Search results for: sample hospital

Authors: R. Karmouch

Abstract:

A thin gold metal layer was deposited on the top of silicon oxide films containing embedded Si nanocrystals (Si-nc). The sample was annealed in gas containing nitrogen, and subsequently characterized by photoluminescence. We obtained 3-fold enhancement of photon emission from the Si-nc embedded in silicon dioxide covered with a Gold layer as compared with an uncovered sample. We attribute this enhancement to the increase of the spontaneous emission rate caused by the coupling of the Si-nc emitters with the surface plasmons (SP). The evolution of PL emission with laser irradiated time was also collected from covered samples, and compared to that from uncovered samples. In an uncovered sample, the PL intensity decreases with time, approximately with two decay constants. Although the decrease of the initial PL intensity associated with the increase of sample temperature under CW pumping is still observed in samples covered with a gold layer, this film significantly contributes to reduce the permanent deterioration of the PL intensity. The resistance to degradation of light-emitting silicon nanocrystals can be increased by SP coupling to suppress the permanent deterioration. Controlling the permanent photodeterioration can allow to perform a reliable optical gain measurement.

Keywords: photodeterioration, silicon nanocrystals, ion implantation, photoluminescence, surface plasmons

Procedia PDF Downloads 408

Authors: Songul Cinaroglu

Abstract:

Regional planning in health has gained speed for developing countries in recent years. In Turkey, 89 different Public Hospital Unions (PHUs) were conducted based on provincial levels. In this study technical efficiencies of 89 PHUs were examined by using Data Envelopment Analysis (DEA) and machine learning techniques by dividing them into two clusters in terms of similarities of input and output indicators. Number of beds, physicians and nurses determined as input variables and number of outpatients, inpatients and surgical operations determined as output indicators. Before performing DEA, PHUs were grouped into two clusters. It is seen that the first cluster represents PHUs which have higher population, demand and service density than the others. The difference between clusters was statistically significant in terms of all study variables (p ˂ 0.001). After clustering, DEA was performed for general and for two clusters separately. It was found that 11% of PHUs were efficient in general, additionally 21% and 17% of them were efficient for the first and second clusters respectively. It is seen that PHUs, which are representing urban parts of the country and have higher population and service density, are more efficient than others. Random forest decision tree graph shows that number of inpatients is a determinative factor of efficiency of PHUs, which is a measure of service density. It is advisable for public health policy makers to use statistical learning methods in resource planning decisions to improve efficiency in health care.

Keywords: public hospital unions, efficiency, data envelopment analysis, random forest

Procedia PDF Downloads 115

Authors: Saeed Vahidifar, Mohammad Nakhaee Sharif, Mohammad Ghaffari

Abstract:

Few people would dispute the fact that one of the most common applications of energy is creating comfort in buildings, so it is probably true to say that management of energy consumption is required due to the environmental issues and increasing the efficiency of mechanical systems. From the geographical point of view, Iran is located in a warm and semi-arid region; therefore, air-cooled chillers are usually used for cooling residential buildings, commercial buildings, medical buildings, etc. In this study, a heat exchanger was designed for providing laundry hot water by utilizing condenser heat lost base on analytical results of a 540-bed hospital in the city of Mashhad in Iran. In this paper, by using the analytical method, energy consumption reduces about 13%, and coefficient of performance increases a bit. Results show that this method can help in the management of energy consumption a lot.

Keywords: air cooled chiller, energy management, environmental issues, heat exchanger, hospital laundry system

Procedia PDF Downloads 138

Authors: Rana Alkattan

Abstract:

Aim: This study aims to identify and analyze the factors predicting the professional clinical competency among newly recruited registered nurses. In addition, it aims to explore factors significantly correlated with high and low professional clinical competency score. Method: A descriptive analytical is applied in this study, cross-sectional which conducted between June 2012 and June 2013 at King Abdulaziz University Hospital, as one of the largest governmental university tertiary Hospital in Saudi Arabia. A survey questionnaire was designed to collect data. And then, data were analyzed using the SPSS. Results: A total of the 86 nurses provided valid responses. 69 were female and 17 were male. The majority of the participants in this study were married, from the Philippines, between 20-29 years old. The majority had certified university bachelor’s degree in nursing, as well as had prior experience in nursing between 1 to 5 years. There are two categories emerged from the data, which significantly correlated with nurses' professional competence and development. The first was the newly employed registered nurses demographic characteristic (correlation coefficients 0.154 to 0.470, P < 0.05), while the second was the list of studied environmental factors except 'job rotation factor' (correlation coefficients 0.122 to 0.540, P < 0.01). However, nurses' attitude including motivation and confidence were not associated with nurse's professional competency. Conclusion: that nurses' professional competence development is a process affected by certain personal demographic and environmental factors which will enable newly graduates nurses to provide safe effective patients' care and maintain their career responsibilities.

