Search results for: automatic emergency braking system
18032 Automatic Detection and Update of Region of Interest in Vehicular Traffic Surveillance Videos
Authors: Naydelis Brito Suárez, Deni Librado Torres Román, Fernando Hermosillo Reynoso
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Automatic detection and generation of a dynamic ROI (Region of Interest) in vehicle traffic surveillance videos based on a static camera in Intelligent Transportation Systems is challenging for computer vision-based systems. The dynamic ROI, being a changing ROI, should capture any other moving object located outside of a static ROI. In this work, the video is represented by a Tensor model composed of a Background and a Foreground Tensor, which contains all moving vehicles or objects. The values of each pixel over a time interval are represented by time series, and some pixel rows were selected. This paper proposes a pixel entropy-based algorithm for automatic detection and generation of a dynamic ROI in traffic videos under the assumption of two types of theoretical pixel entropy behaviors: (1) a pixel located at the road shows a high entropy value due to disturbances in this zone by vehicle traffic, (2) a pixel located outside the road shows a relatively low entropy value. To study the statistical behavior of the selected pixels, detecting the entropy changes and consequently moving objects, Shannon, Tsallis, and Approximate entropies were employed. Although Tsallis entropy achieved very high results in real-time, Approximate entropy showed results slightly better but in greater time.Keywords: convex hull, dynamic ROI detection, pixel entropy, time series, moving objects
Procedia PDF Downloads 6818031 Emergency Department Utilisation of Older People Presenting to Four Emergency Departments
Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis
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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.Keywords: chronic, older person, aged care, emergency department
Procedia PDF Downloads 22818030 Moral Obligation as a Governor to Skeptical Theism's Relativism
Authors: Peter J. Morgan
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In response to evidential arguments from evil, Stephen Wykstra presents CORNEA (Condition of Reasonable Epistemic Access) as a foundational principle for Skeptical Theism which urges one to think in terms of what can be expected in a given situation. The use of CORNEA results in skepticism regarding the ability of human ken to know divine levels of knowledge in instances of intense evil. However, William Rowe presents a critique of Skeptical Theism that questions its ability to argue successfully for theism. Rowe contends that siding with Skeptical Theism is akin to boarding a trolley car that does not stop. Contra Wykstra, Rowe observes that, for all that can be known, there could be greater amounts of evils than goods, and the goods that are seen may not be the best possible goods. This amounts to a mortally challenging critique of Skeptical Theism. However, there is a brake on Rowe’s Trolley. This paper makes the argument that the ubiquitous presence of Moral Obligation (MO) serves as a braking system for Rowe’s Trolley. When the rider begins to feel lost in an epistemic stalemate of good and evil it is MO that turns the tide: MO serves as evidence towards the good on a basic human level, and it is a reminder that God’s character will result in actions towards the good.Keywords: CORNEA, moral obligation, problem of evil, skeptical theism
Procedia PDF Downloads 20118029 The Use of Information and Communication Technology within and between Emergency Medical Teams during a Disaster: A Qualitative study
Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon
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In a disaster event, sharing patient information between the pre-hospital Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre- EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors that are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality, and the data were analyzed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system that can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analyzed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospital staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.Keywords: emergency medical teams, communication, information and communication technologies, disaster
Procedia PDF Downloads 12118028 Global Solar Irradiance: Data Imputation to Analyze Complementarity Studies of Energy in Colombia
Authors: Jeisson A. Estrella, Laura C. Herrera, Cristian A. Arenas
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The Colombian electricity sector has been transforming through the insertion of new energy sources to generate electricity, one of them being solar energy, which is being promoted by companies interested in photovoltaic technology. The study of this technology is important for electricity generation in general and for the planning of the sector from the perspective of energy complementarity. Precisely in this last approach is where the project is located; we are interested in answering the concerns about the reliability of the electrical system when climatic phenomena such as El Niño occur or in defining whether it is viable to replace or expand thermoelectric plants. Reliability of the electrical system when climatic phenomena such as El Niño occur, or to define whether it is viable to replace or expand thermoelectric plants with renewable electricity generation systems. In this regard, some difficulties related to the basic information on renewable energy sources from measured data must first be solved, as these come from automatic weather stations. Basic information on renewable energy sources from measured data, since these come from automatic weather stations administered by the Institute of Hydrology, Meteorology and Environmental Studies (IDEAM) and, in the range of study (2005-2019), have significant amounts of missing data. For this reason, the overall objective of the project is to complete the global solar irradiance datasets to obtain time series to develop energy complementarity analyses in a subsequent project. Global solar irradiance data sets to obtain time series that will allow the elaboration of energy complementarity analyses in the following project. The filling of the databases will be done through numerical and statistical methods, which are basic techniques for undergraduate students in technical areas who are starting out as researchers technical areas who are starting out as researchers.Keywords: time series, global solar irradiance, imputed data, energy complementarity
