Search results for: network intrusion prevention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6259

Search results for: network intrusion prevention

1519 Annexing the Strength of Information and Communication Technology (ICT) for Real-time TB Reporting Using TB Situation Room (TSR) in Nigeria: Kano State Experience

Authors: Ibrahim Umar, Ashiru Rajab, Sumayya Chindo, Emmanuel Olashore

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INTRODUCTION: Kano is the most populous state in Nigeria and one of the two states with the highest TB burden in the country. The state notifies an average of 8,000+ TB cases quarterly and has the highest yearly notification of all the states in Nigeria from 2020 to 2022. The contribution of the state TB program to the National TB notification varies from 9% to 10% quarterly between the first quarter of 2022 and second quarter of 2023. The Kano State TB Situation Room is an innovative platform for timely data collection, collation and analysis for informed decision in health system. During the 2023 second National TB Testing week (NTBTW) Kano TB program aimed at early TB detection, prevention and treatment. The state TB Situation room provided avenue to the state for coordination and surveillance through real time data reporting, review, analysis and use during the NTBTW. OBJECTIVES: To assess the role of innovative information and communication technology platform for real-time TB reporting during second National TB Testing week in Nigeria 2023. To showcase the NTBTW data cascade analysis using TSR as innovative ICT platform. METHODOLOGY: The State TB deployed a real-time virtual dashboard for NTBTW reporting, analysis and feedback. A data room team was set up who received realtime data using google link. Data received was analyzed using power BI analytic tool with statistical alpha level of significance of <0.05. RESULTS: At the end of the week-long activity and using the real-time dashboard with onsite mentorship of the field workers, the state TB program was able to screen a total of 52,054 people were screened for TB from 72,112 individuals eligible for screening (72% screening rate). A total of 9,910 presumptive TB clients were identified and evaluated for TB leading to diagnosis of 445 TB patients with TB (5% yield from presumptives) and placement of 435 TB patients on treatment (98% percentage enrolment). CONCLUSION: The TB Situation Room (TBSR) has been a great asset to Kano State TB Control Program in meeting up with the growing demand for timely data reporting in TB and other global health responses. The use of real time surveillance data during the 2023 NTBTW has in no small measure improved the TB response and feedback in Kano State. Scaling up this intervention to other disease areas, states and nations is a positive step in the right direction towards global TB eradication.

Keywords: tuberculosis (tb), national tb testing week (ntbtw), tb situation rom (tsr), information communication technology (ict)

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1518 Acceptance and Commitment Therapy for Social Anxiety Disorder in Adolescence: A Manualized Online Approach

Authors: Francisca Alves, Diana Figueiredo, Paula Vagos, Luiza Lima, Maria do Céu Salvador, Daniel Rijo

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In recent years, Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of numerous anxiety disorders, including social anxiety disorder (SAD). However, limited evidence exists on its therapeutic gains for adolescents with SAD. The current work presents a weekly 10-session manualized online ACT approach to adolescent SAD, being the first study to do so in a clinical sample of adolescents. The intervention ACT@TeenSAD addresses the six proposed processes of psychological inflexibility (i.e., experiential avoidance, cognitive fusion, lack of values clarity, unworkable action, dominance of the conceptualized past and future, attachment to the conceptualized self) in social situations relevant to adolescents (e.g., doing a presentation). It is organized into four modules. The first module explores the role of psychological (in)flexibility in SAD (session 1 and 2), addressing psychoeducation (i.e., functioning of the mind) according to ACT, the development of an individualized model, and creative hopelessness. The second module focuses on the foundation of psychological flexibility (session 3, 4, and 5), specifically on the development and practice of strategies to promote clarification of values, contact with the present moment, the observing self, defusion, and acceptance. The third module encompasses psychological flexibility in action (sessions 6, 7, 8, and 9), encouraging committed action based on values in social situations relevant to the adolescents. The fourth modules’ focus is the revision of gains and relapse prevention (session 10). This intervention further includes two booster sessions after therapy has ended (3 and 6-month follow-up) that aim to review the continued practice of learned abilities and to plan for their future application to potentially anxious social events. As part of an ongoing clinical trial, the intervention will be assessed on its feasibility with adolescents diagnosed with SAD and on its therapeutic efficacy based on a longitudinal design including pretreatment, posttreatment, 3 and 6-month follow-up. If promising, findings may support the online delivery of ACT interventions for SAD, contributing to increased treatment availability to adolescents. This availability of an effective therapeutic approach will be helpful not only in relation to adolescents who face obstacles (e.g., distance) when attending to face-to-face sessions but also particularly to adolescents with SAD, who are usually more reluctant to look for specialized treatment in public or private health facilities.

Keywords: acceptance and commitment therapy, social anxiety disorder, adolescence, manualized online approach

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1517 Unravelling the Relationship Between Maternal and Fetal ACE2 Gene Polymorphism and Preeclampsia Risk

Authors: Sonia Tamanna, Akramul Hassan, Mohammad Shakil Mahmood, Farzana Ansari, Gowhar Rashid, Mir Fahim Faisal, M. Zakir Hossain Howlader

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Background: Preeclampsia (PE), a pregnancy-specific hypertensive disorder, significantly impacts maternal and fetal health. It is particularly prevalent in underdeveloped countries and is linked to preterm delivery and fetal growth. The renin-angiotensin system (RAS) plays a crucial role in ensuring a successful pregnancy outcome, with Angiotensin-Converting Enzyme 2 (ACE2) being a key component. ACE2 converts ANG II to Ang-(1-7), offering protection against ANG II-induced stress and inflammation while regulating blood pressure and osmotic balance during pregnancy. The reduced maternal plasma angiotensin-converting enzyme 2 (ACE2) seen in preeclampsia might contribute to its pathogenesis. However, there has been a dearth of comprehensive research into the association between ACE2 gene polymorphism and preeclampsia. In the South Asian population, hypertension is strongly linked to two SNPs: rs2285666 and rs879922. This genotype was therefore considered, and the possible association of maternal and fetal ACE2 gene polymorphism with preeclampsia within the Bangladeshi population was evaluated. Method: DNA was extracted from peripheral white blood cells (WBCs) using the organic method, and SNP genotyping was done via PCR-RFLP. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using logistic regression to determine relative risk. Result: A comprehensive case-control study was conducted on 51 PE patients and their infants, along with 56 control subjects and their infants. Maternal single nuvleotide polymorphisms (SNP) (rs2285666) analysis revealed a strong association between the TT genotype and preeclampsia, with a four-fold increased risk in mothers (P=0.024, OR=4.00, 95% CI=1.36-11.37) compared to their ancestral genotype CC. However, the CT genotype (rs2285666) showed no significant difference (P=0.46, OR=1.54, 95% CI=0.57-4.14). Notably, no significant correlation was found in infants, regardless of their gender. For rs879922, no significant association was observed in both mothers and infants. This pioneering study suggests that mothers carrying the ACE2 gene variant rs2285666 (TT allele) may be at higher risk for preeclampsia, potentially influencing hypertension characteristics, whereas rs879922 does not appear to be associated with developing preeclampsia. Conclusion: This study sheds light on the role of ACE2 gene polymorphism, particularly the rs2285666 TT allele, in maternal susceptibility to preeclampsia. However, rs879922 does not appear to be linked to the risk of PE. This research contributes to our understanding of the genetic underpinnings of preeclampsia, offering insights into potential avenues for prevention and management.

