Search results for: medical procedures

Authors: Y. Sunita Rani, Y. Hari Krishna, M. V. Ramana Murthy, K. Sudhaker Reddy

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This article studied effects of radiation and chemical reaction on MHD casson fluoid flow past a Permeable Stretching Sheet in a Porous Medium. Suitable transformations are considered to transform the governing partial differential equations as ordinary ones and then solved by the numerical procedures like Runge- Kutta – Fehlberg shooting technique method. The effects of various governing parameters, on the velocity, temperature and concentration are displayed through graphs and discussed numerically.

Keywords: MHD, Casson fluid, porous medium, permeable stretching sheet

Procedia PDF Downloads 109

Authors: T. Marinaci, C. Venuleo

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Different conceptualizations of disease affect patient care. This study aims to address this gap. It explores how health professionals conceptualize gambling problem, addiction and the goals of recovery process. In-depth, semi-structured, open-ended interviews were conducted with Italian psychologists, psychiatrists, general practitioners, and support staff (N= 114), working within health centres for the treatment of addiction (public health services or therapeutic communities) or medical offices. A Lexical Correspondence Analysis (LCA) was applied to the verbatim transcripts. LCA allowed to identify two main factorial dimensions, which organize similarity and dissimilarity in the discourses of the interviewed. The first dimension labelled 'Models of relationship with the problem', concerns two different models of relationship with the health problem: one related to the request for help and the process of taking charge and the other related to the identification of the psychopathology underlying the disorder. The second dimension, labelled 'Organisers of the intervention' reflects the dialectic between two ways to address the problem. On the one hand, they are the gambling dynamics and its immediate life-consequences to organize the intervention (whatever the request of the user is); on the other hand, they are the procedures and the tools which characterize the health service to organize the way the professionals deal with the user’ s problem (whatever it is and despite the specify of the user’s request). The results highlight how, despite the differences, the respondents share a central assumption: understanding gambling problem implies the reference to the gambler’s identity, more than, for instance, to the relational, social, cultural or political context where the gambler lives. A passive stance is attributed to the user, who does not play any role in the definition of the goal of the intervention. The results will be discussed to highlight the relationship between professional models and users’ ways to understand and deal with the problems related to gambling.

Keywords: cultural models, health professionals, intervention models, problem gambling

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Authors: Thuvanan Borvornvitchotikarn, Werasak Kurutach

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Mutual information (MI) is widely used in medical image registration. In the different medical images analysis, it is difficult to choose an optimal bins size number for calculating the probability distributions in MI. As the result, this paper presents a new adaptive bins number selection approach that named a hybrid EMPCA-Scott approach. This work combines an expectation maximization principal component analysis (EMPCA) and the modified Scott’s rule. The proposed approach solves the binning problem from the various intensity values in medical images. Experimental results of this work show the lower registration errors compared to other adaptive binning approaches.

Keywords: mutual information, EMPCA, Scott, probability distributions

Procedia PDF Downloads 235

Authors: Rakan Alajmi, Rahaf Alnazzawi, Yara Aljefri, Abdullah Alafif, Ali Alraddadi, Awadh Alamri

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Background: The distribution of physicians in different specialties across Saudi Arabia is determined by the career choices of medical students. Dermatology residency program is one of the highly competitive programs here in Saudi Arabia. Assessing and understanding the factors perceived to be attractive in choosing dermatology will aid the directors of the specialty programs to plan for a more balanced workforce distribution to better suit the needs of the specialties. Aim: The aim of our study is to determine and assess the factors perceived to be significantly attractive when choosing dermatology as a future specialty. Methods: The study is a cross-sectional study conducted in King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. A validated questionnaire was sent electronically to clinical year medical students. In addition to the questionnaire, gender, grade point average, preferred specialty, and other socio-demographic data were assessed. Results: A total of 121 clinical years medical students completed the questionnaire, 8 (6.6%) preferred dermatology as a specialty. 76 (62.8%) of the participants score a grade point average of more than 4.5 and 83 students (68.6%) chose their specialty during clinical years. The appeal of being a dermatologist (P= 0.047), the portrayal of different specialities in the media (P= 0.005), and the likelihood that dermatologists can influence patients’ lives (P=0.010) were shown to be significantly attractive factors. Conclusion: There are many factors that are affecting students’ choices when choosing a medical specialty. The appeal of being a dermatologist, the portrayal of different specialities in the media, and the likelihood that dermatologists can influence patients’ lives were shown to be significantly attractive factors when choosing dermatology as a future specialty. Recognizing medical students’ specialty perception will lead them to a proper specialty tailored to their needs.

