Search results for: non-chest trauma patients
1559 Lentiviral-Based Novel Bicistronic Therapeutic Vaccine against Chronic Hepatitis B Induces Robust Immune Response
Authors: Mohamad F. Jamiluddin, Emeline Sarry, Ana Bejanariu, Cécile Bauche
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Introduction: Over 360 million people are chronically infected with hepatitis B virus (HBV), of whom 1 million die each year from HBV-associated liver cirrhosis or hepatocellular carcinoma. Current treatment options for chronic hepatitis B depend on interferon-α (IFNα) or nucleos(t)ide analogs, which control virus replication but rarely eliminate the virus. Treatment with PEG-IFNα leads to a sustained antiviral response in only one third of patients. After withdrawal of the drugs, the rebound of viremia is observed in the majority of patients. Furthermore, the long-term treatment is subsequently associated with the appearance of drug resistant HBV strains that is often the cause of the therapy failure. Among the new therapeutic avenues being developed, therapeutic vaccine aimed at inducing immune responses similar to those found in resolvers is of growing interest. The high prevalence of chronic hepatitis B necessitates the design of better vaccination strategies capable of eliciting broad-spectrum of cell-mediated immunity(CMI) and humoral immune response that can control chronic hepatitis B. Induction of HBV-specific T cells and B cells by therapeutic vaccination may be an innovative strategy to overcome virus persistence. Lentiviral vectors developed and optimized by THERAVECTYS, due to their ability to transduce non-dividing cells, including dendritic cells, and induce CMI response, have demonstrated their effectiveness as vaccination tools. Method: To develop a HBV therapeutic vaccine that can induce a broad but specific immune response, we generated recombinant lentiviral vector carrying IRES(Internal Ribosome Entry Site)-containing bicistronic constructs which allow the coexpression of two vaccine products, namely HBV T- cell epitope vaccine and HBV virus like particle (VLP) vaccine. HBV T-cell epitope vaccine consists of immunodominant cluster of CD4 and CD8 epitopes with spacer in between them and epitopes are derived from HBV surface protein, HBV core, HBV X and polymerase. While HBV VLP vaccine is a HBV core protein based chimeric VLP with surface protein B-cell epitopes displayed. In order to evaluate the immunogenicity, mice were immunized with lentiviral constructs by intramuscular injection. The T cell and antibody immune responses of the two vaccine products were analyzed using IFN-γ ELISpot assay and ELISA respectively to quantify the adaptive response to HBV antigens. Results: Following a single administration in mice, lentiviral construct elicited robust antigen-specific IFN-γ responses to the encoded antigens. The HBV T- cell epitope vaccine demonstrated significantly higher T cell immunogenicity than HBV VLP vaccine. Importantly, we demonstrated by ELISA that antibodies are induced against both HBV surface protein and HBV core protein when mice injected with vaccine construct (p < 0.05). Conclusion: Our results highlight that THERAVECTYS lentiviral vectors may represent a powerful platform for immunization strategy against chronic hepatitis B. Our data suggests the likely importance of Lentiviral vector based novel bicistronic construct for further study, in combination with drugs or as standalone antigens, as a therapeutic lentiviral based HBV vaccines. THERAVECTYS bicistronic HBV vaccine will be further evaluated in animal efficacy studies.Keywords: chronic hepatitis B, lentiviral vectors, therapeutic vaccine, virus-like particle
Procedia PDF Downloads 3321558 Smoking Elevates the Risk of Dysbiosis Associated with Dental Decay
Authors: Razia Hossaini, Maryam Hosseini
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Background and Objective: The impact of smoking on the shift in oral microbial composition has been questioned. This study aims to compare the oral microbiome between Turkish patients with dental caries and healthy individuals. Materials and Methods: An observational case-control study was conducted from January to June 2024, involving 270 young adults (180 with dental caries and 90 healthy controls). Participants were matched by age, gender, education, sugar consumption, and tooth brushing habits. Oral samples were collected using sterilized swabs and preserved in a PBS-glycerol solution. The cultured bacterial samples were characterized based on their morphological characteristics, Gram staining properties, hemolysis patterns, and biochemical tests including methyl red, sugar fermentation, Simmons citrate utilization, coagulase production, and catalase activity. These tests were conducted to accurately identify the bacterial species present. Subsequently, the relationship between smoking and oral health was evaluated, with a particular focus on assessing the smoking-induced changes in the composition of the oral microbiota using statistical analyses. Results: The study’s results demonstrate a clear association between smoking and an increased risk of dental caries, as well as significant shifts in the oral microbiota of smokers (p=0.04). These findings emphasize the critical need for public health initiatives that target smoking cessation as a means of improving oral health outcomes. Since smokers are 1.28 times more likely to develop dental caries than non-smokers, public health campaigns should incorporate messages that highlight the direct impact of smoking on oral health, alongside the well-established risks such as lung disease and cardiovascular conditions.The observed alterations in the oral microbiota—specifically the higher prevalence of pathogens like Escherichia coli, Pseudomonas aeruginosa, Streptococcus mutans, and Lactobacillus acidophilus in patients with dental caries—suggest that smoking not only predisposes individuals to dental decay but also creates an environment conducive to the growth of harmful bacteria. Public health interventions could therefore focus on the dual benefit of smoking cessation: reducing the incidence of dental caries and restoring a healthier oral microbiome. Additionally, the reduced presence of beneficial or less pathogenic species such as Neisseria and Micrococcus luteus in smokers implies that smoking alters the protective balance of the oral microbiome. This further underscores the importance of preventive oral health strategies tailored to smokers. Conclusion: Smoking significantly impacts oral health by promoting dysbiosis, increasing cariogenic bacteria, and reducing beneficial bacteria, which contributes to the development of dental caries. These findings highlight the need for integrated public health efforts that address both smoking cessation and oral health promotion. By raising awareness of the specific oral health risks associated with smoking, public health initiatives could help reduce the burden of dental caries and other smoking-related oral diseases, ultimately improving quality of life for individuals and reducing healthcare costs.Keywords: smoking, dysbiosis, bacteria, oral health, dental decay
Procedia PDF Downloads 161557 The Role of Healthcare Informatics in Combating the COVID-19 Pandemic
Authors: Philip Eappen, Narasimha Rao Vajjhala
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This chapter examines how healthcare organizations harnessed innovative healthcare informatics to navigate the challenges posed by the COVID-19 pan-demic, addressing critical needs and improving care delivery. The pandemic's un-precedented demands necessitated the adoption of new and advanced tools to manage healthcare operations more effectively. Informatics solutions played a crucial role in facilitating the smooth functioning of healthcare systems during this crisis and are anticipated to remain central to future healthcare management. Technologies such as telemedicine helped healthcare professionals minimize ex-posure to COVID-19 patients, thereby reducing infection risks within healthcare facilities. This chapter explores a range of informatics applications utilized worldwide, including telemedicine, AI-driven solutions, big data analytics, drones, robots, and digital platforms for drug delivery, all of which enabled re-mote patient care and enhanced healthcare accessibility and safety during the pan-demic.Keywords: healthcare informatics, COVID-19 Pandemic, telemedicine, AI-driven healthcare, big data analytics, remote patient care, digital health platforms