Keywords: ACE2, PCR-RFLP, preeclampsia, single nuvleotide polymorphisms (SNPs)

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1516 Evidence of Social Media Addiction and Problematic Internet Use Among High School and University Students in Cyprus

Authors: Costas Christodoulides

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Excessive use of social networking sites (SNS) and the Internet by high school pupils and university students, can cause consequences similar to those observed in substance or gambling related addictions, negatively influence individual well-being notwithstanding self-assessments that people make about their life and experiences. The present study examined, for the first time in Cyprus, the levels of problematic use of the Social Media and the Internet among Cypriot pupils and students aiming at contributing to the discussion about the need for a more conclusive policy framework in the island. The Bergen Social Media Addiction Scale (BSMAS) and the Generalized Problematic Internet Use Scale 2 (GPIUS-2) were adapted to a Cypriot version and along with a sociodemographic questionnaire were introduced to a sample of 1059 young persons in order to respectively assess the addiction risk for Social Media Use and the risk of Problematic Internet Use. The sample consisted of 59% females, aged 15 to 35 (M=18.9 years, SD=3.20), 465 of them were high school students and 594 university students. Of 1059 respondents from 4 high-schools and 5 Universities (HEI) in Cyprus, 8.3% of the sample had BSMAS scores suggestive of addiction. Approximately a quarter of the sample (24%), demonstrated GPIUS-2 scores suggestive of high risk for problematic internet use. It is notable that differences seem to exist across gender with the score of the female population (11.1%) reaching levels of addiction to social media more than twice the level of addiction of the male population (4.3%). Also, the female population of high school students seems to be at the most vulnerable position for problematic internet use (28%). The 26% of the sample often or very often used some SNSs to forget of personal problems. The results of this study show that half of those surveyed used the Internet to feel better when they were upset or to escape the isolation they felt. Among the sample population, the study reports that 60% of the pupils and female university students are in agreement with the relevant statements. Conclusively, this study suggests that SNSs addiction levels among pupils and students in Cyprus ought to be an important public health concern. The same if not more alarming is the identified by the study prevalence of problematic Internet use among the same population. These results confirm international trends reported by scholarly research while also suggest that particular categories such as high school pupils and young females may be more exposed to problem SNSs and Internet use. Preventive strategies need first to acknowledge the problem in order to then formulate an effective strategy for prevention and intervention. For relevant authorities it is of primary importance to “exploit” the fact that high schools and universities can be seen as small communities and units potentially available for forging alliances for healthy Social Media and Internet use.

Keywords: problematic internet use, social media addiction, social networking sites, well-being

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1515 Fibrin Glue Reinforcement of Choledochotomy Closure Suture Line for Prevention of Bile Leak in Patients Undergoing Laparoscopic Common Bile Duct Exploration with Primary Closure: A Pilot Study

Authors: Rahul Jain, Jagdish Chander, Anish Gupta

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Introduction: Laparoscopic common bile duct exploration (LCBDE) allows cholecystectomy and the removal of common bile duct (CBD) stones to be performed during the same sitting, thereby decreasing hospital stay. CBD exploration through choledochotomy can be closed primarily with an absorbable suture material, but can lead to biliary leakage postoperatively. In this study we tried to find a solution to further lower the incidence of bile leakage by using fibrin glue to reinforce the sutures put on choledochotomy suture line. It has haemostatic and sealing action, through strengthening the last step of the physiological coagulation and biostimulation, which favours the formation of new tissue matrix. Methodology: This study was conducted at a tertiary care teaching hospital in New Delhi, India, from 2011 to 2013. 20 patients with CBD stones documented on MRCP with CBD diameter of 9 mm or more were included in this study. Patients were randomized into two groups namely Group A in which choledochotomy was closed with polyglactin 4-0 suture and suture line reinforced with fibrin glue, and Group ‘B’ in which choledochotomy was closed with polyglactin 4-0 suture alone. Both the groups were evaluated and compared on clinical parameters such as operative time, drain content, drain output, no. of days drain was required, blood loss & transfusion requirements, length of postoperative hospital stay and conversion to open surgery. Results: The operative time for Group A ranged from 60 to 210 min (mean 131.50 min) and Group B 65 to 300 min (mean 140 minutes). The blood loss in group A ranged from 10 to 120 ml (mean 51.50 ml), in group B it ranged from 10 to 200 ml (mean 53.50 ml). In Group A, there was no case of bile leak but there was bile leak in 2 cases in Group B, minimum 0 and maximum 900 ml with a mean of 97 ml and p value of 0.147 with no statistically significant difference in bile leak in test and control groups. The minimum and maximum serous drainage in Group A was nil & 80 ml (mean 11 ml) and in Group B was nil & 270 ml (mean 72.50 ml). The p value came as 0.028 which is statistically significant. Thus serous leakage in Group A was significantly less than in Group B. The drains in Group A were removed from 2 to 4 days (mean: 3 days) while in Group B from 2 to 9 days (mean: 3.9 days). The patients in Group A stayed in hospital post operatively from 3 to 8 days (mean: 5.30) while in Group B it ranged from 3 to 10 days with a mean of 5 days. Conclusion: Fibrin glue application on CBD decreases bile leakage but in statistically insignificant manner. Fibrin glue application on CBD can significantly decrease post operative serous drainage after LCBDE. Fibrin glue application on CBD is safe and easy technique without any significant adverse effects and can help less experienced surgeons performing LCBDE.