Keywords: clinical, competence, development nurses professional, registered

Procedia PDF Downloads 341

Authors: M. Shahana

Abstract:

Introduction: Leprosy (Hansens) is one of the major health problems in the developing countries. Sixty percent of the world leprosy cases are in India. According to the 2006 census India has about 54% of the total new cases detected globally. The National Leprosy Elimination Programme in 2012 has reported 9.7% of childhood leprosy. There are only few studies related to paediatric leprosy. Aim: To study the epidemiology and various clinical presentations of leprosy in the paediatric age group. Material and Methods: A 4-year prospective study was done in the out-patient department of dermatology in a tertiary care hospital. All the patients were screened for leprosy and children with a confirmed diagnosis of leprosy were taken up for the study. Results: Total of 321 cases of Hansens were recorded during this period out of which 41 were children. The male to female ratio was 2.72:1. A positive family history was found in 18%. Most of them presented with single hypopigmented hypoanesthetic patch. Conclusions: Children presented with more of Borderline tuberculoid type and reactions or deformities were less common.

Keywords: Hansens, hypoaneasthetic patch, leprosy, reactions

Procedia PDF Downloads 176

Authors: Hacer Y. Teke, Sultan Pehlivan, Mustafa Karapırlı, Asude Gökmen, Sait Özsoy

Abstract:

The case is here presented of a patient with DMD with electrocardiograph findings within normal limits who underwent spinal surgery then developed the rarely seen complication of cardiac tamponade which resulted in death. A 17-year old male with DMD was admitted to hospital for spinal surgery. Due to a postoperative drop in hemoglobin, blood transfusion was administered to the patient, no complication developed and he was discharged on the third day. Four days after discharge, the patient worsened at home and an ambulance was called. Before the nearest hospital was reached, the patient died in the ambulance. An autopsy was performed. A fatal but rarely seen complication of Acute Myocardial Infarction (AMI) is myocardial rupture. 85% of ruptures occur in the first week of AMI but just as they can be seen on the day of the infarct, they can also be seen 2 weeks later. The case presented here had infarction findings related to different times and in different areas.

Keywords: duchenne muscular dystrophy, myocardial infarction, myocardial rupture, anesthesia

Procedia PDF Downloads 469

Authors: Nadia Fatima Zahra Malki

Abstract:

Quality is one of the most important modern management patterns that organizations seek to achieve in all areas and sectors in order to meet the needs and desires of customers and to remain and continuity, as they constitute a competitive advantage for the organization. and among the most prominent organizations that must be available on the quality factor are health organizations as they relate to the most valuable component of production. It is a person, and his health, and any error in it threatens his life and may lead to death, so she must provide health services of high quality to achieve the highest degree of satisfaction for the patient. This research aims to study the quality of health services and the extent of their impact on patient satisfaction, and this is through an applied study that relied on measuring the level of quality of health services in the university hospital center of Algeria and the extent of their impact on patient satisfaction according to the dimensions of the quality of health services, and we reached a conclusion that the determinants of the quality of health services It affects patient satisfaction, which necessitates developing health services according to patients' requirements and improving their quality to obtain patient satisfaction.

Keywords: health service, health quality, quality determinants, patient satisfaction

Procedia PDF Downloads 33

Authors: Masoud Swalehe, Semra Günay

Abstract:

Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.

Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest

Procedia PDF Downloads 289

Authors: Sophia Shi

Abstract:

Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

Procedia PDF Downloads 116

Authors: R. Ziaie Moayed, E. Khavaninzadeh, M. Ghorbani Tochaee

Abstract:

Direct shear test is widely used in soil mechanics experiment to determine the shear strength parameters of granular soils. For analysis of soil stability problems such as bearing capacity, slope stability and lateral pressure on soil retaining structures, the shear strength parameters must be known well. In the present study, shear strength parameters are determined in silty-sand mixtures. Direct shear tests are performed on 161 Firoozkooh sand with different silt content at a relative density of 70% in three vertical stress of 100, 150, and 200 kPa. Wet tamping method is used for soil sample preparation, and the results include diagrams of shear stress versus shear deformation and sample height changes against shear deformation. Accordingly, in different silt percent, the shear strength parameters of the soil such as internal friction angle and dilation angle are calculated and compared. According to the results, when the sample contains up to 10% silt, peak shear strength and internal friction angle have an upward trend. However, if the sample contains 10% to 50% of silt a downward trend is seen in peak shear strength and internal friction angle.