Procedia PDF Downloads 6518027 A Proposed Framework for Software Redocumentation Using Distributed Data Processing Techniques and Ontology
Authors: Laila Khaled Almawaldi, Hiew Khai Hang, Sugumaran A. l. Nallusamy
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Legacy systems are crucial for organizations, but their intricacy and lack of documentation pose challenges for maintenance and enhancement. Redocumentation of legacy systems is vital for automatically or semi-automatically creating documentation for software lacking sufficient records. It aims to enhance system understandability, maintainability, and knowledge transfer. However, existing redocumentation methods need improvement in data processing performance and document generation efficiency. This stems from the necessity to efficiently handle the extensive and complex code of legacy systems. This paper proposes a method for semi-automatic legacy system re-documentation using semantic parallel processing and ontology. Leveraging parallel processing and ontology addresses current challenges by distributing the workload and creating documentation with logically interconnected data. The paper outlines challenges in legacy system redocumentation and suggests a method of redocumentation using parallel processing and ontology for improved efficiency and effectiveness.Keywords: legacy systems, redocumentation, big data analysis, parallel processing
Procedia PDF Downloads 3718026 Exploring Factors Influencing Orthopedic Patients' Willingness to Recommend a Hospital: Insights from a Cross-Sectional Survey
Authors: Merav Ben Natan, David Maman, Milana Avramov, Galina Shamilov, Yaron Berkovich
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Introduction: Patient satisfaction and the willingness to recommend a hospital are vital for improving healthcare quality. This study examines orthopedic patients to identify factors influencing their willingness to recommend the hospital. Aim: This study to explore the demographic and clinical variables affecting orthopedic patients' willingness to recommend the hospital and to understand the role of patient satisfaction in this context. Methods: A cross-sectional survey was conducted with 200 orthopedic patients hospitalized between July and December 2023 in north-central Israel. Data were analyzed to assess the impact of various factors on the willingness to recommend the hospital. Results: Age was positively associated with the willingness to recommend (OR=2.44), while the length of stay in the Emergency Department negatively impacted this willingness (OR=0.58). Satisfaction with hospital care had a positive effect on willingness to recommend (OR=1.96). Gender, comorbidities, and total hospital stay length did not significantly influence willingness to recommend. Conclusions: Satisfaction with hospital care and the length of Emergency Department stays are crucial factors affecting orthopedic patients' willingness to recommend the hospital. This underscores the need for strategies to improve patient experiences and address delays in the Emergency Department. The findings offer valuable insights for healthcare providers and policymakers.Keywords: orthopedic patients, patient satisfaction, willingness to recommend, hospital recommendation
Procedia PDF Downloads 1318025 Enhanced Arabic Semantic Information Retrieval System Based on Arabic Text Classification
Authors: A. Elsehemy, M. Abdeen , T. Nazmy
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Since the appearance of the Semantic web, many semantic search techniques and models were proposed to exploit the information in ontology to enhance the traditional keyword-based search. Many advances were made in languages such as English, German, French and Spanish. However, other languages such as Arabic are not fully supported yet. In this paper we present a framework for ontology based information retrieval for Arabic language. Our system consists of four main modules, namely query parser, indexer, search and a ranking module. Our approach includes building a semantic index by linking ontology concepts to documents, including an annotation weight for each link, to be used in ranking the results. We also augmented the framework with an automatic document categorizer, which enhances the overall document ranking. We have built three Arabic domain ontologies: Sports, Economic and Politics as example for the Arabic language. We built a knowledge base that consists of 79 classes and more than 1456 instances. The system is evaluated using the precision and recall metrics. We have done many retrieval operations on a sample of 40,316 documents with a size 320 MB of pure text. The results show that the semantic search enhanced with text classification gives better performance results than the system without classification.Keywords: Arabic text classification, ontology based retrieval, Arabic semantic web, information retrieval, Arabic ontology
Procedia PDF Downloads 51918024 A Methodology for Automatic Diversification of Document Categories
Authors: Dasom Kim, Chen Liu, Myungsu Lim, Su-Hyeon Jeon, ByeoungKug Jeon, Kee-Young Kwahk, Namgyu Kim
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Recently, numerous documents including unstructured data and text have been created due to the rapid increase in the usage of social media and the Internet. Each document is usually provided with a specific category for the convenience of the users. In the past, the categorization was performed manually. However, in the case of manual categorization, not only can the accuracy of the categorization be not guaranteed but the categorization also requires a large amount of time and huge costs. Many studies have been conducted towards the automatic creation of categories to solve the limitations of manual categorization. Unfortunately, most of these methods cannot be applied to categorizing complex documents with multiple topics because the methods work by assuming that one document can be categorized into one category only. In order to overcome this limitation, some studies have attempted to categorize each document into multiple categories. However, they are also limited in that their learning process involves training using a multi-categorized document set. These methods therefore cannot be applied to multi-categorization of most documents unless multi-categorized training sets are provided. To overcome the limitation of the requirement of a multi-categorized training set by traditional multi-categorization algorithms, we previously proposed a new methodology that can extend a category of a single-categorized document to multiple categorizes by analyzing relationships among categories, topics, and documents. In this paper, we design a survey-based verification scenario for estimating the accuracy of our automatic categorization methodology.Keywords: big data analysis, document classification, multi-category, text mining, topic analysis
