Search results for: intelligent systems patient monitoring
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14666

Search results for: intelligent systems patient monitoring

14186 Study Secondary Particle Production in Carbon Ion Beam Radiotherapy

Authors: Shaikah Alsubayae, Gianluigi Casse, Carlos Chavez, Jon Taylor, Alan Taylor, Mohammad Alsulimane

Abstract:

Ensuring accurate radiotherapy with carbon therapy requires precise monitoring of radiation dose distribution within the patient's body. This monitoring is essential for targeted tumor treatment, minimizing harm to healthy tissues, and improving treatment effectiveness while lowering side effects. In our investigation, we employed a methodological approach to monitor secondary proton doses in carbon therapy using Monte Carlo simulations. Initially, Geant4 simulations were utilized to extract the initial positions of secondary particles formed during interactions between carbon ions and water. These particles included protons, gamma rays, alpha particles, neutrons, and tritons. Subsequently, we studied the relationship between the carbon ion beam and these secondary particles. Interaction Vertex Imaging (IVI) is valuable for monitoring dose distribution in carbon therapy. It provides details about the positions and amounts of secondary particles, particularly protons. The IVI method depends on charged particles produced during ion fragmentation to gather information about the range by reconstructing particle trajectories back to their point of origin, referred to as the vertex. In our simulations regarding carbon ion therapy, we observed a strong correlation between some secondary particles and the range of carbon ions. However, challenges arose due to the target's unique elongated geometry, which hindered the straightforward transmission of forward-generated protons. Consequently, the limited protons that emerged mostly originated from points close to the target entrance. The trajectories of fragments (protons) were approximated as straight lines, and a beam back-projection algorithm, using recorded interaction positions in Si detectors, was developed to reconstruct vertices. The analysis revealed a correlation between the reconstructed and actual positions.

Keywords: radiotherapy, carbon therapy, monitoring of radiation dose, interaction vertex imaging

Procedia PDF Downloads 72
14185 Deep Learning-Based Object Detection on Low Quality Images: A Case Study of Real-Time Traffic Monitoring

Authors: Jean-Francois Rajotte, Martin Sotir, Frank Gouineau

Abstract:

The installation and management of traffic monitoring devices can be costly from both a financial and resource point of view. It is therefore important to take advantage of in-place infrastructures to extract the most information. Here we show how low-quality urban road traffic images from cameras already available in many cities (such as Montreal, Vancouver, and Toronto) can be used to estimate traffic flow. To this end, we use a pre-trained neural network, developed for object detection, to count vehicles within images. We then compare the results with human annotations gathered through crowdsourcing campaigns. We use this comparison to assess performance and calibrate the neural network annotations. As a use case, we consider six months of continuous monitoring over hundreds of cameras installed in the city of Montreal. We compare the results with city-provided manual traffic counting performed in similar conditions at the same location. The good performance of our system allows us to consider applications which can monitor the traffic conditions in near real-time, making the counting usable for traffic-related services. Furthermore, the resulting annotations pave the way for building a historical vehicle counting dataset to be used for analysing the impact of road traffic on many city-related issues, such as urban planning, security, and pollution.

Keywords: traffic monitoring, deep learning, image annotation, vehicles, roads, artificial intelligence, real-time systems

Procedia PDF Downloads 188
14184 Improving Fingerprinting-Based Localization System Using Generative AI

Authors: Getaneh Berie Tarekegn, Li-Chia Tai

Abstract:

With the rapid advancement of artificial intelligence, low-power built-in sensors on Internet of Things devices, and communication technologies, location-aware services have become increasingly popular and have permeated every aspect of people’s lives. Global navigation satellite systems (GNSSs) are the default method of providing continuous positioning services for ground and aerial vehicles, as well as consumer devices (smartphones, watches, notepads, etc.). However, the environment affects satellite positioning systems, particularly indoors, in dense urban and suburban cities enclosed by skyscrapers, or when deep shadows obscure satellite signals. This is because (1) indoor environments are more complicated due to the presence of many objects surrounding them; (2) reflection within the building is highly dependent on the surrounding environment, including the positions of objects and human activity; and (3) satellite signals cannot be reached in an indoor environment, and GNSS doesn't have enough power to penetrate building walls. GPS is also highly power-hungry, which poses a severe challenge for battery-powered IoT devices. Due to these challenges, IoT applications are limited. Consequently, precise, seamless, and ubiquitous Positioning, Navigation and Timing (PNT) systems are crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarms, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

Procedia PDF Downloads 36
14183 A Case Study: Effect of Low Carbs High Fats Diet (Also Known as LCHF Diet) Combined with Fried Foods in Extra Virgin Olive Oil in Patient with Type 2 Diabetes and Central Obesity

Authors: Cristian Baldini

Abstract:

‘Diabesity’ is a term for diabetes occurring in the context of obesity. The positive effect of LCHF diets (low-carb, high-fat diets) is well documented: LCHF diets are at least as effective as other dietary strategies for reducing body weight, improving glycaemic control, and reducing both hyperinsulinaemia and blood glucose (reduction of HbA1c) in type 2 diabetes and have unique positive effects on blood lipid concentrations and cardiovascular risk factors. Also, in obese insulin-resistant women, food fried in extra-virgin olive oil significantly reduced both insulin and C-peptide responses after a meal. This case study shows that if combined, both dietary strategies produce a strong effect on blood glucose, resulting in a “forced” reduction of exogenous insulin injection to avoid the problem of hypoglycaemia. Blood tests after three months of this dietary treatment show how HbA1c, triglycerides, and blood lipid profile (LDL, HDL, Total Cholesterol) are improved despite the reduction of exogenous insulin injection of 80% with a parallel body weight decrease of 15%. For continuous glucose monitoring (CGM), the patient used FreeStyle Libre before and after the dietary treatment. In order to check general body functions and glycosuria, the patient used the urine test Multistix 10 SG Siemens.

