Search results for: orthopedic unit
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2344

Search results for: orthopedic unit

1864 A Distributed Smart Battery Management System – sBMS, for Stationary Energy Storage Applications

Authors: António J. Gano, Carmen Rangel

Abstract:

Currently, electric energy storage systems for stationary applications have known an increasing interest, namely with the integration of local renewable energy power sources into energy communities. Li-ion batteries are considered the leading electric storage devices to achieve this integration, and Battery Management Systems (BMS) are decisive for their control and optimum performance. In this work, the advancement of a smart BMS (sBMS) prototype with a modular distributed topology is described. The system, still under development, has a distributed architecture with modular characteristics to operate with different battery pack topologies and charge capacities, integrating adaptive algorithms for functional state real-time monitoring and management of multicellular Li-ion batteries, and is intended for application in the context of a local energy community fed by renewable energy sources. This sBMS system includes different developed hardware units: (1) Cell monitoring units (CMUs) for interfacing with each individual cell or module monitoring within the battery pack; (2) Battery monitoring and switching unit (BMU) for global battery pack monitoring, thermal control and functional operating state switching; (3) Main management and local control unit (MCU) for local sBMS’s management and control, also serving as a communications gateway to external systems and devices. This architecture is fully expandable to battery packs with a large number of cells, or modules, interconnected in series, as the several units have local data acquisition and processing capabilities, communicating over a standard CAN bus and will be able to operate almost autonomously. The CMU units are intended to be used with Li-ion cells but can be used with other cell chemistries, with output voltages within the 2.5 to 5 V range. The different unit’s characteristics and specifications are described, including the different implemented hardware solutions. The developed hardware supports both passive and active methods for charge equalization, considered fundamental functionalities for optimizing the performance and the useful lifetime of a Li-ion battery package. The functional characteristics of the different units of this sBMS system, including different process variables data acquisition using a flexible set of sensors, can support the development of custom algorithms for estimating the parameters defining the functional states of the battery pack (State-of-Charge, State-of-Health, etc.) as well as different charge equalizing strategies and algorithms. This sBMS system is intended to interface with other systems and devices using standard communication protocols, like those used by the Internet of Things. In the future, this sBMS architecture can evolve to a fully decentralized topology, with all the units using Wi-Fi protocols and integrating a mesh network, making unnecessary the MCU unit. The status of the work in progress is reported, leading to conclusions on the system already executed, considering the implemented hardware solution, not only as fully functional advanced and configurable battery management system but also as a platform for developing custom algorithms and optimizing strategies to achieve better performance of electric energy stationary storage devices.

Keywords: Li-ion battery, smart BMS, stationary electric storage, distributed BMS

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1863 Creativity and Innovation in a Military Unit of South America: Decision Making Process, Socio-Emotional Climate, Shared Flow and Leadership

Authors: S. da Costa, D. Páez, E. Martínez, A. Torres, M. Beramendi, D. Hermosilla, M. Muratori

Abstract:

This study examined the association between creative performance, organizational climate and leadership, affectivity, shared flow, and group decision making. The sample consisted of 315 cadets of a military academic unit of South America. Satisfaction with the decision-making process during a creative task was associated with the usefulness and effectiveness of the ideas generated by the teams with a weighted average correlation of r = .18. Organizational emotional climate, positive and innovation leadership were associated with this group decision-making process r = .25, with shared flow, r = .29 and with positive affect felt during the performance of the creative task, r = .12. In a sequential mediational analysis positive organizational leadership styles were significantly associated with decision-making process and trough cohesion with utility and efficacy of the solution of a creative task. Satisfactory decision-making was related to shared flow during the creative task at collective or group level, and positive affect with flow at individual level.This study examined the association between creative performance, organizational climate and leadership, affectivity, shared flow, and group decision making. The sample consisted of 315 cadets of a military academic unit of South America. Satisfaction with the decision-making process during a creative task was associated with the usefulness and effectiveness of the ideas generated by the teams with a weighted average correlation of r = .18. Organizational emotional climate, positive and innovation leadership were associated with this group decision-making process r = .25, with shared flow, r = .29 and with positive affect felt during the performance of the creative task, r = .12. In a sequential mediational analysis positive organizational leadership styles were significantly associated with decision-making process and trough cohesion with utility and efficacy of the solution of a creative task. Satisfactory decision-making was related to shared flow during the creative task at collective or group level, and positive affect with flow at individual level.

Keywords: creativity, innovation, military, organization, teams

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1862 Increasing Adherence to Preventative Care Bundles for Healthcare-Associated Infections: The Impact of Nurse Education

Authors: Lauren G. Coggins

Abstract:

Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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1861 Effect of B2O3 Addition on Sol-gel Synthesized 45S5 Bioglass

Authors: P. Dey, S. K. Pal

Abstract:

Ceramics or glass ceramics with the property of bone bonding at the nearby tissues and producing possible bone in growth are known to be bioactive. The most extensively used glass in this context is 45S5 which is a silica based bioglass mostly explored in the field of tissue engineering as scaffolds for bone repair. Nowadays, the borate based bioglass are being utilized in orthopedic area largely due to its superior bioactivity with the formation of bone bonding. An attempt has been made, in the present study, to observe the effect of B2O3 addition in 45S5 glass and perceive its consequences on the thermal, mechanical and biological properties. The B2O3 was added in 1, 2.5, and 5 wt% with simultaneous reduction in the silica content of the 45S5 composition. The borate based bioglass has been synthesized by the means of sol-gel route. The synthesized powders were then thermally analyzed by DSC-TG. The as synthesized powders were then calcined at 600ºC for 2hrs. The calcined powders were then pressed into pellets followed by sintering at 850ºC with a holding time of 2hrs. The phase analysis and the microstructural analysis of the as synthesized and calcined powder glass samples and the sintered glass samples were being carried out using XRD and FESEM respectively. The formation of hydroxyapatite layer was performed by immersing the sintered samples in the simulated body fluid (SBF) and mechanical property has been tested for the sintered samples by universal testing machine (UTM). The sintered samples showed the presence of sodium calcium silicate phase while the formation of hydroxyapaptite takes place for SBF immersed samples. The formation of hydroxyapatite is more pronounced in case of borated based glass samples instead of 45S5.

