Search results for: medical record system
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 20405

Search results for: medical record system

19925 A Regional Innovation System Model Based on the Systems Thinking Approach

Authors: Samara E., Kilintzis P., Katsoras E., Martinidis G.

Abstract:

Regions play an important role in the global economy by driving research and innovation policies through a major tool, the Regional Innovation System (RIS). RIS is a social system that encompasses the systematic interaction of the various organizations that comprise it in order to improve local knowledge and innovation. This article describes the methodological framework for developing and validating a RIS model utilizing system dynamics. This model focuses on the functional structure of the RIS, separating it in six diverse, interacting sub-systems.

Keywords: innovations, regional development, systems thinking, social system

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19924 A Named Data Networking Stack for Contiki-NG-OS

Authors: Sedat Bilgili, Alper K. Demir

Abstract:

The current Internet has become the dominant use with continuing growth in the home, medical, health, smart cities and industrial automation applications. Internet of Things (IoT) is an emerging technology to enable such applications in our lives. Moreover, Named Data Networking (NDN) is also emerging as a Future Internet architecture where it fits the communication needs of IoT networks. The aim of this study is to provide an NDN protocol stack implementation running on the Contiki operating system (OS). Contiki OS is an OS that is developed for constrained IoT devices. In this study, an NDN protocol stack that can work on top of IEEE 802.15.4 link and physical layers have been developed and presented.

Keywords: internet of things (IoT), named-data, named data networking (NDN), operating system

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19923 Model for Remanufacture of Medical Equipment in Cross Border Collaboration

Authors: Kingsley Oturu, Winifred Ijomah, Wale Coker, Chibueze Achi

Abstract:

With the impact of BREXIT and the need for cross-border collaboration, this international research investigated the use of a conceptual model for remanufacturing medical equipment (with a focus on anesthetic machines and baby incubators). Early findings of the research suggest that contextual factors need to be taken into consideration, as well as an emphasis on cleaning (e.g., sterilization) during the process of remanufacturing medical equipment. For example, copper tubings may be more important in the remanufacturing of anesthetic equipment in tropical climates than in cold climates.

Keywords: medical equipment remanufacture, sustainability, circular business models, remanufacture process model

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19922 Conceptual Design of a Wi-Fi and GPS Based Robotic Library Using an Intelligent System

Authors: M. S. Sreejith, Steffy Joy, Abhishesh Pal, Beom-Sahng Ryuh, V. R. Sanal Kumar

Abstract:

In this paper an attempt has been made for the design of a robotic library using an intelligent system. The robot works on the ARM microprocessor, motor driver circuit with 5 degrees of freedom with Wi-Fi and GPS based communication protocol. The authenticity of the library books is controlled by RFID. The proposed robotic library system is facilitated with embedded system and ARM. In this library issuance system the previous potential readers’ authentic review reports have been taken into consideration for recommending suitable books to the deserving new users and the issuance of books or periodicals is based on the users’ decision. We have conjectured that the Wi-Fi based robotic library management system would allow fast transaction of books issuance and it also produces quality readers.

Keywords: GPS bsed based Robotic library, library management system, robotic library, Wi-Fi library

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19921 Ancient Malay and Spice Trade Routes: A Study of Ancient Malay from the Perspectives of Linguistics and Archaeology

Authors: Totok Suhardijanto, Ninie Susanti Tedjowasono

Abstract:

This paper discusses the relationship between the distribution of Ancient Malay inscriptions and Spice Trade Route, especially in the relation with material cultures that accompany them, to understand how Malay could spread out around the archipelago beyond its original native-speakers’ region. The archipelago was known as the Spice Islands from the very beginning of the first century due to mace, cloves, and nutmeg that were originally exclusively found there. According to the Indian record, since the 2nd century, there has been a contact established between Indian and Indonesian people. A Chinese document from 3rd Century has mentioned Wangka (now widely known as Bangka) an island near Sumatra where some Chinese expeditions had visited. All of these records supported the existence of a maritime trade system and route between the archipelago and other countries during the first millennium. This paper will discuss first the Ancient Malay inscription spread around the archipelago from the perspectives of language variation and writing system style. Analyzing language variations of inscriptions certainly is not as easy as studying current spoken language variations in modern sociolinguistics. A huge amount of data is available for such kind of studies. On the contrary, in language variation research with inscription texts as an object, data is insufficient. Other resources will be needed to support the linguistic analysis. For this reason, this research made use of epigraphical evidence in the surrounding areas of the inscriptions to explain the variation of language and writing style. The research next expands the analysis to figure out the relationship between language variation and inscriptions distribution to the Spice Trade Route that spreads from the Molucca Sea to Mediterranian Sea. Data in this research consists of six different inscriptions: Kedukan Bukit, Koto Kapur, Dapunta Salendra, Sang Hyang Wintang, Ligor, and Laguna from the 7th-9th Century and found in Sumatra, Jawa, and the Philippines. In addition, as a comparative resource, this research also used Hikayat Tanjung Tanah, the first-founded Ancient Malay manuscript. In language analysis, we conduct a sociolinguistic method to explore the language variation and writing style of the inscriptions. For dealing with archaeological data, we conducted a hermeneutic method to analyze the possible meaning and social uses of the data. Language variations and writing system style in this research can be classified into two main groups. The language, epigraphical, and archaeological evidence explain that Ancient Malay had been widely used in the Eastern area of Spice Trade Route because it played an important role in the region as a lingua franca between people from different ethnic groups with different languages.

Keywords: Ancient Malay, Spice trade route, language variation, writing system variation

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19920 Assessing Livelihood Vulnerability to Climate Change and Adaptation Strategies in Rajanpur District, Pakistan

Authors: Muhammad Afzal, Shahbaz Mushtaq, Duc-Anh-An-Vo, Kathryn Reardon Smith, Thanh Ma

Abstract:

Climate change has become one of the most challenging environmental issues in the 21st century. Climate change-induced natural disasters, especially floods, are the major factors of livelihood vulnerability, impacting millions of individuals worldwide. Evaluating and mitigating the effects of floods requires an in-depth understanding of the relationship between vulnerability and livelihood capital assets. Using an integrated approach, sustainable livelihood framework, and system thinking approach, the study developed a conceptual model of a generalized livelihood system in District Rajanpur, Pakistan. The model visualizes the livelihood vulnerability system as a whole and identifies the key feedback loops likely to influence the livelihood vulnerability. The study suggests that such conceptual models provide effective communication and understanding tools to stakeholders and decision-makers to anticipate the problem and design appropriate policies. It can also serve as an evaluation technique for rural livelihood policy and identify key systematic interventions. The key finding of the study reveals that household income, health, and education are the major factors behind the livelihood vulnerability of the rural poor of District Rajanpur. The Pakistani government tried to reduce the livelihood vulnerability of the region through different income, health, and education programs, but still, many changes are required to make these programs more effective especially during the flood times. The government provided only cash to vulnerable and marginalized families through income support programs, but this study suggests that along with the cash, the government must provide seed storage facilities and access to crop insurance to the farmers. Similarly, the government should establish basic health units in villages and frequent visits of medical mobile vans should be arranged with advanced medical lab facilities during and after the flood.

Keywords: livelihood vulnerability, rural communities, flood, sustainable livelihood framework, system dynamics, Pakistan

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19919 Design and Comparative Analysis of Grid-Connected Bipv System with Monocrystalline Silicon and Polycrystalline Silicon in Kandahar Climate

Authors: Ahmad Shah Irshad, Naqibullah Kargar, Wais Samadi

Abstract:

Building an integrated photovoltaic (BIPV) system is a new and modern technique for solar energy production in Kandahar. Due to its location, Kandahar has abundant sources of solar energy. People use both monocrystalline and polycrystalline silicon solar PV modules for the grid-connected solar PV system, and they don’t know which technology performs better for the BIPV system. This paper analyses the parameters described by IEC61724, “Photovoltaic System Performance Monitoring Guidelines for Measurement, Data Exchange and Analysis,” to evaluate which technology shows better performance for the BIPV system. The monocrystalline silicon BIPV system has a 3.1% higher array yield than the polycrystalline silicon BIPV system. The final yield is 0.2%, somewhat higher for monocrystalline silicon than polycrystalline silicon. Monocrystalline silicon has 0.2% and 4.5% greater yearly yield factor and capacity factors than polycrystalline silicon, respectively. Monocrystalline silicon shows 0.3% better performance than polycrystalline silicon. With 1.7% reduction and 0.4% addition in collection losses and useful energy produced, respectively, monocrystalline silicon solar PV system shows good performance than polycrystalline silicon solar PV system. But system losses are the same for both technologies. The monocrystalline silicon BIPV system injects 0.2% more energy into the grid than the polycrystalline silicon BIPV system.