Keywords: diabetes, obesity, diabesity, fat, fried foods

Procedia PDF Downloads 63
14182 Using Multiple Strategies to Improve the Nursing Staff Edwards Lifesciences Hemodynamic Monitoring Correctness of Operation

Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

Abstract:

Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

Procedia PDF Downloads 75
14181 The Communicational Behaviors of the Nurses Towards 'Crying Patient'

Authors: Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık, Birsel Canan Demirbağ, Hacer Erdöl, Songül Aktaş

Abstract:

Introduction: As an expression of an emotion which always exists in life, crying is regarded as one of the problematic behaviors of patients by nurses. Towards such patients, nurses may exhibit emotional and behavioral reactions such as feeling helpless, anger, indifferent, defense, and opposition. However crying either meets a need, reduces the tension to cope with problems or helps patient to gain strength. Therefore, nurses must accept that crying is a normal mechanism that reduces emotional tension and should approach a crying patient accordingly. Objective: This study was carried out to evaluate the communicational behaviors of the nurses towards ‘crying patient’. Methods: This descriptive study was conducted with the nurses working at a university hospital in a city in the Eastern Black Sea in June-September 2015. The entire universe was tried to be reached without sampling. 90% of the population was reached and the study was completed with 309 nurses who volunteered to participate in the study. Data were collected through a questionnaire which was prepared reviewing the literature by researchers. Data were evaluated in SPSS analysis program using percentages, numbers and chi-square test with the 95% confidence interval and p <0.05significance level. Findings: The findings showed that the average age of nurses was 31.52 ± 7.96, work experience was 10:09 ± 7.69 and only 22.7% had training about ‘approach to crying patient’ during their education. 97.1% of the nurses often faced with crying patients in their professional lives, 62.8% stated that they faced crying women patients. When they see crying patients, 84.8% of the nurses ‘do not want the patient to cry’, 80.9% wonder ‘why they are crying’, % 79.6 ‘feel uneasiness’,% 79.3 ‘feel sorry’ and 41.4% ‘ feel helpless’. The question ‘Why do you think the patient is crying?’ was answered by 93.5% nurses as ‘they are suffering’, by 86.1% ‘they are helpless’, 80.9% ‘they are sad’, 79.6% ‘they need help’, 54.4% ‘because they feel inadequate,’ and 44.7% ‘they fail to control their crying behavior. ‘How do you approach to your patient when she/he is crying?’ question was answered by 82.5% of nurses as ‘I would console’, 77.3% as ‘I would ask the reason’, 63.1% as ‘I would try to stop her from crying’ all of which are actually inappropriate nursing approaches. However, 92.2% of the nurses stated that ‘I do not judge the crying patient’, ‘87.1% said ‘I allocate time to crying patients’ and 85.8% said ‘ I ask patient whether they want to cry alone’. The study showed that educational background and work experience of the nurses affected the appropriate approach to crying patients (P <0.05). Conclusion: As a result of the study, it was found out that nurses do not want patients to cry, so they exhibit inappropriate approach such as consoling the patients and they have difficulty in approaching crying patients.

Keywords: approach to patient, communication, crying patient, nurse, Turkey

Procedia PDF Downloads 199
14180 Self-Propelled Intelligent Robotic Vehicle Based on Octahedral Dodekapod to Move in Active Branched Pipelines with Variable Cross-Sections

Authors: Sergey N. Sayapin, Anatoly P. Karpenko, Suan H. Dang

Abstract:

Comparative analysis of robotic vehicles for pipe inspection is presented in this paper. The promising concept of self-propelled intelligent robotic vehicle (SPIRV) based on octahedral dodekapod for inspection and operation in active branched pipelines with variable cross-sections is reasoned. SPIRV is able to move in pipeline, regardless of its spatial orientation. SPIRV can also be used to move along the outside of the pipelines as well as in space between surfaces of annular tubes. Every one of faces of the octahedral dodekapod can clamp/unclamp a thing with a closed loop surface of various forms as well as put pressure on environmental surface of contact. These properties open new possibilities for its applications in SPIRV. We examine design principles of octahedral dodekapod as future intelligent building blocks for various robotic vehicles that can self-move and self-reconfigure.

Keywords: Modular robot, octahedral dodekapod, pipe inspection robot, spatial parallel structure

Procedia PDF Downloads 496
14179 Improving Fingerprinting-Based Localization (FPL) System Using Generative Artificial Intelligence (GAI)

Authors: Getaneh Berie Tarekegn, Li-Chia Tai

Abstract:

