Search results for: wireless patient monitoring

Authors: M. Deligianni, P. Voultsos, E. Tsamadou

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Background/Introduction: Moral distress is a common occurrence for health professionals working in neonatal critical care. Despite a growing number of critically ill neonatal and pediatric patients, only a few articles related to moral distress as experienced by neonatal physicians have been published over the last years. Objectives/Aims: The aim of this study was to define and identify barriers to and facilitators of moral distress based on the perceptions and experiences of neonatal physicians working in neonatal intensive care units (NICUs). This pilot study is a part of a larger nationwide project. Methods: A multicenter qualitative descriptive study using focus group methodology was conducted. In-depth interviews lasting 45 to 60 minutes were audio-recorded. Once data were transcribed, conventional content analysis was used to develop the definition and categories, as well as to identify the barriers to and facilitators of moral distress. Results: Participants defined moral distress broadly in the context of neonatal critical care. A wide variation of definitions was displayed. The physicians' responses to moral distress included different feelings and other situations. The overarching categories that emerged from the data were patient-related, family-related, and physician-related factors. Moreover, organizational factors may constitute major facilitators of moral distress among neonatal physicians in NICUs. Note, however, that moral distress may be regarded as an essential component to caring for neonates in critical care. The present study provides further insight into the moral distress experienced by physicians working in Greek NICUs. Discussion/Conclusions: Understanding how neonatal and pediatric critical care nurses define moral distress and what contributes to its development is foundational to developing targeted strategies for mitigating the prevalence of moral distress among neonate physicians in the context of NICUs.

Keywords: critical care, moral distress, neonatal physician, neonatal intensive care unit, NICU

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Authors: Surya Prasad Sharma, Suyash Katdare, Syed Ainul Hussain

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Human-induced factors contributed to the population decline of crocodylians in India which became evident by the mid-20th century when authorities forewarned the extinction risk for the crocodile and proposed regulation in the crocodile trade. The proposed action led to the enactment of national and international wildlife regulations to prohibit the trade-in of crocodile skins and parts. Subsequently, conservation translocation programs were initiated to restore the species in the wild through a 'head-start' approach. In India, the crocodile conservation program, which began in the early 1970s, has been one of India's longest-running conservation initiatives. The gharial (Gavialis gangeticus) population has benefitted, and the gharial number increased rapidly owing to these efforts. The immediate risk of extinction was averted as the gharial has recovered due to decades-long cumulative conservation efforts, the consideration of the genetic for monitoring the recovery of the recovered populations is still lacking. Hence, we assessed the genetic diversity of the Girwa gharial population in India using six polymorphic nuclear microsatellites loci and mitochondrial control region. The number of alleles per loci ranged between 2 to 5, and the allelic richness (Ar) was 2.67 ± 0.49, and the observed (Ho) and expected (He) heterozygosities were 0.42 ± 0.08 and 0.42 ± 0.09, respectively. The M-ratio yielded a value of (0.41 ± 0.16) lower than critical M, suggesting a genetic bottleneck in the Girwa population. We observed more mitochondrial control region haplotypes in the Girwa population than previously reported in the largest gharial population in the Chambal River. Overall, our study indicates that genetic diversity remains low despite the recovery in the Girwa population. Hence, we recommend a range-wide genetic assessment of gharial populations using high-throughput techniques to identify the source population and plan future translocation programs.

Keywords: conservation translocation, recovery, crocodile, bottleneck

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Authors: Taha SamadSoltani, Peyman Rezaei Hachesu, Marjan GhaziSaeedi, Maryam Zolnoori

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Introduction: Data mining defined as a process to find patterns and relationships along data in the database to build predictive models. Application of data mining extended in vast sectors such as the healthcare services. Medical data mining aims to solve real-world problems in the diagnosis and treatment of diseases. This method applies various techniques and algorithms which have different accuracy and precision. The purpose of this study was to apply knowledge discovery and data mining techniques for the diagnosis of asthma based on patient symptoms and history. Method: Data mining includes several steps and decisions should be made by the user which starts by creation of an understanding of the scope and application of previous knowledge in this area and identifying KD process from the point of view of the stakeholders and finished by acting on discovered knowledge using knowledge conducting, integrating knowledge with other systems and knowledge documenting and reporting.in this study a stepwise methodology followed to achieve a logical outcome. Results: Sensitivity, Specifity and Accuracy of KNN, SVM, Naïve bayes, NN, Classification tree and CN2 algorithms and related similar studies was evaluated and ROC curves were plotted to show the performance of the system. Conclusion: The results show that we can accurately diagnose asthma, approximately ninety percent, based on the demographical and clinical data. The study also showed that the methods based on pattern discovery and data mining have a higher sensitivity compared to expert and knowledge-based systems. On the other hand, medical guidelines and evidence-based medicine should be base of diagnostics methods, therefore recommended to machine learning algorithms used in combination with knowledge-based algorithms.