Keywords: photovoltaic technologies, performance analysis, solar energy, solar irradiance, performance ratio

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19918 Identification of Shark Species off The Nigerian Coast Using DNA Barcoding

Authors: O. O. Fola-Matthews, O. O. Soyinka, D. N. Bitalo

Abstract:

Nigeria is one of the major shark fishing nations in Africa, but its fisheries managers still record catch data in aggregates ‘sharks’ with no species-specific details. This is because most of the shark specimens look identical in morphology, and field identification of some closely related species is tricky. This study uses DNA barcoding as a method to identify shark species from five different landing areas off the Nigerian Coast. 100 dorsal fins were sampled in order to provide a Chondrichthyan sequence that would be matched to reference specimens in a DNA barcode database

Keywords: BOLD, DNA barcoding, nigeria, sharks

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19917 Tele-Monitoring and Logging of Patient Health Parameters Using Zigbee

Authors: Kirubasankar, Sanjeevkumar, Aravindh Nagappan

Abstract:

This paper addresses a system for monitoring patients using biomedical sensors and displaying it in a remote place. The main challenges in present health monitoring devices are lack of remote monitoring and logging for future evaluation. Typical instruments used for health parameter measurement provide basic information regarding health status. This paper identifies a set of design principles to address these challenges. This system includes continuous measurement of health parameters such as Heart rate, electrocardiogram, SpO2 level and Body temperature. The accumulated sensor data is relayed to a processing device using a transceiver and viewed by the implementation of cloud services.

Keywords: bio-medical sensors, monitoring, logging, cloud service

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19916 Expression of Ki-67 in Multiple Myeloma: A Clinicopathological Study

Authors: Kangana Sengar, Sanjay Deb, Ramesh Dawar

Abstract:

Introduction: Ki-67 can be a useful marker in determining proliferative activity in patients with multiple myeloma (MM). However, using Ki-67 alone results in the erroneous inclusion of non-myeloma cells leading to false high counts. We have used Dual IHC (immunohistochemistry) staining with Ki-67 and CD138 to enhance specificity in assessing proliferative activity of bone marrow plasma cells. Aims and objectives: To estimate the proportion of proliferating (Ki-67 expressing) plasma cells in patients with MM and correlation of Ki-67 with other known prognostic parameters. Materials and Methods: Fifty FFPE (formalin fixed paraffin embedded) blocks of trephine biopsies of cases diagnosed as MM from 2010 to 2015 are subjected to H & E staining and Dual IHC staining for CD 138 and Ki-67. H & E staining is done to evaluate various histological parameters like percentage of plasma cells, pattern of infiltration (nodular, interstitial, mixed and diffuse), routine parameters of marrow cellularity and hematopoiesis. Clinical data is collected from patient records from Medical Record Department. Each of CD138 expressing cells (cytoplasmic, red) are scored as proliferating plasma cells (containing a brown Ki¬67 nucleus) or non¬proliferating plasma cells (containing a blue, counter-stained, Ki-¬67 negative nucleus). Ki-67 is measured as percentage positivity with a maximum score of hundred percent and lowest of zero percent. The intensity of staining is not relevant. Results: Statistically significant correlation of Ki-67 in D-S Stage (Durie & Salmon Stage) I vs. III (p=0.026) and ISS (International Staging System) Stage I vs. III (p=0.019), β2m (p=0.029) and percentage of plasma cells (p < 0.001) is seen. No statistically significant correlation is seen between Ki-67 and hemoglobin, platelet count, total leukocyte count, total protein, albumin, S. calcium, S. creatinine, S. LDH, blood urea and pattern of infiltration. Conclusion: Ki-67 index correlated with other known prognostic parameters. However, it is not determined routinely in patients with MM due to little information available regarding its relevance and paucity of studies done to correlate with other known prognostic factors in MM patients. To the best of our knowledge, this is the first study in India using Dual IHC staining for Ki-67 and CD138 in MM patients. Routine determination of Ki-67 will help to identify patients who may benefit with more aggressive therapy. Recommendation: In this study follow up of patients is not included, and the sample size is small. Studying with larger sample size and long follow up is advocated to prognosticate Ki-67 as a marker of survival in patients with multiple myeloma.