Keywords: dermatology, career choice, medical specialties, student's perception

Procedia PDF Downloads 131

Authors: Manal Rauf

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Trained medical practitioners are produced from medical colleges serving in public and private sectors. Prime responsibility of teaching faculty is to inculcate required work ethic among the students by serving as role models for them. It is an observed fact that classroom incivility behaviours are providing a friction in achieving these targets. Present study aimed at identification of classroom incivility behaviours observed by teachers and students of public and private medical colleges as per Glasser’s Choice Theory, making a comparison and investigating the strategies being adopted by teachers of both sectors to control undesired class room behaviours. Findings revealed that a significant difference occurs between teacher and student incivility behaviours. Public sector teacher focussed on survival as a strong factor behind in civil behaviours whereas private sector teachers considered power as the precedent for incivility. Teachers of both sectors are required to use verbal as well as non-verbal immediacy to reach a healthy leaning environment.

Keywords: classroom incivility behaviour, glasser choice theory, Mehrabian immediacy theory

Procedia PDF Downloads 219

Authors: Branislav Kovačević, Andrej Pilipović, Zoran Novčić, Marina Milović, Lazar Kesić, Milan Drekić, Saša Pekeč, Leopold Poljaković Pajnik, Saša Orlović

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Poplars present one of the most important tree species used for phytoremediation in the northern hemisphere. They can be used either as direct “cleaners” of the contaminated soils or as buffer zones preventing the contaminant plume to the surrounding environment. In order to produce appropriate planting material for this purpose, there is a long process of the breeding of the most favorable candidates. Although the development of the poplar propagation technology has been evolving for decades, white poplar nursery production, as well as the establishment of short-rotation coppice plantations, still considerably depends on the success of hardwood cuttings’ survival. This is why easy rooting is among the most desirable properties in white poplar breeding. On the other hand, there are many opportunities for the optimization of the technological procedures in order to meet the demands of particular genotype (clonal technology). In this study the effect of the term of hardwood cuttings’ preparation of four white poplar clones on their survival and further growth of rooted cuttings in nursery conditions were tested. There were three terms of cuttings’ preparation: the beginning of February (2nd Feb 2023), the beginning of March (3rd Mar 2023) and the end of March (21nd Mar 2023), which is regarded as the standard term. The cuttings were stored in cool chamber at 2±2°C. All cuttings were planted on the same date (11th Apr 2023), in soil prepared with rotary tillage, and then cultivated by usual nursey procedures. According to the results obtained after the bud set (29th Sept 2023) there were significant differences in the survival and growth of rooted cuttings between examined terms of cutting preparation. Also, there were significant differences in the reaction of examined clones on terms of cutting preparation. In total, the best results provided cuttings prepared at the first term (2nd Feb 2023) (survival rate of 39.4%), while performance after two later preparation terms was significantly poorer (20.5% after second and 16.5% after third term). These results stress the significance of dormancy preservation in cuttings of examined white poplar clones for their survival, which could be especially important in context of climate change. Differences in clones’ reaction to term of cutting preparation suggest necessity of adjustment of the technology to the needs of particular clone i.e. design of clone specific technology.

Keywords: rooting, Populus alba, nursery, clonal technology

Procedia PDF Downloads 47

Authors: Nejah Ben Mabrouk, Bassem Jarboui, Habib Chabchoub

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Production and distribution planning is the most important part in supply chain management. In this paper, a NP-hard production-distribution problem for one product over a multi-period horizon is investigated. The aim is to minimize the sum of costs of three items: production setups, inventories and distribution, while determining, for each period, the amount produced, the inventory levels and the delivery trips. To solve this difficult problem, we propose a bi-phase approach based on a Variable Neighbourhood Search (VNS). This heuristic is tested on 90 randomly generated instances from the literature, with 20 periods and 50, 100, 200 customers. Computational results show that our approach outperforms existing solution procedures available in the literature

Keywords: logistic, production, distribution, variable neighbourhood search

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Authors: Yoko Yamada, Chizumi Yamada

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Narrative psychology is based on the dialogical relationship between self and other. The dialogue can consist of divided, competitive, or opposite communication between self and other. We constructed models of coexistent dialogue in which self and other were positioned side by side and communicated sympathetically. We propose new mediation models for narrative relationships. The mediation models are based on triadic relationships that incorporate a medium or a mediator along with self and other. We constructed three types of mediation model. In the first type, called the “Joint Attention Model”, self and other are positioned side by side and share attention with the medium. In the second type, the “Triangle Model”, an agent mediates between self and other. In the third type, the “Caring Model”, a caregiver stands beside the communication between self and other. We apply the three models to the illness narratives of medical professionals and patients. As these groups have different views and experiences of disease or illness, triadic mediation facilitates the ability to see things from the other person’s perspective and to bridge differences in people’s experiences and feelings. These models would be useful for medical education in various situations, such as in considering the relationships between senior and junior doctors and between old and young patients.