Procedia PDF Downloads 31556 Telemedicine for Substance-Related Disorders: A Patient Satisfaction Survey among Individuals in Argentina
Authors: Badino Manuel, Farias Maria Alejandra
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Telemedicine (TM) has the potential to develop efficient and cost-effective means for delivering quality health care services and outcomes, showing equal or, in some cases, better results than in-person treatment. To analyze patient satisfaction with the use of TM becomes relevant because this can affect the results of treatment and the adherence to it. The aim is to assess patient satisfaction with telemedicine for treating substance-related disorders in a mental health service in Córdoba, Argentina. A descriptive cross-sectional study was conducted among patients with substance-related disorders (N=115). A patient satisfaction survey was conducted from December 2021 to March 2022. For a total of 115 participants, 59,1% were male, 38,3% were female and 2,6% non-binary. In relation to educational status, 40% finished university, 39,1% high school, and 20,9 % only primary school. Regarding age, 4,3 % were young, 92,2% were adults, and 3,5% were elderly. Regarding TM treatment, 95,7% reported being satisfied. Furthermore, 85,2% of users declared that they would continueTM treatment, and 14,8% said that they would not resume TM treatment. To conclude, high levels of patient satisfaction contributes to the continuity of TM modality.Keywords: telemedicine, mental health, substance-related disorders, patient satisfaction
Procedia PDF Downloads 1071555 Efects of Data Corelation in a Sparse-View Compresive Sensing Based Image Reconstruction
Authors: Sajid Abas, Jon Pyo Hong, Jung-Ryun Le, Seungryong Cho
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Computed tomography and laminography are heavily investigated in a compressive sensing based image reconstruction framework to reduce the dose to the patients as well as to the radiosensitive devices such as multilayer microelectronic circuit boards. Nowadays researchers are actively working on optimizing the compressive sensing based iterative image reconstruction algorithm to obtain better quality images. However, the effects of the sampled data’s properties on reconstructed the image’s quality, particularly in an insufficient sampled data conditions have not been explored in computed laminography. In this paper, we investigated the effects of two data properties i.e. sampling density and data incoherence on the reconstructed image obtained by conventional computed laminography and a recently proposed method called spherical sinusoidal scanning scheme. We have found that in a compressive sensing based image reconstruction framework, the image quality mainly depends upon the data incoherence when the data is uniformly sampled.Keywords: computed tomography, computed laminography, compressive sending, low-dose
Procedia PDF Downloads 4631554 Basic Life Support Training in Rural Uganda: A Mixed Methods Study of Training and Attitudes towards Resuscitation
Authors: William Gallagher, Harriet Bothwell, Lowri Evans, Kevin Jones
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Background: Worldwide, a third of adult deaths are caused by cardiovascular disease, a high proportion occurring in the developing world. Contributing to these poor outcomes are suboptimal assessments, treatments and monitoring of the acutely unwell patient. Successful training in trauma and neonates is recognised in the developing world but there is little literature supporting adult resuscitation. As far as the authors are aware no literature has been published on resuscitation training in Uganda since 2000 when a resuscitation training officer ran sessions in neonatal and paediatric resuscitation. The aim of this project was to offer training in Basic Life Support ( BLS) to staff and healthcare students based at Villa Maria Hospital in the Kalungu District, Central Uganda. This project was undertaken as a student selected component (SSC) offered by Swindon Academy, based at the Great Western Hospital, to medical students in their fourth year of the undergraduate programme. Methods: Semi-structured, informal interviews and focus groups were conducted with different clinicians in the hospital. These interviews were designed to focus on the level of training and understanding of BLS. A training session was devised which focused on BLS (excluding the use of an automatic external defribrillator) involving pre and post-training questionnaires and clinical assessments. Three training sessions were run for different cohorts: a pilot session for 5 Ugandan medical students, a second session for a group of 8 nursing and midwifery students and finally, a third was devised for physicians. The data collected was analysed in excel. Paired T-Tests determined statistical significance between pre and post-test scores and confidence before and after the sessions. Average clinical skill assessment scores were converted to percentages based on the area of BLS being assessed. Results: 27 participants were included in the analysis. 14 received ‘small group training’ whilst 13 received’ large group training’ 88% of all participants had received some form of resuscitation training. Of these, 46% had received theory training, 27% practical training and only 15% received both. 12% had received no training. On average, all participants demonstrated a significant increase of 5.3 in self-assessed confidence (p <0.05). On average, all participants thought the session was very useful. Analysis of qualitative date from clinician interviews in ongoing but identified themes identified include rescue breaths being considered the most important aspect resuscitation and doubts of a ‘good’ outcome from resuscitation. Conclusions: The results of this small study reflect the need for regular formal training in BLS in low resource settings. The active engagement and positive opinions concerning the utility of the training are promising as well as the evidence of improvement in knowledge.Keywords: basic life support, education, resuscitation, sub-Saharan Africa, training, Uganda
Procedia PDF Downloads 1481553 Minimally Invasive Open Lumbar Discectomy with Nucleoplasty and Annuloplasty as a Technique for Effective Reduction of Both Axial and Radicular Pain
Authors: Wael Elkholy, Ashraf Sakr, Mahmoud Qandeel, Adam Elkholy
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Lumbar disc herniation is a common pathology that may cause significant low back pain and radicular pain that could profoundly impair daily life activities of individuals. Patients who undergo surgical treatment for lumbar disc herniation usually present with radiculopathy along with low back pain (LBP) instead of radiculopathy alone. When discectomy is performed, improvement in leg radiating pain is observed due to spinal nerve irritation. However, long-term LBP due to degenerative changes in the disc may occur postoperatively. In addition, limited research has been reported on the short-term (within 1 year) improvement in LBP after discectomy. In this study we would like to share our minimally invasive open technique for lumbar discectomy with annuloplasty and nuceloplasty as a technique for effective reduction of both axial and radicular pain.Keywords: nucleoplasty, sinuvertebral nerve cauterization, annuloplasty, discogenic low back pain, axial pain, radicular pain, minimally invasive lumbar discectomy