Keywords: bone marrow, dual IHC, Ki-67, multiple myeloma

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19915 Inferring Thimlich Ohinga Gender Identity Through Ethnoarchaeological Analysis

Authors: David Maina Muthegethi

Abstract:

The Victoria Basin is associated with gateway for migration to Southern part of Africa. Different communities migrated through the region including the Bantus and Nilotic communities that occupy present day Kenya and Tanzania. A distinct culture of dry-stone technology emerged around 15th century current era, a period associated with peopling of the western Kenya region. One of the biggest dry-stone walls enclosure is Thimlich Ohinga archaeological site. The site was constructed around fourteenth century current era. Architectural design was oval shaped stone structures that were around 4 meters and 2 meters in length and width respectively. The main subsistence strategies of the community that was crop faming, pastoralism, fishing, hunting and gathering. This paper attempts to examine gender dynamics of Thimlich Ohinga society. At that end, attempts are made to infer gender roles as manifested in archaeological record. Therefore, the study entails examination of material evidence excavated from the site. Also, ethnoarchaeological study of contemporary Luo community was undertaken in order to make inferences and analogies concerning gender roles of Thimlich Ohinga society. Overall, the study involved examination of cultural materials excavated from Thimlich Ohinga, extensive survey of the site and ethnography of Luo community. In total, an extensive survey and interviews of 20 households was undertaken in South Kanyamkango ward, Migori County in Western Kenya. The key findings point out that Thimlich Ohinga gender identities were expressed in material forms through architecture, usage of spaces, subsistence strategies, dietary patterns and household organization. Also, gender as social identity was dynamic and responsive to diversification of subsistence strategies and intensification of regional trade as documented in contemporary Luo community. The paper reiterates importance of ethnoarchaeological methods in reconstruction of past social organization as manifested in material record.

Keywords: ethnoarchaeological, gender, subsistence patterns, Thimlich Ohinga

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19914 Reliability Analysis for the Functioning of Complete and Low Capacity MLDB Systems in Piston Plants

Authors: Ramanpreet Kaur, Upasana Sharma

Abstract:

The purpose of this paper is to address the challenges facing the water supply for the Machine Learning Database (MLDB) system at the piston foundry plant. In the MLDB system, one main unit, i.e., robotic, is connected by two sub-units. The functioning of the system depends on the robotic and water supply. Lack of water supply causes system failure. The system operates at full capacity with the help of two sub-units. If one sub-unit fails, the system runs at a low capacity. Reliability modeling is performed using semi-Markov processes and regenerative point techniques. Several system effects such as mean time to system failure, availability at full capacity, availability at reduced capacity, busy period for repair and expected number of visits have been achieved. Benefits have been analyzed. The graphical study is designed for a specific case using programming in C++ and MS Excel.

Keywords: MLDB system, robotic, semi-Markov process, regenerative point technique

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19913 Diagnosis and Analysis of Automated Liver and Tumor Segmentation on CT

Authors: R. R. Ramsheeja, R. Sreeraj

Abstract:

For view the internal structures of the human body such as liver, brain, kidney etc have a wide range of different modalities for medical images are provided nowadays. Computer Tomography is one of the most significant medical image modalities. In this paper use CT liver images for study the use of automatic computer aided techniques to calculate the volume of the liver tumor. Segmentation method is used for the detection of tumor from the CT scan is proposed. Gaussian filter is used for denoising the liver image and Adaptive Thresholding algorithm is used for segmentation. Multiple Region Of Interest(ROI) based method that may help to characteristic the feature different. It provides a significant impact on classification performance. Due to the characteristic of liver tumor lesion, inherent difficulties appear selective. For a better performance, a novel proposed system is introduced. Multiple ROI based feature selection and classification are performed. In order to obtain of relevant features for Support Vector Machine(SVM) classifier is important for better generalization performance. The proposed system helps to improve the better classification performance, reason in which we can see a significant reduction of features is used. The diagnosis of liver cancer from the computer tomography images is very difficult in nature. Early detection of liver tumor is very helpful to save the human life.