Keywords: shear strength parameters, direct shear test, silty sand, shear stress, shear deformation

Procedia PDF Downloads 148

Authors: Chan Hui-Ya, Ding Shin-Tan

Abstract:

Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

Procedia PDF Downloads 273

Authors: Cyril O. Ehi-Eromosele, Ajayi Kayode

Abstract:

The Li-rich layered metal oxides (LLO) are the most promising candidates for promising electrodes of high energy Li-ion battery (LIB). In literature, these electrode system has either been designed as a hetero-structure of the primary components (composite) or as a core-shell structure with improved electrochemistry reported for both configurations when compared with its primary components. With the on-going efforts to improve on the electrochemical performance of the LIB, it is important to investigate comparatively the structural and electrochemical characteristics of the core-shell like and ‘composite’ forms of these materials with the same compositions and synthesis conditions which could influence future engineering of these materials. Therefore, this study concerns the structural and electrochemical properties of the ‘composite’ and core-shell like LLO cathode materials with the same nominal composition of 0.5Li₂MnO₃-0.5LiNi₀.₅Mn₀.₃Co₀.₂O₂ (LiNi₀.₅Mn₀.₃Co₀.₂O₂ as core and Li₂MnO₃ as the shell). The results show that the core-shell sample (–CS) gave better electrochemical performance than the ‘composite’ sample (–C). Both samples gave the same initial charge capacity of ~300 mAh/g when cycled at 10 mA/g and comparable charge capacity (246 mAh/g for the –CS sample and 240 mAh/g for the –C sample) when cycled at 200 mA/g. However, the –CS sample gave a higher initial discharge capacity at both current densities. The discharge capacity of the –CS sample was 232 mAh/g and 164 mAh/g while the –C sample is 208 mAh/g and 143 mAh/g at the current densities of 10 mA/g and 200 mA/g, respectively. Electrochemical impedance spectroscopy (EIS) results show that the –CS sample generally exhibited a smaller resistance than the –C sample both for the uncycled and after 50th cycle. Detailed structural analysis is on-going, but preliminary results show that the –CS sample had bigger unit cell volume and a higher degree of cation mixing. The thermal stability of the –CS sample was higher than the –C sample. XPS investigation also showed that the pristine –C sample gave a more reactive surface (showing formation of carbonate species to a greater degree) which could result in the greater resistance seen in the EIS result. To reinforce the results obtained for the 0.5Li₂MnO₃-0.5LiNi₀.₅Mn₀.₃Co₀.₃O₂ composition, the same investigations were extended to another ‘composite’ and core-shell like LLO cathode materials also with the same nominal composition of 0.5Li₂MnO₃-0.5LiNi₀.₃Mn₀.₃Co₀.₃O₂. In this case, the aim was to determine the electrochemical performance of the material using a low Ni content (LiNi₀.₃Mn₀.₃Co₀.₃O₂) as the core to clarify the contributions of the core-shell configuration to the electrochemical performance of these materials. Ni-rich layered oxides show active catalytic surface leading to electrolyte oxidation resulting in poor thermal stability and cycle life. Here, the core-shell sample also gave better electrochemical performance than the ‘composite’ sample with 0.5Li₂MnO₃-0.5LiNi₀.₃Mn₀.₃Co₀.₃O₂ composition. Furthermore, superior electrochemical performance was also recorded for the core-shell like spinel modified LLO (0.5Li₂MnO₃-0.45LiNi₀.₅Mn₀.₃Co₀.₂O₂-0.05LiNi₀.₅Mn₁.₅O₄) when compared to the composite system. These results show that the core-shell configuration can generally be used to improve the structural and electrochemical properties of the LLO and spinel modified LLO materials.