Procedia PDF Downloads 26518023 e-Learning Security: A Distributed Incident Response Generator
Authors: Bel G Raggad
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An e-Learning setting is a distributed computing environment where information resources can be connected to any public network. Public networks are very unsecure which can compromise the reliability of an e-Learning environment. This study is only concerned with the intrusion detection aspect of e-Learning security and how incident responses are planned. The literature reported great advances in intrusion detection system (ids) but neglected to study an important ids weakness: suspected events are detected but an intrusion is not determined because it is not defined in ids databases. We propose an incident response generator (DIRG) that produces incident responses when the working ids system suspects an event that does not correspond to a known intrusion. Data involved in intrusion detection when ample uncertainty is present is often not suitable to formal statistical models including Bayesian. We instead adopt Dempster and Shafer theory to process intrusion data for the unknown event. The DIRG engine transforms data into a belief structure using incident scenarios deduced by the security administrator. Belief values associated with various incident scenarios are then derived and evaluated to choose the most appropriate scenario for which an automatic incident response is generated. This article provides a numerical example demonstrating the working of the DIRG system.Keywords: decision support system, distributed computing, e-Learning security, incident response, intrusion detection, security risk, statefull inspection
Procedia PDF Downloads 42918022 Impact of Emergency Medicine Department Crowding on Mortality
Authors: Morteza Gharibi, Abdolghader Pakniat, Somayeh Bahrampouri
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Introduction: Emergency department (E.R.) crowding is a serious widespread problem in hospitals that leads to irregularities, a slower rate of delivery of services to patients, and a long-term stay. In addition, the long-term stay in the E.D. reduces the possibility of providing services with appropriate quality to other patients who are undergoing medical emergencies, which leads to dissatisfaction among patients. This study aimed to determine the relationship between ED-crowding and the mortality rate of the patients referred to the E.D. In a retrospective cohort study, all patients who expired in first 24 hours of admission were enrolled in the study. Crowding index at the moment of admission was calculated using Edwin Score. The data including history and physical examination, time of arrival in the E.D., diagnosis (using ICD 10 code), time of death, cause of death, demographic information was recoded based on triage forms on admission and patients’ medical files. Data analysis was performed by using descriptive statistics and chi square test, ANOVA tests using SPSS ver. 19. The time of arrival in E.D. to death in crowded E.D. conditions, with an average of five hours and 25 minutes, was significantly higher than the average admission Time of arrival in E.D. to death in active and crowded E.D. conditions. More physicians and nurses can be employed during crowded times to reduce staff fatigue and improve their performance during these hours.Keywords: mortality, emergency, department, crowding
Procedia PDF Downloads 8818021 Creation of Computerized Benchmarks to Facilitate Preparedness for Biological Events
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Introduction: Communicable diseases and pandemics pose a growing threat to the well-being of the global population. A vital component of protecting the public health is the creation and sustenance of a continuous preparedness for such hazards. A joint Israeli-German task force was deployed in order to develop an advanced tool for self-evaluation of emergency preparedness for variable types of biological threats. Methods: Based on a comprehensive literature review and interviews with leading content experts, an evaluation tool was developed based on quantitative and qualitative parameters and indicators. A modified Delphi process was used to achieve consensus among over 225 experts from both Germany and Israel concerning items to be included in the evaluation tool. Validity and applicability of the tool for medical institutions was examined in a series of simulation and field exercises. Results: Over 115 German and Israeli experts reviewed and examined the proposed parameters as part of the modified Delphi cycles. A consensus of over 75% of experts was attained for 183 out of 188 items. The relative importance of each parameter was rated as part of the Delphi process, in order to define its impact on the overall emergency preparedness. The parameters were integrated in computerized web-based software that enables to calculate scores of emergency preparedness for biological events. Conclusions: The parameters developed in the joint German-Israeli project serve as benchmarks that delineate actions to be implemented in order to create and maintain an ongoing preparedness for biological events. The computerized evaluation tool enables to continuously monitor the level of readiness and thus strengths and gaps can be identified and corrected appropriately. Adoption of such a tool is recommended as an integral component of quality assurance of public health and safety.Keywords: biological events, emergency preparedness, bioterrorism, natural biological events
Procedia PDF Downloads 41818020 The Usefulness of Medical Scribes in the Emengecy Department
Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani
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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.Keywords: emergency medicine, medical scribe, scribe, documentation
Procedia PDF Downloads 8718019 E-Governance: A Key for Improved Public Service Delivery
Authors: Ayesha Akbar