Keywords: computed tomography (CT), multiple region of interest(ROI), feature values, segmentation, SVM classification

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19912 Rural-To-Urban Migrants' Experiences with Primary Care in Four Types of Medical Institutions in Guangzhou, China

Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

Abstract:

Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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19911 Design of Orientation-Free Handler and Fuzzy Controller for Wire-Driven Heavy Object Lifting System

Authors: Bo-Wei Song, Yun-Jung Lee

Abstract:

This paper presents an intention interface and controller for a wire-driven heavy object lifting system that assists the operator with moving a heavy object. The handler is designed to allow a comfortable working posture for the operator. Plus, as a human assistive system, the operator is involved in the control loop, where a fuzzy control system is used to consider the human control characteristics. The effectiveness and performance of the proposed system are proved by experiments.

Keywords: fuzzy controller, handler design, heavy object lifting system, human-assistive device, human-in-the-loop system

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19910 Modal Analysis of Power System with a Microgrid

Authors: Burak Yildirim, Muhsin Tunay Gençoğlu

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A microgrid (MG) is a small power grid composed of localized medium or low level power generation, storage systems, and loads. In this paper, the effects of a MG on power systems voltage stability are shown. The MG model, designed to demonstrate the effects of the MG, was applied to the IEEE 14 bus power system which is widely used in power system stability studies. Eigenvalue and modal analysis methods were used in simulation studies. In the study results, it is seen that MGs affect system voltage stability positively by increasing system voltage instability limit value for buses of a power system in which MG are placed.

Keywords: eigenvalue analysis, microgrid, modal analysis, voltage stability

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19909 Application of Optimization Techniques in Overcurrent Relay Coordination: A Review

Authors: Syed Auon Raza, Tahir Mahmood, Syed Basit Ali Bukhari

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In power system properly coordinated protection scheme is designed to make sure that only the faulty part of the system will be isolated when abnormal operating condition of the system will reach. The complexity of the system as well as the increased user demand and the deregulated environment enforce the utilities to improve system reliability by using a properly coordinated protection scheme. This paper presents overview of over current relay coordination techniques. Different techniques such as Deterministic Techniques, Meta Heuristic Optimization techniques, Hybrid Optimization Techniques, and Trial and Error Optimization Techniques have been reviewed in terms of method of their implementation, operation modes, nature of distribution system, and finally their advantages as well as the disadvantages.

Keywords: distribution system, relay coordination, optimization, Plug Setting Multiplier (PSM)

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19908 Quality Assurances for an On-Board Imaging System of a Linear Accelerator: Five Months Data Analysis

Authors: Liyun Chang, Cheng-Hsiang Tsai

Abstract:

To ensure the radiation precisely delivering to the target of cancer patients, the linear accelerator equipped with the pretreatment on-board imaging system is introduced and through it the patient setup is verified before the daily treatment. New generation radiotherapy using beam-intensity modulation, usually associated the treatment with steep dose gradients, claimed to have achieved both a higher degree of dose conformation in the targets and a further reduction of toxicity in normal tissues. However, this benefit is counterproductive if the beam is delivered imprecisely. To avoid shooting critical organs or normal tissues rather than the target, it is very important to carry out the quality assurance (QA) of this on-board imaging system. The QA of the On-Board Imager® (OBI) system of one Varian Clinac-iX linear accelerator was performed through our procedures modified from a relevant report and AAPM TG142. Two image modalities, 2D radiography and 3D cone-beam computed tomography (CBCT), of the OBI system were examined. The daily and monthly QA was executed for five months in the categories of safety, geometrical accuracy and image quality. A marker phantom and a blade calibration plate were used for the QA of geometrical accuracy, while the Leeds phantom and Catphan 504 phantom were used in the QA of radiographic and CBCT image quality, respectively. The reference images were generated through a GE LightSpeed CT simulator with an ADAC Pinnacle treatment planning system. Finally, the image quality was analyzed via an OsiriX medical imaging system. For the geometrical accuracy test, the average deviations of the OBI isocenter in each direction are less than 0.6 mm with uncertainties less than 0.2 mm, while all the other items have the displacements less than 1 mm. For radiographic image quality, the spatial resolution is 1.6 lp/cm with contrasts less than 2.2%. The spatial resolution, low contrast, and HU homogenous of CBCT are larger than 6 lp/cm, less than 1% and within 20 HU, respectively. All tests are within the criteria, except the HU value of Teflon measured with the full fan mode exceeding the suggested value that could be due to itself high HU value and needed to be rechecked. The OBI system in our facility was then demonstrated to be reliable with stable image quality. The QA of OBI system is really necessary to achieve the best treatment for a patient.