With the rapid advancement of artificial intelligence, low-power built-in sensors on Internet of Things devices, and communication technologies, location-aware services have become increasingly popular and have permeated every aspect of people’s lives. Global navigation satellite systems (GNSSs) are the default method of providing continuous positioning services for ground and aerial vehicles, as well as consumer devices (smartphones, watches, notepads, etc.). However, the environment affects satellite positioning systems, particularly indoors, in dense urban and suburban cities enclosed by skyscrapers, or when deep shadows obscure satellite signals. This is because (1) indoor environments are more complicated due to the presence of many objects surrounding them; (2) reflection within the building is highly dependent on the surrounding environment, including the positions of objects and human activity; and (3) satellite signals cannot be reached in an indoor environment, and GNSS doesn't have enough power to penetrate building walls. GPS is also highly power-hungry, which poses a severe challenge for battery-powered IoT devices. Due to these challenges, IoT applications are limited. Consequently, precise, seamless, and ubiquitous Positioning, Navigation and Timing (PNT) systems are crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a novel semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

Procedia PDF Downloads 40
14178 Experimental Monitoring of the Parameters of the Ionosphere in the Local Area Using the Results of Multifrequency GNSS-Measurements

Authors: Andrey Kupriyanov

Abstract:

In recent years, much attention has been paid to the problems of ionospheric disturbances and their influence on the signals of global navigation satellite systems (GNSS) around the world. This is due to the increase in solar activity, the expansion of the scope of GNSS, the emergence of new satellite systems, the introduction of new frequencies and many others. The influence of the Earth's ionosphere on the propagation of radio signals is an important factor in many applied fields of science and technology. The paper considers the application of the method of transionospheric sounding using measurements from signals from Global Navigation Satellite Systems to determine the TEC distribution and scintillations of the ionospheric layers. To calculate these parameters, the International Reference Ionosphere (IRI) model of the ionosphere, refined in the local area, is used. The organization of operational monitoring of ionospheric parameters is analyzed using several NovAtel GPStation6 base stations. It allows performing primary processing of GNSS measurement data, calculating TEC and fixing scintillation moments, modeling the ionosphere using the obtained data, storing data and performing ionospheric correction in measurements. As a result of the study, it was proved that the use of the transionospheric sounding method for reconstructing the altitude distribution of electron concentration in different altitude range and would provide operational information about the ionosphere, which is necessary for solving a number of practical problems in the field of many applications. Also, the use of multi-frequency multisystem GNSS equipment and special software will allow achieving the specified accuracy and volume of measurements.

Keywords: global navigation satellite systems (GNSS), GPstation6, international reference ionosphere (IRI), ionosphere, scintillations, total electron content (TEC)

Procedia PDF Downloads 175
14177 Comparison of Patient Satisfaction and Observer Rating of Outpatient Care among Public Hospitals in Shanghai

Authors: Tian Yi Du, Guan Rong Fan, Dong Dong Zou, Di Xue

Abstract:

Background: The patient satisfaction survey is becoming of increasing importance for hospitals or other providers to get more reimbursement and/or more governmental subsidies. However, when the results of patient satisfaction survey are compared among medical institutions, there are some concerns. The primary objectives of this study were to evaluate patient satisfaction in tertiary hospitals of Shanghai and to compare the satisfaction rating on physician services between patients and observers. Methods: Two hundred outpatients were randomly selected for patient satisfaction survey in each of 28 public tertiary hospitals of Shanghai. Four or five volunteers were selected to observe 5 physicians’ practice in each of above hospitals and rated observed physicians’ practice. The outpatients that the volunteers observed their physician practice also filled in the satisfaction questionnaires. The rating scale for outpatient survey and volunteers’ observation was: 1 (very dissatisfied) to 6 (very satisfied). If the rating was equal to or greater than 5, we considered the outpatients and volunteers were satisfied with the services. The validity and reliability of the measure were assessed. Multivariate regressions for each of the 4 dimensions and overall of patient satisfaction were used in analyses. Paired t tests were applied to analyze the rating agreement on physician services between outpatients and volunteers. Results: Overall, 90% of surveyed outpatients were satisfied with outpatient care in the tertiary public hospitals of Shanghai. The lowest three satisfaction rates were seen in the items of ‘Restrooms were sanitary and not crowded’ (81%), ‘It was convenient for the patient to pay medical bills’ (82%), and ‘Medical cost in the hospital was reasonable’ (84%). After adjusting the characteristics of patients, the patient satisfaction in general hospitals was higher than that in specialty hospitals. In addition, after controlling the patient characteristics and number of hospital visits, the hospitals with higher outpatient cost per visit had lower patient satisfaction. Paired t tests showed that the rating on 6 items in the dimension of physician services (total 14 items) was significantly different between outpatients and observers, in which 5 were rated lower by the observers than by the outpatients. Conclusions: The hospital managers and physicians should use patient satisfaction and observers’ evaluation to detect the room for improvement in areas such as social skills cost control, and medical ethics.

Keywords: patient satisfaction, observation, quality, hospital

Procedia PDF Downloads 317
14176 A Car Parking Monitoring System Using a Line-Topology Wireless Sensor Network

Authors: Dae Il Kim, Jungho Moon, Tae Yun Chung

Abstract:

This paper presents a car parking monitoring system using a wireless sensor network. The presented sensor network has a line-shaped topology and adopts a TDMA-based protocol for allowing multi-hop communications. Sensor nodes are deployed in the ground of an outdoor parking lot in such a way that a sensor node monitors a parking space. Each sensor node detects the availability of the associated parking space and transmits the detection result to a sink node via intermediate sensor nodes existing between the source sensor node and the sink node. We evaluate the feasibility of the presented sensor network and the TDMA-based communication protocol through experiments using 11 sensor nodes deployed in a real parking lot. The result shows that the presented car parking monitoring system is robust to changes in the communication environments and efficient for monitoring parking spaces of outdoor parking lots.