Procedia PDF Downloads 651552 Evaluating the Diagnostic Accuracy of the ctDNA Methylation for Liver Cancer
Authors: Maomao Cao
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Objective: To test the performance of ctDNA methylation for the detection of liver cancer. Methods: A total of 1233 individuals have been recruited in 2017. 15 male and 15 female samples (including 10 cases of liver cancer) were randomly selected in the present study. CfDNA was extracted by MagPure Circulating DNA Maxi Kit. The concentration of cfDNA was obtained by Qubit™ dsDNA HS Assay Kit. A pre-constructed predictive model was used to analyze methylation data and to give a predictive score for each cfDNA sample. Individuals with a predictive score greater than or equal to 80 were classified as having liver cancer. CT tests were considered the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the diagnosis of liver cancer were calculated. Results: 9 patients were diagnosed with liver cancer according to the prediction model (with high sensitivity and threshold of 80 points), with scores of 99.2, 91.9, 96.6, 92.4, 91.3, 92.5, 96.8, 91.1, and 92.2, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of ctDNA methylation for the diagnosis of liver cancer were 0.70, 0.90, 0.78, and 0.86, respectively. Conclusions: ctDNA methylation could be an acceptable diagnostic modality for the detection of liver cancer.Keywords: liver cancer, ctDNA methylation, detection, diagnostic performance
Procedia PDF Downloads 1481551 A Hybrid Fuzzy Clustering Approach for Fertile and Unfertile Analysis
Authors: Shima Soltanzadeh, Mohammad Hosain Fazel Zarandi, Mojtaba Barzegar Astanjin
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Diagnosis of male infertility by the laboratory tests is expensive and, sometimes it is intolerable for patients. Filling out the questionnaire and then using classification method can be the first step in decision-making process, so only in the cases with a high probability of infertility we can use the laboratory tests. In this paper, we evaluated the performance of four classification methods including naive Bayesian, neural network, logistic regression and fuzzy c-means clustering as a classification, in the diagnosis of male infertility due to environmental factors. Since the data are unbalanced, the ROC curves are most suitable method for the comparison. In this paper, we also have selected the more important features using a filtering method and examined the impact of this feature reduction on the performance of each methods; generally, most of the methods had better performance after applying the filter. We have showed that using fuzzy c-means clustering as a classification has a good performance according to the ROC curves and its performance is comparable to other classification methods like logistic regression.Keywords: classification, fuzzy c-means, logistic regression, Naive Bayesian, neural network, ROC curve
Procedia PDF Downloads 3351550 Peptide Aptasensor for Electrochemical Detection of Rheumatoid Arthritis
Authors: Shah Abbas
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Rheumatoid arthritis is a systemic, inflammatory autoimmune disease, affecting an overall 1% of the global population. Despite being tremendous efforts by scientists, early diagnosis of RA still has not been achieved. In the current study, a Graphene oxide (GO) based electrochemical sensor has been developed for early diagnosis of RA through Cyclic voltammetry. Chitosan (CHI), a CPnatural polymer has also been incorporated along with GO in order to enhance the biocompatibility and functionalization potential of the biosensor. CCPs are known antigens for Anti Citrullinated Peptide Antibodies (ACPAs) which can be detected in serum even 14 years before the appearance of symptoms, thus they are believed to be an ideal target for the early diagnosis of RA. This study has yielded some promising results regarding the binding and detection of ACPAs through changes in the electrochemical properties of biosensing material. The cyclic voltammogram of this biosensor reflects the binding of ACPAs to the biosensor surface, due to its shifts observed in the current flow (cathodic current) as compared to the when no ACPAs bind as it is absent in RA negative patients.Keywords: rheumatoid arthritis, peptide sensor, graphene oxide, anti citrullinated peptide antibodies, cyclic voltammetry
Procedia PDF Downloads 1411549 Manage an Acute Pain Unit based on the Balanced Scorecard
Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho
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The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.Keywords: acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal
Procedia PDF Downloads 1451548 Mutiple Medical Landmark Detection on X-Ray Scan Using Reinforcement Learning
Authors: Vijaya Yuvaram Singh V M, Kameshwar Rao J V
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The challenge with development of neural network based methods for medical is the availability of data. Anatomical landmark detection in the medical domain is a process to find points on the x-ray scan report of the patient. Most of the time this task is done manually by trained professionals as it requires precision and domain knowledge. Traditionally object detection based methods are used for landmark detection. Here, we utilize reinforcement learning and query based method to train a single agent capable of detecting multiple landmarks. A deep Q network agent is trained to detect single and multiple landmarks present on hip and shoulder from x-ray scan of a patient. Here a single agent is trained to find multiple landmark making it superior to having individual agents per landmark. For the initial study, five images of different patients are used as the environment and tested the agents performance on two unseen images.Keywords: reinforcement learning, medical landmark detection, multi target detection, deep neural network
Procedia PDF Downloads 1401547 Investigating Role of Autophagy in Cispaltin Induced Stemness and Chemoresistance in Oral Squamous Cell Carcinoma
Authors: Prajna Paramita Naik, Sujit Kumar Bhutia
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Background: Regardless of the development multimodal treatment strategies, oral squamous cell carcinoma (OSCC) is often associated with a high rate of recurrence, metastasis and chemo- and radio- resistance. The present study inspected the relevance of CD44, ABCB1 and ADAM17 expression as a putative stem cell compartment in oral squamous cell carcinoma (OSCC) and deciphered the role of autophagy in regulating the expression of aforementioned proteins, stemness and chemoresistance. Methods: A retrospective analysis of CD44, ABCB1 and ADAM17 expression with respect to the various clinicopathological factors of sixty OSCC patients were determined via immunohistochemistry. The correlation among CD44, ABCB1 and ADAM17 expression was established. Sphere formation assay, flow cytometry and fluorescence microscopy were conducted to elucidate the stemness and chemoresistance nature of established cisplatin-resistant oral cancer cells (FaDu). The pattern of expression of CD44, ABCB1 and ADAM17 in parental (FaDu-P) and resistant FaDu cells (FaDu-CDDP-R) were investigated through fluorescence microscopy. Western blot analysis of autophagy marker proteins was performed to compare the status of autophagy in parental and resistant FaDu cell. To investigate the role of autophagy in chemoresistance and stemness, sphere formation assay, immunofluorescence and Western blot analysis was performed post transfection with siATG14 and the level of expression of autophagic proteins, mitochondrial protein and stemness-associated proteins were analyzed. The statistical analysis was performed by GraphPad Prism 4.0 software. p-value was defined as