Keywords: illness narrative, mediation, psychology, model, medical education

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Authors: Amin Masoumiganjgah, Luke Salmon, Julianne Burnton, Fahimeh Bagheri, Gavin Lenton, S. L. Ezekial Tan

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Introduction: The incidence of proximal biceps tenodesis and acute distal biceps repair is increasing, and rehabilitation protocols following both are variable. Golf is a popular sport within Australia, and the Gold Coast has become a Mecca for golfers, with more courses per capita than anywhere else in the world. Currently, there are no clear guidelines regarding return to golf play following biceps procedures. The aim of this study was to determine biceps brachii activation during the golf swing through electromyographic analysis, and subsequently, aid in rehabilitation guidelines and return to golf following tenodesis and repair. Methods: Subjects were amateur golfers with no previous upper limb surgery. Surface electromyography (EMG) and high-speed video recording were used to analyse activation of the left and right biceps brachii and the anterior deltoid during the golf swing. Each participant’s maximum voluntary contraction (MVC) was recorded, and they were then required to hit a golf ball aiming for specific distances of 2, 50, 100 and 150 metres at a driving range. Noraxon myoResearch and Matlab were used for data analysis. Mean % MVC was calculated for leading and trailing arms during the full swing and its’ 4 phases: back-swing, acceleration, early follow-through and late follow-through. Results: 12 golfers (2 female and 10 male), participated in the study. Median age was 27 (25 – 38), with all being right handed. Over all distances, the mean activation of the short and long head of biceps brachii was < 10% through the full swing. When breaking down the 50, 100 and 150m swing into phases, mean MVC activation was lowest in backswing (5.1%), followed by acceleration (9.7%), early follow-through (9.2%), and late follow-through (21.4%). There was more variation and slightly higher activation in the right biceps (trailing arm) in backswing, acceleration, and early follow-through; with higher activation in the leading arm in late follow-through (25.4% leading, 17.3% trailing). 2m putts resulted in low MVC values (3.1% ) with little variation across swing phases. There was considerable individual variation in results – one tense subject averaged 11.0% biceps MVC through the 2m putting stroke and others recorded peak mean MVC biceps activations of 68.9% at 50m, 101.3% at 100m, and 111.3% at 150m. Discussion: Previous studies have investigated the role of rotator cuff, spine, and hip muscles during the golf swing however, to our knowledge, this is the first study that investigates the activation of biceps brachii. Many rehabilitation programs following a biceps tenodesis or repair allow active range against gravity and restrict strengthening exercises until 6 weeks, and this does not appear to be associated with any adverse outcome. Previous studies demonstrate a range of < 10% MVC is similar to the unloaded biceps brachii during walking(1), active elbow flexion with the hand positioned either in pronation or supination will produce MVC < 20% throughout range(2) and elbow flexion with a 4kg dumbbell can produce mean MVC’s of around 40%(3). Our study demonstrates that increasing activation is associated with the leading arm, increasing shot distance and the late follow-through phase. Although the cohort mean MVC of the biceps brachii is <10% through the full swing, variability is high and biceps activation reach peak mean MVC’s of over 100% in different swing phases for some individuals. Given these EMG values, caution is advised when advising patients post biceps procedures to return to long distance golf shots, particularly when the leading arm is involved. Even though it would appear that putting would be as safe as having an unloaded hand out of a sling following biceps procedures, the variability of activation patterns across different golfers would lead us to caution against accelerated golf rehabilitation in those who may be particularly tense golfers. The 50m short iron shot was too long to consider as a chip shot and more work can be done in this area to determine the safety of chipping.

Keywords: electromyographic analysis, biceps brachii rupture, golf swing, tendon surgery

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Authors: Prasita Sooksamran, Wareerat Kaewurai

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STEM is an integrated teaching approach promoted by the Ministry of Education in Thailand. STEM Education is an integrated approach to teaching Science, Technology, Engineering, and Mathematics. It has been questioned by Thai teachers on the grounds of how to integrate STEM into the classroom. Therefore, the main objective of this study is to develop a science instructional model based on the STEM approach to enhance scientific mind and problem-solving skills for primary students. This study is participatory action research, and follows the following steps: 1) develop a model 2) seek the advice of experts regarding the teaching model. Developing the instructional model began with the collection and synthesis of information from relevant documents, related research and other sources in order to create prototype instructional model. 2) The examination of the validity and relevance of instructional model by a panel of nine experts. The findings were as follows: 1. The developed instructional model comprised of principles, objective, content, operational procedures and learning evaluation. There were 4 principles: 1) Learning based on the natural curiosity of primary school level children leading to knowledge inquiry, understanding and knowledge construction, 2) Learning based on the interrelation between people and environment, 3) Learning that is based on concrete learning experiences, exploration and the seeking of knowledge, 4) Learning based on the self-construction of knowledge, creativity, innovation and 5) relating their findings to real life and the solving of real-life problems. The objective of this construction model is to enhance scientific mind and problem-solving skills. Children will be evaluated according to their achievements. Lesson content is based on science as a core subject which is integrated with technology and mathematics at grade 6 level according to The Basic Education Core Curriculum 2008 guidelines. The operational procedures consisted of 6 steps: 1) Curiosity 2) Collection of data 3) Collaborative planning 4) Creativity and Innovation 5) Criticism and 6) Communication and Service. The learning evaluation is an authentic assessment based on continuous evaluation of all the material taught. 2. The experts agreed that the Science Instructional Model based on the STEM Education Approach had an excellent level of validity and relevance (4.67 S.D. 0.50).