Keywords: lithium-ion battery, lithium rich oxide cathode, core-shell structure, composite structure

Procedia PDF Downloads 110

Authors: Jianshu Yang, Delphine Sordes, Marek Kolmer, Christian Joachim

Abstract:

Nanoelectronics, for example the calculating circuits integrating at molecule scale logic gates, atomic scale circuits, has been constructed and investigated recently. A major challenge is their functional properties characterization because of the connecting problem from atomic scale to micrometer scale. New experimental instruments and new processes have been proposed therefore. To satisfy a precisely measurement at atomic scale and then connecting micrometer scale electrical integration controller, the technique improvement is kept on going. Our new machine, a low temperature high vacuum four scanning tunneling microscope, as a customer required instrument constructed by Omicron GmbH, is expected to be scaling down to atomic scale characterization. Here, we will present our first testified results about the performance of this new instrument. The sample we selected is Au(111) surface. The measurements have been taken at 4.2 K. The atomic resolution surface structure was observed with each of four scanners with noise level better than 3 pm. With a tip-sample distance calibration by I-z spectra, the sample conductance has been derived from its atomic locally I-V spectra. Furthermore, the surface conductance measurement has been performed using two methods, (1) by landing two STM tips on the surface with sample floating; and (2) by sample floating and one of the landed tips turned to be grounding. In addition, single atom manipulation has been achieved with a modified tip design, which is comparable to a conventional LT-STM.

Keywords: low temperature ultra-high vacuum four scanning tunneling microscope, nanoelectronics, point contact, single atom manipulation, tunneling resistance

Procedia PDF Downloads 265

Authors: Nthabiseng Portia Mahumapelo, Andre van Niekerk, Ndabenhle Sosibo, Nirdesh Singh

Abstract:

The foundry industry generates large quantities of solid waste in the form of waste foundry sand. The ever-increasing quantities of this type of industrial waste put pressure on land-filling space and its proper management has become a global concern. The South African foundry industry is not different when it comes to this solid waste generation. Utilizing the foundry waste sand in other applications has become an attractive avenue to deal with this waste stream. In the present paper, an evaluation was done on the suitability of foundry waste sand as an additive in clay masonry products. Purchased clay was added to the foundry waste sand sample in a 50/50 ratio. The mixture was named FC sample. The FC sample was mixed with water in a pan mixer until the mixture was consistent and suitable for extrusion. The FC sample was extruded and cut into briquettes. Water absorption, shrinkage and modulus of rupture tests were conducted on the resultant briquettes. Foundry waste sand and FC samples were respectively characterized mineralogically using X-Ray Diffraction, and the major and trace elements were determined using Inductively Coupled Plasma Optical Emission Spectroscopy. Adding purchased clay to the foundry waste sand positively influenced the workability of the test sample. Another positive characteristic was the low linear shrinkage, which indicated that products manufactured from the FC sample would not be susceptible to cracking. The water absorption values were acceptable and the unfired and fired strength values of the briquette’s samples were acceptable. In conclusion, tests showed that foundry waste sand can be used as an additive in masonry clay bricks, provided it is blended with good quality clay.

Keywords: foundry waste sand, masonry clay bricks, modulus of rupture, shrinkage

Procedia PDF Downloads 214

Authors: Amal Raqib Shameran, Ghanim Aboud Al-Mola

Abstract:

Respiratory syncytial virus (hRSV) is the major pathogens of respiratory tract infections (RTI) among infants and children in the world. They are classified in family Paramyxoviridae and sub-family Pneumovirinae. The current work aimed to detect the role of RSV in the lower respiratory tract infection (LRTI) in Hilla, Iraq. The samples were collected from 50 children who were admitted to hospital suffering from lower respiratory tract infections (LRTI). 50 nasal and pharyngeal swabs were taken from patients at the period from January 2010 till April 2011, hospitalized in Hilla Maternity and Children Hospital. The results showed that the proportion of children infected with hRSV accounted for 24% 12/50 with lower respiratory tract infections (LRTI) when they tested by polymerase chain reaction (RT-PCR).