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Public service delivery has witnessed a significant improvement with the integration of information communication technology (ICT). It not only improves management structure with advanced technology for surveillance of service delivery but also provides evidence for informed decisions and policy. Pakistan’s public sector organizations have not been able to produce some good results to ensure service delivery. Notwithstanding, some of the public sector organizations in Pakistan has diffused modern technology and proved their credence by providing better service delivery standards. These good indicators provide sound basis to integrate technology in public sector organizations and shift of policy towards evidence based policy making. Rescue-1122 is a public sector organization which provides emergency services and proved to be a successful model for the provision of service delivery to save human lives and to ensure human development in Pakistan. The information about the organization has been received by employing qualitative research methodology. The information is broadly based on primary and secondary sources which includes Rescue-1122 website, official reports of organizations; UNDP (United Nation Development Program), WHO (World Health Organization) and by conducting 10 in-depth interviews with the high administrative staff of organizations who work in the Lahore offices. The information received has been incorporated with the study for the better understanding of the organization and their management procedures. Rescue-1122 represents a successful model in delivering the services in an efficient way to deal with the disaster management. The management of Rescue has strategized the policies and procedures in such a way to develop a comprehensive model with the integration of technology. This model provides efficient service delivery as well as maintains the standards of the organization. The service delivery model of rescue-1122 works on two fronts; front-office interface and the back-office interface. Back-office defines the procedures of operations and assures the compliance of the staff whereas, front-office equipped with the latest technology and good infrastructure handles the emergency calls. Both ends are integrated with satellite based vehicle tracking, wireless system, fleet monitoring system and IP camera which monitors every move of the staff to provide better services and to pinpoint the distortions in the services. The standard time of reaching to the emergency spot is 7 minutes, and during entertaining the case; driver‘s behavior, traffic volume and the technical assistance being provided to the emergency case is being monitored by front-office. Then the whole information get uploaded to the main dashboard of Lahore headquarter from the provincial offices. The latest technology is being materialized by Rescue-1122 for delivering the efficient services, investigating the flaws; if found, and to develop data to make informed decision making. The other public sector organizations of Pakistan can also develop such models to integrate technology for improving service delivery and to develop evidence for informed decisions and policy making.Keywords: data, e-governance, evidence, policy
Procedia PDF Downloads 23718018 Latest Generation Conducted Electrical Weapon Dart Design: Signature Marking and Removal for the Emergency Medicine Professional
Authors: J. D. Ho, D. M. Dawes, B. Driver
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Introduction: TASER Conducted Electrical Weapons (CEWs) are the dominant CEWs in use and have been used in modern police and military operations since the late 1990s as a form of non-lethal weaponry. The 3rd generation of CEWs has been recently introduced and is known as The TASER 7. This new CEW will be replacing current CEW technology and has a new dart design that is important for emergency medical professionals to be familiar with because it requires a different method of removal and will leave a different marking pattern in human tissue than they may have been previously familiar with. features of this new dart design include: higher velocity impact, larger impact surface area, break away dart body segment, dual back-barb retention, newly designed removal process. As the TASER 7 begins to be deployed by the police and military personnel, these new features make it imperative that emergency medical professionals become familiar with the signature markings that this new dart design will make on human tissue and how to remove them. Methods: Multiple observational studies using high speed photography were used to record impact patterns of the new dart design on fresh tissue and also the newly recommended dart removal process. Both animal and human subjects were used to test this dart design prior to production release. Results: Data presented will include dart design overview, flight pattern accuracy, impact analysis, and dart removal example. Tissue photographs will be presented to demonstrate examples of signature TASER 7 dart markings that emergency medical professionals can expect to see. Conclusion: This work will provide the reader with an understanding of this newest generation CEW dart design, its key features, its signature marking pattern that can be expected and a recommendation of how to remove it from human tissue.Keywords: TASER 7, conducted electrical weapon, dart mark, dart removal
Procedia PDF Downloads 14918017 An Automatic Feature Extraction Technique for 2D Punch Shapes
Authors: Awais Ahmad Khan, Emad Abouel Nasr, H. M. A. Hussein, Abdulrahman Al-Ahmari
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Sheet-metal parts have been widely applied in electronics, communication and mechanical industries in recent decades; but the advancement in sheet-metal part design and manufacturing is still behind in comparison with the increasing importance of sheet-metal parts in modern industry. This paper presents a methodology for automatic extraction of some common 2D internal sheet metal features. The features used in this study are taken from Unipunch ™ catalogue. The extraction process starts with the data extraction from STEP file using an object oriented approach and with the application of suitable algorithms and rules, all features contained in the catalogue are automatically extracted. Since the extracted features include geometry and engineering information, they will be effective for downstream application such as feature rebuilding and process planning.Keywords: feature extraction, internal features, punch shapes, sheet metal
Procedia PDF Downloads 60718016 Automatic Identification of Pectoral Muscle
Authors: Ana L. M. Pavan, Guilherme Giacomini, Allan F. F. Alves, Marcela De Oliveira, Fernando A. B. Neto, Maria E. D. Rosa, Andre P. Trindade, Diana R. De Pina