Keywords: CBCT, image quality, quality assurance, OBI

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19907 The Design of Information Technology System for Traceability of Thailand’s Tubtimjun Roseapple

Authors: Pimploi Tirastittam, Phutthiwat Waiyawuththanapoom, Sawanath Treesathon

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As there are several countries which import agriculture product from Thailand, those countries demand Thailand to establish the traceability system. The traceability system is the tool to reduce the risk in the supply chain in a very effective way as it will help the stakeholder in the supply chain to identify the defect point which will reduce the cost of operation in the supply chain. This research is aimed to design the traceability system for Tubtimjun roseapple for exporting to China, and it is the qualitative research. The data was collected from the expert in the tuntimjun roseapple and fruit exporting industry, and the data was used to design the traceability system. The design of the tubtimjun roseapple traceability system was followed the theory of supply chain which starts from the upstream of the supply chain to the downstream of the supply chain to support the process and condition of the exporting which included the database designing, system architecture, user interface design and information technology of the traceability system.

Keywords: design information, technology system, traceability, tubtimjun roseapple

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19906 EMS Providers' Ability and Willingness to Respond to Bioterrorism

Authors: Ryan Houser

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Introduction: Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services, even in the accelerating environment of biothreats. Methods: This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS (Emergency Medical Services ) providers. The survey was available for one month in 2021, during which 190 EMS providers responded to the survey. Results: Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a CBRN agent. The provider Clinical Competency levels range from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution and community). Only 10% of the respondents are both willing and able to effectively function in a bioterror environment. Discussion: In order to effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.

Keywords: bioterrorism, prehospital, EMS, disaster, emergency, medicine, preparedness, policy

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19905 Model Based Design of Fly-by-Wire Flight Controls System of a Fighter Aircraft

Authors: Nauman Idrees

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Modeling and simulation during the conceptual design phase are the most effective means of system testing resulting in time and cost savings as compared to the testing of hardware prototypes, which are mostly not available during the conceptual design phase. This paper uses the model-based design (MBD) method in designing the fly-by-wire flight controls system of a fighter aircraft using Simulink. The process begins with system definition and layout where modeling requirements and system components were identified, followed by hierarchical system layout to identify the sequence of operation and interfaces of system with external environment as well as the internal interface between the components. In the second step, each component within the system architecture was modeled along with its physical and functional behavior. Finally, all modeled components were combined to form the fly-by-wire flight controls system of a fighter aircraft as per system architecture developed. The system model developed using this method can be simulated using any simulation software to ensure that desired requirements are met even without the development of a physical prototype resulting in time and cost savings.

Keywords: fly-by-wire, flight controls system, model based design, Simulink

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19904 A Question of Ethics and Faith

Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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19903 Identification of a Lead Compound for Selective Inhibition of Nav1.7 to Treat Chronic Pain

Authors: Sharat Chandra, Zilong Wang, Ru-Rong Ji, Andrey Bortsov

Abstract:

Chronic pain (CP) therapeutic approaches have limited efficacy. As a result, doctors are prescribing opioids for chronic pain, leading to opioid overuse, abuse, and addiction epidemic. Therefore, the development of effective and safe CP drugs remains an unmet medical need. Voltage-gated sodium (Nav) channels act as cardiovascular and neurological disorder’s molecular targets. Nav channels selective inhibitors are hard to design because there are nine closely-related isoforms (Nav1.1-1.9) that share the protein sequence segments. We are targeting the Nav1.7 found in the peripheral nervous system and engaged in the perception of pain. The objective of this project was to screen a 1.5 million compound library for identification of inhibitors for Nav1.7 with analgesic effect. In this study, we designed a protocol for identification of isoform-selective inhibitors of Nav1.7, by utilizing the prior information on isoform-selective antagonists. First, a similarity search was performed; then the identified hits were docked into a binding site on the fourth voltage-sensor domain (VSD4) of Nav1.7. We used the FTrees tool for similarity searching and library generation; the generated library was docked in the VSD4 domain binding site using FlexX and compounds were shortlisted using a FlexX score and SeeSAR hyde scoring. Finally, the top 25 compounds were tested with molecular dynamics simulation (MDS). We reduced our list to 9 compounds based on the MDS root mean square deviation plot and obtained them from a vendor for in vitro and in vivo validation. Whole-cell patch-clamp recordings in HEK-293 cells and dorsal root ganglion neurons were conducted. We used patch pipettes to record transient Na⁺ currents. One of the compounds reduced the peak sodium currents in Nav1.7-HEK-293 stable cell line in a dose-dependent manner, with IC50 values at 0.74 µM. In summary, our computer-aided analgesic discovery approach allowed us to develop pre-clinical analgesic candidate with significant reduction of time and cost.