follows: not significant (n.s.): p > 0.05;*: p ≤ 0.05; **: p ≤ 0.01; ***: p ≤ 0.001; ****: p ≤ 0.0001 were considered statistically significant. Results: In OSCC, high CD44, ABCB1 and ADAM17 expression were significantly correlated with higher tumor grades and poor differentiation. However, the expression of these proteins was not related to the age and sex of OSCC patients. Moreover, the expression of CD44, ABCB1 and ADAM17 were positively correlated with each other. In vitro and OSCC tissue double labeling experiment data showed that CD44+ cells were highly associated with ABCB1 and ADAM17 expression. Further, FaDu-CDDP-R cells showed higher sphere forming capacity along with increased fraction of the CD44+ population and β-catenin expression FaDu-CDDP-R cells also showed accelerated expression of CD44, ABCB1 and ADAM17. A comparatively higher autophagic flux was observed in FaDu-CDDP-R against FaDu-P cells. The expression of mitochondrial proteins was noticeably reduced in resistant cells as compared to parental cells indicating the occurrence of autophagy-mediated mitochondrial degradation in oral cancer. Moreover, inhibition of autophagy was coupled with the decreased formation of orospheres suggesting autophagy-mediated stemness in oral cancer. Blockade of autophagy was also found to induce the restoration of mitochondrial proteins in FaDu-CDDP-R cells indicating the involvement of mitophagy in chemoresistance. Furthermore, a reduced expression of CD44, ABCB1 and ADAM17 was also observed in ATG14 deficient cells FaDu-P and FaDu-CDDP-R cells. Conclusion: The CD44+ ⁄ABCB1+ ⁄ADAM17+ expression in OSCC might be associated with chemoresistance and a putative CSC compartment. Further, the present study highlights the contribution of mitophagy in chemoresistance and confirms the potential involvement of autophagic regulation in acquisition of stem-like characteristics in OSCC.Keywords: ABCB1, ADAM17, autophagy, CD44, chemoresistance, mitophagy, OSCC, stemness
Procedia PDF Downloads 1931546 Knowledge and Attitude of Palliative Care Towards Work Performance of Nurses in Private Hospital
Authors: Novita Verayanti Manalu, Alvin Salim
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Background: Palliative care is caring holistically for patients and families to improve their quality of life. Experts stated that palliative care could be applied not only for terminally ill cases but also for acute illnesses. Therefore, this study wants to find out the level of knowledge about palliative care of the nurses along with the relationship with attitude and performance. Method: This study applies a cross-sectional survey design and allows the respondents to fill two questionnaires to determine the level of knowledge and attitude toward palliative care, while one questionnaire is filled out by the head nurse to evaluate nurses’ performance. The relationship was analyzed by Spearman rho’s correlation in alpha < 0,05 by SPSS. Results: The majority of respondents were females, aged above 25 years old, and married. Most of the nurses are staff nurses and the ratio of education level is not significantly different. The knowledge level is poor, while the attitude and performance are at an adequate level. Knowledge may affect attitude, but it doesn’t happen toward performance. Conclusion: There is a need for increased knowledge about palliative care to improve attitude and work performance. Future researchers might use this finding as a reference to conduct further study in improving knowledge of palliative care.Keywords: knowledge, attitude, work performance, palliative care
Procedia PDF Downloads 2001545 Nuancing the Indentured Migration in Amitav Ghosh's Sea of Poppies
Authors: Murari Prasad
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This paper is motivated by the implications of indentured migration depicted in Amitav Ghosh’s critically acclaimed novel, Sea of Poppies (2008). Ghosh’s perspective on the experiences of North Indian indentured labourers moving from their homeland to a distant and unknown location across the seas suggests a radical attitudinal change among the migrants on board the Ibis, a schooner chartered to carry the recruits from Calcutta to Mauritius in the late 1830s. The novel unfolds the life-altering trauma of the bonded servants, including their efforts to maintain a sense of self while negotiating significant social and cultural transformations during the voyage which leads to the breakdown of familiar life-worlds. Equally, the migrants are introduced to an alternative network of relationships to ensure their survival away from land. They relinquish their entrenched beliefs and prejudices and commit themselves to a new brotherhood formed by ‘ship siblings.’ With the official abolition of direct slavery in 1833, the supply of cheap labour to the sugar plantation in British colonies as far-flung as Mauritius and Fiji to East Africa and the Caribbean sharply declined. Around the same time, China’s attempt to prohibit the illegal importation of opium from British India into China threatened the lucrative opium trade. To run the ever-profitable plantation colonies with cheap labour, Indian peasants, wrenched from their village economies, were indentured to plantations as girmitiyas (vernacularized from ‘agreement’) by the colonial government using the ploy of an optional form of recruitment. After the British conquest of the Isle of France in 1810, Mauritius became Britain’s premier sugar colony bringing waves of Indian immigrants to the island. In the articulations of their subjectivities one notices how the recruits cope with the alienating drudgery of indenture, mitigate the hardships of the voyage and forge new ties with pragmatic acts of cultural syncretism in a forward-looking autonomous community of ‘ship-siblings’ following the fracture of traditional identities. This paper tests the hypothesis that Ghosh envisions a kind of futuristic/utopian political collectivity in a hierarchically rigid, racially segregated and identity-obsessed world. In order to ground the claim and frame the complex representations of alliance and love across the boundaries of caste, religion, gender and nation, the essential methodology here is a close textual analysis of the novel. This methodology will be geared to explicate the utopian futurity that the novel gestures towards by underlining new regulations of life during voyage and dissolution of multiple differences among the indentured migrants on board the Ibis.Keywords: indenture, colonial, opium, sugar plantation
Procedia PDF Downloads 3961544 Voice and Head Controlled Intelligent Wheelchair
Authors: Dechrit Maneetham
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The aim of this paper was to design a void and head controlled electric power wheelchair (EPW). A novel activate the control system for quadriplegics with voice, head and neck mobility. Head movement has been used as a control interface for people with motor impairments in a range of applications. Acquiring measurements from the module is simplified through a synchronous a motor. Axis measures the two directions namely x and y. At the same time, patients can control the motorized wheelchair using voice signals (forward, backward, turn left, turn right, and stop) given by it self. The model of a dc motor is considered as a speed control by selection of a PID parameters using genetic algorithm. An experimental set-up constructed, which consists of micro controller as controller, a DC motor driven EPW and feedback elements. This paper is tuning methods of parameter for a pulse width modulation (PWM) control system. A speed controller has been designed successfully for closed loop of the dc motor so that the motor runs very closed to the reference speed and angle. Intelligent wheelchair can be used to ensure the person’s voice and head are attending the direction of travel asserted by a conventional, direction and speed control.Keywords: wheelchair, quadriplegia, rehabilitation , medical devices, speed control