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Mammography is a worldwide image modality used to diagnose breast cancer, even in asymptomatic women. Due to its large availability, mammograms can be used to measure breast density and to predict cancer development. Women with increased mammographic density have a four- to sixfold increase in their risk of developing breast cancer. Therefore, studies have been made to accurately quantify mammographic breast density. In clinical routine, radiologists perform image evaluations through BIRADS (Breast Imaging Reporting and Data System) assessment. However, this method has inter and intraindividual variability. An automatic objective method to measure breast density could relieve radiologist’s workload by providing a first aid opinion. However, pectoral muscle is a high density tissue, with similar characteristics of fibroglandular tissues. It is consequently hard to automatically quantify mammographic breast density. Therefore, a pre-processing is needed to segment the pectoral muscle which may erroneously be quantified as fibroglandular tissue. The aim of this work was to develop an automatic algorithm to segment and extract pectoral muscle in digital mammograms. The database consisted of thirty medio-lateral oblique incidence digital mammography from São Paulo Medical School. This study was developed with ethical approval from the authors’ institutions and national review panels under protocol number 3720-2010. An algorithm was developed, in Matlab® platform, for the pre-processing of images. The algorithm uses image processing tools to automatically segment and extract the pectoral muscle of mammograms. Firstly, it was applied thresholding technique to remove non-biological information from image. Then, the Hough transform is applied, to find the limit of the pectoral muscle, followed by active contour method. Seed of active contour is applied in the limit of pectoral muscle found by Hough transform. An experienced radiologist also manually performed the pectoral muscle segmentation. Both methods, manual and automatic, were compared using the Jaccard index and Bland-Altman statistics. The comparison between manual and the developed automatic method presented a Jaccard similarity coefficient greater than 90% for all analyzed images, showing the efficiency and accuracy of segmentation of the proposed method. The Bland-Altman statistics compared both methods in relation to area (mm²) of segmented pectoral muscle. The statistic showed data within the 95% confidence interval, enhancing the accuracy of segmentation compared to the manual method. Thus, the method proved to be accurate and robust, segmenting rapidly and freely from intra and inter-observer variability. It is concluded that the proposed method may be used reliably to segment pectoral muscle in digital mammography in clinical routine. The segmentation of the pectoral muscle is very important for further quantifications of fibroglandular tissue volume present in the breast.Keywords: active contour, fibroglandular tissue, hough transform, pectoral muscle
Procedia PDF Downloads 34518015 Population Dynamics and Land Use/Land Cover Change on the Chilalo-Galama Mountain Range, Ethiopia
Authors: Yusuf Jundi Sado
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Changes in land use are mostly credited to human actions that result in negative impacts on biodiversity and ecosystem functions. This study aims to analyze the dynamics of land use and land cover changes for sustainable natural resources planning and management. Chilalo-Galama Mountain Range, Ethiopia. This study used Thematic Mapper 05 (TM) for 1986, 2001 and Landsat 8 (OLI) data 2017. Additionally, data from the Central Statistics Agency on human population growth were analyzed. Semi-Automatic classification plugin (SCP) in QGIS 3.2.3 software was used for image classification. Global positioning system, field observations and focus group discussions were used for ground verification. Land Use Land Cover (LU/LC) change analysis was using maximum likelihood supervised classification and changes were calculated for the 1986–2001 and the 2001–2017 and 1986-2017 periods. The results show that agricultural land increased from 27.85% (1986) to 44.43% and 51.32% in 2001 and 2017, respectively with the overall accuracies of 92% (1986), 90.36% (2001), and 88% (2017). On the other hand, forests decreased from 8.51% (1986) to 7.64 (2001) and 4.46% (2017), and grassland decreased from 37.47% (1986) to 15.22%, and 15.01% in 2001 and 2017, respectively. It indicates for the years 1986–2017 the largest area cover gain of agricultural land was obtained from grassland. The matrix also shows that shrubland gained land from agricultural land, afro-alpine, and forest land. Population dynamics is found to be one of the major driving forces for the LU/LU changes in the study area.Keywords: Landsat, LU/LC change, Semi-Automatic classification plugin, population dynamics, Ethiopia
Procedia PDF Downloads 7818014 Automatic Speech Recognition Systems Performance Evaluation Using Word Error Rate Method
Authors: João Rato, Nuno Costa
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The human verbal communication is a two-way process which requires a mutual understanding that will result in some considerations. This kind of communication, also called dialogue, besides the supposed human agents it can also be performed between human agents and machines. The interaction between Men and Machines, by means of a natural language, has an important role concerning the improvement of the communication between each other. Aiming at knowing the performance of some speech recognition systems, this document shows the results of the accomplished tests according to the Word Error Rate evaluation method. Besides that, it is also given a set of information linked to the systems of Man-Machine communication. After this work has been made, conclusions were drawn regarding the Speech Recognition Systems, among which it can be mentioned their poor performance concerning the voice interpretation in noisy environments.Keywords: automatic speech recognition, man-machine conversation, speech recognition, spoken dialogue systems, word error rate
Procedia PDF Downloads 31618013 Examining the Impact of De-Escalation Training among Emergency Department Nurses
Authors: Jonathan D. Recchi
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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.Keywords: de-escalation, nursing, emergency department, workplace violence
Procedia PDF Downloads 9818012 A System for Preventing Inadvertent Exposition of Staff Present outside the Operating Theater: Description and Clinical Test
Authors: Aya Al Masri, Kamel Guerchouche, Youssef Laynaoui, Safoin Aktaou, Malorie Martin, Fouad Maaloul