Keywords: 45S5 bioglass, bioactive, borate, hydroxyapatite, sol-gel synthesis

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1860 Qualitative Study Method on Case Assignment Adopted by Singapore Medical Social Workers

Authors: Joleen L. H. Lee, K. F. Yen, Janette W. P. Ng, D. Woon, Mandy M. Y. Lau, Ivan M. H. Woo, S. N. Goh

Abstract:

Case assignment systems are created to meet a need for equity in work distribution and better match between medical social workers' (MSWs) competencies and patients' problems. However, there is no known study that has explored how MSWs in Singapore assign cases to achieve equity in work distribution. Focus group discussions were conducted with MSWs from public hospitals to understand their perception on equitable workload and case allocation. Three approaches to case allocation were found. First is the point system where points are allocated to cases based on a checklist of presenting issues identified most of the time by non-MSWs. Intensity of case is taken into consideration, but allocation of points is often subject to variation in appreciation of roles of MSWs by the source of referral. Second is the round robin system, where all MSWs are allocated cases based on a roster. This approach resulted in perceived equity due to element of luck, but it does not match case complexity with competencies of MSWs. Third approach is unit-based allocation, where MSWs are assigned to attend to cases from specific unit. This approach helps facilitate specialization among MSWs but may result in MSWs having difficulty providing transdisciplinary care due to narrow set of knowledge and skills. Trade-offs resulted across existing approaches for case allocation by MSWs. Conversations are needed among Singapore MSWs to decide on a case allocation system that comes with trade-offs that are acceptable for patients and other key stakeholders of the care delivery system.

Keywords: case allocation, equity, medical social worker, work distribution

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1859 The Application and Relevance of Costing Techniques in Service Oriented Business Organisations: A Review of the Activity-Based Costing (ABC) Technique

Authors: Udeh Nneka Evelyn

Abstract:

The shortcomings of traditional costing system, in terms of validity, accuracy, consistency and relevance increased the need for modern management accounting system. ABC (Activity-Based Costing) can be used as a modern tool for planning, control and decision making for management. Past studies on activity-based costing (ABC) system have focused on manufacturing firms thereby making the studies on service firms scanty to some extent. This paper reviewed the application and relevance of activity-based costing techniques in service oriented business organisations by employing a qualitative research method which relied heavily on literature review of past and current relevant articles focusing on activity-based costing (ABC). Findings suggest that ABC is not only appropriate for use in a manufacturing environment; it is also most appropriate for service organizations such as financial institutions, the healthcare industry, and government organizations. In fact, some banking and financial institutions have been applying the concept for years under other names. One of them is unit costing, which is used to calculate the cost of banking services by determining the cost and consumption of each unit of output of functions required to deliver the service. ABC in very basic terms may provide very good payback for businesses. Some of the benefits that relate directly to the financial services industry are: Identification of the most profitable customers; more accurate product and service pricing; increase product profitability; well-organized process costs.

Keywords: profitability, activity-based costing (ABC), management accounting, manufacture

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1858 Transport Mode Selection under Lead Time Variability and Emissions Constraint

Authors: Chiranjit Das, Sanjay Jharkharia

Abstract:

This study is focused on transport mode selection under lead time variability and emissions constraint. In order to reduce the carbon emissions generation due to transportation, organization has often faced a dilemmatic choice of transport mode selection since logistic cost and emissions reduction are complementary with each other. Another important aspect of transportation decision is lead-time variability which is least considered in transport mode selection problem. Thus, in this study, we provide a comprehensive mathematical based analytical model to decide transport mode selection under emissions constraint. We also extend our work through analysing the effect of lead time variability in the transport mode selection by a sensitivity analysis. In order to account lead time variability into the model, two identically normally distributed random variables are incorporated in this study including unit lead time variability and lead time demand variability. Therefore, in this study, we are addressing following questions: How the decisions of transport mode selection will be affected by lead time variability? How lead time variability will impact on total supply chain cost under carbon emissions? To accomplish these objectives, a total transportation cost function is developed including unit purchasing cost, unit transportation cost, emissions cost, holding cost during lead time, and penalty cost for stock out due to lead time variability. A set of modes is available to transport each node, in this paper, we consider only four transport modes such as air, road, rail, and water. Transportation cost, distance, emissions level for each transport mode is considered as deterministic and static in this paper. Each mode is having different emissions level depending on the distance and product characteristics. Emissions cost is indirectly affected by the lead time variability if there is any switching of transport mode from lower emissions prone transport mode to higher emissions prone transport mode in order to reduce penalty cost. We provide a numerical analysis in order to study the effectiveness of the mathematical model. We found that chances of stock out during lead time will be higher due to the higher variability of lead time and lad time demand. Numerical results show that penalty cost of air transport mode is negative that means chances of stock out zero, but, having higher holding and emissions cost. Therefore, air transport mode is only selected when there is any emergency order to reduce penalty cost, otherwise, rail and road transport is the most preferred mode of transportation. Thus, this paper is contributing to the literature by a novel approach to decide transport mode under emissions cost and lead time variability. This model can be extended by studying the effect of lead time variability under some other strategic transportation issues such as modal split option, full truck load strategy, and demand consolidation strategy etc.