Keywords: multi-hop communication, parking monitoring system, TDMA, wireless sensor network

Procedia PDF Downloads 296
14175 Imputing Missing Data in Electronic Health Records: A Comparison of Linear and Non-Linear Imputation Models

Authors: Alireza Vafaei Sadr, Vida Abedi, Jiang Li, Ramin Zand

Abstract:

Missing data is a common challenge in medical research and can lead to biased or incomplete results. When the data bias leaks into models, it further exacerbates health disparities; biased algorithms can lead to misclassification and reduced resource allocation and monitoring as part of prevention strategies for certain minorities and vulnerable segments of patient populations, which in turn further reduce data footprint from the same population – thus, a vicious cycle. This study compares the performance of six imputation techniques grouped into Linear and Non-Linear models on two different realworld electronic health records (EHRs) datasets, representing 17864 patient records. The mean absolute percentage error (MAPE) and root mean squared error (RMSE) are used as performance metrics, and the results show that the Linear models outperformed the Non-Linear models in terms of both metrics. These results suggest that sometimes Linear models might be an optimal choice for imputation in laboratory variables in terms of imputation efficiency and uncertainty of predicted values.

Keywords: EHR, machine learning, imputation, laboratory variables, algorithmic bias

Procedia PDF Downloads 78
14174 Planning the Journey of Unifying Medical Record Numbers in Five Facilities and the Expected Challenges: Case Study in Saudi Arabia

Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

Abstract:

Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

Procedia PDF Downloads 189
14173 Integrated Gas Turbine Performance Diagnostics and Condition Monitoring Using Adaptive GPA

Authors: Yi-Guang Li, Suresh Sampath

Abstract:

Gas turbine performance degrades over time, and the degradation is greatly affected by environmental, ambient, and operating conditions. The engines may degrade slowly under favorable conditions and result in a waste of engine life if a scheduled maintenance scheme is followed. They may also degrade fast and fail before a scheduled overhaul if the conditions are unfavorable, resulting in serious secondary damage, loss of engine availability, and increased maintenance costs. To overcome these problems, gas turbine owners are gradually moving from scheduled maintenance to condition-based maintenance, where condition monitoring is one of the key supporting technologies. This paper presents an integrated adaptive GPA diagnostics and performance monitoring system developed at Cranfield University for gas turbine gas path condition monitoring. It has the capability to predict the performance degradation of major gas path components of gas turbine engines, such as compressors, combustors, and turbines, using gas path measurement data. It is also able to predict engine key performance parameters for condition monitoring, such as turbine entry temperature that cannot be directly measured. The developed technology has been implemented into digital twin computer Software, Pythia, to support the condition monitoring of gas turbine engines. The capabilities of the integrated GPA condition monitoring system are demonstrated in three test cases using a model gas turbine engine similar to the GE aero-derivative LM2500 engine widely used in power generation and marine propulsion. It shows that when the compressor of the model engine degrades, the Adaptive GPA is able to predict the degradation and the changing engine performance accurately using gas path measurements. Such a presented technology and software are generic, can be applied to different types of gas turbine engines, and provide crucial engine health and performance parameters to support condition monitoring and condition-based maintenance.

Keywords: gas turbine, adaptive GPA, performance, diagnostics, condition monitoring

Procedia PDF Downloads 79
14172 Implementation of A Treatment Escalation Plan During The Covid 19 Outbreak in Aneurin Bevan University Health Board

Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman

Abstract:

For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.

Keywords: acute medicine, clinical governance, intensive care, patient centered decision making

Procedia PDF Downloads 170
14171 Ensuring Safe Operation by Providing an End-To-End Field Monitoring and Incident Management Approach for Autonomous Vehicle Based on ML/Dl SW Stack

Authors: Lucas Bublitz, Michael Herdrich

Abstract:

By achieving the first commercialization approval in San Francisco the Autonomous Driving (AD) industry proves the technology maturity of the SAE L4 AD systems and the corresponding software and hardware stack. This milestone reflects the upcoming phase in the industry, where the focus is now about scaling and supervising larger autonomous vehicle (AV) fleets in different operation areas. This requires an operation framework, which organizes and assigns responsibilities to the relevant AV technology and operation stakeholders from the AV system provider, the Remote Intervention Operator, the MaaS provider and regulatory & approval authority. This holistic operation framework consists of technological, processual, and organizational activities to ensure safe operation for fully automated vehicles. Regarding the supervision of large autonomous vehicle fleets, a major focus is on the continuous field monitoring. The field monitoring approach must reflect the safety and security criticality of incidents in the field during driving operation. This includes an automatic containment approach, with the overall goal to avoid safety critical incidents and reduce downtime by a malfunction of the AD software stack. An End-to-end (E2E) field monitoring approach detects critical faults in the field, uses a knowledge-based approach for evaluating the safety criticality and supports the automatic containment of these E/E faults. Applying such an approach will ensure the scalability of AV fleets, which is determined by the handling of incidents in the field and the continuous regulatory compliance of the technology after enhancing the Operational Design Domain (ODD) or the function scope by Functions on Demand (FoD) over the entire digital product lifecycle.