Keywords: asthma, datamining, classification, machine learning

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Authors: Tanyaporn Chairoch

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Introduction: Cannabis is a drug to treat patients with many diseases such as Multiple sclerosis, Alzheimer’s disease, and Epilepsy, where theycontain many active compounds such as delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). Especially, THC is the primary psychoactive ingredient in cannabis and binds to cannabinoid 1 (CB1) receptors. Moreover, CB1 is located on the neocortex, hippocampus, basal ganglia, cerebellum, and brainstem. In previous study, we found the association between the variant of CB1recptors gene (rs2023239) and decreased effect of nicotine reinforcement in patients. However, there are no data describing whether the distribution of CB1 receptor gene is a genetic marker for Thai patients who are treated with cannabis. Objective: Thus, the aim of this study we want to investigate the frequency of the CB1 receptor gene in Thai patients. Materials and Methods: All of sixty Thai patients received the medical cannabis for treatment who were recruited in this study. DNA will be extracted from EDTA whole blood by Genomic DNA Mini Kit. The genotyping of CNR1 gene (rs 2023239) was genotyped by the TaqMan real time PCR assay (ABI, Foster City, CA, USA).and using the real-time PCR ViiA7 (ABI, Foster City, CA, USA). Results: We found thirty-eight (63.3%) Thai patients were female, and twenty-two (36.70%) were male in this study with median age of 45.8 (range19 – 87 ) years. Especially, thirty-two (53.30%) medical cannabis tolerant controls were female ( 55%) and median age of52.1 (range 27 – 79 ) years. The most adverse effects for medical cannabis treatment was tachycardia. Furthermore, the number of rs 2023239 (TT) carriers was 26 of 27 (96.29%) in medical cannabis-induced adverse effects and 32 of 33 (96.96%) in tolerant controls. Additionally, rs 2023239 (CT) variant was found just only one of twenty-seven (3.7%) in medical cannabis-induced adverse effects and 1 of 33 (3.03%) in tolerant controls. Conclusions: The distribution of genetic variant in CNR1 gene might serve as a pharmacogenetics markers for screening before initiating the therapy with medical cannabis in Thai patients.

Keywords: cannabis, pharmacogenetics, CNR1 gene, thai patient

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Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: DCIS accounts for 20% of malignancies diagnosed by the breast screening programme and is primarily managed by surgical excision. There is variable guidance on defining excision margins, and adjuvant treatments vary widely. This study aimed to investigate the clinical outcomes for patients following surgical excision of small volume DCIS. Methods: This single-centreretrospective cohort study of 101 consecutive breast screened patients diagnosed with DCIS who underwent surgical excision. All patients diagnosed with DCIS had radiological abnormalities <15mm. Clinical, radiological, and histological data were collected from patients who had been diagnosed within a 5 year period, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Outcomes included re-excision rates, radiotherapy usage, and the presence of invasive cancer. Results: Breast conservation surgery was performed in 94.1% (n=95). Following surgical excision, 74(73.27%)patients had complete DCIS excision (>2mm margin), 4(4.0%) had margins 1-2mm, and 17(16.84%)had margins <1mm. The median size of DCIS in the specimen sample was 4mm. In 86% of patients with involved margins (n=18), the mammogram underestimated the DCIS size by a median of 12.5mm (range: 1-42mm). Of the patients with involved margins, 11(10.9%)had a re-excision, and 6 of these (50%) required two re-excisions to completely excise the DCIS. Post-operative radiotherapy was provided to 53(52.48%)patients. Four (3.97%) patients were found to have invasive ductal carcinoma on surgical excision, which was not present on core biopsy – all had high-grade DCIS. Recurrence of DCIS was seen in the same site during follow-up in 1 patient (1%), 1 year after their first DCIS diagnosis. Conclusion: Breast conservation surgery is safe in patients with DCIS, with low rates of re-excision, recurrence, and upstaging to invasive cancer. Furthermore, the median size of DCIS found in the specimens of patients who had DCIS fully removed in surgery was low, suggesting it may be possible that total removal through VAE was possible for these patients.

Keywords: surgical excision, breast conservation surgery, DCIS, Re-excision, radiotherapy, invasive cancer

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Authors: M. Bilal Ishfaq, Adnan N. Qureshi

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COVID-19 is the most infectious disease these days, it was first reported in Wuhan, the capital city of Hubei in China then it spread rapidly throughout the whole world. Later on 11 March 2020, the World Health Organisation (WHO) declared it a pandemic. Since COVID-19 is highly contagious, it has affected approximately 219M people worldwide and caused 4.55M deaths. It has brought the importance of accurate diagnosis of respiratory diseases such as pneumonia and COVID-19 to the forefront. In this paper, we propose a hybrid approach for the automated detection of COVID-19 using medical imaging. We have presented the hybridization of manually extracted and convolutional features. Our approach combines Haralick texture features and convolutional features extracted from chest X-rays and CT scans. We also employ a minimum redundancy maximum relevance (MRMR) feature selection algorithm to reduce computational complexity and enhance classification performance. The proposed model is evaluated on four publicly available datasets, including Chest X-ray Pneumonia, COVID-19 Pneumonia, COVID-19 CTMaster, and VinBig data. The results demonstrate high accuracy and effectiveness, with 0.9925 on the Chest X-ray pneumonia dataset, 0.9895 on the COVID-19, Pneumonia and Normal Chest X-ray dataset, 0.9806 on the Covid CTMaster dataset, and 0.9398 on the VinBig dataset. We further evaluate the effectiveness of the proposed model using ROC curves, where the AUC for the best-performing model reaches 0.96. Our proposed model provides a promising tool for the early detection and accurate diagnosis of COVID-19, which can assist healthcare professionals in making informed treatment decisions and improving patient outcomes. The results of the proposed model are quite plausible and the system can be deployed in a clinical or research setting to assist in the diagnosis of COVID-19.