Keywords: carbon emissions, inventory theoretic model, lead time variability, transport mode selection

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1857 Retrospective Study of Positive Blood Cultures Carried out in the Microbiology Department of General Hospital of Ioannina in 2017

Authors: M. Gerasimou, S. Mantzoukis, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

Abstract:

Purpose: Microbial infection of the blood is a serious condition where bacteria invade the bloodstream and cause systemic disease. In such cases, blood cultures are performed. Blood cultures are a key diagnostic test for intensive care unit (ICU) patients. Material and method: The BacT/Alert system, which measures the production of carbon dioxide with metabolic organisms, is used. The positive result in the BacT/Alert system is followed by culture in the following selective media: Blood, Mac Conkey No 2, Chocolate, Mueller Hinton, Chapman and Sabaureaud agar. Gram staining method was used to differentiate bacterial species. The microorganisms were identified by biochemical techniques in the automated Microscan (Siemens) system and followed by a sensitivity test on the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer-based test. Results: In 2017 the Laboratory of Microbiology received 3347 blood cultures. Of these, 170 came from the ICU. 116 found positive. Of these S. epidermidis was identified in 42, A. baumannii in 27, K. pneumoniae in 12 (4 of these KPC ‘Klebsiella pneumoniae carbapenemase’), S. hominis in 8, E. faecium in 7, E. faecalis in 5, P. aeruginosa in 3, C. albicans in 3, S. capitis in 2, K. oxytoca in 2, P. mirabilis in 2, E. coli in 1, S. intermidius in 1 and S. lugdunensis in 1. Conclusions: The study of epidemiological data and microbial resistance phenotypes is essential for the choice of therapeutic regimen for the early treatment and limitation of multivalent strains, while it is a crucial factor to solve diagnostic problems.

Keywords: blood culture, bloodstream, infection, intensive care unit

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1856 Morphological Anatomical Study of the Axis Vertebra and Its Clinical Orientation

Authors: Mangala M. Pai, B. V. Murlimanju, Latha V. Prabhu, P. J. Jiji , Vandana Blossom

Abstract:

Background:To study the morphological parameters of the axis vertebra in anatomical specimens. Methods: The present study was designed to obtain the morphometric data of axis vertebra. The superior and inferior articular facets of the axis were macroscopically observed for their shapes and the different parameters were measured using the digital Vernier caliper. It included 20 dried axis bones, which were obtained from the anatomy laboratory. Results: The morphometric data obtained in the present study are represented in the tables. The side wise comparison of the length and width of the articular facets of the axis vertebra were done. The present study observed that, there is no statistically significant difference observed among the parameters of right and left side articular facets (p>0.05). The superior and inferior articular facets were observed to have variable shapes. The frequencies of different shapes of superior and inferior articular facets are represented in figures. All the shapes of the inferior and superior articular facets were symmetrical over the right and left sides. Among the superior articular facets, the constrictions were absent in 13 cases (65%), 2 (10%) exhibited a single constriction, 3 (15%) had 2 constrictions and 2 (10%) were having 3 constrictions. The constrictions were absent in 11 (55%) of the inferior articular facets, 3 (15%) of them had 1 constriction, 3 (15%) were having 2 constrictions, 2 (10%) exhibited 3 constrictions and 1 (5%) of them had 4 constrictions. The constrictions of the inferior and superior articular facets were symmetrical over the right and left sides. Conclusion: We believe that the present study has provided additional information on the morphometric data of the axis vertebra. The data are important to the neurosurgeons, orthopedic surgeons and radiologists. The preoperative assessment of the axis vertebra may prevent dangerous complications like spinal cord and nerve root compression during the surgical intervention.

Keywords: axis, articular facet, morphology, morphometry

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1855 Nutritional Status of Surgical and Orthopedic Patients: 3B Ward

Authors: Jitaree Tantiyasawatdikul, Bantita Jadnok, Sarunya Tijana

Abstract:

Background: Nutritional status is an important factor before, during, and after an operation. It can help wound healing. If the patients have good nutritional status before and after an operation, wound healing can occur more easily. It can strengthen the immune system leading to decreased infection, reduced length of stay, and reducing the cost to patients and caregivers. Therefore, screening to evaluate the nutritional status of patients in 3B becomes the database for further developing the treatment and also will lead to excellent service from the interdisciplinary team. Objective: To study the nutritional status of patients in surgical ward 3B at Surgical and Orthopedics Nursing Division, Srinagarind Hospital. Method: A descriptive study, to evaluate the nutritional status of 86 patients admitted in 3B between October 2014 and March 2015.The instruments used in this study consisted of two parts: 1) personal data, 2) Screening nutritional status. The data were analyzed by percentage and mean. Results: A sample population of 86 patients aged 22-81 years old, mean age 52.59years, 90.69% are married, female were 55.81%, regular diet 70.93%, patients with no problem oral cavity was 87.21%.The sample population had high incidence of CA 47.67% and secondly cardiovascular disease 36.05 %. Patients with high-risk nutrition was 12.79 % including 45.45% cardiovascular disease and 36.36% CA. Screening of nutritional status of high-risk nutrition was 39.36% severe triceps skinfold (TSF), severe mid-arm muscle circumference(MAMC) 9.09% and severe total lymphocyte 39.36%. Conclusion: The result of nutritional status screening of surgical ward 3B found 12.79% patients with high-risk nutrition including 45.45% with cardiovascular disease .There was no problem with oral cavity and eating.

Keywords: nutritional status, screening, surgical patients, 3B ward, Srinagarind Hospital

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1854 Determining the Factors Affecting Social Media Addiction (Virtual Tolerance, Virtual Communication), Phubbing, and Perception of Addiction in Nurses

Authors: Fatima Zehra Allahverdi, Nukhet Bayer

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Objective: Three questions were formulated to examine stressful working units (intensive care units, emergency unit nurses) utilizing the self-perception theory and social support theory. This study provides a distinctive input by inspecting the combination of variables regarding stressful working environments. Method: The descriptive research was conducted with the participation of 400 nurses working at Ankara City Hospital. The study used Multivariate Analysis of Variance (MANOVA), regression analysis, and a mediation model. Hypothesis one used MANOVA followed by a Scheffe post hoc test. Hypothesis two utilized regression analysis using a hierarchical linear regression model. Hypothesis three used a mediation model. Result: The study utilized mediation analyses. Findings supported the hypotheses that intensive care units have significantly high scores in virtual communication and virtual tolerance. The number of years on the job, virtual communication, virtual tolerance, and phubbing significantly predicted 51% of the variance of perception of addiction. Interestingly, the number of years on the job, while significant, was negatively related to perception of addiction. Conclusion: The reasoning behind these findings and the lack of significance in the emergency unit is discussed. Around 7% of the variance of phubbing was accounted for through working in intensive care units. The model accounted for 26.80 % of the differences in the perception of addiction.