Keywords: field monitoring, incident management, multicompliance management for AI in AD, root cause analysis, database approach

Procedia PDF Downloads 64
14170 A Building Structure Health Monitoring DeviceBased on Cost Effective 1-Axis Accelerometers

Authors: Chih Hsing Lin, Wen-Ching Chen, Ssu-Ying Chen, Chih-Chyau Yang, Chien-Ming Wu, Chun-Ming Huang

Abstract:

Critical structures such as buildings, bridges and dams require periodic inspections to ensure safe operation. The reliable inspection of structures can be achieved by combing temperature sensor and accelerometers. In this work, we propose a building structure health monitoring device (BSHMD) with using three 1-axis accelerometers, gateway, analog to digital converter (ADC), and data logger to monitoring the building structure. The proposed BSHMD achieves the features of low cost by using three 1-axis accelerometers with the data synchronization problem being solved, and easily installation and removal. Furthermore, we develop a packet acquisition program to receive the sensed data and then classify it based on time and date. Compared with 3-axis accelerometer, our proposed 1-axis accelerometers based device achieves 64.3% cost saving. Compared with previous structural monitoring device, the BSHMD achieves 89% area saving. Therefore, with using the proposed device, the realtime diagnosis system for building damage monitoring can be conducted effectively.

Keywords: building structure health monitoring, cost effective, 1-axis accelerometers, real-time diagnosis

Procedia PDF Downloads 357
14169 Arterial Line Use for Acute Type 2 Respiratory Failure

Authors: C. Scurr, J. Jeans, S. Srivastava

Abstract:

Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

Procedia PDF Downloads 422
14168 Early Vasopressor and De-resuscitation in Steven Johnson Syndrome with Septic Shock: A Case Report

Authors: Darma Putra Sitepu, Dewi Larasati, Yohanes Wolter Hendrik George

Abstract:

Sepsis is a life-threatening medical emergency frequently observed in intensive care unit (ICU). Surviving Sepsis Campaign in 2018 has recommended the administration of early vasopressor in the first hour of sepsis or septic shock but has not yet included de-resuscitation protocol. De-resuscitation in acute management of septic shock is where patient received active removal of accumulated fluid. It has been proposed by some studies and ongoing clinical trials. Here we present a case with early vasopressor and de-resuscitation. Male, 27 years old presenting to the emergency room with shortness of breath, altered mental status, and widespread blisters on his body and lips started a few hours prior, after receiving non-steroidal anti-inflammatory drug through intravenous injection. Patient was hypotensive, tachycardic, and tachypneic at admission, diagnosed with Steven Johnson Syndrome with Septic Shock. Patient received fluid resuscitation, early vasopressor, and diuresis agent aimed to actively remove fluid after the initial phase of resuscitation. Patient was admitted to ICU and progressively recovering. At day-10, patient was stabilized and was transferred to general ward. Early vasopressor and de-resuscitation are beneficial for the patient.

Keywords: sepsis, shock, de-resuscitation, vasopressor, fluid, case report

Procedia PDF Downloads 157
14167 Designing an Operational Control System for the Continuous Cycle of Industrial Technological Processes Using Fuzzy Logic

Authors: Teimuraz Manjapharashvili, Ketevani Manjaparashvili

Abstract:

Fuzzy logic is a modeling method for complex or ill-defined systems and is a relatively new mathematical approach. Its basis is to consider overlapping cases of parameter values and define operations to manipulate these cases. Fuzzy logic can successfully create operative automatic management or appropriate advisory systems. Fuzzy logic techniques in various operational control technologies have grown rapidly in the last few years. Fuzzy logic is used in many areas of human technological activity. In recent years, fuzzy logic has proven its great potential, especially in the automation of industrial process control, where it allows to form of a control design based on the experience of experts and the results of experiments. The engineering of chemical technological processes uses fuzzy logic in optimal management, and it is also used in process control, including the operational control of continuous cycle chemical industrial, technological processes, where special features appear due to the continuous cycle and correct management acquires special importance. This paper discusses how intelligent systems can be developed, in particular, how fuzzy logic can be used to build knowledge-based expert systems in chemical process engineering. The implemented projects reveal that the use of fuzzy logic in technological process control has already given us better solutions than standard control techniques. Fuzzy logic makes it possible to develop an advisory system for decision-making based on the historical experience of the managing operator and experienced experts. The present paper deals with operational control and management systems of continuous cycle chemical technological processes, including advisory systems. Because of the continuous cycle, many features are introduced in them compared to the operational control of other chemical technological processes. Among them, there is a greater risk of transitioning to emergency mode; the return from emergency mode to normal mode must be done very quickly due to the impossibility of stopping the technological process due to the release of defective products during this period (i.e., receiving a loss), accordingly, due to the need for high qualification of the operator managing the process, etc. For these reasons, operational control systems of continuous cycle chemical technological processes have been specifically discussed, as they are different systems. Special features of such systems in control and management were brought out, which determine the characteristics of the construction of control and management systems. To verify the findings, the development of an advisory decision-making information system for operational control of a lime kiln using fuzzy logic, based on the creation of a relevant expert-targeted knowledge base, was discussed. The control system has been implemented in a real lime production plant with a lime burn kiln, which has shown that suitable and intelligent automation improves operational management, reduces the risks of releasing defective products, and, therefore, reduces costs. The special advisory system was successfully used in the said plant both for the improvement of operational management and, if necessary, for the training of new operators due to the lack of an appropriate training institution.