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Introduction: Mobile C-arms move throughout operating rooms of the operating theater. Being designed to move between rooms, they are not equipped with relays to retrieve the exposition information and export it outside the room. Therefore, no light signaling is available outside the room to warn the X-ray emission for staff. Inadvertent exposition of staff outside the operating theater is a real problem for radiation protection. The French standard NFC 15-160 require that: (1) access to any room containing an X-ray emitting device must be controlled by a light signage so that it cannot be inadvertently crossed, and (2) setting up an emergency button to stop the X-ray emission. This study presents a system that we developed to meet these requirements and the results of its clinical test. Materials and methods: The system is composed of two communicating boxes: o The "DetectBox" is to be installed inside the operating theater. It identifies the various operation states of the C-arm by analyzing its power supply signal. The DetectBox communicates (in wireless mode) with the second box (AlertBox). o The "AlertBox" can operate in socket or battery mode and is to be installed outside the operating theater. It detects and reports the state of the C-arm by emitting a real time light signal. This latter can have three different colors: red when the C-arm is emitting X-rays, orange when it is powered on but does not emit X-rays, and green when it is powered off. The two boxes communicate on a radiofrequency link exclusively carried out in the ‘Industrial, Scientific and Medical (ISM)’ frequency bands and allows the coexistence of several on-site warning systems without communication conflicts (interference). Taking into account the complexity of performing electrical works in the operating theater (for reasons of hygiene and continuity of medical care), this system (having a size <10 cm²) works in complete safety without any intrusion in the mobile C-arm and does not require specific electrical installation work. The system is equipped with emergency button that stops X-ray emission. The system has been clinically tested. Results: The clinical test of the system shows that: it detects X-rays having both high and low energy (50 – 150 kVp), high and low photon flow (0.5 – 200 mA: even when emitted for a very short time (<1 ms)), Probability of false detection < 10-5, it operates under all acquisition modes (continuous, pulsed, fluoroscopy mode, image mode, subtraction and movie mode), it is compatible with all C-arm models and brands. We have also tested the communication between the two boxes (DetectBox and AlertBox) in several conditions: (1) Unleaded room, (2) leaded room, and (3) rooms with particular configuration (sas, great distances, concrete walls, 3 mm of lead). The result of these last tests was positive. Conclusion: This system is a reliable tool to alert the staff present outside the operating room for X-ray emission and insure their radiation protection.Keywords: Clinical test, Inadvertent staff exposition, Light signage, Operating theater
Procedia PDF Downloads 12018011 Application to Monitor the Citizens for Corona and Get Medical Aids or Assistance from Hospitals
Authors: Vathsala Kaluarachchi, Oshani Wimalarathna, Charith Vandebona, Gayani Chandrarathna, Lakmal Rupasinghe, Windhya Rankothge
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It is the fundamental function of a monitoring system to allow users to collect and process data. A worldwide threat, the corona outbreak has wreaked havoc in Sri Lanka, and the situation has gotten out of hand. Since the epidemic, the Sri Lankan government has been unable to establish a systematic system for monitoring corona patients and providing emergency care in the event of an outbreak. Most patients have been held at home because of the high number of patients reported in the nation, but they do not yet have access to a functioning medical system. It has resulted in an increase in the number of patients who have been left untreated because of a lack of medical care. The absence of competent medical monitoring is the biggest cause of mortality for many people nowadays, according to our survey. As a result, a smartphone app for analyzing the patient's state and determining whether they should be hospitalized will be developed. Using the data supplied, we are aiming to send an alarm letter or SMS to the hospital once the system recognizes them. Since we know what those patients need and when they need it, we will put up a desktop program at the hospital to monitor their progress. Deep learning, image processing and application development, natural language processing, and blockchain management are some of the components of the research solution. The purpose of this research paper is to introduce a mechanism to connect hospitals and patients even when they are physically apart. Further data security and user-friendliness are enhanced through blockchain and NLP.Keywords: blockchain, deep learning, NLP, monitoring system
Procedia PDF Downloads 12818010 Sensing to Respond & Recover in Emergency
Authors: Alok Kumar, Raviraj Patil
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The ability to respond to an incident of a disastrous event in a vulnerable area is very crucial an aspect of emergency management. The ability to constantly predict the likelihood of an event along with its severity in an area and react to those significant events which are likely to have a high impact allows the authorities to respond by allocating resources optimally in a timely manner. It provides for measuring, monitoring, and modeling facilities that integrate underlying systems into one solution to improve operational efficiency, planning, and coordination. We were particularly involved in this innovative incubation work on the current state of research and development in collaboration. technologies & systems for a disaster.Keywords: predictive analytics, advanced analytics, area flood likelihood model, area flood severity model, level of impact model, mortality score, economic loss score, resource allocation, crew allocation
Procedia PDF Downloads 31418009 A Comparative Analysis of Evacuation Behavior in Case of Cyclone Sidr, Typhoon Yolanda and the Great East Japan Earthquake
Authors: Swarnali Chakma, Akihiko Hokugo