Keywords: phubbing, social media, working units, years on the job, stress

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1853 Design and Evaluation of Corrective Orthosis Knee for Hyperextension

Authors: Valentina Narvaez Gaitan, Paula K. Rodriguez Ramirez, Derian D. Espinosa

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Corrective orthosis has great importance in orthopedic treatments providing assistance in improving mobility and stability in order to improve the quality of life for a different patient. The corrective orthosis studied in this article can correct deformities, reduce pain, and improve the ability to perform daily activities. This work describes the design and evaluation of a corrective orthosis for knee hyperextension. This orthosis is capable of generating a progressive and variable alignment of the joint, limiting the range of motion according to medical criteria. The main objective was to design a corrective knee orthosis capable of correcting knee hyperextension progressively to return to its natural angle with greater economic affordability and adjustable size. The limiting mechanism is based on a goniometer to determine the desired angles. The orthosis was made of acrylic to reduce costs and maintenance; neoprene is also used to make comfortable contact; additionally, Velcro was used in order to adjust the orthosis for various sizes. Simulations of static and fatigue analysis of the mechanism were performed to verify its resistance and durability under normal conditions. A biomechanical gait study of gait was carried out on 10 healthy subjects without the orthosis and limiting their knee extension capacity in a normal gait cycle with the orthosis to observe the efficiency of the proposed system. In the results obtained, the knee angle curves show that the maximum extension angle was the established angle by the orthosis. Showing the efficiency of the proposed design for different leg sizes.

Keywords: biomechanical study, corrective orthosis, efficiency, goniometer, knee hyperextension.

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1852 Battery Energy Storage System Economic Benefits Assessment on a Network Frequency Control

Authors: Kréhi Serge Agbli, Samuel Portebos, Michaël Salomon

Abstract:

Here a methodology is considered aiming at evaluating the economic benefit of the provision of a primary frequency control unit using a Battery Energy Storage System (BESS). In this methodology, two control types (basic and hysteresis) are implemented and the corresponding minimum energy storage system power allowing to maintain the frequency drop inside a given threshold under a given contingency is identified and compared using DigSilent’s PowerFactory software. Following this step, the corresponding energy storage capacity (in MWh) is calculated. As PowerFactory is dedicated to dynamic simulation for transient analysis, a first order model related to the IEEE 9 bus grid used for the analysis under PowerFactory is characterized and implemented on MATLAB-Simulink. Primary frequency control is simulated using the two control types over one-month grid's frequency deviation data on this Simulink model. This simulation results in the energy throughput both basic and hysteresis BESSs. It emerges that the 15 minutes operation band of the battery capacity allocated to frequency control is sufficient under the considered disturbances. A sensitivity analysis on the width of the control deadband is then performed for the two control types. The deadband width variation leads to an identical sizing with the hysteresis control showing a better frequency control at the cost of a higher delivered throughput compared to the basic control. An economic analysis comparing the cost of the sized BESS to the potential revenues is then performed.

Keywords: battery energy storage system, electrical network frequency stability, frequency control unit, PowerFactor

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1851 The Lessons Learned from Managing Malignant Melanoma During COVID-19 in a Plastic Surgery Unit in Ireland

Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

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Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

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1850 Quality-Of-Service-Aware Green Bandwidth Allocation in Ethernet Passive Optical Network

Authors: Tzu-Yang Lin, Chuan-Ching Sue

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Sleep mechanisms are commonly used to ensure the energy efficiency of each optical network unit (ONU) that concerns a single class delay constraint in the Ethernet Passive Optical Network (EPON). How long the ONUs can sleep without violating the delay constraint has become a research problem. Particularly, we can derive an analytical model to determine the optimal sleep time of ONUs in every cycle without violating the maximum class delay constraint. The bandwidth allocation considering such optimal sleep time is called Green Bandwidth Allocation (GBA). Although the GBA mechanism guarantees that the different class delay constraints do not violate the maximum class delay constraint, packets with a more relaxed delay constraint will be treated as those with the most stringent delay constraint and may be sent early. This means that the ONU will waste energy in active mode to send packets in advance which did not need to be sent at the current time. Accordingly, we proposed a QoS-aware GBA using a novel intra-ONU scheduling to control the packets to be sent according to their respective delay constraints, thereby enhancing energy efficiency without deteriorating delay performance. If packets are not explicitly classified but with different packet delay constraints, we can modify the intra-ONU scheduling to classify packets according to their packet delay constraints rather than their classes. Moreover, we propose the switchable ONU architecture in which the ONU can switch the architecture according to the sleep time length, thus improving energy efficiency in the QoS-aware GBA. The simulation results show that the QoS-aware GBA ensures that packets in different classes or with different delay constraints do not violate their respective delay constraints and consume less power than the original GBA.