Keywords: chemical process control systems, continuous cycle industrial technological processes, fuzzy logic, lime kiln

Procedia PDF Downloads 10
14166 An Application of a Machine Monitoring by Using the Internet of Things to Improve a Preventive Maintenance: Case Study of an Automated Plastic Granule-Packing Machine

Authors: Anek Apipatkul, Paphakorn Pitayachaval

Abstract:

Preventive maintenance is a standardized procedure to control and prevent risky problems affecting production in order to increase work efficiency. Machine monitoring also routinely works to collect data for a scheduling maintenance period. This paper is to present the application of machine monitoring by using the internet of things (IOTs) and a lean technique in order to manage with complex maintenance tasks of an automated plastic granule packing machine. To organize the preventive maintenance, there are several processes that the machine monitoring was applied, starting with defining a clear scope of the machine, establishing standards in maintenance work, applying a just-in-time (JIT) technique for timely delivery in the maintenance work, solving problems on the floor, and also improving the inspection process. The result has shown that wasted time was reduced, and machines have been operated as scheduled. Furthermore, the efficiency of the scheduled maintenance period was increased by 95%.

Keywords: internet of things, preventive maintenance, machine monitoring, lean technique

Procedia PDF Downloads 91
14165 An Artificially Intelligent Teaching-Agent to Enhance Learning Interactions in Virtual Settings

Authors: Abdulwakeel B. Raji

Abstract:

This paper introduces a concept of an intelligent virtual learning environment that involves communication between learners and an artificially intelligent teaching agent in an attempt to replicate classroom learning interactions. The benefits of this technology over current e-learning practices is that it creates a virtual classroom where real time adaptive learning interactions are made possible. This is a move away from the static learning practices currently being adopted by e-learning systems. Over the years, artificial intelligence has been applied to various fields, including and not limited to medicine, military applications, psychology, marketing etc. The purpose of e-learning applications is to ensure users are able to learn outside of the classroom, but a major limitation has been the inability to fully replicate classroom interactions between teacher and students. This study used comparative surveys to gain information and understanding of the current learning practices in Nigerian universities and how they compare to these practices compare to the use of a developed e-learning system. The study was conducted by attending several lectures and noting the interactions between lecturers and tutors and as an aftermath, a software has been developed that deploys the use of an artificial intelligent teaching-agent alongside an e-learning system to enhance user learning experience and attempt to create the similar learning interactions to those found in classroom and lecture hall settings. Dialogflow has been used to implement a teaching-agent, which has been developed using JSON, which serves as a virtual teacher. Course content has been created using HTML, CSS, PHP and JAVASCRIPT as a web-based application. This technology can run on handheld devices and Google based home technologies to give learners an access to the teaching agent at any time. This technology also implements the use of definite clause grammars and natural language processing to match user inputs and requests with defined rules to replicate learning interactions. This technology developed covers familiar classroom scenarios such as answering users’ questions, asking ‘do you understand’ at regular intervals and answering subsequent requests, taking advanced user queries to give feedbacks at other periods. This software technology uses deep learning techniques to learn user interactions and patterns to subsequently enhance user learning experience. A system testing has been undergone by undergraduate students in the UK and Nigeria on the course ‘Introduction to Database Development’. Test results and feedback from users shows that this study and developed software is a significant improvement on existing e-learning systems. Further experiments are to be run using the software with different students and more course contents.

Keywords: virtual learning, natural language processing, definite clause grammars, deep learning, artificial intelligence

Procedia PDF Downloads 129
14164 Soil Bioremediation Monitoring Systems Powered by Microbial Fuel Cells

Authors: András Fülöp, Lejla Heilmann, Zsolt Szabó, Ákos Koós

Abstract:

Microbial fuel cells (MFCs) present a sustainable biotechnological solution to future energy demands. The aim of this study was to construct soil based, single cell, membrane-less MFC systems, operated without treatment to continuously power on-site monitoring and control systems during the soil bioremediation processes. Our Pseudomonas aeruginosa 541 isolate is an ideal choice for MFCs, because it is able to produce pyocyanin which behaves as electron-shuttle molecule, furthermore, it also has a significant antimicrobial effect. We tested several materials and structural configurations to obtain long term high power output. Comparing different configurations, a proton exchange membrane-less, 0.6 m long with 0.05 m diameter MFC tubes offered the best long-term performances. The long-term electricity production were tested from starch, yeast extract (YE), carboxymethyl cellulose (CMC) with humic acid (HA) as a mediator. In all cases, 3 kΩ external load have been used. The two best-operated systems were the Pseudomonas aeruginosa 541 containing MFCs with 1 % carboxymethyl cellulose and the MFCs with 1% yeast extract in the anode area and 35% hydrogel in the cathode chamber. The first had 3.3 ± 0.033 mW/m2 and the second had 4.1 ± 0.065 mW/m2 power density values. These systems have operated for 230 days without any treatment. The addition of 0.2 % HA and 1 % YE referred to the volume of the anode area resulted in 1.4 ± 0.035 mW/m2 power densities. The mixture of 1% starch with 0.2 % HA gave 1.82 ± 0.031 mW/m2. Using CMC as retard carbon source takes effect in the long-term bacterial survivor, thus enable the expression of the long term power output. The application of hydrogels in the cathode chamber significantly increased the performance of the MFC units due to their good water retention capacity.