Procedia PDF Downloads 5351543 Securing Healthcare IoT Devices and Enabling SIEM Integration: Addressing
Authors: Mubarak Saadu Nabunkari, Abdullahi Abdu Ibrahim, Muhammad Ilyas
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This study looks at how Internet of Things (IoT) devices are used in healthcare to monitor and treat patients better. However, using these devices in healthcare comes with security problems. The research explores using Security Information and Event Management (SIEM) systems with healthcare IoT devices to solve these security challenges. Reviewing existing literature shows the current state of IoT security and emphasizes the need for better protection. The main worry is that healthcare IoT devices can be easily hacked, putting patient data and device functionality at risk. To address this, the research suggests a detailed security framework designed for these devices. This framework, based on literature and best practices, includes important security measures like authentication, data encryption, access controls, and anomaly detection. Adding SIEM systems to this framework helps detect threats in real time and respond quickly to incidents, making healthcare IoT devices more secure. The study highlights the importance of this integration and offers guidance for implementing healthcare IoT securely, efficiently, and effectively.Keywords: cyber security, threat intelligence, forensics, heath care
Procedia PDF Downloads 621542 Quality of Life Among People with Mental Illness Attending a Psychiatric Outpatient Clinic in Ethiopia: A Structural Equation Model
Authors: Wondale Getinet Alemu, Lillian Mwanri, Clemence Due, Telake Azale, Anna Ziersch
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Background: Mental illness is one of the most severe, chronic, and disabling public health problems that affect patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods: A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total number of study participants who had a follow-up appointment during the data collection period (2400) by the total sample size of 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the QoL of people with mental illness. The domains and Health-Related Quality of Life (HRQoL) were identified. The indirect and direct effects of variables were calculated using structural equation modeling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results: A total of 636 (99.7%) participants responded and completed the WHOQOL-BREF questionnaire. The mean score of overall HRQoL of people with mental illness in the outpatient clinic was (49.6 ± 10 Sd). The highest QoL was found in the physical health domain (50.67 ±9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41±10 Sd). Rural residents, drug nonadherence, suicidal ideation, not getting counseling, moderate or severe subjective severity, the family does not participate in patient care, and a family history of mental illness had an indirect negative effect on HRQoL. Alcohol use and psychological health domain had a direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having a history of mental illness in the family had both direct and indirect effects on QoL. Furthermore, sociodemographic factors (residence, educational status, marital status), social support-related factors (self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use,) and clinical factors (objective and subjective severity of illness, not getting counseling, suicidal ideation, number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions: In this study, the QoL of people with mental illness was poor, with the psychological health domain being the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors directly and indirectly, affect QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the scourge of mental health, including the development of policy and practice drivers that address the above-identified factors.Keywords: quality of life, mental wellbeing, mental illness, mental disorder, Ethiopia
Procedia PDF Downloads 791541 Xeroderma Pigmentosum Group G: Gene Polymorphism and Risk of Breast Cancer
Authors: Malik SS, Masood N, Mubarik S, Khadim TM
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Introduction: Xeroderma pigmentosum group G (XPG) gene plays a crucial role in the correction of UV-induced DNA damage through nucleotide excision repair pathway. Single nucleotide polymorphisms in XPG gene have been reported to be associated with different cancers. Current case-control study was designed to evaluate the relationship between one of the most frequently found XPG (rs1047768 T>C) polymorphism and breast cancer risk. Methodology: A total of 200 individuals were screened for this polymorphism including 100 pathologically confirmed breast cancer cases and age-matched 100 controls. Genotyping was carried out using Tetra amplification-refractory mutation system (ARMS) PCR and results were confirmed by gel electrophoresis. Results: Conditional logistic regression analysis showed significant association between TC genotype (OR: 8.9, CI: 2.0 – 38.7) and increased breast cancer risk. Although homozygous CC genotype was more frequent in patients as compared to controls, but it was statistically non-significant (OR: 3.9, CI: 0.4 – 35.7). Conclusion: In conclusion, XPG (rs1047768 T>C) polymorphism may contribute towards increased risk of breast cancer but other polymorphisms may also be evaluated to elucidate their role in breast cancer.Keywords: XPG, breast cancer, NER, ARMS-PCR
Procedia PDF Downloads 1861540 The Development of Congeneric Elicited Writing Tasks to Capture Language Decline in Alzheimer Patients
Authors: Lise Paesen, Marielle Leijten
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People diagnosed with probable Alzheimer disease suffer from an impairment of their language capacities; a gradual impairment which affects both their spoken and written communication. Our study aims at characterising the language decline in DAT patients with the use of congeneric elicited writing tasks. Within these tasks, a descriptive text has to be written based upon images with which the participants are confronted. A randomised set of images allows us to present the participants with a different task on every encounter, thus allowing us to avoid a recognition effect in this iterative study. This method is a revision from previous studies, in which participants were presented with a larger picture depicting an entire scene. In order to create the randomised set of images, existing pictures were adapted following strict criteria (e.g. frequency, AoA, colour, ...). The resulting data set contained 50 images, belonging to several categories (vehicles, animals, humans, and objects). A pre-test was constructed to validate the created picture set; most images had been used before in spoken picture naming tasks. Hence the same reaction times ought to be triggered in the typed picture naming task. Once validated, the effectiveness of the descriptive tasks was assessed. First, the participants (n=60 students, n=40 healthy elderly) performed a typing task, which provided information about the typing speed of each individual. Secondly, two descriptive writing tasks were carried out, one simple and one complex. The simple task contains 4 images (1 animal, 2 objects, 1 vehicle) and only contains elements with high frequency, a young AoA (<6 years), and fast reaction times. Slow reaction times, a later AoA (≥ 6 years) and low frequency were criteria for the complex task. This task uses 6 images (2 animals, 1 human, 2 objects and 1 vehicle). The data were collected with the keystroke logging programme Inputlog. Keystroke logging tools log and time stamp keystroke activity to reconstruct and describe text production processes. The data were analysed using a selection of writing process and product variables, such as general writing process measures, detailed pause analysis, linguistic analysis, and text length. As a covariate, the intrapersonal interkey transition times from the typing task were taken into account. The pre-test indicated that the new images lead to similar or even faster reaction times compared to the original images. All the images were therefore used in the main study. The produced texts of the description tasks were significantly longer compared to previous studies, providing sufficient text and process data for analyses. Preliminary analysis shows that the amount of words produced differed significantly between the healthy elderly and the students, as did the mean length of production bursts, even though both groups needed the same time to produce their texts. However, the elderly took significantly more time to produce the complex task than the simple task. Nevertheless, the amount of words per minute remained comparable between simple and complex. The pauses within and before words varied, even when taking personal typing abilities (obtained by the typing task) into account.Keywords: Alzheimer's disease, experimental design, language decline, writing process