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Research on three case studies reviewed here explains many aspects and complications of evacuation behavior during an emergency period. The scenario and phenomenon of the disaster were different, but the similarities are that after receiving the warning peoples does not take it seriously. Many individuals evacuated after taking some kind of action, for example; return to home, searching for family members, prepared valuable things etc. Based on a review of the literature, the data identified a number of factors that help explain evacuation behavior during the disaster. In the case of Japan, cultural inhibitors impact people’s behavior; for example, following the traffic rules, some people lost their time to skip because of the slow-moving car makes overcrowded traffic and some of them were washed away by the tsunami. In terms of Bangladeshi culture, women did not want to evacuate without men because staying men and women who do not know each other under the same roof together is not regular practice or comfortable. From these three case studies, it is observed that early warning plays an important role in cyclones, typhoons and earthquakes. A high level of trust from residents in the warning system is important to real evacuation. It is necessary to raise awareness of disaster and provide information on the vulnerability to cyclones, typhoons and earthquakes hazards at community levels. The local level may help decision makers and other stakeholders to make a better decision regarding an effective disaster management.Keywords: disaster management, emergency period, evacuation, shelter, typhoon
Procedia PDF Downloads 15318008 Automatic LV Segmentation with K-means Clustering and Graph Searching on Cardiac MRI
Authors: Hae-Yeoun Lee
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Quantification of cardiac function is performed by calculating blood volume and ejection fraction in routine clinical practice. However, these works have been performed by manual contouring,which requires computational costs and varies on the observer. In this paper, an automatic left ventricle segmentation algorithm on cardiac magnetic resonance images (MRI) is presented. Using knowledge on cardiac MRI, a K-mean clustering technique is applied to segment blood region on a coil-sensitivity corrected image. Then, a graph searching technique is used to correct segmentation errors from coil distortion and noises. Finally, blood volume and ejection fraction are calculated. Using cardiac MRI from 15 subjects, the presented algorithm is tested and compared with manual contouring by experts to show outstanding performance.Keywords: cardiac MRI, graph searching, left ventricle segmentation, K-means clustering
Procedia PDF Downloads 39318007 Implementation of Smart Card Automatic Fare Collection Technology in Small Transit Agencies for Standards Development
Authors: Walter E. Allen, Robert D. Murray
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Many large transit agencies have adopted RFID technology and electronic automatic fare collection (AFC) or smart card systems, but small and rural agencies remain tied to obsolete manual, cash-based fare collection. Small countries or transit agencies can benefit from the implementation of smart card AFC technology with the promise of increased passenger convenience, added passenger satisfaction and improved agency efficiency. For transit agencies, it reduces revenue loss, improves passenger flow and bus stop data. For countries, further implementation into security, distribution of social services or currency transactions can provide greater benefits. However, small countries or transit agencies cannot afford expensive proprietary smart card solutions typically offered by the major system suppliers. Deployment of Contactless Fare Media System (CFMS) Standard eliminates the proprietary solution, ultimately lowering the cost of implementation. Acumen Building Enterprise, Inc. chose the Yuma County Intergovernmental Public Transportation Authority (YCIPTA) existing proprietary YCAT smart card system to implement CFMS. The revised system enables the purchase of fare product online with prepaid debit or credit cards using the Payment Gateway Processor. Open and interoperable smart card standards for transit have been developed. During the 90-day Pilot Operation conducted, the transit agency gathered the data from the bus AcuFare 200 Card Reader, loads (copies) the data to a USB Thumb Drive and uploads the data to the Acumen Host Processing Center for consolidation of the data into the transit agency master data file. The transition from the existing proprietary smart card data format to the new CFMS smart card data format was transparent to the transit agency cardholders. It was proven that open standards and interoperability design can work and reduce both implementation and operational costs for small transit agencies or countries looking to expand smart card technology. Acumen was able to avoid the implementation of the Payment Card Industry (PCI) Data Security Standards (DSS) which is expensive to develop and costly to operate on a continuing basis. Due to the substantial additional complexities of implementation and the variety of options presented to the transit agency cardholder, Acumen chose to implement only the Directed Autoload. To improve the implementation efficiency and the results for a similar undertaking, it should be considered that some passengers lack credit cards and are averse to technology. There are more than 1,300 small and rural agencies in the United States. This grows by 10 fold when considering small countries or rural locations throughout Latin American and the world. Acumen is evaluating additional countries, sites or transit agency that can benefit from the smart card systems. Frequently, payment card systems require extensive security procedures for implementation. The Project demonstrated the ability to purchase fare value, rides and passes with credit cards on the internet at a reasonable cost without highly complex security requirements.Keywords: automatic fare collection, near field communication, small transit agencies, smart cards
Procedia PDF Downloads 27418006 Analysis of Information Sharing and Capacity Constraint on Backlog Bullwhip Effect in Two Level Supply Chain
Authors: Matloub Hussaina
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This paper investigates the impact of information sharing and capacity constraints on backlog bullwhip effect of Automatic Pipe Line Inventory and Order Based Production Control System (APIOBPCS). System dynamic simulation using iThink Software has been applied. It has been found that smooth ordering by Tier 1 can be achieved when Tier 1 has medium capacity constraints. Simulation experiments also show that information sharing helps to reduce 50% of backlog bullwhip effect in capacitated supply chains. This knowledge is of value per se, giving supply chain operations managers and designers a practical way in to controlling the backlog bullwhip effect. Future work should investigate the total cost implications of capacity constraints and safety stocks in multi-echelon supply chain.Keywords: supply chain dynamics, information sharing, capacity constraints, simulation, APIOBPCS