Keywords: microbial fuel cell, bioremediation, Pseudomonas aeruginosa, biotechnological solution

Procedia PDF Downloads 286
14163 Modelling Patient Condition-Based Demand for Managing Hospital Inventory

Authors: Esha Saha, Pradip Kumar Ray

Abstract:

A hospital inventory comprises of a large number and great variety of items for the proper treatment and care of patients, such as pharmaceuticals, medical equipment, surgical items, etc. Improper management of these items, i.e. stockouts, may lead to delay in treatment or other fatal consequences, even death of the patient. So, generally the hospitals tend to overstock items to avoid the risk of stockout which leads to unnecessary investment of money, difficulty in storing, more expiration and wastage, etc. Thus, in such challenging environment, it is necessary for hospitals to follow an inventory policy considering the stochasticity of demand in a hospital. Statistical analysis captures the correlation of patient condition based on bed occupancy with the patient demand which changes stochastically. Due to the dependency on bed occupancy, the markov model is developed that helps to map the changes in demand of hospital inventory based on the changes in the patient condition represented by the movements of bed occupancy states (acute care state, rehabilitative state and long-care state) during the length-of-stay of patient in a hospital. An inventory policy is developed for a hospital based on the fulfillment of patient demand with the objective of minimizing the frequency and quantity of placement of orders of inventoried items. The analytical structure of the model based on probability calculation is provided to show the optimal inventory-related decisions. A case-study is illustrated in this paper for the development of hospital inventory model based on patient demand for multiple inpatient pharmaceutical items. A sensitivity analysis is conducted to investigate the impact of inventory-related parameters on the developed optimal inventory policy. Therefore, the developed model and solution approach may help the hospital managers and pharmacists in managing the hospital inventory in case of stochastic demand of inpatient pharmaceutical items.

Keywords: bed occupancy, hospital inventory, markov model, patient condition, pharmaceutical items

Procedia PDF Downloads 318
14162 Smart Side View Mirror Camera for Real Time System

Authors: Nunziata Ivana Guarneri, Arcangelo Bruna, Giuseppe Spampinato, Antonio Buemi

Abstract:

In the last decade, automotive companies have invested a lot in terms of innovation about many aspects regarding the automatic driver assistance systems. One innovation regards the usage of a smart camera placed on the car’s side mirror for monitoring the back and lateral road situation. A common road scenario is the overtaking of the preceding car and, in this case, a brief distraction or a loss of concentration can lead the driver to undertake this action, even if there is an already overtaking vehicle, leading to serious accidents. A valid support for a secure drive can be a smart camera system, which is able to automatically analyze the road scenario and consequentially to warn the driver when another vehicle is overtaking. This paper describes a method for monitoring the side view of a vehicle by using camera optical flow motion vectors. The proposed solution detects the presence of incoming vehicles, assesses their distance from the host car, and warns the driver through different levels of alert according to the estimated distance. Due to the low complexity and computational cost, the proposed system ensures real time performances.

Keywords: camera calibration, ego-motion, Kalman filters, object tracking, real time systems

Procedia PDF Downloads 218
14161 Effective Use of X-Box Kinect in Rehabilitation Centers of Riyadh

Authors: Reem Alshiha, Tanzila Saba

Abstract:

Physical rehabilitation is the process of helping people to recover and be able to go back to their former activities that have been delayed due to external factors such as car accidents, old age and victims of strokes (chronic diseases and accidents, and those related to sport activities).The cost of hiring a personal nurse or driving the patient to and from the hospital could be costly and time-consuming. Also, there are other factors to take into account such as forgetfulness, boredom and lack of motivation. In order to solve this dilemma, some experts came up with rehabilitation software to be used with Microsoft Kinect to help the patients and their families for in-home rehabilitation. In home rehabilitation software is becoming more and more popular, since it is more convenient for all parties affiliated with the patient. In contrast to the other costly market-based systems that have no portability, Microsoft’s Kinect is a portable motion sensor that reads body movements and interprets it. New software development has made rehabilitation games available to be used at home for the convenience of the patient. The game will benefit its users (rehabilitation patients) in saving time and money. There are many software's that are used with the Kinect for rehabilitation, but the software that is chosen in this research is Kinectotherapy. Kinectotherapy software is used for rehabilitation patients in Riyadh clinics to test its acceptance by patients and their physicians. In this study, we used Kinect because it was affordable, portable and easy to access in contrast to expensive market-based motion sensors. This paper explores the importance of in-home rehabilitation by using Kinect with Kinectotherapy software. The software targets both upper and lower limbs, but in this research, the main focus is on upper-limb functionality. However, the in-home rehabilitation is applicable to be used by all patients with motor disability, since the patient must have some self-reliance. The targeted subjects are patients with minor motor impairment that are somewhat independent in their mobility. The presented work is the first to consider the implementation of in-home rehabilitation with real-time feedback to the patient and physician. This research proposes the implementation of in-home rehabilitation in Riyadh, Saudi Arabia. The findings show that most of the patients are interested and motivated in using the in-home rehabilitation system in the future. The main value of the software application is due to these factors: improve patient engagement through stimulating rehabilitation, be a low cost rehabilitation tool and reduce the need for expensive one-to-one clinical contact. Rehabilitation is a crucial treatment that can improve the quality of life and confidence of the patient as well as their self-esteem.