Keywords: Passive Optical Networks, PONs, Optical Network Unit, ONU, energy efficiency, delay constraint

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1849 Application of Fatty Acid Salts for Antimicrobial Agents in Koji-Muro

Authors: Aya Tanaka, Mariko Era, Shiho Sakai, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita

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Objectives: Aspergillus niger and Aspergillus oryzae are used as koji fungi in the spot of the brewing. Since koji-muro (room for making koji) was a low level of airtightness, microbial contamination has long been a concern to the alcoholic beverage production. Therefore, we focused on the fatty acid salt which is the main component of soap. Fatty acid salts have been reported to show some antibacterial and antifungal activity. So this study examined antimicrobial activities against Aspergillus and Bacillus spp. This study aimed to find the effectiveness of the fatty acid salt in koji-muro as antimicrobial agents. Materials & Methods: A. niger NBRC 31628, A. oryzae NBRC 5238, A. oryzae (Akita Konno store) and Bacillus subtilis NBRC 3335 were chosen as tested. Nine fatty acid salts including potassium butyrate (C4K), caproate (C6K), caprylate (C8K), caprate (C10K), laurate (C12K), myristate (C14K), oleate (C18:1K), linoleate (C18:2K) and linolenate (C18:3K) at 350 mM and pH 10.5 were used as antimicrobial activity. FASs and spore suspension were prepared in plastic tubes. The spore suspension of each fungus (3.0×104 spores/mL) or the bacterial suspension (3.0×105 CFU/mL) was mixed with each of the fatty acid salts (final concentration of 175 mM). The mixtures were incubated at 25 ℃. Samples were counted at 0, 10, 60, and 180 min by plating (100 µL) on potato dextrose agar. Fungal and bacterial colonies were counted after incubation for 1 or 2 days at 30 ℃. The MIC (minimum inhibitory concentration) is defined as the lowest concentration of drug sufficient for inhibiting visible growth of spore after 10 min of incubation. MICs against fungi and bacteria were determined using the two-fold dilution method. Each fatty acid salt was separately inoculated with 400 µL of Aspergillus spp. or B. subtilis NBRC 3335 at 3.0 × 104 spores/mL or 3.0 × 105 CFU/mL. Results: No obvious change was observed in tested fatty acid salts against A. niger and A. oryzae. However, C12K was the antibacterial effect of 5 log-unit incubated time for 10 min against B. subtilis. Thus, C12K suppressed 99.999 % of bacterial growth. Besides, C10K was the antibacterial effect of 5 log-unit incubated time for 180 min against B. subtilis. C18:1K, C18:2K and C18:3K was the antibacterial effect of 5 log-unit incubated time for 10 min against B. subtilis. However, compared to saturated fatty acid salts to unsaturated fatty acid salts, saturated fatty acid salts are lower cost. These results suggest C12K has potential in the field of koji-muro. It is necessary to evaluate the antimicrobial activity against other fungi and bacteria, in the future.

Keywords: Aspergillus, antimicrobial, fatty acid salts, koji-muro

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1848 Synthesis, Characterization and Catecholase Study of Novel Bidentate Schiff Base Derived from Dehydroacetic Acid

Authors: Salima Tabti, Chaima Maouche, Tinhinene Louaileche, Amel Djedouani, Ismail Warad

Abstract:

Novel Schiff base ligand HL has been synthesized by condensation of aromatic amine and DHA. It was characterized by UV-Vis, FT-IR, SM, NMR (1H, 13C) and also by single-crystal X-ray diffraction. The crystal structure shows that compound crystallized in a triclinic system in P-1 space group and with a two unit per cell (Z = 2).The asymmetric unit, contains one independent molecules, the conformation is determined by an intermolecular N-H…O hydrogen bond with an S(6) ring motif. The molecule have an (E) conformation about the C=N bond. The dihedral angles between the phenyl and pyran ring planes is 89.37 (1), the two plans are approximately perpendicular. The catecholase activity of is situ copper complexes of this ligand has been investigated against catechol. The progress of the oxidation reactions was closely monitored over time following the strong peak of catechol using UV-Vis. Oxidation rates were determined from the initial slope of absorbance. time plots, then analyzed by Michaelis-Menten equations. Catechol oxidation reactions were realized using different concentrations of copper acetate and ligand (L/Cu: 1/1, 1/2, 2/1). The results show that all complexes were able to catalyze the oxidation of catechol. Acetate complexes have the highest activity. Catalysis is a branch of chemical kinetics that, more generally, studies the influence of all physical or chemical factors determining reaction rates. It solves a lot of problems in the chemistry reaction process, especially for a green, economic and less polluting chemistry. For this reason, the search for new catalysts for known organic reactions, occupies a very advanced place in the themes proposed by the chemists.

Keywords: dehydroacetic acid, catechol, copper, catecholase activity, x-ray

Procedia PDF Downloads 115
1847 Technology of Gyro Orientation Measurement Unit (Gyro Omu) for Underground Utility Mapping Practice

Authors: Mohd Ruzlin Mohd Mokhtar

Abstract:

At present, most operators who are working on projects for utilities such as power, water, oil, gas, telecommunication and sewerage are using technologies e.g. Total station, Global Positioning System (GPS), Electromagnetic Locator (EML) and Ground Penetrating Radar (GPR) to perform underground utility mapping. With the increase in popularity of Horizontal Directional Drilling (HDD) method among the local authorities and asset owners, most of newly installed underground utilities need to use the HDD method. HDD method is seen as simple and create not much disturbance to the public and traffic. Thus, it was the preferred utilities installation method in most of areas especially in urban areas. HDDs were installed much deeper than exiting utilities (some reports saying that HDD is averaging 5 meter in depth). However, this impacts the accuracy or ability of existing underground utility mapping technologies. In most of Malaysia underground soil condition, those technologies were limited to maximum of 3 meter depth. Thus, those utilities which were installed much deeper than 3 meter depth could not be detected by using existing detection tools. The accuracy and reliability of existing underground utility mapping technologies or work procedure were in doubt. Thus, a mitigation action plan is required. While installing new utility using Horizontal Directional Drilling (HDD) method, a more accurate underground utility mapping can be achieved by using Gyro OMU compared to existing practice using e.g. EML and GPR. Gyro OMU is a method to accurately identify the location of HDD thus this mapping can be used or referred to avoid those cost of breakdown due to future HDD works which can be caused by inaccurate underground utility mapping.