Keywords: instructional model, STEM education, scientific mind, problem solving

Procedia PDF Downloads 176

Authors: Mohammad Jamalallail

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Self-esteem implies a person’s overall self-worth, self-respect, and self-value. It helps a person to maintain good mental health, personality, and achievement. Gifted students face some emotional problems, sometimes, which cause decreases in their self-esteem. Such emotional problems include loneliness, anxiety, and depression as examples. For this reason, designing a counseling program is necessary for gifted students who need a high level of self-esteem. The available counseling programs focused on developmental aspect only to the best of the writer’s knowledge. While the proposed program focuses on both clinical and developmental counseling by applying psychoanalytic play therapy. The proposed program consists of; Theoretical background such as; Behavior, and RET. It also consists of counseling procedures and therapeutic interventions.

Keywords: self-esteem, gifted, program, design

Procedia PDF Downloads 397

Authors: En-Tzu Wang, Ting-Ann Wang, Yi-Hui Shen, Yu-Min Chou, Chi-Tai Fang, Chin-Hui Yang

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Background and purpose: A mass varicella immunization program was established to provide free 1-dose vaccination for all 1-year-old children throughout Taiwan since 2004. The epidemiological characteristics and disease burden of varicella from 2000 to 2012 was investigated and the results will be essential to refine the national immunization policy. Method: We included patients (n = 17,838–164,245) with ICD-9-CM codes 052 (chickenpox) from the 2000 to 2012 National Health Insurance Database. The age, period, and cohort-specific incidence of varicella were calculated. The hospital admission rate, medical costs and indirect costs from the societal perspective of varicella including travel costs to the medical facility, registration fee, productivity losses of the patients and caregivers were also estimated. Result: There were 979,252 patients for medical treatment due to varicella from 2000 to 2012 in Taiwan. The implementation of a routine childhood varicella vaccination program has resulted in 87% decline in morbidity (881.49 to 115.17 per 100,000). The average age of patients increased from 7.9 years to 16.3 years. The overall varicella-related hospital admission rate was 15.5 per 1000 patients, and peaked in the groups of infants younger than 1 year, adults aged from 20 to 39 years and elders over 70 years. Among patients admitted to hospital, 33.5% of them had one or more complications. Patients with underlying diseases had higher admission rate (241.6 per 1,000) and longer duration of hospital stay (6.61 days vs. 4.76 days). The annual varicella-related medical expense declined after 2002 and the proportion of medical costs for admission has increased to 42%. The annual indirect costs from the societal perspective of varicella were 5.29 to 9.63 times higher than varicella-related medical costs. Every one dollar invested in the varicella immunization program, 2.97 dollars of medical and social costs were saved on average. Conclusion: The dramatic decline in morbidity, hospitalization, medical and social costs of varicella can be directly attributed to the implementation of the mass immunization program. Two-dose vaccination is recommended for both children with underlying diseases and susceptible adults to prevent serious complications and hospitalizations.

Keywords: disease burden, epidemiology, medical and social costs, varicella, varicella vaccine

Procedia PDF Downloads 376

Authors: Tony Ikponmwosa Obaseki

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The paper studied Colleges of education environments with specific insight at available technologies in college libraries with the objective of ascertaining the services rendered and the impact of information services on teacher trainings in the overall development and benefit of the educational ecosystem. Problems were situated and assumptions formulated made to guide the study proper. Twelve (12) Colleges of education environment from the six geopolitical zones in Nigeria were comparatively studied, using twelve (12) librarians and six hundred (600) randomly selected training teachers. Analysis and presentation of findings will be done using well stated scientific procedures.

Keywords: library, technologies, digital library, colleges of education, teacher training, education ecosystem

Procedia PDF Downloads 44

Authors: S. S. Rwanga, J. M. Ndambuki

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Groundwater quantification needs a method which is not only flexible but also reliable in order to accurately quantify its spatial and temporal variability. As groundwater is dynamic and interdisciplinary in nature, an integrated approach of remote sensing (RS) and GIS technique is very useful in various groundwater management studies. Thus, the GIS water balance model (WetSpass) together with remote sensing (RS) can be used to quantify groundwater recharge. This paper discusses the concept of WetSpass in combination with GIS on the quantification of recharge with a view to managing water resources in an integrated framework. The paper presents the simulation procedures and expected output after simulation. Preliminary data are presented from GIS output only.