Keywords: chronic pain, voltage-gated sodium channel, isoform-selective antagonist, similarity search, virtual screening, analgesics development

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19902 Characterization of Probability Distributions through Conditional Expectation of Pair of Generalized Order Statistics

Authors: Zubdahe Noor, Haseeb Athar

Abstract:

In this article, first a relation for conditional expectation is developed and then is used to characterize a general class of distributions F(x) = 1-e^(-ah(x)) through conditional expectation of difference of pair of generalized order statistics. Some results are reduced for particular cases. In the end, a list of distributions is presented in the form of table that are compatible with the given general class.

Keywords: generalized order statistics, order statistics, record values, conditional expectation, characterization

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19901 Bit Error Rate Analysis of Multiband OFCDM UWB System in UWB Fading Channel

Authors: Sanjay M. Gulhane, Athar Ravish Khan, Umesh W. Kaware

Abstract:

Orthogonal frequency and code division multiplexing (OFCDM) has received large attention as a modulation scheme to realize high data rate transmission. Multiband (MB) Orthogonal frequency division multiplexing (OFDM) Ultra Wide Band (UWB) system become promising technique for high data rate due to its large number of advantage over Singleband (UWB) system, but it suffer from coherent frequency diversity problem. In this paper we have proposed MB-OFCDM UWB system, in which two-dimensional (2D) spreading (time and frequency domain spreading), has been introduced, combining OFDM with 2D spreading, proposed system can provide frequency diversity. This paper presents the basic structure and main functions of the MB-OFCDM system, and evaluates the bit error rate BER performance of MB-OFDM and MB-OFCDM system under UWB indoor multi-path channel model. It is observe that BER curve of MB-OFCDM UWB improve its performance by 2dB as compare to MB-OFDM UWB system.

Keywords: MB-OFDM UWB system, MB-OFCDM UWB system, UWB IEEE channel model, BER

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19900 China's Health Diplomacy in Africa

Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

Abstract:

The outbreak of the COVID-19 epidemic has caused great difficulties for South-South cooperation, but there are also opportunities. China’s health diplomacy has changed from dispatching medical teams, assisting in the construction of hospitals, and encouraging medical investment in the Africa health sector. This paper adopted a retrospective review of China’s health diplomacy in Africa from 1963 to 2020. Findings suggested that China has a preference for aiding Africa health infrastructure and sending medical teams to African countries. China’s health diplomacy in Africa is a success and has established secure diplomatic relations with African countries, thanks to the medical and health assistance to Africa over 60 years. This research contributes to the literature of health diplomacy and foreign relations and indicates that China’s health aid has fostered cooperation at the medical and diplomatic levels.

Keywords: Africa, china’s health diplomacy, COVID-19, bilateral relations

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19899 Optimal Implementation of Photovoltaic Water Pumping System

Authors: Sarah Abdourraziq

Abstract:

To improve the efficiency of photovoltaic pumping system, more attention has been paid to their setting up. This paper presents an optimal technique to establish an efficient system under different conditions of irradiance and temperature. The state of place should be carefully studied before stage of installation of the over system: local climate, boreholes, soil, crops and water resources. The studied system consists of a PV panel, a DC-DC boost converter, a DC motor-pump, and storage tank. The concepts shown in this paper presents a support for an optimal installation of each solar pump.

Keywords: photovoltaic pumping system, optimal implementation, boost converter, motor-pump

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19898 Optimizing Machine Vision System Setup Accuracy by Six-Sigma DMAIC Approach

Authors: Joseph C. Chen

Abstract:

Machine vision system provides automatic inspection to reduce manufacturing costs considerably. However, only a few principles have been found to optimize machine vision system and help it function more accurately in industrial practice. Mostly, there were complicated and impractical design techniques to improve the accuracy of machine vision system. This paper discusses implementing the Six Sigma Define, Measure, Analyze, Improve, and Control (DMAIC) approach to optimize the setup parameters of machine vision system when it is used as a direct measurement technique. This research follows a case study showing how Six Sigma DMAIC methodology has been put into use.