Keywords: bile leak, fibrin glue, LCBDE, serous leak

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1514 Virtual Container Yard: Assessing the Perceived Impact of Legal Implications to Container Carriers

Authors: L. Edirisinghe, P. Mukherjee, H. Edirisinghe

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Virtual Container Yard (VCY) is a modern concept that helps to reduce the empty container repositioning cost of carriers. The concept of VCY is based on container interchange between shipping lines. Although this mechanism has been theoretically accepted by the shipping community as a feasible solution, it has not yet achieved the necessary momentum among container shipping lines (CSL). This paper investigates whether there is any legal influence on this industry myopia about the VCY. It is believed that this is the first publication that focuses on the legal aspects of container exchange between carriers. Not much literature on this subject is available. This study establishes with statistical evidence that there is a phobia prevailing in the shipping industry that exchanging containers with other carriers may lead to various legal implications. The complexity of exchange is two faceted. CSLs assume that offering a container to another carrier (obviously, a competitor in terms of commercial context) or using a container offered by another carrier may lead to undue legal implications. This research reveals that this fear is reflected through four types of perceived components, namely: shipping associate; warehouse associate; network associate; and trading associate. These components carry eighteen subcomponents that comprehensively cover the entire process of a container shipment. The statistical explanation has been supported through regression analysis; INCO terms were used to illustrate the shipping process.

Keywords: virtual container yard, legal, maritime law, inventory

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1513 Comprehensive Review of Ultralightweight Security Protocols

Authors: Prashansa Singh, Manjot Kaur, Rohit Bajaj

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The proliferation of wireless sensor networks and Internet of Things (IoT) devices in the quickly changing digital landscape has highlighted the urgent need for strong security solutions that can handle these systems’ limited resources. A key solution to this problem is the emergence of ultralightweight security protocols, which provide strong security features while respecting the strict computational, energy, and memory constraints imposed on these kinds of devices. This in-depth analysis explores the field of ultralightweight security protocols, offering a thorough examination of their evolution, salient features, and the particular security issues they resolve. We carefully examine and contrast different protocols, pointing out their advantages and disadvantages as well as the compromises between resource limitations and security resilience. We also study these protocols’ application domains, including the Internet of Things, RFID systems, and wireless sensor networks, to name a few. In addition, the review highlights recent developments and advancements in the field, pointing out new trends and possible avenues for future research. This paper aims to be a useful resource for researchers, practitioners, and developers, guiding the design and implementation of safe, effective, and scalable systems in the Internet of Things era by providing a comprehensive overview of ultralightweight security protocols.

Keywords: wireless sensor network, machine-to-machine, MQTT broker, server, ultralightweight, TCP/IP

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1512 Blockchain for Transport: Performance Simulations of Blockchain Network for Emission Monitoring Scenario

Authors: Dermot O'Brien, Vasileios Christaras, Georgios Fontaras, Igor Nai Fovino, Ioannis Kounelis

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With the rise of the Internet of Things (IoT), 5G, and blockchain (BC) technologies, vehicles are becoming ever increasingly connected and are already transmitting substantial amounts of data to the original equipment manufacturers (OEMs) servers. This data could be used to help detect mileage fraud and enable more accurate vehicle emissions monitoring. This would not only help regulators but could enable applications such as permitting efficient drivers to pay less tax, geofencing for air quality improvement, as well as pollution tolling and trading platforms for transport-related businesses and EU citizens. Other applications could include traffic management and shared mobility systems. BC enables the transmission of data with additional security and removes single points of failure while maintaining data provenance, identity ownership, and the possibility to retain varying levels of privacy depending on the requirements of the applied use case. This research performs simulations of vehicles interacting with European member state authorities and European Commission BC nodes that are running hyperleger fabric and explores whether the technology is currently feasible for transport applications such as the emission monitoring use-case.

Keywords: future transportation systems, technological innovations, policy approaches for transportation future, economic and regulatory trends, blockchain

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1511 Development of Prediction Models of Day-Ahead Hourly Building Electricity Consumption and Peak Power Demand Using the Machine Learning Method

Authors: Dalin Si, Azizan Aziz, Bertrand Lasternas

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To encourage building owners to purchase electricity at the wholesale market and reduce building peak demand, this study aims to develop models that predict day-ahead hourly electricity consumption and demand using artificial neural network (ANN) and support vector machine (SVM). All prediction models are built in Python, with tool Scikit-learn and Pybrain. The input data for both consumption and demand prediction are time stamp, outdoor dry bulb temperature, relative humidity, air handling unit (AHU), supply air temperature and solar radiation. Solar radiation, which is unavailable a day-ahead, is predicted at first, and then this estimation is used as an input to predict consumption and demand. Models to predict consumption and demand are trained in both SVM and ANN, and depend on cooling or heating, weekdays or weekends. The results show that ANN is the better option for both consumption and demand prediction. It can achieve 15.50% to 20.03% coefficient of variance of root mean square error (CVRMSE) for consumption prediction and 22.89% to 32.42% CVRMSE for demand prediction, respectively. To conclude, the presented models have potential to help building owners to purchase electricity at the wholesale market, but they are not robust when used in demand response control.

Keywords: building energy prediction, data mining, demand response, electricity market

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1510 Isolation and Screening of Antagonistic Bacteria against Wheat Pathogenic Fungus Tilletia indica