Keywords: COVID-19, feature engineering, artificial neural networks, radiology images

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Authors: Angel Liduvino Vara-Vela, Dirceu Luis Herdies, Debora Souza Alvim, Eder Paulo Vendrasco, Silvio Nilo Figueroa, Jayant Pendharkar, Julio Pablo Reyes Fernandez

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Biomass-burning episodes are quite common in the central Amazon rainforest and represent a dominant source of aerosols during the dry season, between August and October. The increase in the occurrence of fires in 2019 in the world’s largest biomes has captured the attention of the international community. In particular, a rare and extreme smoke-related event occurred in the afternoon of Monday, August 19, 2019, in the most populous city in the Western Hemisphere, the São Paulo Metropolitan Area (SPMA), located in southeastern Brazil. The sky over the SPMA suddenly blackened, with the day turning into night, as reported by several news media around the world. In order to clarify whether or not the smoke that plunged the SPMA into sudden darkness was related to wildfires in the Amazon rainforest region, a set of 48-hour simulations over South America were performed using the Weather Research and Forecasting with Chemistry (WRF-Chem) model at 20 km horizontal resolution, on a daily basis, during the period from August 16 to August 19, 2019. The model results were satisfactorily compared against satellite-based data products and in situ measurements collected from air quality monitoring sites. Although a very strong smoke transport coming from the Amazon rainforest was observed in the middle of the afternoon on August 19, its impact on air quality over the SPMA took place in upper levels far above the surface, where, conversely, low air pollutant concentrations were observed.

Keywords: Amazon rainforest, biomass burning aerosols, São Paulo metropolitan area, WRF-Chem model

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Authors: Gabrielle O'Donoghue

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Background: Pre-operative radiographs facilitate assessment and treatment planning in minor oral surgery. Quality assurance for dental radiography advocates the As Low As Reasonably Achievable (ALARA) principle in collecting accurate diagnostic information. Aims: To audit the quality of digital intraoral periapicals (IOPAs) taken prior to dental extractions in a metropolitan general dental practice setting. Standards: The National Radiological Protection Board (NRPB) guidance outlines three grades of radiograph quality: excellent (Grade 1 > 70% of total exposures), diagnostically acceptable (Grade 2 <20%), and unacceptable (Grade 3 <10%). Methodology: A study of pre-operative radiographs taken prior to dental extractions across 12 private general dental practices in a large metropolitan area by 44 practitioners. A total of 725 extractions were assessed, allowing 258 IOPAs to be reviewed in one audit cycle. Results: First cycle: Of 258 IOPAs: 223(86.4%) scored Grade 1, 27(10.5%) Grade 2, and 8(3.1%) Grade 3. The standard was met. 35 dental extractions were performed without an available pre-operative radiograph. Action Plan & Recommendations: Results were distributed to all staff and a continuous professional development evening organized to outline recommendations to improve image quality. A second audit cycle is proposed at a six-month interval to review the recommendations and appraise results. Conclusion: The overall standard of radiographs met the published guidelines. A significant improvement in the number of procedures undertaken without pre-operative imaging is expected at a six-month interval period. An investigation into undiagnostic imaging and associated adverse patient outcomes is being considered. Maintenance of the standards achieved is predicted in the second audit cycle to ensure consistent high quality imaging.

Keywords: audit, oral radiology, oral surgery, periapical radiographs, quality assurance

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Authors: Gulyas Erzsebet

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The multimerisation of proteins is a common feature of many cellular processes; however, it could also impair protein functions and/or be associated with the occurrence of diseases. Thus, development of a research tool monitoring the appearance/presence of multimeric protein forms has great importance for a variety of research fields. Such a tool is potentially applicable in the ante-mortem diagnosis of certain conformational diseases, such as transmissible spongiform encephalopathies (TSE) and Alzheimer’s disease. These conditions are accompanied by the appearance of aggregated protein multimers, present in low concentrations in various tissues. This detection is particularly relevant for TSE where the handling of tissues derived from affected individuals and of meat products of infected animals have become an enormous health concern. Here we demonstrate the potential of such a multimer detection approach in TSE by developing a facile approach. The Biospiral-Detect system resembles a traditional sandwich ELISA, except that the capturing antibody that is attached to a solid surface and the detecting antibody is directed against the same or overlapping epitopes. As a consequence, the capturing antibody shields the epitope on the captured monomer from reacting with the detecting antibody, therefore monomers are not detected. Thus, MDS is capable of detecting only protein multimers with high specificity. We developed an alternative system as well, where RNA aptamers were employed instead of monoclonal antibodies. In order to minimize degradation, the 3' and 5' ends of the aptamer contained deoxyribonucleotides and phosphorothioate linkages. When compared the monoclonal antibodies-based system with the aptamers-based one, the former proved to be superior. Thus all subsequent experiments were conducted by employing the Biospiral -Detect modified sandwich ELISA kit. Our approach showed an order of magnitude higher sensitivity toward mulimers than monomers suggesting that this approach may become a valuable diagnostic tool for conformational diseases that are accompanied by multimerization.

Keywords: diagnosis, ELISA, Prion, TSE

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Authors: Houda Oueriemmi, Petra Susan Kidd, Carmen Trasar-Cepeda, Beatriz Rodríguez-Garrido, Mohamed Moussa, Ángeles Prieto-Fernández, Mohamed Ouessar

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Organic amendments are generally used for improving the fertility of arid and semi-arid soils. However, the price of farmyard manure, the organic amendment typically applied to many arid and semi-arid soils has highly increased in the last years. To investigate at field scale whether cheap, highly available organic amendments, such as sewage sludge compost and municipal solid waste compost, may be acceptable as substitutes for farmyard manure is therefore of great interest. A field plots experiment was carried out to assess the effects of a single application of three organic amendments on soil fertility, distribution of trace elements and on barley yield. Municipal solid waste compost (MSWC), farmyard manure (FYM) and sewage sludge compost (SSC) were applied at rates of 0, 20, 40 and 60 t ha⁻¹, and barley was cultivated in two consecutive years. Plant samples and soils were collected for laboratory analyses after two consecutive harvests. Compared with unamended soil, the application of the three organic residues improved the fertility of the topsoil, showing a significant dose-dependent increase of TOC, N, P contents up to the highest dose of 60 t ha⁻¹ (0.74%, 0.06% and 40 mg kg⁻¹, respectively). The enhancement of soil nutrient status impacted positively on grain yield (up to 51%). The distribution of trace elements in the soil, analysed by a sequential extraction procedure, revealed that the MSWC increased the acid-extractable Co and Cu and reducible Ni, while SSC increased reducible Co and Ni and oxidisable Cu, relative to the control soil.