Keywords: DMAIC, machine vision system, process capability, Taguchi Parameter Design

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19897 Computer-Aided Classification of Liver Lesions Using Contrasting Features Difference

Authors: Hussein Alahmer, Amr Ahmed

Abstract:

Liver cancer is one of the common diseases that cause the death. Early detection is important to diagnose and reduce the incidence of death. Improvements in medical imaging and image processing techniques have significantly enhanced interpretation of medical images. Computer-Aided Diagnosis (CAD) systems based on these techniques play a vital role in the early detection of liver disease and hence reduce liver cancer death rate.  This paper presents an automated CAD system consists of three stages; firstly, automatic liver segmentation and lesion’s detection. Secondly, extracting features. Finally, classifying liver lesions into benign and malignant by using the novel contrasting feature-difference approach. Several types of intensity, texture features are extracted from both; the lesion area and its surrounding normal liver tissue. The difference between the features of both areas is then used as the new lesion descriptors. Machine learning classifiers are then trained on the new descriptors to automatically classify liver lesions into benign or malignant. The experimental results show promising improvements. Moreover, the proposed approach can overcome the problems of varying ranges of intensity and textures between patients, demographics, and imaging devices and settings.

Keywords: CAD system, difference of feature, fuzzy c means, lesion detection, liver segmentation

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19896 Promoting Environmental Sustainability in Rural Areas with CMUH Green Experiential Education Center

Authors: Yi-Chu Liu, Hsiu-Huei Hung, Li-Hui Yang, Ming-Jyh Chen

Abstract:

introduction: To promote environmental sustainability, the hospital formed a corporate volunteer team in 2016 to build the Green Experiential Education Center. Our green creation center utilizes attic space to achieve sustainability objectives such as energy efficiency and carbon reduction. Other than executing sustainable plans, the center emphasizes experiential education. We invite our community to actively participate in building a sustainable, economically viable environment. Since 2020, the China Medical University Hospital has provided medical care to the Tgbin community in Taichung City's Heping District. The tribe, primarily composed of Atayal people, the elderly comprise 18% of the total population, and these families' per capita income is relatively low compared to Taiwanese citizens elsewhere. Purpose / Methods: With the experiences at the Green Experiential Education Center, CMUH team identifies the following objectives: Create an aquaponic system to supply vulnerable local households with food. Create a solar renewable energy system to meet the electricity needs of vulnerable local households. Promote the purchase of green electricity certificates to reduce the hospital's carbon emissions and generate additional revenue for the local community. Materials and Methods: In March 2020, we visited the community and installed The aquaponic system in January 2021. CMUH spent 150,000NT (approximately 5000US dollars) in March 2021 to build a 100-square-meter aquaponic system. The production of vegetables and fish caught determines the number of vulnerable families that can be supported. The aquaponics system is a kind of Low energy consumption and environmentally friendly production method, and can simultaneously achieve energy saving, water saving, and fertilizer saving .In September 2023, CMUH will complete a solar renewable energy system. The system will cover an area of 308 square meters and costs approximately NT$240,000 (approximately US$8,000). The installation of electricity meters will enable statistical analysis of power generation. And complete the Taiwan National Renewable Energy Certificate application process. The green electricity certificate will be obtained based on the monthly power generation from the solar renewable energy system. Results: I Food availability and access are crucial considering the remote location and aging population. By creating a fish and vegetable symbiosis system, the vegetables and catches produced will enable economically disadvantaged families to lower food costs. In 2021 and 2022, the aquaponic system produced 52 kilograms of vegetables and 75 kilograms of catch. The production ensures the daily needs of 8 disadvantaged families. Conclusions: The hospital serves as a fortress for public health and the ideal setting for corporate social responsibility. China Medical University Hospital and the Green Experiential Education Center work to strengthen ties with rural communities and offer top-notch specialty medical care. We are committed to assisting people in escaping poverty and hunger as part of the 2030 Sustainable Development Goals.

Keywords: environmental education, sustainability, energy conservation, carbon emissions, rural area development

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