Procedia PDF Downloads 2731539 The Transformation of Hot Spring Destinations in Taiwan in a Post-pandemic Future: Exploring the COVID-19 Impacts on Hot Spring Experiences, Individual, and Community Resilience of Residents From a Posttraumatic Growth Perspective
Authors: Hsin-Hung Lin, Janet Chang, Te-Yi Chang, You-Sheng Huang
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The natural and men-made disasters have become huge challenges for tourism destinations as well as emphasizing the fragility of the industry. Hot springs, among all destinations, are prone to disasters due to their dependence on natural resources and locations. After the COVID-19 outbreak, hot spring destinations have experienced not only the loss of businesses but also the psychological trauma. However, evidence has also shown that the impacts may not necessarily reduce the resilience for people but may be converted into posttraumatic growth. In Taiwan, a large proportion of hot springs are located in rural or indigenous areas. As a result, hot spring resources are associated with community cohesion for local residents. Yet prior research on hot spring destinations has mainly focused on visitors, whereas residents have been overlooked. More specifically, the relationship between hot springs resources and resident resilience in the face of the COVID-19 impacts remains unclear. To fulfill this knowledge gap, this paper aims to explore the COVID-19 impacts on residents’ hot spring experiences as well as individual and community resilience from the perspective of posttraumatic growth. A total of 315 residents of 13 hot spring destinations that are most popular in Taiwan were recruited. Online questionnaires were distributed over travel forums and social networks after the COVID-19. This paper subsequently used Partial Least Squares Structural Equation Modeling for data analysis as the technique offers significant advantages in addressing nonnormal data and small sample sizes. A preliminary test was conducted, and the results showed acceptable internal consistency and no serious common method variance. The path analysis demonstrated that the COVID-19 impacts strengthened residents’ perceptions of hot spring resources and experiences, implying that the pandemic had propelled the residents to visit hot springs for the healing benefits. In addition, the COVID-19 impacts significantly enhanced residents’ individual and community resilience, which indicates that the residents at hot springs are more resilient thanks to their awareness of external risks. Thirdly, residents’ individual resilience was positively associated with hot spring experiences, while community resilience was not affected by hot spring experiences. Such findings may suggest that hot spring experiences are more related to individual-level experiences and, consequently, have insignificant influence on community resilience. Finally, individual resilience was proved to be the most relevant factor that help foster community resilience. To conclude, the authorities may consider exploiting the hot spring resources so as to increase individual resilience for local residents. Such implications can be used as a reference for other post-disaster tourist destinations as well. As for future research, longitudinal studies with qualitative methods are suggested to better understand how the hot spring experiences have changed individuals and communities over the long term. It should be noted that the main subjects of this paper were focused on the hot spring communities in Taiwan. Therefore, the results cannot be generalized for all types of tourism destinations. That is, more diverse tourism destinations may be investigated to provide a broader perspective of post-disaster recovery.Keywords: community resilience, hot spring destinations, individual resilience, posttraumatic growth
Procedia PDF Downloads 811538 Repeated Suicidal Attempts in Foster Teenagers: Breaking the Cycle Using a Stepped Care Approach
Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister
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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care
Procedia PDF Downloads 321537 The Transformation of Hot Spring Destinations in Taiwan in a Post-pandemic Future: Exploring the COVID-19 Impacts on Hot Spring Experiences and Resilience of Local Residents from a Posttraumatic Growth Perspective
Authors: Hsin-Hung Lin, Janet Chang, Te-Yi Chang, You-Sheng Huang
Abstract:
The natural and men-made disasters have become huge challenges for tourism destinations as well as emphasizing the fragility of the industry. Hot springs, among all destinations, are prone to disasters due to their dependence on natural resources and locations. After the COVID-19 outbreak, hot spring destinations have experienced not only the loss of businesses but also the psychological trauma. However, evidence has also shown that the impacts may not necessarily reduce the resilience for people but may be converted into posttraumatic growth. In Taiwan, a large proportion of hot springs are located in rural or indigenous areas. As a result, hot spring resources are associated with community cohesion for local residents. Yet prior research on hot spring destinations has mainly focused on visitors, whereas residents have been overlooked. More specifically, the relationship between hot springs resources and resident resilience in the face of the COVID-19 impacts remains unclear. To fulfill this knowledge gap, this paper aims to explore the COVID-19 impacts on residents’ hot spring experiences as well as individual and community resilience from the perspective of posttraumatic growth. A total of 315 residents of 13 hot spring destinations that are most popular in Taiwan were recruited. Online questionnaires were distributed over travel forums and social networks after the COVID-19. This paper subsequently used Partial Least Squares Structural Equation Modeling for data analysis as the technique offers significant advantages in addressing nonnormal data and small sample sizes. A preliminary test was conducted, and the results showed acceptable internal consistency and no serious common method variance. The path analysis demonstrated that the COVID-19 impacts strengthened residents’ perceptions of hot spring resources and experiences, implying that the pandemic had propelled the residents to visit hot springs for the healing benefits. In addition, the COVID-19 impacts significantly enhanced residents’ individual and community resilience, which indicates that the residents at hot springs are more resilient thanks to their awareness of external risks. Thirdly, residents’ individual resilience was positively associated with hot spring experiences, while community resilience was not affected by hot spring experiences. Such findings may suggest that hot spring experiences are more related to individual-level experiences and, consequently, have insignificant influence on community resilience. Finally, individual resilience was proved to be the most relevant factor that help foster community resilience. To conclude, the authorities may consider exploiting the hot spring resources so as to increase individual resilience for local residents. Such implications can be used as a reference for other post-disaster tourist destinations as well.As for future research, longitudinal studies with qualitative methods are suggested to better understand how the hot spring experiences have changed individuals and communities over the long term. It should be noted that the main subjects of this paper were focused on the hot spring communities in Taiwan. Therefore, the results cannot be generalized for all types of tourism destinations. That is, more diverse tourism destinations may be investigated to provide a broader perspective of post-disaster recovery.Keywords: community resilience, hot spring destinations, individual resilience, posttraumatic growth (PTG)