Authors: Sugandha Asthana, Geetika Vajpayee, Pratibha Kumari, Shanthy Sundaram

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An economically important disease of wheat in North Western region of India is Karnal Bunt caused by smut fungus Tilletia indica. This fungal pathogen spreads by air, soil and seed borne sporodia at the time of flowering, which ultimately leads to partial bunting of wheat kernels with fishy odor and taste to wheat flour. It has very serious effects due to quarantine measures which have to be applied for grain exports. Chemical fungicides such as mercurial compounds and Propiconazole applied to the control of Karnal bunt have been only partially successful. Considering the harmful effects of chemical fungicides on man as well as environment, many countries are developing biological control as the superior substitute to chemical control. Repeated use of fungicides can be responsible for the development of resistance in fungal pathogens against certain chemical compounds. The present investigation is based on the isolation and evaluation of antifungal properties of some isolated (from natural manure) and commercial bacterial strains against Tilletia indica. Total 23 bacterial isolates were obtained and antagonistic activity of all isolates and commercial bacterial strains (Bacillus subtilis MTCC8601, Bacillus pumilus MTCC 8743, Pseudomonas aeruginosa) were tested against T. indica by dual culture plate assay (pour plate and streak plate). Test for the production of antifungal volatile organic compounds (VOCs) by antagonistic bacteria was done by sealed plate method. Amongst all s1, s3, s5, and B. subtilis showed more than 80% inhibition. Production of extracellular hydrolytic enzymes such as protease, beta 1, 4 glucanase, HCN and ammonia was studied for confirmation of antifungal activity. s1, s3, s5 and B. subtilis were found to be the best for protease activity and s5 and B. subtilis for beta 1, 4 glucanase activity. Bacillus subtilis was significantly effective for HCN whereas s3, s5 and Bacillus subtilis for ammonia production. Isolates were identified as Pseudomonas aeruginosa (s1) and B. licheniformis (s3, s5) by various biochemical assays and confirmed by16s rRNA sequencing. Use of microorganisms or their secretions as biocontrol agents to avoid plant diseases is ecologically safe and may offer long term of protection to crop. The above study reports the promising effects of these strains in better pathogen free crop production and quality maintenance as well as prevention of the excessive use of synthetic fungicides.

Keywords: antagonistic, antifungal, biocontrol, Karnal bunt

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1509 Matching Law in Autoshaped Choice in Neural Networks

Authors: Giselle Maggie Fer Castañeda, Diego Iván González

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The objective of this work was to study the autoshaped choice behavior in the Donahoe, Burgos and Palmer (DBP) neural network model and analyze it under the matching law. Autoshaped choice can be viewed as a form of economic behavior defined as the preference between alternatives according to their relative outcomes. The Donahoe, Burgos and Palmer (DBP) model is a connectionist proposal that unifies operant and Pavlovian conditioning. This model has been used for more than three decades as a neurobehavioral explanation of conditioning phenomena, as well as a generator of predictions suitable for experimental testing with non-human animals and humans. The study consisted of different simulations in which, in each one, a ratio of reinforcement was established for two alternatives, and the responses (i.e., activations) in each of them were measured. Choice studies with animals have demonstrated that the data generally conform closely to the generalized matching law equation, which states that the response ratio equals proportionally to the reinforcement ratio; therefore, it was expected to find similar results with the neural networks of the Donahoe, Burgos and Palmer (DBP) model since these networks have simulated and predicted various conditioning phenomena. The results were analyzed by the generalized matching law equation, and it was observed that under some contingencies, the data from the networks adjusted approximately to what was established by the equation. Implications and limitations are discussed.

Keywords: matching law, neural networks, computational models, behavioral sciences

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1508 Non-Melanoma Skin Cancer of Cephalic Extremity – Clinical and Histological Aspects

Authors: Razvan Mercut, Mihaela Ionescu, Vlad Parvanescu, Razvan Ghita, Tudor-Gabriel Caragea, Cristina Simionescu, Marius-Eugen Ciurea

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Introduction: Over the past years, the incidence of non-melanoma skin cancer (NMSC) has continuously increased, being one of the most commonly diagnosed carcinomasofthe cephalic extremity. NMSC regroups basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Merkel cell carcinoma, cutaneous lymphoma, and sarcoma. The most common forms are BCC and SCC, both still implying a significant level of morbidity due to local invasion (especially BCC), even if the overall death rates are declining. The objective of our study was the evaluation of clinical and histological aspects of NMSC for a group of patients with BCC and SCC, from Craiova, a south-western major city in Romania. Materialand method: Our study lot comprised 65 patients, with an almost equal distribution of sexes, and ages between 23-91 years old (mean value±standard deviation62.61±16.67), all treated within the Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency County Hospital Craiova, Romania, between 2019-2020. In order to determine the main morphological characteristics of both studied cancers, we used paraffin embedding techniques, with various staining methods:hematoxylin-eosin, Masson's trichrome stain with aniline blue, and Periodic acid-schiffAlcian Blue. The statistical study was completed using Microsoft Excel (Microsoft Corp., Redmond, WA, USA), with XLSTAT (Addinsoft SARL, Paris, France). Results: The overall results of our study indicate that BCC accounts for 67.69% of all NMSC forms; SCC covers 27.69%, while 4.62% are representedby other forms. The most frequent site is the nose for BCC (27.69%, 18 patients), being followed by preauricular regions, forehead, and periorbital areas. For patients with SCC, tumors were mainly located at lips level (66.67%, 12 patients). The analysis of NMSC histological forms indicated that nodular BCC is predominant (45.45%, 20 patients), as well as ulcero-vegetant SCC (38.89%, 7 patients). We have not identified any topographic characteristics or NMSC forms significantly related to age or sex. Conclusions: The most frequent NMSC form identified for our study lot was BCC. The preferred location was the nose for BCC. For SCC, the oral cavity is the most frequent anatomical site, especially the lips level. Nodular BCC and ulcero-vegetant SCC were the most commonly identified histological types. Our findings emphasize the need for periodic screening, in order to improve prevention and early treatment for these malignancies.

Keywords: non-melanoma skin cancer, basal cell carcinoma, squamous cell carcinoma, histological

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1507 Services, Stigma and Discrimination: Perceptions of African Descendant Men Living with HIV/AIDS in Brazil and in the US