Keywords: groundwater, recharge, GIS, WetSpass

Procedia PDF Downloads 433

Authors: Sarah P. Wuebbolt, Ashlee N. Sawyer-Mays

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Non-medical prescription and other drug (NMPOD) use has been a significant public health issue for the last few decades, with problematic use increasing among university students more recently. The current study focused on associations between NMPOD use and mental health, well-being, and world beliefs among young adults. Young adults (N=513) completed online questionnaires assessing stress, demographic characteristics, self-esteem, NMPOD use, coping mechanisms, and anxiety. A substantial portion of participants reported using cannabis (48.5%, n=249), while smaller portions of participants reported using stimulants (26.7%, n = 137), sedatives (17.2%, n=88), opioids (10.8%, n=55), and hallucinogens (14.4%, n=74). Five hierarchical logistic regressions were performed to determine the independent relationships between mental health, well-being, and world belief factors and NMPOD use for the five classes of substances. After controlling for demographic factors (age, gender, race/ethnicity, sexual orientation, and religious affiliation), depression was associated with increased non-medical stimulant, opioid, and cannabis use; coping self-efficacy was associated with increased hallucinogen use, and attendance of worship services was associated with decreased non-medical cannabis and hallucinogen use. Results suggest that depression was strongly associated with non-medical stimulant, opioid, and cannabis use, and attendance of worship services was protective against cannabis and hallucinogen use. To the best of our knowledge, this is one of the first studies to investigate the relationships between mental health, well-being, world beliefs, and NMPOD use among young adults. The present study illuminates future targets for intervention, such as increased access to mental health diagnosis and treatment and the exploration of the roles of religion and shared community in the prevention of drug use among young adults.

Keywords: cannabis, mental health, non-medical prescription and other drug use, world beliefs

Procedia PDF Downloads 41

Authors: S. J. Yune, K. H. Park

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The purpose of this study was to understand the experiences of medical students in volunteer activities and to draw implications for medical education. For this purpose, the questionnaire and the reflection essay on the volunteer experience of 54 students in the first year and 57 students in the second year were analyzed and analyzed. As a result, the participation of the students in the volunteer activities was the highest in the first semester and once a month in the second grade. Activities were mostly through volunteer organizations. The essence of the volunteering activities experience revealed through reflection essays was 'I want to avoid with fear' and 'I feel far away' in the recognition before volunteering activities. In terms of knowledge after participating in volunteer activities, 'breaking eggs and getting to know the world' and 'intellectual growth through social experience' appeared. In terms of attitude, it revealed 'deep reflection on me and others', 'understanding of service life'. And in terms of behavior, 'Begin preparing for a life of service' appeared. The results of this study revealed that volunteering activities provide students with opportunities for growth and development. In order to obtain more meaningful results, consciousness education related to social service should be done in advance.

Keywords: volunteering activity, pre-medical school student, reflection essay, qualitative analysis

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Authors: Mohammad Amin Mozaheb, Mahnaz Saeidi, Saeideh Ahangari, Saeideh Ahangari

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The present genre-driven study aims at comparing moves and sub-moves deployed by Iranian and English medical writers while writing their research articles in English. To obtain the goals of the study, the researchers randomly selected a number of medical articles and compared them using Nwogu (1997)’s model. The results of relevant statistical tests, Chi-square tests for goodness of fit, used for comparing the two groups of the articles dubbed IrISI (Iranian ISI articles) and EISI (English ISI articles) have shown that no significant difference exists between the two groups of the articles in terms of the moves and sub-moves used in the method and results sections of them. The findings can be beneficial for people interested in English for Specific Purposes (ESP) and medical experts. The findings can also increase language awareness and genre awareness among researchers who are interested in publishing their research outcomes in ISI-indexed journals in the Islamic Republic of Iran and some other world countries.

Keywords: writing, ESP, research articles, medical sciences, language, scientific writing

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Authors: Pavel H. Llamocca, Victoria Lopez

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The main objective of our work is the comparative analysis of environmental data from Open Data bases, belonging to different governments. This means that you have to integrate data from various different sources. Nowadays, many governments have the intention of publishing thousands of data sets for people and organizations to use them. In this way, the quantity of applications based on Open Data is increasing. However each government has its own procedures to publish its data, and it causes a variety of formats of data sets because there are no international standards to specify the formats of the data sets from Open Data bases. Due to this variety of formats, we must build a data integration process that is able to put together all kind of formats. There are some software tools developed in order to give support to the integration process, e.g. Data Tamer, Data Wrangler. The problem with these tools is that they need data scientist interaction to take part in the integration process as a final step. In our case we don’t want to depend on a data scientist, because environmental data are usually similar and these processes can be automated by programming. The main idea of our tool is to build Hadoop procedures adapted to data sources per each government in order to achieve an automated integration. Our work focus in environment data like temperature, energy consumption, air quality, solar radiation, speeds of wind, etc. Since 2 years, the government of Madrid is publishing its Open Data bases relative to environment indicators in real time. In the same way, other governments have published Open Data sets relative to the environment (like Andalucia or Bilbao). But all of those data sets have different formats and our solution is able to integrate all of them, furthermore it allows the user to make and visualize some analysis over the real-time data. Once the integration task is done, all the data from any government has the same format and the analysis process can be initiated in a computational better way. So the tool presented in this work has two goals: 1. Integration process; and 2. Graphic and analytic interface. As a first approach, the integration process was developed using Java and Oracle and the graphic and analytic interface with Java (jsp). However, in order to open our software tool, as second approach, we also developed an implementation with R language as mature open source technology. R is a really powerful open source programming language that allows us to process and analyze a huge amount of data with high performance. There are also some R libraries for the building of a graphic interface like shiny. A performance comparison between both implementations was made and no significant differences were found. In addition, our work provides with an Official Real-Time Integrated Data Set about Environment Data in Spain to any developer in order that they can build their own applications.

