical management of her urinary symptoms with anticholinergic medication, she underwent a diagnostic cystoscopy which revealed an erythematous and indurated bladder. Bladder biopsies of these regions revealed plasmacytoid urothelial carcinoma. Pre-operative staging scans were clear of any metastatic disease and the patient subsequently underwent a radical cystectomy and pelvic clearance with the formation of ileal conduit for urinary diversion. Histology confirmed plasmacytoid urothelial carcinoma with involvement of right upper vagina and focally positive margins in soft tissue at right and left sides of bladder. She received adjuvant chemotherapy but passed away within a year from disease progression. PUC can present atypically and our case highlights the role of cystoscopy in patients with persistent urinary symptoms. By reviewing the literature on PUC, we aim to raise awareness and improve understanding of this rare bladder cancer subtype amongst urologists.

Keywords: urology, bladder cancer, plasmacytoid urothelial cancer, literature review

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Authors: S. Salah, S. A. El-Masry, H. F. Sheba, R. A. El-Banna, W. Saad

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Background: Familial Mediterranean fever (FMF) has episodic or subclinical inflammation that may lead to a decrease in bone mineral density (BMD). Objective: To assess BMD in Egyptian children with FMF on genetic basis. Subjects and Methods: A cross sectional study included 45 FMF patients and 25 control children of both sexes, with age range between 3-16 years old. The patients were reclassified into 2 groups: Group I (A) 23 cases used colchicines for 1 month or less, and Group I (B) 22 cases used colchicines for more than 6 months. For both patients and control, MEFV mutations were defined using molecular genetics technique and BMD was measured by DXA at 2 sites: proximal femur and the lumber spines. Results: four frequent gene mutations were found in the patient group: E148Q (35.6%), V726A (33.3%), M680I (28.9.0%) and M694V (2.2%). There were also 4 heterozygous gene mutations in 40% of control children. Patients received colchicines treatment for less than 1 month had highly significant lower values of BMD at femur and lumber spines than control children (p<0.05). Patients received colchicines treatment for more than 6 months had improved values of BMD at femur compared to control, but there were still significant differences between them at lumbar spine (p>0.05). There are insignificant effect of type of gene mutation on BMD and the risk of osteopenia among the patients. Conclusion: FMF had significant effect on BMD. However, regular use of colchicines treatment improves this effect mainly at femur.

Keywords: familial mediterranean fever, bone mineral density, genes, children

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Authors: Novi Prasanty, Mustafa Ma, Elmeida Effendy

Abstract:

Background: Schizophrenia is a psychotic disorder that most often encountered. Nearly 1% of the world population suffers from schizophrenia during their lifetime. Schizophrenia is a severe form of psychotic disorders, and tend to be chronic. Vitamin D plays crucial roles in neuroprotection and neurodevelopment, and low levels are commonly associated with schizophrenia. Lower vitamin D levels were correlated with more severe positive, negative, and overall symptoms in schizophrenia patient men and women. Methods: 54 schizophrenic patients, male and female, who are diagnosed with semistructured MINI ICD-X. A symptom of schizophrenia was measured by using positive and negative Syndrome Scale (PANSS). Examination of serum vitamin D using ELFA. Analysis to compare the serum levels of vitamin D male and female with Independent T-test, and the relationship between serum level of vitamin D and symptom with correlation. Results: In this study serum levels in male schizophrenic patients 22.12 (4.16), and 16.54 (2.88) in female schizophrenic patients. There are differences in male schizophrenic patients and women (p < 0.001). The negative correlation between serum levels of vitamin D in the PANSS total score in patients with schizophrenic male with r -0.58, p (0,016), and the female schizophrenic patients with r -0.69, p (0.031). Conclusion and Suggestion: There is a negative correlation between serum levels of vitamin D with a total score of PANSS, the lower the serum levels of vitamin D, the higher the total score of the PANSS.

Keywords: PANSS, schizophrenia, serum levels of vitamin D, severity illness

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Authors: Nafiseh Mollaei, Reihaneh Kardehi Moghaddam

Abstract:

In case of Diabetes Mellitus the controlling of insulin is very difficult. This illness is an incurable disease affecting millions of people worldwide. Glucose is a sugar which provides energy to the cells. Insulin is a hormone which supports the absorption of glucose. Fuzzy control strategy is attractive for glucose control because it mimics the first and second phase responses that the pancreas beta cells use to control glucose. We propose two control algorithms a type-1 fuzzy controller and an interval type-2 fuzzy method for the insulin infusion. The closed loop system has been simulated for different patients with different parameters, in present of the food intake disturbance and it has been shown that the blood glucose concentrations at a normoglycemic level of 110 mg/dl in the reasonable amount of time. This paper deals with type 1 diabetes as a nonlinear model, which has been simulated in MATLAB-SIMULINK environment. The novel model, termed the Augmented Minimal Model is used in the simulations. There are some uncertainties in this model due to factors such as blood glucose, daily meals or sudden stress. In addition to eliminate the effects of uncertainty, different control methods may be utilized. In this article, fuzzy controller performance were assessed in terms of its ability to track a normoglycemic set point (110 mg/dl) in response to a [0-10] g meal disturbance. Finally, the development reported in this paper is supposed to simplify the insulin delivery, so increasing the quality of life of the patient.

Keywords: interval type-2, fuzzy controller, minimal augmented model, uncertainty

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Authors: Khaled Alkadamani

Abstract:

Using the simultaneous equations model, this paper examines the impact of capital requirements on bank risk-taking during the recent financial crisis. It also explores the relationship between capital and risk decisions and the impact of economic instability on this relationship. By analyzing the data of 20 Islamic commercial banks between 2004 and 2014 from four Middle East countries, the study concludes a positive effect of regulatory pressure on bank capital in Saudi Arabia and UAE and a negative effect in Jordan and Kuwait. Moreover, the results show a negative impact of regulatory pressure on bank risk taking in Saudi Arabia, Jordan and UAE. The findings reveal also that banks close to the minimum regulatory capital requirements improve their capital adequacy by increasing their capital and decreasing their risk taking. Furthermore, the results show that economic crisis negatively affects bank risk changes, suggesting that banks react to the impact of uncertainty by reducing their risk taking. Finally, the estimations show a negative correlation between banks profitability and capital adequacy ratio (CAR), implying that as more capital is set aside as a buffer for banks safety; it affects the performance of Islamic banks.

Keywords: bank capital, bank regulation, crisis, Islamic banks, risk taking

Procedia PDF Downloads 442