Keywords: municipal solid waste compost, sewage sludge compost, fertility, trace metals

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Authors: Lakmali Anthony, Bushra Oathman, Anshini Jain, Raaj Chandra

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Introduction: Abscesses are traditionally treated by incision and drainage with the packing of the residual abscess cavity until healing. This method requires regular visits from community nurses for continuous wound packing upon discharge from the hospital and causes considerable patient discomfort. Whether abscess cavity packing offers any advantage over non-packing has not yet been adequately studied to the best of our knowledge. This study aims to determine if there are differences in clinical outcomes of time to healing, fistula formation and recurrence of abscess between abscess cavity packing vs. non-packing groups. Methods: This study was a single-center, single-blind, randomized controlled trial where patients were randomized into packing and non-packing arms. All patients over 18 years presenting to Eastern Health with an abscess requiring incision and drainage in the theatre were invited to participate. Those with underlying conditions that cause recurrent abscesses were excluded. Data were collected from December 2018 to April 2020. Results: There were 63 patients who had abscesses treated with incision and drainage that were enrolled in the study, 52 of which were suitable for analysis. Demographic characteristics were similar in both groups. The packing group had a significantly longer time to heal compared to the non-packing group. Rates of fistula formation and recurrence of abscess were low and there were no statistically significant differences between groups. The packing group had more patients with delayed healing (defined as >60 days) and required more follow-up visits compared to the non-packing group. Conclusion: This pilot study indicates that abscesses can not only be managed safely with incision and drainage alone without the need for continuous abscess cavity packing but also that non-packing may offer clinical benefits to patients with earlier healing of abscesses compared to continuous cavity packing.

Keywords: abscess packing, subcutaneous, perianal, pilonidal

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Authors: Levent Basayigit, Sinan Demir, Yusuf Ucar, Burhan Kara

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Many research projects require accurate delineation of the different land cover type of the agricultural area. Especially it is critically important for the definition of specific plants like cannabis. However, the complexity of vegetation stands structure, abundant vegetation species, and the smooth transition between different seconder section stages make vegetation classification difficult when using traditional approaches such as the maximum likelihood classifier. Most of the time, classification distinguishes only between trees/annual or grain. It has been difficult to accurately determine the cannabis mixed with other plants. In this paper, a mixed distribution models approach is applied to classify pure and mix cannabis parcels using Worldview-2 imagery in the Lakes region of Turkey. Five different land use types (i.e. sunflower, maize, bare soil, and cannabis) were identified in the image. A constrained Gaussian mixture discriminant analysis (GMDA) was used to unmix the image. In the study, 255 reflectance ratios derived from spectral signatures of seven bands (Blue-Green-Yellow-Red-Rededge-NIR1-NIR2) were randomly arranged as 80% for training and 20% for test data. Gaussian mixed distribution model approach is proved to be an effective and convenient way to combine very high spatial resolution imagery for distinguishing cannabis vegetation. Based on the overall accuracies of the classification, the Gaussian mixed distribution model was found to be very successful to achieve image classification tasks. This approach is sensitive to capture the illegal cannabis planting areas in the large plain. This approach can also be used for monitoring and determination with spectral reflections in illegal cannabis planting areas.

Keywords: Gaussian mixture discriminant analysis, spectral mixture model, Worldview-2, land parcels

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Authors: Maria Bercea, Monica Diana Olteanu

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Investigation of polymer systems able to change inside of the body into networks represent an attractive approach, especially when there is a minimally invasive and patient friendly administration. Pharmaceutical formulations based on Pluronic F127 [poly (oxyethylene) (PEO) blocks (70%) and poly(oxypropylene) (PPO) blocks (30%)] present an excellent potential as drug delivery systems. The use of Pluronic F127 alone as gel-forming solution is limited by some characteristics, such as poor mechanical properties, short residence time, high permeability, etc. Investigation of the interactions between the natural and synthetic polymers and surfactants in solution is a subject of great interest from both scientific and practical point of view. As for example, formulations based on Pluronics and chitosan could be used to obtain dual phase transition hydrogels responsive to temperature and pH changes. In this study, different materials were prepared by using poly(vinyl alcohol), chitosan solutions mixed with aqueous solutions of Pluronic F127. The rheological properties of different formulations were investigated in temperature sweep experiments as well as at a constant temperature of 37oC for exploring in-situ gel formation in the human body conditions. In addition, some viscometric investigations were carried out in order to understand the interactions which determine the complex behaviour of these systems. Correlation between the thermodynamic and rheological parameters and phase separation phenomena observed for the investigated systems allowed the dissemination the constitutive response of polymeric materials at different external stimuli, such as temperature and pH. The rheological investigation demonstrated that the viscoelastic moduli of the hydrogels can be tuned depending on concentration of different components as well as pH and temperature conditions and cumulative contributions can be obtained.