Keywords: respiratory syncytial virus, respiratory tract infections, infants, polymerase chain reaction (PCR)

Procedia PDF Downloads 319

Authors: Muziwandile Luthuli

Abstract:

Although numerous factors predicting adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been broadly studied on both regional and global level, up-to-date adherence of patients to ART remains an overarching, dynamic and multifaceted problem that needs to be investigated over time and across various contexts. There is a rarity of empirical data in the literature on interactive mechanisms by which psychosocial factors influence adherence to ART among PLWHA within the South African context. Therefore, this study was designed to investigate the relationship between depression, HIV stigma, and adherence to ART among adult patients living with HIV at a tertiary hospital in Durban, South Africa, and the mediating roles of self-efficacy and social support. The health locus of control theory and the social support theory were the underlying theoretical frameworks for this study. Using a cross-sectional research design, a total of 201 male and female adult patients aged between 18-75 years receiving ART at a tertiary hospital in Durban, KwaZulu-Natal were sampled, using time location sampling (TLS). A self-administered questionnaire was employed to collect the data in this study. Data were analysed through SPSS version 27. Several statistical analyses were conducted in this study, namely univariate statistical analysis, correlational analysis, Pearson’s chi-square analysis, cross-tabulation analysis, binary logistic regression analysis, and mediational analysis. Univariate analysis indicated that the sample mean age was 39.28 years (SD=12.115), while most participants were females 71.0% (n=142), never married 74.2% (n=147), and most were also secondary school educated 48.3% (n=97), as well as unemployed 65.7% (n=132). The prevalence rate of participants who had high adherence to ART was 53.7% (n=108), and 46.3% (n=93) of participants had low adherence to ART. Chi-square analysis revealed that employment status was the only statistically significant socio-demographic influence of adherence to ART in this study (χ2 (3) = 8.745; p < .033). Chi-square analysis showed that there was a statistically significant difference found between depression and adherence to ART (χ2 (4) = 16.140; p < .003), while between HIV stigma and adherence to ART, no statistically significant difference was found (χ2 (1) = .323; p >.570). Binary logistic regression indicated that depression was statistically associated with adherence to ART (OR= .853; 95% CI, .789–.922, P < 001), while the association between self-efficacy and adherence to ART was statistically significant (OR= 1.04; 95% CI, 1.001– 1.078, P < .045) after controlling for the effect of depression. However, the findings showed that the effect of depression on adherence to ART was not significantly mediated by self-efficacy (Sobel test for indirect effect, Z= 1.01, P > 0.31). Binary logistic regression showed that the effect of HIV stigma on adherence to ART was not statistically significant (OR= .980; 95% CI, .937– 1.025, P > .374), but the effect of social support on adherence to ART was statistically significant, only after the effect of HIV stigma was controlled for (OR= 1.017; 95% CI, 1.000– 1.035, P < .046). This study promotes behavioral and social change effected through evidence-based interventions by emphasizing the need for additional research that investigates the interactive mechanisms by which psychosocial factors influence adherence to ART. Depression is a significant predictor of adherence to ART. Thus, to alleviate the psychosocial impact of depression on adherence to ART, effective interventions must be devised, along with special consideration of self-efficacy and social support. Therefore, this study is helpful in informing and effecting change in health policy and healthcare services through its findings

Keywords: ART adherence, depression, HIV/AIDS, PLWHA

Procedia PDF Downloads 167

Authors: Vignesh Ratnaraj, Jaewon Chang

Abstract:

Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

Procedia PDF Downloads 61

Authors: Mounir Zili

Abstract:

We will introduce a new extension of the Brownian motion, that could serve to get a good model of many natural phenomena. It is a linear combination of a finite number of sub-fractional Brownian motions; that is why we will call it the mixed sub-fractional Brownian motion. We will present some basic properties of this process. Among others, we will check that our process is non-Markovian and that it has non-stationary increments. We will also give the conditions under which it is a semimartingale. Finally, the main features of its sample paths will be specified.

Keywords: mixed Gaussian processes, Sub-fractional Brownian motion, sample paths

Procedia PDF Downloads 474

Authors: J. Shiue, I. H. Chen, S. W. Y. Chiu, Y. L. Wang

Abstract:

In this work, we present a nondestructive method to characterize bacteria in a TEM system. Unlike the conventional TEM specimen preparation method, which needs to thin the specimen in a destructive way, or spread the samples on a tiny millimeter sized carbon grid, our method is easy to operate without the need of sample pretreatment. With a specially designed transparent chip that allows the electron beam to pass through, and a custom made chip holder to fit into a standard TEM sample holder, the bacteria specimen can be easily prepared on the chip without any pretreatment, and then be observed under TEM. The centimeter-sized chip is covered with Au nanoparticles in the surface as the markers which allow the bacteria to be observed easily on the chip. We demonstrate the success of our method by using E. coli as an example, and show that high-resolution TEM images of E. coli can be obtained with the method presented. Some E. coli morphology characteristics imaged using this method are also presented.