Keywords: x-box, rehabilitation, physical therapy, rehabilitation software, kinect

Procedia PDF Downloads 335
14160 Bridge Health Monitoring: A Review

Authors: Mohammad Bakhshandeh

Abstract:

Structural Health Monitoring (SHM) is a crucial and necessary practice that plays a vital role in ensuring the safety and integrity of critical structures, and in particular, bridges. The continuous monitoring of bridges for signs of damage or degradation through Bridge Health Monitoring (BHM) enables early detection of potential problems, allowing for prompt corrective action to be taken before significant damage occurs. Although all monitoring techniques aim to provide accurate and decisive information regarding the remaining useful life, safety, integrity, and serviceability of bridges, understanding the development and propagation of damage is vital for maintaining uninterrupted bridge operation. Over the years, extensive research has been conducted on BHM methods, and experts in the field have increasingly adopted new methodologies. In this article, we provide a comprehensive exploration of the various BHM approaches, including sensor-based, non-destructive testing (NDT), model-based, and artificial intelligence (AI)-based methods. We also discuss the challenges associated with BHM, including sensor placement and data acquisition, data analysis and interpretation, cost and complexity, and environmental effects, through an extensive review of relevant literature and research studies. Additionally, we examine potential solutions to these challenges and propose future research ideas to address critical gaps in BHM.

Keywords: structural health monitoring (SHM), bridge health monitoring (BHM), sensor-based methods, machine-learning algorithms, and model-based techniques, sensor placement, data acquisition, data analysis

Procedia PDF Downloads 84
14159 Fuzzy Logic for Control and Automatic Operation of Natural Ventilation in Buildings

Authors: Ekpeti Bukola Grace, Mahmoudi Sabar Esmail, Chaer Issa

Abstract:

Global energy consumption has been increasing steadily over the last half - century, and this trend is projected to continue. As energy demand rises in many countries throughout the world due to population growth, natural ventilation in buildings has been identified as a viable option for lowering these demands, saving costs, and also lowering CO2 emissions. However, natural ventilation is driven by forces that are generally unpredictable in nature thus, it is important to manage the resulting airflow in order to maintain pleasant indoor conditions, making it a complex system that necessitates specific control approaches. The effective application of fuzzy logic technique amidst other intelligent systems is one of the best ways to bridge this gap, as its control dynamics relates more to human reasoning and linguistic descriptions. This article reviewed existing literature and presented practical solutions by applying fuzzy logic control with optimized techniques, selected input parameters, and expert rules to design a more effective control system. The control monitors used indoor temperature, outdoor temperature, carbon-dioxide levels, wind velocity, and rain as input variables to the system, while the output variable remains the control of window opening. This is achieved through the use of fuzzy logic control tool box in MATLAB and running simulations on SIMULINK to validate the effectiveness of the proposed system. Comparison analysis model via simulation is carried out, and with the data obtained, an improvement in control actions and energy savings was recorded.

Keywords: fuzzy logic, intelligent control systems, natural ventilation, optimization

Procedia PDF Downloads 122
14158 Artificial Intelligent Methodology for Liquid Propellant Engine Design Optimization

Authors: Hassan Naseh, Javad Roozgard

Abstract:

This paper represents the methodology based on Artificial Intelligent (AI) applied to Liquid Propellant Engine (LPE) optimization. The AI methodology utilized from Adaptive neural Fuzzy Inference System (ANFIS). In this methodology, the optimum objective function means to achieve maximum performance (specific impulse). The independent design variables in ANFIS modeling are combustion chamber pressure and temperature and oxidizer to fuel ratio and output of this modeling are specific impulse that can be applied with other objective functions in LPE design optimization. To this end, the LPE’s parameter has been modeled in ANFIS methodology based on generating fuzzy inference system structure by using grid partitioning, subtractive clustering and Fuzzy C-Means (FCM) clustering for both inferences (Mamdani and Sugeno) and various types of membership functions. The final comparing optimization results shown accuracy and processing run time of the Gaussian ANFIS Methodology between all methods.

Keywords: ANFIS methodology, artificial intelligent, liquid propellant engine, optimization

Procedia PDF Downloads 576
14157 A Study on the Prevalence and Microbiological Profile of Nosocomial Infections in the ICU of a Tertiary Care Hospital in Eastern India

Authors: Pampita Chakraborty, Sukumar Mukherjee

Abstract:

This study was done to determine the prevalence of nosocomial infections in the ICU and to identify the common microorganisms causing these infections and their antimicrobial sensitivity pattern. Nosocomial infection or hospital-acquired infection is a localized or a systemic condition resulting from an adverse reaction to the presence of infectious agents. Nosocomial infections are not present or incubating when the patient is admitted to hospital or other health care facility. They are caused by pathogens that easily spread through the body. Many hospitalized patients have compromised immune systems, so they are less able to fight off infections. These infections occur worldwide, both in the developed and developing the world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients, which is a matter of serious concern today. This study was done during the period of one year (2012-2013) in the ICU of the tertiary care hospital in eastern India. Prevalence of nosocomial infection was determined; site of infection and the pattern of microorganisms were identified along with the assessment of antibiotic susceptibility profile. Patients who developed an infection after 48 hours of admission to the ICU were included in the study. A total of 324 ICU patients were analyzed, of these 79 patients were found to have developed a nosocomial infection (24.3% prevalence). Urinary tract infection was found to be more predominant followed by respiratory tract infection and soft tissue infection. The most frequently isolated microorganism was E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae followed by other organisms respectively. Antibiotic susceptibility test of these isolates was done against commonly used antibiotics. Patients admitted to the ICU are especially susceptible to nosocomial infections. Despite adequate antimicrobial treatment, nosocomial ICU infections can significantly affect ICU stay and can cause an increase in patient’s morbidity and mortality. Adherence to infection protocol, proper monitoring and the judicious use of antibiotics are important in preventing such infections on a regular basis.

Keywords: antibiotic susceptibility, intensive care unit, nosocomial infection, nosocomial pathogen

Procedia PDF Downloads 316