Authors: Aparecida De Fatima Dutra, Freddie Avant, Wilma Cordova

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People living with HIV/AIDS (PLWHA) have benefited from advances in treatment. Medical costs are a challenge for some, but the real challenge is the stigma and discrimination PLWHA continue to face, even though the disease has festered for the last four decades. Few studies regarding stigma and discrimination give voice to those affected by these practices. This study provides a voice to PLWHA in Brazil and in the US as to how they perceive stigma and discrimination, as well as services they access. The methodology of this study was designed based on phenomenological research, which is a research that aims to identify what individuals facing the same situation have to share about their experiences. Qualitative research using in- depth interviews was used in order to gather participants’ perceptions about services they access, and stigma and discrimination they experience as PLWHA (hypothesis). The target population was a minority group of 13 Afro-descendant men, mean age of 48.3, residents in East Texas, United States and Salvador, Brazil. Our findings indicate that in both countries, overall, participants have reasonable access to medication and qualified services, except for some specialties, such as dentistry. With regard to stigma and discrimination the majority of participants have not disclosed their diagnosis. They state they prefer not to disclose for fear of being ostracized and rejected. Participants who did reveal their status indicate that stigma and discrimination is a daily occurrence. These experiences tend to occur within their own families, neighborhoods, and in public health agencies where HIV/AIDS is not the focus. Participants who did offer suggestions for social change indicated they would have to reveal their status even if it means being stigmatized and discriminated against. Other factors contributing to this discrimination include skin color and poverty. This study concludes that even after decades since the spread of this epidemic, nothing has changed regarding stigma and discrimination towards PLWHA. Lack of awareness, empathy and education continue to be a major challenge, not only at a local level but across the globe. In conclusion, as documented in previous studies while stigma and discrimination towards this population prevail, negative attitudes will continue to jeopardize all individuals from receiving equal access to prevention, treatment and care. It is crucial to face stigma and discrimination not only as individual experiences, but as social practices that violate and restrict human rights and that as a result, reinforce inequality and social exclusion. Policies should be at the forefront to eliminate the stigma and discrimination PLWHA experience. Health professionals and societies must take a stand in order to promote mindfulness about the negative effect of oppression towards individuals living with HIV/AIDS and the potential global impact of these practices.

Keywords: discrimination, HIV/AIDS, human rights, stigma

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1506 Incidence and Molecular Mechanism of Human Pathogenic Bacterial Interaction with Phylloplane of Solanum lycopersicum

Authors: Indu Gaur, Neha Bhadauria, Shilpi Shilpi, Susmita Goswami, Prem D. Sharma, Prabir K. Paul

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The concept of organic agriculture has been accepted as novelty in Indian society, but there is no data available on the human pathogens colonizing plant parts due to such practices. Also, the pattern and mechanism of their colonization need to be understood in order to devise possible strategies for their prevention. In the present study, human pathogenic bacteria were isolated from organically grown tomato plants and five of them were identified as Klebsiella pneumoniae, Enterobacter ludwigii, Serratia fonticola, Stenotrophomonas maltophilia and Chryseobacterium jejuense. Tomato plants were grown in controlled aseptic conditions with 25±1˚C, 70% humidity and 12 hour L/D photoperiod. Six weeks old plants were divided into 6 groups of 25 plants each and treated as follows: Group 1: K. pneumonia, Group 2: E. ludwigii, Group 3: S. fonticola, Group 4: S. maltophilia, Group 5: C. jejuense, Group 6: Sterile distilled water (control). The inoculums for all treatments were prepared by overnight growth with uniform concentration of 108 cells/ml. Leaf samples from above groups were collected at 0.5, 2, 4, 6 and 24 hours post inoculation for the colony forming unit counts (CFU/cm2 of leaf area) of individual pathogens using leaf impression method. These CFU counts were used for the in vivo colonization assay and adherence assay of individual pathogens. Also, resistance of these pathogens to at least 12 antibiotics was studied. Based on these findings S. fonticola was found to be most prominently colonizing the phylloplane of tomato and was further studied. Tomato plants grown in controlled aseptic conditions same as mentioned above were divided into 2 groups of 25 plants each and treated as follows: Group 1: S. fonticola, Group 2: Sterile distilled water (control). Leaf samples from above groups were collected at 0, 24, 48, 72 and 96 hours post inoculation and homogenized in suitable buffers for surface and cell wall protein isolation. Protein samples thus obtained were subjected to isocratic SDS-gel electrophoresis and analyzed. It was observed that presence of S. fonticola could induce the expression of at least 3 additional cell wall proteins at different time intervals. Surface proteins also showed variation in the expression pattern at different sampling intervals. Further identification of these proteins by MALDI-MS and bioinformatics tools revealed the gene(s) involved in the interaction of S. fonticola with tomato phylloplane.

Keywords: cell wall proteins, human pathogenic bacteria, phylloplane, solanum lycopersicum

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1505 Deep Learning to Improve the 5G NR Uplink Control Channel

Authors: Ahmed Krobba, Meriem Touzene, Mohamed Debeyche

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The wireless communications system (5G) will provide more diverse applications and higher quality services for users compared to the long-term evolution 4G (LTE). 5G uses a higher carrier frequency, which suffers from information loss in 5G coverage. Most 5G users often cannot obtain high-quality communications due to transmission channel noise and channel complexity. Physical Uplink Control Channel (PUCCH-NR: Physical Uplink Control Channel New Radio) plays a crucial role in 5G NR telecommunication technology, which is mainly used to transmit link control information uplink (UCI: Uplink Control Information. This study based of evaluating the performance of channel physical uplink control PUCCH-NR under low Signal-to-Noise Ratios with various antenna numbers reception. We propose the artificial intelligence approach based on deep neural networks (Deep Learning) to estimate the PUCCH-NR channel in comparison with this approach with different conventional methods such as least-square (LS) and minimum-mean-square-error (MMSE). To evaluate the channel performance we use the block error rate (BLER) as an evaluation criterion of the communication system. The results show that the deep neural networks method gives best performance compared with MMSE and LS

Keywords: 5G network, uplink (Uplink), PUCCH channel, NR-PUCCH channel, deep learning

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1504 Geodynamics Behaviour of Greater Cairo as Deduced from 4D Gravity and Seismic Activities

Authors: Elsayed A. Issawy, Anwar H. Radwan

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Recent crustal deformations studies in Egypt are applied on the most active areas with relation to seismic activity. Temporal gravity variations in parallel with the geodetic technique (GPS) were used to monitor recent crustal movements in Egypt since 1997. The non-tidal gravity changes were constrained by the vertical component of surface movements derived from the GPS observations. The gravity changes were used to understand the surface tectonics and geodynamic modelling of the Greater Cairo region after the occurrence of an earthquake of 1992. It was found that there is a certain relation showed by increasing of gravity values before the main seismic activity. As example, relative considerable increase of gravity values was noticed for the network between the epochs of 2000 and 2004. Otherwise, the temporal gravity variations were reported a considerable decrease in gravity values between the two campaigns of 2004 and 2007 for the same stations. This behaviour could explain by compressive deformation and strain build-up stage before the South western Cairo earthquake (July 31, 2005 with magnitude of 4.3) and the stress release stage occurred after the main event. The geodetic measurements showed that, the estimated horizontal velocities for almost of points are 5.5 mm/year in approximately NW direction.