Keywords: hydrogel, polymer mixture, stimuli responsive, biomedical applications

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Authors: Simone Huber, Bianca Schnalzer, Baptiste Alcalde, Sten Hanke, Lampros Mpaltadoros, Thanos G. Stavropoulos, Spiros Nikolopoulos, Ioannis Kompatsiaris, Lina Pérez- Breva, Vallivana Rodrigo-Casares, Jaime Fons-Martínez, Jeroen de Bruin

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Developing new medicine and health solutions and improving patient health currently rely on the successful execution of clinical trials, which generate relevant safety and efficacy data. For their success, recruitment and retention of participants are some of the most challenging aspects of protocol adherence. Main barriers include: i) lack of awareness of clinical trials; ii) long distance from the clinical site; iii) the burden on participants, including the duration and number of clinical visits and iv) high dropout rate. Most of these aspects could be addressed with a new paradigm, namely the Remote Decentralized Clinical Trials (RDCTs). Furthermore, the COVID-19 pandemic has highlighted additional advantages and challenges for RDCTs in practice, allowing participants to join trials from home and not depend on site visits, etc. Nevertheless, RDCTs should follow the process and the quality assurance of conventional clinical trials, which involve several processes. For each part of the trial, the Building Blocks, existing software and technologies were assessed through a systematic search. The technology needed to perform RDCTs is widely available and validated but is yet segmented and developed in silos, as different software solutions address different parts of the trial and at various levels. The current paper is analyzing the availability of technology to perform RDCTs, identifying gaps and providing an overview of Basic Building Blocks and functionalities that need to be covered to support the described processes.

Keywords: architectures and frameworks for health informatics systems, clinical trials, information and communications technology, remote decentralized clinical trials, technology availability

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Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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Authors: Francisco Miroslav Ulloa-Stanojlovic, Gina Polo, Ricardo Augusto Dias

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In Brazil, there is a high incidence of rabies in herbivores of economic interest (HEI) transmitted by the common vampire bat Desmodus rotundus, the presence of human rabies cases and the huge economic losses in the world's largest cattle industry, it is important to assist the National Program for Control of Rabies in herbivores in Brazil, that aims to reduce the incidence of rabies in HEI populations, mainly through epidemiological surveillance, vaccination of herbivores and control of vampire-bat roosts. Material and Methods: A spatiotemporal retrospective Kulldorff's spatial scan statistic based on a Poisson model and Monte Carlo simulation and an Anselin's Local Moran's I statistic were used to uncover spatial clustering of HEI rabies from 2000 – 2014. Results: Were identify three important clusters with significant year-to-year variation (Figure 1). In 2000, was identified one area of clustering in the North region, specifically in the State of Tocantins. Between the year 2000 and 2004, a cluster centered in the Midwest and Southeast region including the States of Goiás, Minas Gerais, Rio de Janeiro, Espirito Santo and São Paulo was prominent. And finally between 2000 and 2005 was found an important cluster in the North, Midwest and South region. Conclusions: The HEI rabies is endemic in the country, in addition, appears to be significant differences among the States according to their surveillance services, that may be difficulting the control of the disease, also other factors could be influencing in the maintenance of this problem like the lack of information of vampire-bat roosts identification, and limited human resources for realization of field monitoring. A review of the program control by the authorities it’s necessary.

Keywords: Brazil, Desmodus rotundus, herbivores, rabies

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Authors: R. R. Billones, N. Lukkahatai, L. N. Saligan

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Mindfulness based interventions (MBIs) have been used in medically unexplained symptoms (MUS). This systematic review describes the literature investigating the general effect of MBIs on MUS and identifies the effects of specific MBIs on specific MUS conditions. The preferred reporting items for systematic reviews and meta-analysis guidelines (PRISMA) and the modified Oxford quality scoring system (JADAD) were applied to the review, yielding an initial 1,556 articles. The search engines included PubMed, ScienceDirect, Web of Science, Scopus, EMBASE, and PsychINFO using the search terms: mindfulness, or mediations, or mindful or MBCT or MBSR and medically unexplained symptoms or MUS or fibromyalgia or FMS. A total of 24 articles were included in the final systematic review. MBIs showed large effects on socialization skills for chronic fatigue syndrome (d=0.65), anger in fibromyalgia (d=0.61), improvement of somatic symptoms (d=1.6) and sleep (d=1.12) for painful conditions, physical health for chronic back pain (d=0.51), and disease intensity for irritable bowel disease/syndrome (d=1.13). A manualized MBI that applies the four fundamental elements present in all types of interventions were critical to efficacy. These elements were psycho-education sessions specific to better understand the medical symptoms, the practice of awareness, the non-judgmental observance of the experience at the moment, and the compassion to ones’ self. The effectiveness of different mindfulness interventions necessitates giving attention to improve the gaps that were identified related to home-based practice monitoring, competency training of mindfulness teachers, and sound psychometric properties to measure the mindfulness practice.