Keywords: open data, R language, data integration, environmental data

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Authors: Kwei Huan Liw, Sashi B. Darshan

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Background: Double eyelid surgery has become one of the most sought-after aesthetic procedures among Asians. Many surgeons perform surgical blepharoplasty and various other methods of non-incisional blepharoplasty. Face-Q is a validated method of measuring patient satisfaction for facial aesthetic procedures. Here we have analyzed the overall eye satisfaction score, the upper eyelid appraisal score and the adverse effect on eyes score Methods: 274 patients (548 eyes), aged between 18 to 40 years old, were recruited from 2015-2018. Each patient underwent a non-incisional double-eyelid blepharoplasty using a single-knotted continuous buried suture. 3 – 5 stab incisions were made depending on the upper eyelid size. A needle loaded with 7-0 nylon is passed from the lateral most wound through the dermis and the conjunctiva in an alternate fashion into the remaining stab wounds. The suture is then tunneled back laterally in the deeper dermis and knotted securely with the suture end. The knot is then buried within the orbicularis oculi muscle. Each patient was required to fill the Face-Q questionnaire before the procedure and 2 weeks post procedure. The results are described based on the percentage of the maximum achievable score. Patients were reviewed after 12 to 18 months to assess the long-term outcome. Results: The overall eye satisfaction score demonstrated a high level of post-operative satisfaction (97.85%), compared to 27.32% pre-operatively. The appraisal of upper eyelid scores showed drastic improvement in perception post-operatively (95.31%) compared to 21.44% pre-operatively. Adverse effect on eyes score showed a very low post-operative complication rate (0.4%) The long-term follow-up showed 6 cases that had developed asymmetrical folds. Only 1 patient agreed for revision surgery. The other 5 patients were still satisfied with the outcome and were not keen for revision surgery. None of the cases had loosening of knots. Conclusion: Modified single-knot continuous buried suture technique is a simple and non-invasive method to create aesthetically pleasing non-surgical double-eyelids, which has long-term effects. Proper patient selection is crucial and good surgical technique is required to achieve a desirable outcome.

Keywords: blepharoplasty, double-eyelid, face-Q, non-incisional

Procedia PDF Downloads 104

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

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

Keywords: medical education, clinical education, andragogy, pedagogy

Procedia PDF Downloads 108

Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

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Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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Authors: Nir Nissim, Erez Shalom, Tomer Lancewiki, Yuval Elovici, Yuval Shahar

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Background: A Medical Device (MD) is an instrument, machine, implant, or similar device that includes a component intended for the purpose of the diagnosis, cure, treatment, or prevention of disease in humans or animals. Medical devices play increasingly important roles in health services eco-systems, including: (1) Patient Diagnostics and Monitoring; Medical Treatment and Surgery; and Patient Life Support Devices and Stabilizers. MDs are part of the medical device eco-system and are connected to the network, sending vital information to the internal medical information systems of medical centers that manage this data. Wireless components (e.g. Wi-Fi) are often embedded within medical devices, enabling doctors and technicians to control and configure them remotely. All these functionalities, roles, and uses of MDs make them attractive targets of cyber-attacks launched for many malicious goals; this trend is likely to significantly increase over the next several years, with increased awareness regarding MD vulnerabilities, the enhancement of potential attackers’ skills, and expanded use of medical devices. Significance: We propose to develop and implement Cyber-Med, a unique collaborative project of Ben-Gurion University of the Negev and the Clalit Health Services Health Maintenance Organization. Cyber-Med focuses on the development of a comprehensive detection framework that relies on a critical attack repository that we aim to create. Cyber-Med will allow researchers and companies to better understand the vulnerabilities and attacks associated with medical devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The Cyber-Med detection framework will consist of two independent, but complementary detection approaches: one for known attacks, and the other for unknown attacks. These modules incorporate novel ideas and algorithms inspired by our team's domains of expertise, including cyber security, biomedical informatics, and advanced machine learning, and temporal data mining techniques. The establishment and maintenance of Cyber-Med’s up-to-date attack repository will strengthen the capabilities of Cyber-Med’s detection framework. Major Findings: Based on our initial survey, we have already found more than 15 types of vulnerabilities and possible attacks aimed at MDs and their eco-system. Many of these attacks target individual patients who use devices such pacemakers and insulin pumps. In addition, such attacks are also aimed at MDs that are widely used by medical centers such as MRIs, CTs, and dialysis engines; the information systems that store patient information; protocols such as DICOM; standards such as HL7; and medical information systems such as PACS. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched against MDs. Very little research has been conducted in order to protect these devices from cyber-attacks, since most of the development and engineering efforts are aimed at the devices’ core medical functionality, the contribution to patients’ healthcare, and the business aspects associated with the medical device.