Keywords: Gyro Orientation Measurement Unit (Gyro OMU), Horizontal Directional Drilling (HDD), Ground Penetrating Radar (GPR), Electromagnetic Locator (EML)

Procedia PDF Downloads 145
1846 Positive Effect of Manipulated Virtual Kinematic Intervention in Individuals with Traumatic Stiff Shoulder: Pilot Study

Authors: Isabella Schwartz, Ori Safran, Naama Karniel, Michal Abel, Adina Berko, Martin Seyres, Tamir Tsoar, Sigal Portnoy

Abstract:

Virtual Reality allows to manipulate the patient’s perception, thereby providing a motivational addition to real-time biofeedback exercises. We aimed to test the effect of manipulated virtual kinematic intervention on measures of active and passive Range of Motion (ROM), pain, and disability level in individuals with traumatic stiff shoulder. In a double-blinded study, patients with stiff shoulder following proximal humerus fracture and non-operative treatment were randomly divided into a non-manipulated feedback group (NM-group; N=6) and a manipulated feedback group (M-group; N=7). The shoulder ROM, pain, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores were tested at baseline and after the 6 sessions, during which the subjects performed shoulder flexion and abduction in front of a graphic visualization of the shoulder angle. The biofeedback provided to the NM-group was the actual shoulder angle and the feedback provided to the M-group was manipulated so that 10° were constantly subtracted from the actual angle detected by the motion capture system. The M-group showed greater improvement in the active flexion ROM, with median and interquartile range of 197.1 (140.5-425.0) compared to 142.5 (139.1-151.3) for the NM-group (p=.046). Also, the M-group showed greater improvement in the DASH scores, with median and interquartile range of 67.7 (52.8-86.2) compared to 89.7 (83.8-98.3) for the NM-group (p=.022). Manipulated intervention is beneficial in individuals with traumatic stiff shoulder and should be further tested for other populations with orthopedic injuries.

Keywords: virtual reality, biofeedback, shoulder pain, range of motion

Procedia PDF Downloads 129
1845 Certain Results of a New Class of Meromorphic Multivalent Functions Involving Ruscheweyh Derivative

Authors: Kassim A. Jassim

Abstract:

In the present paper, we introduce and discuss a new class Kp(λ,α) of meromorphic multivalent functions in the punctured unit disk U*={z∈¢:0<|z|<1} defined by Ruscheweyh derivative. We obtain some sufficient conditions for the functions belonging to the class Kp(λ,α).

Keywords: meromorphic multivalent function, Ruscheweyh derivative, hadamard product

Procedia PDF Downloads 339
1844 Performance Augmentation of a Combined Cycle Power Plant with Waste Heat Recovery and Solar Energy

Authors: Mohammed A. Elhaj, Jamal S. Yassin

Abstract:

In the present time, energy crises are considered a severe problem across the world. For the protection of global environment and maintain ecological balance, energy saving is considered one of the most vital issues from the view point of fuel consumption. As the industrial sectors everywhere continue efforts to improve their energy efficiency, recovering waste heat losses provides an attractive opportunity for an emission free and less costly energy resource. In the other hand the using of solar energy has become more insistent particularly after the high gross of prices and running off the conventional energy sources. Therefore, it is essential that we should endeavor for waste heat recovery as well as solar energy by making significant and concrete efforts. For these reasons this investigation is carried out to study and analyze the performance of a power plant working by a combined cycle in which Heat Recovery System Generator (HRSG) gets its energy from the waste heat of a gas turbine unit. Evaluation of the performance of the plant is based on different thermal efficiencies of the main components in addition to the second law analysis considering the exergy destructions for the whole components. The contribution factors including the solar as well as the wasted energy are considered in the calculations. The final results have shown that there is significant exergy destruction in solar concentrator and the combustion chamber of the gas turbine unit. Other components such as compressor, gas turbine, steam turbine and heat exchangers having insignificant exergy destruction. Also, solar energy can contribute by about 27% of the input energy to the plant while the energy lost with exhaust gases can contribute by about 64% at maximum cases.

Keywords: solar energy, environment, efficiency, waste heat, steam generator, performance, exergy destruction

Procedia PDF Downloads 301
1843 Effects of Spent Dyebath Recycling on Pollution and Cost of Production in a Cotton Textile Industry

Authors: Dinesh Kumar Sharma, Sanjay Sharma

Abstract:

Textile manufacturing industry uses a substantial amount of chemicals not only in the production processes but also in manufacturing the raw materials. Dyes are the most significant raw material which provides colour to the fabric and yarn. Dyes are produced by using a large amount of chemicals both organic and inorganic in nature. Dyes are further classified as Reactive or Vat Dyes which are mostly used in cotton textiles. In the process of application of dyes to the cotton fiber, yarn or fabric, several auxiliary chemicals are also used in the solution called dyebath to improve the absorption of dyes. There is a very little absorption of dyes and auxiliary chemicals and a residual amount of all these substances is released as the spent dye bath effluent. Because of the wide variety of chemicals used in cotton textile dyes, there is always a risk of harmful effects which may not be apparent immediately but may have an irreversible impact in the long term. Colour imparted by the dyes to the water also has an adverse effect on its public acceptability and the potability. This study has been conducted with an objective to assess the feasibility of reuse of the spent dye bath. Studies have been conducted in two independent industries manufacturing dyed cotton yarn and dyed cotton fabric respectively. These have been referred as Unit-I and Unit-II. The studies included assessment of reduction in pollution levels and the economic benefits of such reuse. The study conclusively establishes that the reuse of spent dyebath results in prevention of pollution, reduction in pollution loads and cost of effluent treatment & production. This pollution prevention technique presents a good preposition for pollution prevention in cotton textile industry.