Keywords: mindfulness-based interventions, medically unexplained symptoms, mindfulness-based cognitive therapy, mindfulness-based stress reduction, fibromyalgia, irritable bowel syndrome

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service (GLIS), location-based service (LBS), emergency medical services information system (EMSIS)

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Authors: Zhilong Xie, Jinwen Huang, Guofang Zeng

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The existing body of research on bilingualism has consistently linked the use of multiple languages to enhanced cognitive control. Numerous studies have demonstrated that bilingual individuals exhibit advantages in non-linguistic tasks demanding cognitive control. However, recent investigations have challenged these findings, leading to a debate regarding the extent and nature of bilingual advantages. The adaptive control hypothesis posits that variations in bilingual experiences hold the key to resolving these controversies. This study aims to contribute to this discussion by exploring the impact of second language (L2) listening experience on cognitive control among young Chinese-English bilinguals. By examining this specific aspect of bilingualism, the study offers a perspective on the origins of bilingual advantages. This study employed a range of cognitive tasks, including the Flanker task, Wisconsin Card Sorting Test (WCST), Operation Span Task (OSPAN), and a second language listening comprehension test. After controlling for potential confounding variables such as intelligence, socioeconomic status, and overall language proficiency, independent sample t-test analysis revealed significant differences in performance between groups with high and low L2 listening proficiency in the Flanker task and OSPAN. However, no significant differences emerged between the two groups in the WCST. These findings suggest that L2 listening proficiency has a significant impact on inhibitory control and working memory but not on conflict monitoring or mental set shifting. These specific findings provide a more nuanced understanding of the origins of bilingual advantages within a specific bilingual context, highlighting the importance of considering the nature of bilingual experience when exploring cognitive benefits.

Keywords: bilingual advantage, inhibitory control, L2 listening, working memory

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Authors: Joshna Rani S., Ahmadi Banu

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Artificial Intelligence (AI) has a significant task to carry out in the medical care contributions of things to come. As AI, it is the essential capacity behind the advancement of accuracy medication, generally consented to be a painfully required development in care. Albeit early endeavors at giving analysis and treatment proposals have demonstrated testing, we anticipate that AI will at last dominate that area too. Given the quick propels in AI for imaging examination, it appears to be likely that most radiology, what's more, pathology pictures will be inspected eventually by a machine. Discourse and text acknowledgment are now utilized for assignments like patient correspondence and catch of clinical notes, and their utilization will increment. The best test to AI in these medical services areas isn't regardless of whether the innovations will be sufficiently skilled to be valuable, but instead guaranteeing their appropriation in day by day clinical practice. For far reaching selection to happen, AI frameworks should be affirmed by controllers, coordinated with EHR frameworks, normalized to an adequate degree that comparative items work likewise, instructed to clinicians, paid for by open or private payer associations, and refreshed over the long haul in the field. These difficulties will, at last, be survived, yet they will take any longer to do as such than it will take for the actual innovations to develop. Therefore, we hope to see restricted utilization of AI in clinical practice inside 5 years and more broad use inside 10 years. It likewise appears to be progressively evident that AI frameworks won't supplant human clinicians for a huge scope, yet rather will increase their endeavors to really focus on patients. Over the long haul, human clinicians may advance toward errands and work plans that draw on remarkably human abilities like sympathy, influence, and higher perspective mix. Maybe the lone medical services suppliers who will chance their professions over the long run might be the individuals who will not work close by AI

Keywords: artificial intellogence, health care, breast cancer, AI applications

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Authors: Petronella Lunda, Catharina Susanna Minnie, Welma Lubbe

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Background This review aimed to provide healthcare professionals with a scientific summary of the best available research evidence on factors influencing respectful perinatal care. The review question was ‘What were the perceptions of midwives and doctors on factors that influence respectful perinatal care?’ Methods A detailed search was done on electronic databases: EBSCOhost: Medline, OAlster, Scopus, SciELO, Science Direct, PubMed, Psych INFO, and SocINDEX. The databases were searched for available literature using a predetermined search strategy. Reference lists of included studies were analysed to identify studies missing from databases. The phenomenon of interest was factors influencing maternity care practices according to midwives and doctors. Pre-determined inclusion and exclusion criteria were used during the selection of potential studies. In total, 13 studies were included in the data analysis and synthesis. Three themes were identified and a total of nine sub-themes. Results Studies conducted in various settings were included in the study. Multiple factors influencing respectful perinatal care were identified. During data synthesis, three themes emerged: healthcare institution, healthcare professionals, and women-related factors. Alongside the themes were sub-themes human resources, medical supplies, norms and practices, physical infrastructure, healthcare professional competencies and attributes, women’s knowledge, and preferences. The three factors influence the provision of respectful perinatal care; addressing them might improve the provision of the care. Conclusion Addressing factors that influence respectful perinatal care is vital towards the prevention of compromised patient care during the perinatal period as these factors have the potential to accelerate or hinder provision of respectful care.

Keywords: doctors, maternity care, midwives, obstetrician, perceptions, perinatal care, respectful care

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Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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Authors: Mumtaz Ahmed Sohag, Ishaq Ahmed Sohag

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Kebbi State, located in the Nort-West of Nigeria, is rich in water resources as the major rivers viz. Niger and Rima irrigate a vast majority of land. Besides, there is significant amount of groundwater, which farmers use for agriculture purpose. The groundwater is also a major source of agricultural and domestic water as wells are installed in almost all parts of the region. Although Kebbi State is rich in water, however, there are some pertinent issues which are hampering its agricultural productivity. The low lands (locally called Fadama), has spread out to a vast area. It is inundated every year during the rainy season which lasts from June to September every year. The farmers grow rice during the rainy season when water is standing. They cannot do further agricultural activity for almost two months due to high standing water. This has resulted in widespread waterlogging problem. Besides, the impact of climate change is resulting in rapid variation in river/stream flows. The information about water bodies regarding the availability of water for agricultural and other uses and the behavior of rivers at different flows is seldom available. Furthermore, sediment load (suspended and bedload) is not measured due to which land erosion cannot be countered effectively. This study, carried out in seven different irrigation regions of Kebbi state, found that diversion structures need to be constructed at some strategic locations for the supply of surface water to the farmers. The water table needs to be lowered through an effective drainage system. The monitoring of water bodies is crucial for sound data to help efficient regulation and management of water. Construction of embankments is necessary to control frequent floods in the rivers of Niger and Rima. Furthermore, farmers need capacity and awareness for participatory irrigation management.