Keywords: bacteria, chip, nanoparticles, TEM

Procedia PDF Downloads 301

Authors: Enido Fabiano de Ramos, Ieda Kanashiro Makiya, Francisco I. Giocondo Cesar

Abstract:

This study investigates the application of Digital Twins (DT) in Smart Hospital Environments (SHE), through a bibliometric study and literature review, including comparison with the principles of Industry 4.0. It aims to analyze the current state of the implementation of digital twins in clinical and non-clinical operations in healthcare settings, identifying trends and challenges, comparing these practices with Industry 4.0 concepts and technologies, in order to present a basic framework including stages and maturity levels. The bibliometric methodology will allow mapping the existing scientific production on the theme, while the literature review will synthesize and critically analyze the relevant studies, highlighting pertinent methodologies and results, additionally the comparison with Industry 4.0 will provide insights on how the principles of automation, interconnectivity and digitalization can be applied in healthcare environments/operations, aiming at improvements in operational efficiency and quality of care. The results of this study will contribute to a deeper understanding of the potential of Digital Twins in Smart Hospitals, in addition to the future potential from the effective integration of Industry 4.0 concepts in this specific environment, presented through the practical framework, after all, the urgent need for changes addressed in this article is undeniable, as well as all their value contribution to human sustainability, designed in SDG3 – Health and well-being: ensuring that all citizens have a healthy life and well-being, at all ages and in all situations. We know that the validity of these relationships will be constantly discussed, and technology can always change the rules of the game.

Keywords: digital twin, smart hospital, healthcare operations, industry 4.0, SDG3, technology

Procedia PDF Downloads 38

Authors: Jing Jiang, Yuguang Gao, Yang Yu

Abstract:

Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

Procedia PDF Downloads 44

Authors: S. I. Nwadioha, M. S. Odimayo, J. A. Omotayo, A. Olu Taiwo, O. E. Olabiyi

Abstract:

The current study was conducted to determine the epidemiology and antibiotic sensitivity pattern of bacteria isolated from blood of septicemic patients for improved antibiotic therapy. A three-year descriptive study has been carried out at Microbiology Laboratory, Ekiti State University Teaching Hospital, Ado Ekiti, from April 2012 to April 2015. Information compiled from patients’ records includes age, sex, isolated organisms and antibiotic susceptibility patterns. Three hundred and thirteen blood cultures were collected from neonatology and pediatrics wards, Out Patients’ Department (OPD) and from other adult patients. Forty-one cultures yielded mono microbial growth (no polymicrobial growth), giving an incidence of 13.1% positive blood culture (N=41/313). There were 58.4% Gram-negative bacilli and 41.6% Gram-positive cocci in the microbial growth. Bacteria isolated were Staphylococcus aureus 34%(14/41), Klebsiella species22% (9/41), Enterococci 17%(7/41), Proteus species12%(5/41), Escherichia coli 7%(3/41) and Streptococcal pneumoniae 7%(3/41). There was a (35%) higher occurrence of septicemia in neonates than in any other age groups in the hospital. Bacterial sensitivity to 13 antibiotic agents was determined by antibiotics disc diffusion using modified Kirby Bauer’s method. Gram-positive organisms showed a higher antibiotic sensitivity ranging from 14- 100% than the Gram-negative bacteria (11-80%). Staphylococcus aureus and Klebsiella species are the most prevalent organisms. The third generation Cephalosporins (Ceftriaxone) and Floroquinolone(Levofloxacin, Ofloxacin) have proved reliable for management of these blood infections.

Keywords: blood cultures, septicemia, antibiogram, Nigeria

Procedia PDF Downloads 213

Authors: Zinah Jabbar Mohammed Alrubaye

Abstract:

Objective: The purpose of this study was to compare the efficacy of prophylactic and rescue cervical cerclages for pregnant patients with an incompetent cervix, and to assess the neonatal outcomes of both clinical conditions. Methods: This was a retrospective observational study of all women who had an elective or rescue cerclage between January 2008 and December 2016 in our hospital .Prophylactic cerclage was defined as a cerclage before 16 weeks of gestation, while rescue cerclages were performed between 16 and 23 weeks of gestation. Results: In total, we analyzed the outcomes of 212 cervical interventions; 71% of the recruited patients experienced prophylactic cerclage, while 29% underwent rescue cerclage. Most of the patients delivered vaginally (70%) and were able to leave the hospital with a healthy newborn (78%). The mean pregnancy prolongation time after cerclage in the prophylactic and rescue groups were 21 weeks and 10 weeks, respectively. Conclusion: Prophylactic cerclage interventions are most likely to be associated with a reduction of fetal demise because of the correlation between fetal prognosis and the gestational age at which cerclage is performed. Once the diagnosis of cervical insufficiency is confirmed, cerclage should be recommended as this will help to prolong the pregnancy.