Keywords: temporal gravity variations, geodynamics, greater Cairo, recent crustal movements, earthquakes

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1503 Critical Analysis of International Protections for Children from Sexual Abuse and Examination of Indian Legal Approach

Authors: Ankita Singh

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Sex trafficking and child pornography are those kinds of borderless crimes which can not be effectively prevented only through the laws and efforts of one country because it requires a proper and smooth collaboration among countries. Eradication of international human trafficking syndicates, criminalisation of international cyber offenders, and effective ban on child pornography is not possible without applying effective universal laws; hence, continuous collaboration of all countries is much needed to adopt and routinely update these universal laws. Congregation of countries on an international platform is very necessary from time to time, where they can simultaneously adopt international agendas and create powerful universal laws to prevent sex trafficking and child pornography in this modern digital era. In the past, some international steps have been taken through The Convention on the Rights of the Child (CRC) and through The Optional Protocol to the Convention on the Rights of the Child on the Sale of Children, Child Prostitution, and Child Pornography, but in reality, these measures are quite weak and are not capable in effectively protecting children from sexual abuse in this modern & highly advanced digital era. The uncontrolled growth of artificial intelligence (AI) and its misuse, lack of proper legal jurisdiction over foreign child abusers and difficulties in their extradition, improper control over international trade of digital child pornographic content, etc., are some prominent issues which can only be controlled through some new, effective and powerful universal laws. Due to a lack of effective international standards and a lack of improper collaboration among countries, Indian laws are also not capable of taking effective actions against child abusers. This research will be conducted through both doctrinal as well as empirical methods. Various literary sources will be examined, and a questionnaire survey will be conducted to analyse the effectiveness of international standards and Indian laws against child pornography. Participants in this survey will be Indian University students. In this work, the existing international norms made for protecting children from sexual abuse will be critically analysed. It will explore why effective and strong collaboration between countries is required in modern times. It will be analysed whether existing international steps are enough to protect children from getting trafficked or being subjected to pornography, and if these steps are not found to be sufficient enough, then suggestions will be given on how international standards and protections can be made more effective and powerful in this digital era. The approach of India towards the existing international standards, the Indian laws to protect children from being subjected to pornography, and the contributions & capabilities of India in strengthening the international standards will also be analysed.

Keywords: child pornography, prevention of children from sexual offences act, the optional protocol to the convention on the rights of the child on the sale of children, child prostitution and child pornography, the convention on the rights of the child

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1502 Hybrid Bee Ant Colony Algorithm for Effective Load Balancing and Job Scheduling in Cloud Computing

Authors: Thomas Yeboah

Abstract:

Cloud Computing is newly paradigm in computing that promises a delivery of computing as a service rather than a product, whereby shared resources, software, and information are provided to computers and other devices as a utility (like the electricity grid) over a network (typically the Internet). As Cloud Computing is a newly style of computing on the internet. It has many merits along with some crucial issues that need to be resolved in order to improve reliability of cloud environment. These issues are related with the load balancing, fault tolerance and different security issues in cloud environment.In this paper the main concern is to develop an effective load balancing algorithm that gives satisfactory performance to both, cloud users and providers. This proposed algorithm (hybrid Bee Ant Colony algorithm) is a combination of two dynamic algorithms: Ant Colony Optimization and Bees Life algorithm. Ant Colony algorithm is used in this hybrid Bee Ant Colony algorithm to solve load balancing issues whiles the Bees Life algorithm is used for optimization of job scheduling in cloud environment. The results of the proposed algorithm shows that the hybrid Bee Ant Colony algorithm outperforms the performances of both Ant Colony algorithm and Bees Life algorithm when evaluated the proposed algorithm performances in terms of Waiting time and Response time on a simulator called CloudSim.

Keywords: ant colony optimization algorithm, bees life algorithm, scheduling algorithm, performance, cloud computing, load balancing

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1501 Conservative and Surgical Treatment of Antiresorptive Drug-Related Osteonecrosis of the Jaw with Ultrasonic Piezoelectric Bone Surgery under Polyvinylpyrrolidone Iodine Irrigation: A Case Series of 13 Treated Sites

Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

Abstract:

Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

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1500 Behaviour of Polypropylene Fiber Reinforced Concrete under Dynamic Impact Loads

Authors: Masoud Abedini, Azrul A. Mutalib

Abstract:

A study of the used of additives which mixed with concrete in order to increase the strength and durability of concrete was examined to improve the quality of many aspects in the concrete. This paper presents a polypropylene (PP) fibre was added into concrete to study the dynamic response under impact load. References related to dynamic impact test for sample polypropylene fibre reinforced concrete (PPFRC) is very limited and there is no specific research and information related to this research. Therefore, the study on the dynamic impact of PPFRC using a Split Hopkinson Pressure Bar (SHPB) was done in this study. Provided samples for this study was composed of 1.0 kg/m³ PP fibres, 2.0 kg/m³ PP fibres and plain concrete as a control samples. This PP fibre contains twisted bundle non-fibrillating monofilament and fibrillating network fibres. Samples were prepared by cylindrical mould with three samples of each mix proportion, 28 days curing period and concrete grade 35 Mpa. These samples are then tested for dynamic impact by SHPB at 2 Mpa pressure under the strain rate of 10 s-1. Dynamic compressive strength results showed an increase of SC1 and SC2 samples than the control sample which is 13.22 % and 76.9 % respectively with the dynamic compressive strength of 74.5 MPa and 116.4 MPa compared to 65.8 MPa. Dynamic increased factor (DIF) shows that, sample SC2 gives higher value with 4.15 than others samples SC1 and SC3 that gives the value of 2.14 and 1.97 respectively.