Keywords: water bodies, floods, agriculture, waterlogging

Procedia PDF Downloads 239

Authors: Iwona Kasior

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Purpose: Pelvic organ prolapse is the descent of pelvic organs into the vaginal opening. Currently, few trials have been conducted to determine the influence of pelvic floor muscle training in decreasing stage or symptoms associated with pelvic organ prolapse. The purpose of this case study is to determine whether pelvic floor muscle training can decrease the stage of pelvic organ prolapse and related symptoms. Case Presentation: This is the case of a 55-year-old female; recently diagnosed with midline cystocele, stage three. She has undergone corrective surgery that failed. She has now resorted to managing the condition with a home exercise regimen of voluntary pelvic floor muscle contractions, topical vaginal crème prescribed by her gynecologist, and slight lifestyle modifications. Methods: The patient was treated by a physical therapist for evaluation, vaginal exam, and educated in the ‘knack’ maneuver, lifestyle modifications, and proper technique of performing pelvic floor muscle contractions. The subject continued with a home exercise program with a specific regimen of pelvic floor muscle contractions and topical vaginal crème. Outcome: As determined by her physical therapist and the subject, her pelvic floor muscle strength had increased following the pelvic floor muscle training regimen and the use of the ‘knack’ maneuver. The subject reported a small decrease in the size of bulging prolapse and related symptoms of dryness, odor, vaginal discomfort, and the sensation of descent. Conclusion: Pelvic floor muscle training helped to lessen the degree of the prolapse, but not significantly enough to decrease the diagnosed stage.

Keywords: Kegel exercises, pelvic floor, pelvic organ prolapse, physical therapy

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Authors: Saeid Gharechelou, Stuart Green, Fiona Cawkwell

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Hedgerow has an important role for a wide range of ecological habitats, landscape, agriculture management, carbon sequestration, wood production. Hedgerow detection accurately using satellite imagery is a challenging problem in remote sensing techniques, because in the special approach it is very similar to line object like a road, from a spectral viewpoint, a hedge is very similar to a forest. Remote sensors with very high spatial resolution (VHR) recently enable the automatic detection of hedges by the acquisition of images with enough spectral and spatial resolution. Indeed, recently VHR remote sensing data provided the opportunity to detect the hedgerow as line feature but still remain difficulties in monitoring the characterization in landscape scale. In this research is used the TerraSAR-x Spotlight and Staring mode with 3-5 m resolution in wet and dry season in the test site of Fermoy County, Ireland to detect the hedgerow by acquisition time of 2014-2015. Both dual polarization of Spotlight data in HH/VV is using for detection of hedgerow. The varied method of SAR image technique with try and error way by integration of classification algorithm like texture analysis, support vector machine, k-means and random forest are using to detect hedgerow and its characterization. We are applying the Shannon entropy (ShE) and backscattering analysis in single and double bounce in polarimetric analysis for processing the object-oriented classification and finally extracting the hedgerow network. The result still is in progress and need to apply the other method as well to find the best method in study area. Finally, this research is under way to ahead to get the best result and here just present the preliminary work that polarimetric image of TSX potentially can detect the hedgerow.

Keywords: TerraSAR-X, hedgerow detection, high resolution SAR image, dual polarization, polarimetric analysis

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Authors: Manar Al-Ateeq

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The building construction industry plays a major role in the economy of the word and the state of Kuwait. This paper evaluates existing new civil site engineers, describes a new system for improvement and insures the importance of prequalifying and developing for new engineers. In order to have a strong base in engineering, educational institutes and workplaces should be responsible to continuously train engineers and update them with new methods and techniques in engineering. As to achieve that, school of engineering should constantly update computational resources to be used in the professions. A survey was prepared for graduated Engineers based on stated objectives to understand the status of graduate engineers in both the public and private sector. Interviews were made with different sectors in Kuwait, and several visits were made to different training centers within different workplaces in Kuwait to evaluate training process and try to improve it. Virtual Reality (VR) technology could be applied as a complement to three-dimensional (3D) modeling, leading to better communication whether in job training, in education or in professional practice. Techniques of 3D modeling and VR can be applied to develop the models related to the construction process. The 3D models can support rehabilitation design as it can be considered as a great tool for monitoring failure and defaults in structures; also it can support decisions based on the visual analyses of alternative solutions. Therefore, teaching computer-aided design (CAD) and VR techniques in school will help engineering students in order to prepare them to site work and also will assist them to consider these technologies as important supports in their later professional practice. This teaching technique will show how the construction works developed, allow the visual simulation of progression of each type of work and help them to know more about the necessary equipment needed for tasks and how it works on site.