Keywords: medical device, cyber security, attack, detection, machine learning

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Authors: Michael Zaidman, Naum Simanovsky

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Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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Authors: Suzan Wedyan

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Data mining is one of the main phases in the Knowledge Discovery Database (KDD) which is responsible of finding hidden and useful knowledge from databases. There are many different tasks for data mining including regression, pattern recognition, clustering, classification, and association rule. In recent years a promising data mining approach called associative classification (AC) has been proposed, AC integrates classification and association rule discovery to build classification models (classifiers). This paper surveys and critically compares several AC algorithms with reference of the different procedures are used in each algorithm, such as rule learning, rule sorting, rule pruning, classifier building, and class allocation for test cases.

Keywords: associative classification, classification, data mining, learning, rule ranking, rule pruning, prediction

Procedia PDF Downloads 519

Authors: Yuexi Xiong, Jingwu He

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The structural components in an energy facility such as steam turbine machines are operated under high stress and elevated temperature in an endured time period and thus the creep deformation and creep rupture failure are important issues that need to be addressed in the design of such components. There are numerous creep models being used for creep analysis that have both advantages and disadvantages in terms of accuracy and efficiency. The Isochronous Creep Analysis is one of the simplified approaches in which a full-time dependent creep analysis is avoided and instead an elastic-plastic analysis is conducted at each time point. This approach has been established based on the rupture dependent creep equations using the well-known Larson-Miller parameter. In this paper, some fundamental aspects of creep deformation and the rupture dependent creep models are reviewed and the analysis procedures using isochronous creep curves are discussed. Four rupture failure criteria are examined from creep fundamental perspectives including criteria of Stress Damage, Strain Damage, Strain Rate Damage, and Strain Capability. The accuracy of these criteria in predicting creep life is discussed and applications of the creep analysis procedures and failure predictions of simple models will be presented. In addition, a new failure criterion is proposed to improve the accuracy and effectiveness of the existing criteria. Comparisons are made between the existing criteria and the new one using several examples materials. Both strain increase and stress relaxation form a full picture of the creep behaviour of a material under high temperature in an endured time period. It is important to bear this in mind when dealing with creep problems. Accordingly there are two sets of rupture dependent creep equations. While the rupture strength vs LMP equation shows how the rupture time depends on the stress level under load controlled condition, the strain rate vs rupture time equation reflects how the rupture time behaves under strain-controlled condition. Among the four existing failure criteria for rupture life predictions, the Stress Damage and Strain Damage Criteria provide the most conservative and non-conservative predictions, respectively. The Strain Rate and Strain Capability Criteria provide predictions in between that are believed to be more accurate because the strain rate and strain capability are more determined quantities than stress to reflect the creep rupture behaviour. A modified Strain Capability Criterion is proposed making use of the two sets of creep equations and therefore is considered to be more accurate than the original Strain Capability Criterion.

Keywords: creep analysis, high temperature mateials, rapture evalution, steam turbine machines

Procedia PDF Downloads 270

Authors: P. G. F. Siqueira, N. G. S. Almeida, P. M. A. Stemler, P. R. Cetlin, M. T. P. Aguilar

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The processing of metals through Equal Channel Angular Pressing (ECAP) leads to their remarkable strengthening. The ECAP dies control the amount of strain imposed on the material through its geometry, especially through the angle between the die channels, and thus the microstructural and mechanical properties evolution of the material. The present study describes the design of an ECAP die whose utilization and maintenance are facilitated, and that also controls the eventual undesired flow of the material during processing. The proposed design was validated through numerical simulations procedures using commercial software. The die was manufactured according to the present design and tested. Tests using aluminum alloys also indicated to be suitable for the processing of higher strength alloys.

Keywords: ECAP, mechanical design, numerical methods, SPD

Procedia PDF Downloads 124

Authors: Lolwa Alansari, Hanen Mrabet, Kholoud Khaled, Abdelhamid Azhaghdani, Sufia Athar, Aska Kaima, Zaineb Mhamdia, Zubaria Altaf, Almunzer Zakaria, Tamara Alshadafat