Keywords: cervical, neonate, cerclage, Cervix

Procedia PDF Downloads 36

Authors: Recep Kesli, Gulsah Asik, Cengiz Demir, Onur Turkyilmaz

Abstract:

Objective: Pseudomonas aeruginosa (P. aeruginosa) is an important nosocomial pathogen which causes serious hospital infections and is resistant to many commonly used antibiotics. P. aeruginosa can develop resistance during therapy and also it is very resistant to disinfectant chemicals. It may be found in respiratory support devices in hospitals. In this study, the antibiotic resistance of P. aeruginosa strains isolated from bronchial aspiration samples was evaluated retrospectively. Methods: Between October 2013 and September 2015, a total of 318 P. aeruginosa were isolated from clinical samples obtained from various intensive care units and inpatient patients hospitalized at Afyon Kocatepe University, ANS Practice and Research Hospital. Isolated bacteria identified by using both the conventional methods and automated identification system-VITEK 2 (bioMerieux, Marcy l’etoile France). Antibacterial resistance tests were performed by using Kirby-Bauer disc (Oxoid, Hampshire, England) diffusion method following the recommendations of CLSI. Results: Antibiotic resistance rates of identified 318 P. aeruginosa strains were found as follows for tested antibiotics; 32 % amikacin, 42% gentamicin, 43% imipenem, 43% meropenem, 50% ciprofloxacin, 57% levofloxacin, 38% cefepime, 63% ceftazidime, and 85% piperacillin/tazobactam. Conclusion: Resistance profiles change according to years and provinces for P. aeruginosa, so these findings should be considered empirical treatment choices. In this study, the highest and lowest resistance rates found against piperacillin/tazobactam % 85, and amikacin %32.

Keywords: Pseudomonas aeruginosa, antibiotic resistance rates, intensive care unit, Pseudomonas spp.

Procedia PDF Downloads 279

Authors: B. Oji, O. Olaniran

Abstract:

The prospect of improving the corrosion property of Al 6063 alloy based hybrid composites reinforced with cassava peel ash (CPA) and silicon carbide (SiC) is the target of this research. It seeks to determine the viability of using locally sourced material (CPA) as a complimentary reinforcement for SiC to produce low cost high performance aluminum matrix composite. The CPA was mixed with the SiC in the ratios 0:1, 1:3, 1:1, 3:1 and 1:0 for 8 wt % reinforcement in the produced composites by double stir-casting method. The microstructures of the composites were studied before and after corrosion using the scanning electron microscopy which reveals the matrix (dark region) and eutectic phase (lamellar region). The corrosion rate was studied in accordance with ASTM G59-97 (2014) using an AutoLab potentiostat (Versa STAT 400) with versaSTUDIO electrochemical software which analyses the results obtained. The result showed that Al 6063 alloy exhibited good corrosion resistance in 0.3M H₂SO₄ and 3.5 wt. % NaCl solutions with sample C containing the 25% wt CPA showing the highest resistance to corrosion with corrosion rate of 0.0046 mmpy as compared to the control sample which has a value of 13.233 mmpy. Sample B, D, E, and F also showed a corrosion rate of 3.9502, 2.6903, 2.1223, and 5.7344 mmpy which indicated a better corrosion rate than the control in the acidic environment. The corrosion rate in the saline medium shows that sample E with 75% wt CPA has the lowest corrosion rate of 0.0422 mmpy as compared to the control sample with 0.0873 mmpy corrosion rate.