Keywords: dyes, dyebath, reuse, toxic, pollution, costs

Procedia PDF Downloads 397
1842 A Vision-Based Early Warning System to Prevent Elephant-Train Collisions

Authors: Shanaka Gunasekara, Maleen Jayasuriya, Nalin Harischandra, Lilantha Samaranayake, Gamini Dissanayake

Abstract:

One serious facet of the worsening Human-Elephant conflict (HEC) in nations such as Sri Lanka involves elephant-train collisions. Endangered Asian elephants are maimed or killed during such accidents, which also often result in orphaned or disabled elephants, contributing to the phenomenon of lone elephants. These lone elephants are found to be more likely to attack villages and showcase aggressive behaviour, which further exacerbates the overall HEC. Furthermore, Railway Services incur significant financial losses and disruptions to services annually due to such accidents. Most elephant-train collisions occur due to a lack of adequate reaction time. This is due to the significant stopping distance requirements of trains, as the full braking force needs to be avoided to minimise the risk of derailment. Thus, poor driver visibility at sharp turns, nighttime operation, and poor weather conditions are often contributing factors to this problem. Initial investigations also indicate that most collisions occur in localised “hotspots” where elephant pathways/corridors intersect with railway tracks that border grazing land and watering holes. Taking these factors into consideration, this work proposes the leveraging of recent developments in Convolutional Neural Network (CNN) technology to detect elephants using an RGB/infrared capable camera around known hotspots along the railway track. The CNN was trained using a curated dataset of elephants collected on field visits to elephant sanctuaries and wildlife parks in Sri Lanka. With this vision-based detection system at its core, a prototype unit of an early warning system was designed and tested. This weatherised and waterproofed unit consists of a Reolink security camera which provides a wide field of view and range, an Nvidia Jetson Xavier computing unit, a rechargeable battery, and a solar panel for self-sufficient functioning. The prototype unit was designed to be a low-cost, low-power and small footprint device that can be mounted on infrastructures such as poles or trees. If an elephant is detected, an early warning message is communicated to the train driver using the GSM network. A mobile app for this purpose was also designed to ensure that the warning is clearly communicated. A centralized control station manages and communicates all information through the train station network to ensure coordination among important stakeholders. Initial results indicate that detection accuracy is sufficient under varying lighting situations, provided comprehensive training datasets that represent a wide range of challenging conditions are available. The overall hardware prototype was shown to be robust and reliable. We envision a network of such units may help contribute to reducing the problem of elephant-train collisions and has the potential to act as an important surveillance mechanism in dealing with the broader issue of human-elephant conflicts.

Keywords: computer vision, deep learning, human-elephant conflict, wildlife early warning technology

Procedia PDF Downloads 231
1841 Characterization and Degradation of 3D Printed Polycaprolactone-Freeze Dried Bone Matrix Constructs for Use in Critical Sized Bone Defects

Authors: Samantha Meyr, Eman Mirdamadi, Martha Wang, Tao Lowe, Ryan Smith, Quinn Burke

Abstract:

Critical-sized bone defects (CSD) treatment options remain a major clinical orthopedic challenge. They are uniquely contoured diseased or damaged bones and can be defined as those that will not heal spontaneously and require surgical intervention. Autografts are the current gold standard CSD treatment, which are histocompatible and provoke a minimal immunogenic response; however, they can cause donor site morbidity and will not suffice for the size required for replacement. As an alternative to traditional surgical methods, bone tissue engineering will be implemented via 3D printing methods. A freeze-dried bone matrix (FDBM) is a type of graft material available but will only function as desired when in the presence of bone growth factors. Polycaprolactone (PCL) is a known biodegradable material with good biocompatibility that has been proven manageable in 3D printing as a medical device. A 3D-extrusion printing strategy is introduced to print these materials into scaffolds for bone grafting purposes, which could be more accessible and rapid than the current standard. Mechanical, thermal, cytotoxic, and physical properties were investigated throughout a degradation period of 6 months using fibroblasts and dental pulp stem cells. PCL-FDBM scaffolds were successfully printed with high print fidelity in their respective pore sizes and allograft content. Additionally, we have created a method for evaluating PCL using differential scanning calorimetry (DSC) and have evaluated PCL degradation over roughly 6 months.

Keywords: 3D printing, bone tissue engineering, cytotoxicity, degradation, scaffolds

Procedia PDF Downloads 111
1840 Predictors of Non-Adherence to Pharmacological Therapy in Patients with Type 2 Diabetes

Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto

Abstract:

Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.

Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan

Procedia PDF Downloads 442
1839 Relationship between Physical Activity Level and Functional Movement in 16-years old Schoolchildren: A Multilevel Modelling Approach

Authors: Josip Karuc, Marjeta Mišigoj-Duraković, Goran Marković, Vedran Hadžić, Michael J. Duncan, Hrvoje Podnar, Maroje Sorić

Abstract:

As a part of the CRO-PALS longitudinal study, this investigation aimed to examine the association between different levels of physical activity (PA) and movement quality in 16-years old school children. The total number of participants in this research was 725. Movement quality was assessed via the Functional Movement Screen (FMSTM), and the PA level was estimated using the School Health Action, Planning, and Evaluation System (SHAPES) questionnaire. In addition, body fat and socioeconomic status (SES) were assessed. In order to investigate the association between total FMS score and different levels of PA, multilevel modeling was employed for boys (n=359) and girls (n=366) separately. All models were adjusted for age, body fat, and SES. Among boys, MVPA, MPA, and VPA were not significant predictors of the total FMS score (β=0.000, p=0.78; β=-0.002, p=0.455; β=0.004, p=0.158, respectively). On the contrary, among girls, VPA and MVPA showed significant effects on the total FMS score (β=0.011, p=0.001, β=0.005, p=0.006, respectively). The findings of this research provide evidence that the intensity of PA is a minor but relevant factor in describing the association between PA and movement quality in adolescent girls but not in boys. This means that the PA level does not guarantee optimal functional movement patterns. Therefore, practicing functional movement patterns in an isolated manner and at moderate to vigorous intensity could be beneficial in order to reduce the risk of injury incidence and potential orthopedic abnormalities in later life. This work was supported by the Croatian Science Foundation, grant no: IP-2016-06-9926 and grant no: DOK-2018-01-2328.