Keywords: three dimensional modeling (3DM), civil engineers (CE), professional practice (PP), virtual reality (VR)

Procedia PDF Downloads 179

Authors: Pabitra Sahu, M. Manohari, S. Priyadharshini, R. Santhanam, S. Chandrasekaran, B. Venkatraman

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Radiation workers of reprocessing plants have a potential for internal exposure due to actinides and fission products. Radionuclides like Americium, lead, Polonium and Europium are bone seekers and get accumulated in the skeletal part. As the major skeletal content is in the skull (13%) and knee (22%), measurements of old intake have to be carried out in the skull and knee. At the Indira Gandhi Centre for Atomic Research, a twin HPGe-based actinide monitor is used for the measurement of actinides present in bone. Efficiency estimation, which is one of the prerequisites for the quantification of radionuclides, requires anthropomorphic phantoms. Such phantoms are very limited. Hence, in this study, efficiency curves for a Twin HPGe-based actinide monitoring system are established theoretically using the FLUKA Monte Carlo method and ICRP adult male voxel phantom. In the case of skull measurement, the detector is placed over the forehead, and for knee measurement, one detector is placed over each knee. The efficiency values of radionuclides present in the knee and skull vary from 3.72E-04 to 4.19E-04 CPS/photon and 5.22E-04 to 7.07E-04 CPS/photon, respectively, for the energy range 17 to 3000keV. The efficiency curves for the measurement are established, and it is found that initially, the efficiency value increases up to 100 keV and then starts decreasing. It is found that the skull efficiency values are 4% to 63% higher than that of the knee, depending on the energy for all the energies except 17.74 keV. The reason is the closeness of the detector to the skull compared to the knee. But for 17.74 keV the efficiency of the knee is more than the skull due to the higher attenuation caused in the skull bones because of its greater thickness. The Minimum Detectable Activity (MDA) for 241Am present in the skull and knee is 9 Bq. 239Pu has a MDA of 950 Bq and 1270 Bq for knee and skull, respectively, for a counting time of 1800 sec. This paper discusses the simulation method and the results obtained in the study.

Keywords: FLUKA Monte Carlo Method, ICRP adult male voxel phantom, knee, Skull.

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Authors: Luksanaporn Krungkraipetch

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Pterygium is a frequent ocular surface lesion that begins in the limbal conjunctiva within the palpebral fissure and spreads to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a wing-like aspect. Indications for surgery, in decreasing order of significance, are growth over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and esthetic concerns. The aim of this study is twofold: first, to determine the frequency of pterygium recurrence after surgery at the mentioned hospital, and second, to identify the factors that influence the recurrence of pterygium. The research design is a retrospective examination of 164 patient samples in an eastern Thai university hospital (Code 13766). Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium, and for factor analysis, the inferential statistics chi-square and ANOVA are utilized. Twenty-four of the 164 patients who underwent surgery exhibited recurrent pterygium. Consequently, the incidence of recurrent pterygium after surgery was 14.6%. There were an equal number of men and women present. The participants' ages ranged from 41 to 60 years (62, 8 percent). According to the findings, the majority of patients were female (60.4%), over the age of 60 (51.2%), did not live near the beach (83.5%), did not have an underlying disease (92.1%), and 95.7% did not have any other eye problems. Gender (X² = 1.26, p = .289), age (X² = 5.86, p = .119), an address near the sea (X² = 3.30, p = .081)), underlying disease (X² = 0.54, p = .694), and eye disease (X² = 0.00, p = 1.00) had no effect on pterygium recurrence. Recurrences occurred in 79.1% of all surgical procedures and 11.6% of all patients using the bare sclera technique. The recurrence rate for conjunctival autografts was 20.9% for all procedures and 3.0% for all participants. Mitomycin-C and amniotic membrane transplant techniques had no recurrence following surgery. Comparing the surgeries done on people with recurrent pterygium did not show anything important (F = 1.13, p = 0.339). In conclusion, the prevalence of pterygium recurrence following pterygium, 14.6%, does not differ from earlier research. Underlying disease, other eye conditions, and surgical procedures such as pterygium recurrence are unaffected by pterygium surgery.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Danila Zuffetti, Lorenzo Chiesa

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Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.

Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease

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Authors: M. Doyeni, S. Suproniene, V. Tilvikiene

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Agricultural wastes contribute significantly to global climate change through greenhouse gas emissions if not adequately recycled and sustainably managed. A recurring agricultural waste is livestock wastes that have consistently served as feedstock for biogas systems. The objective of this study was to access the influence of digestate fertilization on soil microbial activity and greenhouse gas emissions in agricultural fields. Wheat (Triticum spp. L.) was fertilized with different types of animal wastes digestates (organic fertilizers) and mineral nitrogen (inorganic fertilizer) for three years. The 170 kg N ha⁻¹ presented in digestates were split fertilized at an application rate of 90 and 80 kg N ha⁻¹. The soil microorganism activity could be predicted significantly using the dehydrogenase activity and soil microbial biomass carbon. By combining the two different monitoring approaches, the different methods applied in this study were sensitive to enzymatic activities and organic carbon in the living component of the soil organic matter. The emissions of greenhouse gasses (carbon dioxide (CO₂), methane (CH₄), and nitrous oxide (N₂O) were monitored directly by a static chamber system. The soil and environmental variables were measured to determine their influence on greenhouse gas emissions. Emission peaks was observed in N₂O and CO₂ after the first application of fertilizers with the emissions flattening out over the cultivating season while CH₄ emission was negligible with no apparent patterns observed. Microbial biomass carbon and dehydrogenase activity were affected by the fertilized organic digestates. A significant difference was recorded between the control and the digestate treated soils for the microbial biomass carbon and dehydrogenase. Results also showed individual and cumulative emissions of CO₂, CH₄ and N₂O from the digestates were relatively low suggesting the digestate fertilization can be an efficient method for improving soil quality and reducing greenhouse gases from agricultural sources in temperate climate conditions.

Keywords: greenhouse gas emission, manure digestate, soil microbial activity, yield

Procedia PDF Downloads 138