Procedia PDF Downloads 31018005 Effect of Experience on Evacuation of Mice in Emergency Conditions
Authors: Teng Zhang, Shenshi Huang, Gang Xu, Xuelin Zhang, Shouxiang Lu
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With the acceleration of urbanization and the increasing of the population in the city, the evacuation of pedestrians suffering from disaster environments such as fire in a room or other limited space becomes a vital issue in modern society. Mice have been used in experimental crowd evacuation in recent years for its good similarities to human in physical structure and stress reaction. In this study, the effect of experience or memory on the collective behavior of mice was explored. To help mice familiarize themselves with the design of the space and the stimulus caused by smoke, we trained them repeatedly for 2 days so that they can escape from the emergency conditions as soon as possible. The escape pattern, trajectories, walking speed, turning angle and mean individual escape time of mice in each training trail were analyzed. We found that mice can build memory quickly after the first trial on the first day. On the second day, the evacuation of mice was maintained in a stable and efficient state. Meanwhile, the group with size of 30 (G30) had a shorter mean individual escape time compared with G12. Furthermore, we tested the experience of evacuation skill of mice after several days. The results showed that the mice can hold the experience or memory over 3 weeks. We proposed the importance of experience of evacuation skill and the research of training methods in experimental evacuation of mice. The results can deepen our understanding of collective behavior of mice and conduce to the establishment of animal models in the study of pedestrian crowd dynamics in emergency conditions.Keywords: experience, evacuation, mice, group size, behavior
Procedia PDF Downloads 26418004 Implications of Meteorological Parameters in Decision Making for Public Protective Actions during a Nuclear Emergency
Authors: M. Hussaina, K. Mahboobb, S. Z. Ilyasa, S. Shaheena
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Plume dispersion modeling is a computational procedure to establish a relationship between emissions, meteorology, atmospheric concentrations, deposition and other factors. The emission characteristics (stack height, stack diameter, release velocity, heat contents, chemical and physical properties of the gases/particle released etc.), terrain (surface roughness, local topography, nearby buildings) and meteorology (wind speed, stability, mixing height, etc.) are required for the modeling of the plume dispersion and estimation of ground and air concentration. During the early phase of Fukushima accident, plume dispersion modeling and decisions were taken for the implementation of protective measures. A difference in estimated results and decisions made by different countries for taking protective actions created a concern in local and international community regarding the exact identification of the safe zone. The current study is focused to highlight the importance of accurate and exact weather data availability, scientific approach for decision making for taking urgent protective actions, compatible and harmonized approach for plume dispersion modeling during a nuclear emergency. As a case study, the influence of meteorological data on plume dispersion modeling and decision-making process has been performed.Keywords: decision making process, radiation doses, nuclear emergency, meteorological implications
Procedia PDF Downloads 17618003 Circle of Learning Using High-Fidelity Simulators Promoting a Better Understanding of Resident Physicians on Point-of-Care Ultrasound in Emergency Medicine
Authors: Takamitsu Kodama, Eiji Kawamoto
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Introduction: Ultrasound in emergency room has advantages of safer, faster, repeatable and noninvasive. Especially focused Point-Of-Care Ultrasound (POCUS) is used daily for prompt and accurate diagnoses, for quickly identifying critical and life-threatening conditions. That is why ultrasound has demonstrated its usefulness in emergency medicine. The true value of ultrasound has been once again recognized in recent years. It is thought that all resident physicians working at emergency room should perform an ultrasound scan to interpret signs and symptoms of deteriorating patients in the emergency room. However, a practical education on ultrasound is still in development. To resolve this issue, we established a new educational program using high-fidelity simulators and evaluated the efficacy of this course. Methods: Educational program includes didactic lectures and skill stations in half-day course. Instructor gives a lecture on POCUS such as Rapid Ultrasound in Shock (RUSH) and/or Focused Assessment Transthoracic Echo (FATE) protocol at the beginning of the course. Then, attendees are provided for training of scanning with cooperation of normal simulated patients. In the end, attendees learn how to apply focused POCUS skills at clinical situation using high-fidelity simulators such as SonoSim® (SonoSim, Inc) and SimMan® 3G (Laerdal Medical). Evaluation was conducted through surveillance questionnaires to 19 attendees after two pilot courses. The questionnaires were focused on understanding course concept and satisfaction. Results: All attendees answered the questionnaires. With respect to the degree of understanding, 12 attendees (number of valid responses: 13) scored four or more points out of five points. High-fidelity simulators, especially SonoSim® was highly appreciated to enhance learning how to handle ultrasound at an actual practice site by 11 attendees (number of valid responses: 12). All attendees encouraged colleagues to take this course because the high level of satisfaction was achieved. Discussion: Newly introduced educational course using high-fidelity simulators realizes the circle of learning to deepen the understanding on focused POCUS by gradual stages. SonoSim® can faithfully reproduce scan images with pathologic findings of ultrasound and provide experimental learning for a growth number of beginners such as resident physicians. In addition, valuable education can be provided if it is used combined with SimMan® 3G. Conclusions: Newly introduced educational course using high-fidelity simulators is supposed to be effective and helps in providing better education compared with conventional courses for emergency physicians.Keywords: point-of-care ultrasound, high-fidelity simulators, education, circle of learning
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