Keywords: polypropylene fiber, Split Hopkinson Pressure Bar, impact load, dynamic compressive strength

Procedia PDF Downloads 542
1499 Social Interaction of Gifted Students in a Heterogeneous Educational Environment

Authors: Ekaterina Donii

Abstract:

Understanding interpersonal competence, social interaction and peer relationships of gifted children is a concern for specialists in the field of gifted education. To gain more in-depth knowledge concerning the social functioning of gifted children among peers, we decided to study the social abilities of gifted children in a heterogeneous academic environment. Eight gifted children (5 of age 7, 1 of age 8.5, 1 of age 9.5 and 1 of age 10), their classmates (10 of age 7-8, 12 of age 8.5-9, 16 of age 9.5-10) and teachers participated in the study. The sociometric questionnaire analysis was based on the method of Rodríguez and Morera to check the social status of the gifted children among classmates. The Instrument Observational Protocol for Interactions within the Classroom (OPINTEC-v.5) was used to assess the social interactions between the gifted students, their classmates, and the teacher within the educational context. While doing a task together, the gifted children interacted more with popular and neither popular nor gifted classmates than with rejected classmates. While spending time together, the gifted children interacted more with neither popular nor rejected classmates than with popular or rejected classmates. All gifted children chose other gifted and non-gifted classmates for interaction, established close relations and demonstrated good social abilities interacting with their classmates. The aim of this study was to examine the social interactions, social status, and social network of the gifted students in a regular classroom. The majority of the gifted children were popular among their classmates and had good social skills. We should be alert, though, for those gifted children who do have social problems, in order to help them functioning in a regular classroom.

Keywords: gifted, heterogeneous environment, sociometric status, social interactions

Procedia PDF Downloads 338
1498 An MrPPG Method for Face Anti-Spoofing

Authors: Lan Zhang, Cailing Zhang

Abstract:

In recent years, many face anti-spoofing algorithms have high detection accuracy when detecting 2D face anti-spoofing or 3D mask face anti-spoofing alone in the field of face anti-spoofing, but their detection performance is greatly reduced in multidimensional and cross-datasets tests. The rPPG method used for face anti-spoofing uses the unique vital information of real face to judge real faces and face anti-spoofing, so rPPG method has strong stability compared with other methods, but its detection rate of 2D face anti-spoofing needs to be improved. Therefore, in this paper, we improve an rPPG(Remote Photoplethysmography) method(MrPPG) for face anti-spoofing which through color space fusion, using the correlation of pulse signals between real face regions and background regions, and introducing the cyclic neural network (LSTM) method to improve accuracy in 2D face anti-spoofing. Meanwhile, the MrPPG also has high accuracy and good stability in face anti-spoofing of multi-dimensional and cross-data datasets. The improved method was validated on Replay-Attack, CASIA-FASD, Siw and HKBU_MARs_V2 datasets, the experimental results show that the performance and stability of the improved algorithm proposed in this paper is superior to many advanced algorithms.

Keywords: face anti-spoofing, face presentation attack detection, remote photoplethysmography, MrPPG

Procedia PDF Downloads 167
1497 LncRNA NEAT1 Promotes NSCLC Progression through Acting as a ceRNA of miR-377-3p

Authors: Chengcao Sun, Shujun Li, Cuili Yang, Yongyong Xi, Liang Wang, Feng Zhang, Dejia Li

Abstract:

Recently, the long non-coding RNA (lncRNA) NEAT1 has been identified as an oncogenic gene in multiple cancer types and elevated expression of NEAT1 was tightly linked to tumorigenesis and cancer progression. However, the molecular basis for this observation has not been characterized in progression of non-small cell lung cancer (NSCLC). In our studies, we identified NEAT1 was highly expressed in NSCLC patients and was a novel regulator of NSCLC progression. Patients whose tumors had high NEAT1 expression had a shorter overall survival than patients whose tumors had low NEAT1 expression. Further, NEAT1 significantly accelerates NSCLC cell growth and metastasis in vitro and tumor growth in vivo. Additionally, by using bioinformatics study and RNA pull down combined with luciferase reporter assays, we demonstrated that NEAT1 functioned as a competing endogenous RNA (ceRNA) for has-miR-377-3p, antagonized its functions and led to the de-repression of its endogenous targets E2F3, which was a core oncogene in promoting NSCLC progression. Taken together, these observations imply that the NEAT1 modulated the expression of E2F3 gene by acting as a competing endogenous RNA, which may build up the missing link between the regulatory miRNA network and NSCLC progression.

Keywords: long non-coding RNA NEAT1, hsa-miRNA-377-3p, E2F3, non-small cell lung cancer, tumorigenesis

Procedia PDF Downloads 364
1496 Multi Agent Based Pre-Hospital Emergency Management Architecture

Authors: Jaleh Shoshtarian Malak, Niloofar Mohamadzadeh

Abstract:

Managing pre-hospital emergency patients requires real-time practices and efficient resource utilization. Since we are facing a distributed Network of healthcare providers, services and applications choosing the right resources and treatment protocol considering patient situation is a critical task. Delivering care to emergency patients at right time and with the suitable treatment settings can save ones live and prevent further complication. In recent years Multi Agent Systems (MAS) introduced great solutions to deal with real-time, distributed and complicated problems. In this paper we propose a multi agent based pre-hospital emergency management architecture in order to manage coordination, collaboration, treatment protocol and healthcare provider selection between different parties in pre-hospital emergency in a self-organizing manner. We used AnyLogic Agent Based Modeling (ABM) tool in order to simulate our proposed architecture. We have analyzed and described the functionality of EMS center, Ambulance, Consultation Center, EHR Repository and Quality of Care Monitoring as main collaborating agents. Future work includes implementation of the proposed architecture and evaluation of its impact on patient quality of care improvement.

Keywords: multi agent systems, pre-hospital emergency, simulation, software architecture

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1495 Analysis of Linguistic Disfluencies in Bilingual Children’s Discourse

Authors: Sheena Christabel Pravin, M. Palanivelan

Abstract:

Speech disfluencies are common in spontaneous speech. The primary purpose of this study was to distinguish linguistic disfluencies from stuttering disfluencies in bilingual Tamil–English (TE) speaking children. The secondary purpose was to determine whether their disfluencies are mediated by native language dominance and/or on an early onset of developmental stuttering at childhood. A detailed study was carried out to identify the prosodic and acoustic features that uniquely represent the disfluent regions of speech. This paper focuses on statistical modeling of repetitions, prolongations, pauses and interjections in the speech corpus encompassing bilingual spontaneous utterances from school going children – English and Tamil. Two classifiers including Hidden Markov Models (HMM) and the Multilayer Perceptron (MLP), which is a class of feed-forward artificial neural network, were compared in the classification of disfluencies. The results of the classifiers document the patterns of disfluency in spontaneous speech samples of school-aged children to distinguish between Children Who Stutter (CWS) and Children with Language Impairment CLI). The ability of the models in classifying the disfluencies was measured in terms of F-measure, Recall, and Precision.