Keywords: functional movement screen, fundamental movement patterns, movement quality, pediatric

Procedia PDF Downloads 163
1838 School Partners in Initial Teacher Education: An Including or Excluding Approach When Engaging Schools

Authors: Laila Niklasson

Abstract:

The aim of the study is to critically discuss how partner schools are engaged during Initial teacher education, ITE. The background is an experiment in Sweden where the practicum organization is reorganized due to a need to enhance quality during practicum. It is a national initiative from the government, supported by the National Agency of Education and lasts 2014-2019. The main features are concentration of students to school with a certain amount of mentors, mentors who have a mentor education and teachers with relevant subject areas and where there could be a mentor team with a leader at the school. An expected outcome is for example that the student teachers should be engaged in peer-learning. The schools should be supported by extra lectures from university teachers during practicum and also extra research projects where the schools should be engaged. A case study of one university based ITE was carried out to explore the consequences for the schools not selected. The result showed that from engaging x schools in a region, x was engaged. The schools are both in urban and rural areas, mainly in the latter. There is also a tendency that private schools are not engaged. On a unit level recruitment is perceived as harder for schools not engaged. In addition they cannot market themselves as ´selected school´ which can affect parent´s selection of school for their children. Also, on unit level, but with consequences for professional development, they are not selected for research project and thereby are not fully supported during school development. The conclusion is that from an earlier inclusive approach concerning professions where all teachers were perceived as possible mentors, there is a change to an exclusive approach where selected schools and selected teachers should be engaged. The change could be perceived as a change in governance mentality, but also in how professions are perceived, and development work is pursued.

Keywords: initial teacher education, practicum schools, profession, quality development

Procedia PDF Downloads 144
1837 Systematic Identification of Noncoding Cancer Driver Somatic Mutations

Authors: Zohar Manber, Ran Elkon

Abstract:

Accumulation of somatic mutations (SMs) in the genome is a major driving force of cancer development. Most SMs in the tumor's genome are functionally neutral; however, some cause damage to critical processes and provide the tumor with a selective growth advantage (termed cancer driver mutations). Current research on functional significance of SMs is mainly focused on finding alterations in protein coding sequences. However, the exome comprises only 3% of the human genome, and thus, SMs in the noncoding genome significantly outnumber those that map to protein-coding regions. Although our understanding of noncoding driver SMs is very rudimentary, it is likely that disruption of regulatory elements in the genome is an important, yet largely underexplored mechanism by which somatic mutations contribute to cancer development. The expression of most human genes is controlled by multiple enhancers, and therefore, it is conceivable that regulatory SMs are distributed across different enhancers of the same target gene. Yet, to date, most statistical searches for regulatory SMs have considered each regulatory element individually, which may reduce statistical power. The first challenge in considering the cumulative activity of all the enhancers of a gene as a single unit is to map enhancers to their target promoters. Such mapping defines for each gene its set of regulating enhancers (termed "set of regulatory elements" (SRE)). Considering multiple enhancers of each gene as one unit holds great promise for enhancing the identification of driver regulatory SMs. However, the success of this approach is greatly dependent on the availability of comprehensive and accurate enhancer-promoter (E-P) maps. To date, the discovery of driver regulatory SMs has been hindered by insufficient sample sizes and statistical analyses that often considered each regulatory element separately. In this study, we analyzed more than 2,500 whole-genome sequence (WGS) samples provided by The Cancer Genome Atlas (TCGA) and The International Cancer Genome Consortium (ICGC) in order to identify such driver regulatory SMs. Our analyses took into account the combinatorial aspect of gene regulation by considering all the enhancers that control the same target gene as one unit, based on E-P maps from three genomics resources. The identification of candidate driver noncoding SMs is based on their recurrence. We searched for SREs of genes that are "hotspots" for SMs (that is, they accumulate SMs at a significantly elevated rate). To test the statistical significance of recurrence of SMs within a gene's SRE, we used both global and local background mutation rates. Using this approach, we detected - in seven different cancer types - numerous "hotspots" for SMs. To support the functional significance of these recurrent noncoding SMs, we further examined their association with the expression level of their target gene (using gene expression data provided by the ICGC and TCGA for samples that were also analyzed by WGS).

Keywords: cancer genomics, enhancers, noncoding genome, regulatory elements

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1836 COVID_ICU_BERT: A Fine-Tuned Language Model for COVID-19 Intensive Care Unit Clinical Notes

Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

Abstract:

Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation

Procedia PDF Downloads 213
1835 Khon Kaen University Family Health Assessment Tool Training Program on Primary Care Unit Nurses’ Skills

Authors: Suwarno, D. Jongudomkarn

Abstract:

Family Health Assessment (FHA) is a key process to identify the family health needs, family health problems, and family health history. Assessing the family health is not only from the assessment tool but also from health care provider especially Nurse. Nurses’ have duties to assess the family as holistic view and they have to increase their capacities (knowledge, skills and experiences) in FHA. Thus, the continuing nursing education-training program on using the KKU FHA Tool was aimed to enhance the participant nurses’ capacities in (FHA) based on such tool. The aim of this study was to evaluate the KKU FHA Tool training program on PCU nurses’ capacity before and after training program in Primary Care Unit Bantul, Yogyakarta. The Quasi-Experiment with one group pre-, post-test design as a research design with convenient sampling technique and one group pre- post test formula for Nurses who work in Six PCU Bantul, Yogyakarta as much as fourteen respondents. The research processes were used training program with module, video and handbook KKU FHA Tool, KKU FHA tool form and capacities questionnaires. It was analyzed by descriptive data, Kolmogorov-Smirnov and Paired Sample t-test. The overall comparing analysis of paired sample t-test revealed that the mean values of pre-test were 3.35 with SD 0.417, post-test was 3.86 with SD 0.154 and post-test in later two weeks was 4.00 with SD 0.243. It was found that the p value of among the pre-test, the intermediate post-test and the post–test in later two weeks were 0.000. The p value of the intermediate post-test and post-test in later two weeks was 0.053. KKU FHA Tool training program in PCU Bantul Yogyakarta was enhanced the participant nurses’ capacities significantly. In conclusion, we are recommending KKU FHA Tool forms have to develop and implement with qualitative research as complementary data in PCU Bantul Yogyakarta by Focus Group Discussion.

Keywords: family health assessment, KKU FHA tool, training program, nurses capacities

Procedia PDF Downloads 382