Procedia PDF Downloads 741536 Rectus Sheath Block to Extend the Effectiveness of Post Operative Epidural Analgesia
Authors: Sugam Kale, Arif Uzair Bin Mohammed Roslan, Cindy Lee, Syed Beevee Mohammed Ismail
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Preemptive analgesia is an established concept in the modern practice of anaesthesia. To be most effective, it is best instituted earlier than the surgical stimulus and should last beyond the offset of surgically induced pain till healing is complete. Whereas the start of afferent pain blockade with regional anaesthesia is common, its effect often falls short to cover the entire period of pain impulses making their way to CNS in the post-operative period. We tried to use a combination of two regional anaesthetic techniques used sequentially to overcome this handicap. Madam S., a 56 year old lady, was scheduled for elective surgery for pancreatic cancer. She underwent laparotomy and distal pancreatectomy, splenectomy, bilateral salpingo oophorectomy, and sigmoid colectomy. Surgery was expected to be extensive, and it was presumed that the standard pain relief with PCA with opiates and oral analgesics would not be adequate. After counselling the patient pre-operative about the technique of regional anaesthesia techniques, including epidural catheterization and rectus sheath catheter placement, their benefits, and potential complications, informed consent was obtained. Epidural catheter was placed awake, and general anaesthesia was then induced. Epidural infusion of local anaesthetics was started prior to surgical incision and was continued till 60 hours into the postoperative period. Before skin closure, the surgeons inserted commercially available rectus sheath catheters bilaterally along the midline incision used for laparotomy. After 46 hours post-op, local anaesthetic infusion via these was started as bridging while the epidural infusion rate was tapered off. The epidural catheter was removed at 75 hours. Elastomeric pumps were used to provide local anaesthetic infusion with the ability to vary infusion rates. Acute pain service followed up the patient’s vital signs and effectiveness of pain relief twice daily or more frequently as required. Rectus sheath catheters were removed 137 hours post-op. The patient had good post-op analgesia with the minimal additional analgesic requirement. For the most part, the visual analog score (VAS) for pain remained at 1-3 on a scale of 1 to 10. Haemodynamics remained stable, and surgical recovery was as expected. Minimal opiate requirement after an extensive laparotomy also translates to the early return of intestinal motility. Our experience was encouraging, and we are hoping to extend this combination of two regional anaesthetic techniques to patients undergoing similar surgeries. Epidural analgesia is denser and offers excellent pain relief for both visceral and somatic pain in the first few days after surgery. As the pain intensity grows weaker, rectus sheath block and oral analgesics provide almost the same degree of pain relief after the epidural catheter is removed. We discovered that the background infusion of local anaesthetic down the rectus sheath catherter largely reduced the requirement for other classes of analgesics. We aim to study this further with a larger patient cohort and hope that it may become an established clinical practice that benefits patients everywhere.Keywords: rectus sheath, epidural infusion, post operative analgesia, elastomeric
Procedia PDF Downloads 1311535 Application of Artificial Neural Network Technique for Diagnosing Asthma
Authors: Azadeh Bashiri
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Introduction: Lack of proper diagnosis and inadequate treatment of asthma leads to physical and financial complications. This study aimed to use data mining techniques and creating a neural network intelligent system for diagnosis of asthma. Methods: The study population is the patients who had visited one of the Lung Clinics in Tehran. Data were analyzed using the SPSS statistical tool and the chi-square Pearson's coefficient was the basis of decision making for data ranking. The considered neural network is trained using back propagation learning technique. Results: According to the analysis performed by means of SPSS to select the top factors, 13 effective factors were selected, in different performances, data was mixed in various forms, so the different models were made for training the data and testing networks and in all different modes, the network was able to predict correctly 100% of all cases. Conclusion: Using data mining methods before the design structure of system, aimed to reduce the data dimension and the optimum choice of the data, will lead to a more accurate system. Therefore, considering the data mining approaches due to the nature of medical data is necessary.Keywords: asthma, data mining, Artificial Neural Network, intelligent system
Procedia PDF Downloads 2731534 Depression and Suicide Risk among HIV/AIDS Positive Individuals Attending an Out Patient HIV/AIDS Clinic in a Nigerian Tertiary Health Institution
Authors: Onyebueke Godwin, Okwarafor Friday
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Introduction: Persons with HIV/AIDS disease are predisposed to mental health disorders such as depression and suicide. HIV/AIDS, being a chronic medical illness with antecedent stigmatization ostracization, leads to low mood, low self-esteem, and a tendency to kill oneself due to the burden of the disease in terms of cost and disability. The aim of one study was to examine the prevalence of depression and risk of suicide among HIV/AIDS patients compared to negative persons. Instruments: The Major Depressive Episode and Suicidality modules of the MINI-Neuropsychiatric inventory were used to screen the attendees. Report: The prevalence of depression and risk of suicide were 27.8% and 7.8%, respectively, for the HIV positive subjects, but 1208% and 2.2%, respectively, for negative subjects. Conclusion and Significance: Persons with HIV/AIDS usually present with mental health symptoms, but the attending physicians usually pay attention to physical symptoms. The symptoms of the disease or the side effects of the medication may mask the mental health disease. Recommendation: There is need to screen HIV/AIDS patents for mental health disorders during clinic visits.Keywords: depression, HIV/AIDS, suicidality
Procedia PDF Downloads 581533 The Predictive Value of Serum Bilirubin in the Post-Transplant De Novo Malignancy: A Data Mining Approach
Authors: Nasim Nosoudi, Amir Zadeh, Hunter White, Joshua Conrad, Joon W. Shim