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Introduction: The Obstetrics and Gynecology Emergency Department at Alwakra Hospital has faced significant challenges, which have been further worsened by the impact of the COVID-19 pandemic. These challenges involve issues such as overcrowding, extended wait times, and a notable surge in demand for emergency care services. Moreover, prolonged waiting times have emerged as a primary factor contributing to situations where patients leave without receiving attention, known as left without being seen (LWBS), and unexpectedly abscond. Addressing the issue of insufficient patient mobility in the obstetrics and gynecology emergency department has brought about substantial improvements in patient care, healthcare administration, and overall departmental efficiency. These changes have not only alleviated overcrowding but have also elevated the quality of emergency care, resulting in higher patient satisfaction, better outcomes, and operational rewards. Methodology: The COVID-19 pandemic has served as a catalyst for substantial transformations in the obstetrics and gynecology emergency, aligning seamlessly with the strategic direction of Hamad Medical Corporation (HMC). The fundamental aim of this initiative is to revolutionize the operational efficiency of the OB-GYN ED. To accomplish this mission, a range of transformations has been initiated, focusing on essential areas such as digitizing systems, optimizing resource allocation, enhancing budget efficiency, and reducing overall costs. The project utilized the Plan-Do-Study-Act (PDSA) model, involving a diverse team collecting baseline data and introducing throughput improvements. Post-implementation data and feedback were analysed, leading to the integration of effective interventions into standard procedures. These interventions included optimized space utilization, real-time communication, bedside registration, technology integration, pre-triage screening, enhanced communication and patient education, consultant presence, and a culture of continuous improvement. These strategies significantly reduced waiting times, enhancing both patient care and operational efficiency. Results: Results demonstrated a substantial reduction in overall average waiting time, dropping from 35 to approximately 14 minutes by August 2023. The wait times for priority 1 cases have been reduced from 22 to 0 minutes, and for priority 2 cases, the wait times have been reduced from 32 to approximately 13.6 minutes. The proportion of patients spending less than 8 hours in the OB ED observation beds rose from 74% in January 2022 to over 98% in 2023. Notably, there was a remarkable decrease in LWBS and absconded patient rates from 2020 to 2023. Conclusion: The project initiated a profound change in the department's operational environment. Efficiency became deeply embedded in the unit's culture, promoting teamwork among staff that went beyond the project's original focus and had a positive influence on operations in other departments. This effectiveness not only made processes more efficient but also resulted in significant cost reductions for the hospital. These cost savings were achieved by reducing wait times, which in turn led to fewer prolonged patient stays and reduced the need for additional treatments. These continuous improvement initiatives have now become an integral part of the Obstetrics and Gynecology Division's standard operating procedures, ensuring that the positive changes brought about by the project persist and evolve over time.

Keywords: overcrowding, waiting time, person centered care, quality initiatives

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Authors: Usiobaifo Agharese Rosemary, Osaseri Roseline Oghogho

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Diabetes is a complex group of disease with a variety of causes; it is a disorder of the body metabolism in the digestion of carbohydrates food. The application of machine learning in the field of medical diagnosis has been the focus of many researchers and the use of recognition and classification model as a decision support tools has help the medical expert in diagnosis of diseases. Considering the large volume of medical data which require special techniques, experience, and high diagnostic skill in the diagnosis of diseases, the application of an artificial intelligent system to assist medical personnel in order to enhance their efficiency and accuracy in diagnosis will be an invaluable tool. In this study will propose a diabetes diagnosis model using rough set and K-nearest Neighbor classifier algorithm. The system consists of two modules: the feature extraction module and predictor module, rough data set is used to preprocess the attributes while K-nearest neighbor classifier is used to classify the given data. The dataset used for this model was taken for University of Benin Teaching Hospital (UBTH) database. Half of the data was used in the training while the other half was used in testing the system. The proposed model was able to achieve over 80% accuracy.

Keywords: classifier algorithm, diabetes, diagnostic model, machine learning

Procedia PDF Downloads 319

Authors: Melissa Mattos, Camila Lima, Ibraim Castro, Augusto Carioca, Saulo Magalhães, Paula Freitas, Keciany Oliveira

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Obesity is a chronic, multifactorial, relapsing disease that has increased dramatically over the years. Its control is considered a public health issue, and more and more treatments and interventions are being studied to reduce its prevalence. When interventions in lifestyle and the use of drugs do not generate lasting results, bariatric procedures emerge as a resource for obesity control. The main guidelines for the treatment of obesity emphasize the need for pre-procedure and post-procedure nutritional monitoring to avoid nutritional deficiencies that may occur. The individual who undergoes bariatric surgery needs to understand the changes that will be necessary for life in view of the intense anatomical and metabolic changes that result from surgical techniques. To assess the nutritional profile of patients who undergo bariatric surgery, we analyzed data from the medical records of all people who underwent sleeve-type bariatric surgery from January to June 2022 at a clinic in the City of Fortaleza. 38 patients were analyzed, 32 women and 6 men in the pre-surgical period, 6 and 12 months after surgery. The data showed an average weight loss of 24.45% at 6 months and 30.85% at 12 months, with a reduction of 21.32% and 30.41%, respectively, in the fat percentage, also indicating that 13.15% used drugs for weight loss during this period, leading to reflection on the isolated long-term efficacy of bariatric surgery, requiring multidisciplinary follow-up for a change in lifestyle. Only 12 individuals, corresponding to 31.57%, reached eutrophic BMI 12 months after surgery, 20 individuals remained overweight, corresponding to 52.63% of the sample, and 6 individuals (15.78%) remained in the BMI obese class I. As for body composition, there was a 52.39% reduction in fat mass and a 12.82% reduction in muscle mass, and 21% of individuals underwent cholecystectomy. Sleeve-type bariatric surgery promoted significant weight loss after 1 year of the procedure, with a reduction in body fat percentage and fat mass. Most patients were still overweight and had a significant reduction in muscle mass.

Keywords: bariatric surgery, sleeve gastrectomy, obesity, sleeve

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Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

Procedia PDF Downloads 333