Keywords: bi-lingual, children who stutter, children with language impairment, hidden markov models, multi-layer perceptron, linguistic disfluencies, stuttering disfluencies

Procedia PDF Downloads 207
1494 PLC Based Automatic Railway Crossing System for India

Authors: Tapan Upadhyay, Aqib Siddiqui, Sameer Khan

Abstract:

Railway crossing system in India is a manually operated level crossing system, either manned or unmanned. The main aim is to protect pedestrians and vehicles from colliding with trains, which pass at regular intervals, as India has the largest and busiest railway network. But because of human error and negligence, every year thousands of lives are lost due to accidents at railway crossings. To avoid this, we suggest a solution, by using Programmable Logical Controller (PLC) based automatic system, which will automatically control the barrier as well as roadblocks to stop people from crossing while security warning is given. Often people avoid security warning, and pass two-wheelers from beneath the barrier, while the train is at a distance away. This paper aims at reducing the fatality and accident rate by controlling barrier and roadblocks using sensors which sense the incoming train and vehicles and sends a signal to PLC. The PLC in return sends a signal to barrier and roadblocks. Once the train passes, the barrier and roadblocks retrieve back, and the passage is clear for vehicles and pedestrians to cross. PLC’s are used because they are very flexible, cost effective, space efficient, reduces complexity and minimises errors. Supervisory Control And Data Acquisition (SCADA) is used to monitor the functioning.

Keywords: level crossing, PLC, sensors, SCADA

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1493 Internet of Things Edge Device Power Modelling and Optimization Simulator

Authors: Cian O'Shea, Ross O'Halloran, Peter Haigh

Abstract:

Wireless Sensor Networks (WSN) are Internet of Things (IoT) edge devices. They are becoming widely adopted in many industries, including health care, building energy management, and conditional monitoring. As the scale of WSN deployments increases, the cost and complexity of battery replacement and disposal become more significant and in time may become a barrier to adoption. Harvesting ambient energies provide a pathway to reducing dependence on batteries and in the future may lead to autonomously powered sensors. This work describes a simulation tool that enables the user to predict the battery life of a wireless sensor that utilizes energy harvesting to supplement the battery power. To create this simulator, all aspects of a typical WSN edge device were modelled including, sensors, transceiver, and microcontroller as well as the energy source components (batteries, solar cells, thermoelectric generators (TEG), supercapacitors and DC/DC converters). The tool allows the user to plug and play different pre characterized devices as well as add user-defined devices. The goal of this simulation tool is to predict the lifetime of a device and scope for extension using ambient energy sources.

Keywords: Wireless Sensor Network, IoT, edge device, simulation, solar cells, TEG, supercapacitor, energy harvesting

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1492 Considering Effect of Wind Turbines in the Distribution System

Authors: Majed Ahmadi

Abstract:

In recent years, the high penetration of different types of renewable energy sources (RESs) has affected most of the available strategies. The main motivations behind the high penetration of RESs are clean energy, modular system and easy installation. Among different types of RESs, wind turbine (WT) is an interesting choice referring to the availability of wind in almost any area. The new technologies of WT can provide energy from residential applications to wide grid connected applications. Regarding the WT, advantages such as reducing the dependence on fossil fuels and enhancing the independence and flexibility of large power grid are the most prominent. Nevertheless, the high volatile nature of wind speed injects much uncertainty in the grid that if not managed optimally can put the analyses far from the reality.the aim of this project is scrutiny and to offer proper ways for renewing distribution networks with envisage the effects of wind power plants and uncertainties related to distribution systems including wind power generating plants output rate and consumers consuming rate and also decrease the incidents of the whole network losses, amount of pollution, voltage refraction and cost extent.to solve this problem we use dual point estimate method.And algorithm used in this paper is reformed bat algorithm, which will be under exact research furthermore the results.

Keywords: order renewal, wind turbines, bat algorithm, outspread production, uncertainty

Procedia PDF Downloads 272
1491 Time of Death Determination in Medicolegal Death Investigations

Authors: Michelle Rippy

Abstract:

Medicolegal death investigation historically is a field that does not receive much research attention or advancement, as all of the subjects are deceased. Public health threats, drug epidemics and contagious diseases are typically recognized in decedents first, with thorough and accurate death investigations able to assist in epidemiology research and prevention programs. One vital component of medicolegal death investigation is determining the decedent’s time of death. An accurate time of death can assist in corroborating alibies, determining sequence of death in multiple casualty circumstances and provide vital facts in civil situations. Popular television portrays an unrealistic forensic ability to provide the exact time of death to the minute for someone found deceased with no witnesses present. The actuality of unattended decedent time of death determination can generally only be narrowed to a 4-6 hour window. In the mid- to late-20th century, liver temperatures were an invasive action taken by death investigators to determine the decedent’s core temperature. The core temperature was programmed into an equation to determine an approximate time of death. Due to many inconsistencies with the placement of the thermometer and other variables, the accuracy of the liver temperatures was dispelled and this once common place action lost scientific support. Currently, medicolegal death investigators utilize three major after death or post-mortem changes at a death scene. Many factors are considered in the subjective determination as to the time of death, including the cooling of the decedent, stiffness of the muscles, release of blood internally, clothing, ambient temperature, disease and recent exercise. Current research is utilizing non-invasive hospital grade tympanic thermometers to measure the temperature in the each of the decedent’s ears. This tool can be used at the scene and in conjunction with scene indicators may provide a more accurate time of death. The research is significant and important to investigations and can provide an area of accuracy to a historically inaccurate area, considerably improving criminal and civil death investigations. The goal of the research is to provide a scientific basis to unwitnessed deaths, instead of the art that the determination currently is. The research is currently in progress with expected termination in December 2018. There are currently 15 completed case studies with vital information including the ambient temperature, decedent height/weight/sex/age, layers of clothing, found position, if medical intervention occurred and if the death was witnessed. This data will be analyzed with the multiple variables studied and available for presentation in January 2019.

Keywords: algor mortis, forensic pathology, investigations, medicolegal, time of death, tympanic

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1490 Applying the Global Trigger Tool in German Hospitals: A Retrospective Study in Surgery and Neurosurgery

Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

Abstract:

Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

Procedia PDF Downloads 240