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De novo Malignancy has become one of the major causes of death after transplantation, so early cancer diagnosis and detection can drastically improve survival rates post-transplantation. Most previous work focuses on using artificial intelligence (AI) to predict transplant success or failure outcomes. In this work, we focused on predicting de novo malignancy after liver transplantation using AI. We chose the patients that had malignancy after liver transplantation with no history of malignancy pre-transplant. Their donors were cancer-free as well. We analyzed 254,200 patient profiles with post-transplant malignancy from the US Organ Procurement and Transplantation Network (OPTN). Several popular data mining methods were applied to the resultant dataset to build predictive models to characterize de novo malignancy after liver transplantation. Recipient's bilirubin, creatinine, weight, gender, number of days recipient was on the transplant waiting list, Epstein Barr Virus (EBV), International normalized ratio (INR), and ascites are among the most important factors affecting de novo malignancy after liver transplantationKeywords: De novo malignancy, bilirubin, data mining, transplantation
Procedia PDF Downloads 1041532 Detection of Patient Roll-Over Using High-Sensitivity Pressure Sensors
Authors: Keita Nishio, Takashi Kaburagi, Yosuke Kurihara
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Recent advances in medical technology have served to enhance average life expectancy. However, the total time for which the patients are prescribed complete bedrest has also increased. With patients being required to maintain a constant lying posture- also called bedsore- development of a system to detect patient roll-over becomes imperative. For this purpose, extant studies have proposed the use of cameras, and favorable results have been reported. Continuous on-camera monitoring, however, tends to violate patient privacy. We have proposed unconstrained bio-signal measurement system that could detect body-motion during sleep and does not violate patient’s privacy. Therefore, in this study, we propose a roll-over detection method by the date obtained from the bi-signal measurement system. Signals recorded by the sensor were assumed to comprise respiration, pulse, body motion, and noise components. Compared the body-motion and respiration, pulse component, the body-motion, during roll-over, generate large vibration. Thus, analysis of the body-motion component facilitates detection of the roll-over tendency. The large vibration associated with the roll-over motion has a great effect on the Root Mean Square (RMS) value of time series of the body motion component calculated during short 10 s segments. After calculation, the RMS value during each segment was compared to a threshold value set in advance. If RMS value in any segment exceeded the threshold, corresponding data were considered to indicate occurrence of a roll-over. In order to validate the proposed method, we conducted experiment. A bi-directional microphone was adopted as a high-sensitivity pressure sensor and was placed between the mattress and bedframe. Recorded signals passed through an analog Band-pass Filter (BPF) operating over the 0.16-16 Hz bandwidth. BPF allowed the respiration, pulse, and body-motion to pass whilst removing the noise component. Output from BPF was A/D converted with the sampling frequency 100Hz, and the measurement time was 480 seconds. The number of subjects and data corresponded to 5 and 10, respectively. Subjects laid on a mattress in the supine position. During data measurement, subjects—upon the investigator's instruction—were asked to roll over into four different positions—supine to left lateral, left lateral to prone, prone to right lateral, and right lateral to supine. Recorded data was divided into 48 segments with 10 s intervals, and the corresponding RMS value for each segment was calculated. The system was evaluated by the accuracy between the investigator’s instruction and the detected segment. As the result, an accuracy of 100% was achieved. While reviewing the time series of recorded data, segments indicating roll-over tendencies were observed to demonstrate a large amplitude. However, clear differences between decubitus and the roll-over motion could not be confirmed. Extant researches possessed a disadvantage in terms of patient privacy. The proposed study, however, demonstrates more precise detection of patient roll-over tendencies without violating their privacy. As a future prospect, decubitus estimation before and after roll-over could be attempted. Since in this paper, we could not confirm the clear differences between decubitus and the roll-over motion, future studies could be based on utilization of the respiration and pulse components.Keywords: bedsore, high-sensitivity pressure sensor, roll-over, unconstrained bio-signal measurement
Procedia PDF Downloads 1201531 Impact of Ethnomedicinal Plants on Toothpaste Improvement
Authors: Muna Jalal Ali, Essam A. Makky, Mashitah M. Yusoff
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Objectives: The aim of this study to evaluate the antimicrobial susceptibility of combined toothpaste with medicinal plants and the relations between the commercial toothpaste to its price and the patient age as well. Materials and Methods: Oral isolates of different patients aged 3 to 60 years were obtained, purified, and tested against four different ethnomedicinal plant extracts for antimicrobial activity. A total of 10 different commercial toothpastes (different brands and prices) were collected from the market, and the combined action of the medicinal plants and toothpaste was studied. Results: We found a higher bacterial population in the age group of 3–40 years than the group of 40–60 years, with approximately 44% and 32%, respectively. The combined action of ethanolic extract (alone) against oral isolates showed a synergistic effect, with 32.20, 30.50, and 25.42% for combinations A (Ci/Ca), B (Ci/Ca/P), and C (Ci/Ca/P/N), respectively. By contrast, the combined action of ethnomedicinal plants with 10 different toothpastes improved the antimicrobial sensitivity by 60, 100, and 0% for combinations A, B, and C respectively. Clinical relevance: The ethanolic extract of only combinations A and B with commercial toothpaste showed high antibacterial activity against oral isolates and the effectiveness of toothpaste is not related to the price.Keywords: microbial evolution, oral isolates, ethnomedicinal plants, antimicrobial activity, toothpaste
Procedia PDF Downloads 3111530 [Keynote Talk]: From Clinical Practice to Academic Setup, 'Quality Circles' for Quality Outputs in Both
Authors: Vandita Mishra
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From the management of patients, reception, record, and assistants in a clinical practice; to the management of ongoing research, clinical cases and department profile in an academic setup, the healthcare provider has to deal with all of it. The victory lies in smooth running of the show in both the above situations with an apt solution of problems encountered and smooth management of crisis faced. Thus this paper amalgamates dental science with health administration by means of introduction of a concept for practice management and problem-solving called 'Quality Circles'. This concept uses various tools for problem solving given by experts from different fields. QC tools can be applied in both clinical and academic settings in dentistry for better productivity and for scientifically approaching the process of continuous improvement in both the categories. When approached through QC, our organization showed better patient outcomes and more patient satisfaction. Introduced in 1962 by Kaoru Ishikawa, this tool has been extensively applied in certain fields outside dentistry and healthcare. By exemplification of some clinical cases and virtual scenarios, the tools of Quality circles will be elaborated and discussed upon.Keywords: academics, dentistry, healthcare, quality
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