Keywords: Al-Mg-Si alloy, AutoLab potentiostat, Cassava Peel Ash, CPA, hybrid composite, stir-cast method

Procedia PDF Downloads 118

Authors: Yin-Chen Liu, Chih-Chun Wu, Mei-He Shih

Abstract:

In this technology society, using ICT(Information and communications technology) to contact each other is very common. Interpersonal ICT communication maintains social support. Therefore, the study investigated the ICT communication between undergraduates and their parents, and gender differences were also detected. The sample size was 1,209 undergraduates, including 624(51.6%) males, 584(48.3%) females, and 1 gender unidentified. In the sample, 91.8% of the sample used phones to contact their fathers and 93.8% of them use phones to contact their mothers. 78.5% and 87.6% of the sample utilized LINE to contact their fathers and mothers respectively. As for Facebook, only 13.4% and 16.5% of the sample would use to contact their fathers and mothers respectively. Aforementioned results implied that the undergraduates nowadays use phone and LINE to contact their parents more common than Facebook. According to results from Pearson correlations, the more undergraduates refused to add their fathers as their Facebook friends, the more they refused to add their mothers as Facebook friends. The possible reasons for it could be that to distinguish different social network such as family and friends. Another possible reason could be avoiding parents’ controlling. It could be why the kids prefer to use phone and LINE to Facebook when contacting their parents. Result from Pearson correlations showed that the more undergraduates actively contact their fathers, the more they actively contact their mothers. On the other hand, the more their fathers actively contact them, the more their mothers actively contact them. Based on the results, this study encourages both parents and undergraduates to contact each other, for any contact between any two family members is associated with contact between other two family members. Obviously, the contact between family members is bidirectional. Future research might want to investigate if this bidirectional contact is associated with the family relation. For gender differences, results from the independent t-tests showed that compared to sons, daughters actively contacted their parents more. Maybe it is because parents keep saying that it is dangerous out there for their daughters, so they build up the habit for their daughters to contact them more. Results from paired sample t-tests showed that the undergraduates agreed that talking to mother on the phone had more satisfaction, felt more intimacy and supported than fathers.

Keywords: family ICT communication, parent-child ICT communication, FACEBOOK and LINE, gender differences

Procedia PDF Downloads 188

Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

Abstract:

Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

Procedia PDF Downloads 249

Authors: G. I. Onwuka, A. Danbaba, S. U. Gulumbe

Abstract:

This study investigated of Infant Mortality Rate as observed at a general hospital in Kaduna-South, Kaduna State, North West Nigeria. The causes of infant Mortality were examined. The data used for this analysis were collected at the statistics unit of the Hospital. The analysis was carried out on the data using Multiple Linear regression Technique and this showed that there is linear relationship between the dependent variable (death) and the independent variables (malaria, measles, anaemia, and coronary heart disease). The resultant model also revealed that a unit increment in each of these diseases would result to a unit increment in death recorded, 98.7% of the total variation in mortality is explained by the given model. The highest number of mortality was recorded in July, 2005 and the lowest mortality recorded in October, 2009.Recommendations were however made based on the results of the study.

Keywords: infant mortality rate, multiple linear regression, diseases, serial correlation

Procedia PDF Downloads 307

Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

Abstract:

Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

Procedia PDF Downloads 178

Authors: Sarah Fatima, Ahmad A. Malik, Saima Sadaf

Abstract:

This study was conducted in order to assess the dietary record and vitamin A status of young females of Lahore. A total sample of 376 consisted of 16 – 20 years of unmarried college going females. Three main tools were adopted: questionnaire, 3-day food diary and serum retinol test. The anthropometric measurements showed that a total of 32.6% of the sample was underweight (BMI < 18.5) and 54.5% had a healthy weight (BMI 18.5 – 22.9). The average Vitamin A intake of the sample was 257.95 µg/day while the RDA for the selected age group was 700 µg/day. The mean energy intake of the adolescents was 1153.64 kcal/ day, whereas the Estimated Energy Requirement (EER) for this age group was 2368 kcal/day. The mean serum Vitamin A level was 24.81µg/dL. 69.6% of the sample was deficient in serum Vitamin A i.e. serum retinol < 24 µg/dL. 30.4% had serum retinol in normal limit (24 – 84 µg/dL) from which 25.3% lied in lower limit (24 – 44 µg/dL) and only 5.1% had serum retinol in 44 – 64 µg/dL range. A slightly negative correlation (r = - 0.21, 95% confidence interval) was found between dietary intake of Vitamin A and serum Vitamin A It was concluded that the dietary intake of major nutrients and vitamin A is not adequate in the selected group. This is also confirmed by the lower serum retinol levels. Hence, vitamin An intake and status are generally inadequate, and vitamin deficiency is prevalent in the unmarried young females of Lahore.

Keywords: vitamin A, young Females, vitamin deficiency, Lahore

Procedia PDF Downloads 295