Search results for: sentinel node biopsy (SLNB)
204 A New DIDS Design Based on a Combination Feature Selection Approach
Authors: Adel Sabry Eesa, Adnan Mohsin Abdulazeez Brifcani, Zeynep Orman
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Feature selection has been used in many fields such as classification, data mining and object recognition and proven to be effective for removing irrelevant and redundant features from the original data set. In this paper, a new design of distributed intrusion detection system using a combination feature selection model based on bees and decision tree. Bees algorithm is used as the search strategy to find the optimal subset of features, whereas decision tree is used as a judgment for the selected features. Both the produced features and the generated rules are used by Decision Making Mobile Agent to decide whether there is an attack or not in the networks. Decision Making Mobile Agent will migrate through the networks, moving from node to another, if it found that there is an attack on one of the nodes, it then alerts the user through User Interface Agent or takes some action through Action Mobile Agent. The KDD Cup 99 data set is used to test the effectiveness of the proposed system. The results show that even if only four features are used, the proposed system gives a better performance when it is compared with the obtained results using all 41 features.Keywords: distributed intrusion detection system, mobile agent, feature selection, bees algorithm, decision tree
Procedia PDF Downloads 408203 Autism Spectrum Disorder Classification Algorithm Using Multimodal Data Based on Graph Convolutional Network
Authors: Yuntao Liu, Lei Wang, Haoran Xia
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Machine learning has shown extensive applications in the development of classification models for autism spectrum disorder (ASD) using neural image data. This paper proposes a fusion multi-modal classification network based on a graph neural network. First, the brain is segmented into 116 regions of interest using a medical segmentation template (AAL, Anatomical Automatic Labeling). The image features of sMRI and the signal features of fMRI are extracted, which build the node and edge embedding representations of the brain map. Then, we construct a dynamically updated brain map neural network and propose a method based on a dynamic brain map adjacency matrix update mechanism and learnable graph to further improve the accuracy of autism diagnosis and recognition results. Based on the Autism Brain Imaging Data Exchange I dataset(ABIDE I), we reached a prediction accuracy of 74% between ASD and TD subjects. Besides, to study the biomarkers that can help doctors analyze diseases and interpretability, we used the features by extracting the top five maximum and minimum ROI weights. This work provides a meaningful way for brain disorder identification.Keywords: autism spectrum disorder, brain map, supervised machine learning, graph network, multimodal data, model interpretability
Procedia PDF Downloads 66202 A Virtual Grid Based Energy Efficient Data Gathering Scheme for Heterogeneous Sensor Networks
Authors: Siddhartha Chauhan, Nitin Kumar Kotania
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Traditional Wireless Sensor Networks (WSNs) generally use static sinks to collect data from the sensor nodes via multiple forwarding. Therefore, network suffers with some problems like long message relay time, bottle neck problem which reduces the performance of the network. Many approaches have been proposed to prevent this problem with the help of mobile sink to collect the data from the sensor nodes, but these approaches still suffer from the buffer overflow problem due to limited memory size of sensor nodes. This paper proposes an energy efficient scheme for data gathering which overcomes the buffer overflow problem. The proposed scheme creates virtual grid structure of heterogeneous nodes. Scheme has been designed for sensor nodes having variable sensing rate. Every node finds out its buffer overflow time and on the basis of this cluster heads are elected. A controlled traversing approach is used by the proposed scheme in order to transmit data to sink. The effectiveness of the proposed scheme is verified by simulation.Keywords: buffer overflow problem, mobile sink, virtual grid, wireless sensor networks
Procedia PDF Downloads 391201 Process Safety Evaluation of a Nuclear Power Plant through Virtual Process Hazard Analysis Using Hazard and Operability Technique
Authors: Elysa V. Largo, Lormaine Anne A. Branzuela, Julie Marisol D. Pagalilauan, Neil C. Concibido, Monet Concepcion M. Detras
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The energy demand in the country is increasing; thus, nuclear energy is recently mandated to add to the energy mix. The Philippines has the Bataan Nuclear Power Plant (BNPP), which can be a source of nuclear energy; however, it has not been operated since the completion of its construction. Thus, evaluating the safety of BNPP is vital. This study explored the possible deviations that may occur in the operation of a nuclear power plant with a pressurized water reactor, which is similar to BNPP, through a virtual process hazard analysis (PHA) using the hazard and operability (HAZOP) technique. Temperature, pressure, and flow were used as parameters. A total of 86 causes of various deviations were identified, wherein the primary system and line from reactor coolant pump to reactor vessel are the most critical system and node, respectively. A total of 348 scenarios were determined. The critical events are radioactive leaks due to nuclear meltdown and sump overflow that could lead to multiple worker fatalities, one or more public fatalities, and environmental remediation. There were existing safeguards identified; however, further recommendations were provided to have additional and supplemental barriers to reduce the risk.Keywords: PSM, PHA, HAZOP, nuclear power plant
Procedia PDF Downloads 154200 Optimal Design of Composite Cylindrical Shell Based on Nonlinear Finite Element Analysis
Authors: Haider M. Alsaeq
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The present research is an attempt to figure out the best configuration of composite cylindrical shells of the sandwich type, i.e. the lightest design of such shells required to sustain a certain load over a certain area. The optimization is based on elastic-plastic geometrically nonlinear incremental-iterative finite element analysis. The nine-node degenerated curved shell element is used in which five degrees of freedom are specified at each nodal point, with a layered model. The formulation of the geometrical nonlinearity problem is carried out using the well-known total Lagrangian principle. For the structural optimization problem, which is dealt with as a constrained nonlinear optimization, the so-called Modified Hooke and Jeeves method is employed by considering the weight of the shell as the objective function with stress and geometrical constraints. It was concluded that the optimum design of composite sandwich cylindrical shell that have a rigid polyurethane foam core and steel facing occurs when the area covered by the shell becomes almost square with a ratio of core thickness to facing thickness lies between 45 and 49, while the optimum height to length ration varies from 0.03 to 0.08 depending on the aspect ratio of the shell and its boundary conditions.Keywords: composite structure, cylindrical shell, optimization, non-linear analysis, finite element
Procedia PDF Downloads 391199 Signal Strength Based Multipath Routing for Mobile Ad Hoc Networks
Authors: Chothmal
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In this paper, we present a route discovery process which uses the signal strength on a link as a parameter of its inclusion in the route discovery method. The proposed signal-to-interference and noise ratio (SINR) based multipath reactive routing protocol is named as SINR-MP protocol. The proposed SINR-MP routing protocols has two following two features: a) SINR-MP protocol selects routes based on the SINR of the links during the route discovery process therefore it select the routes which has long lifetime and low frame error rate for data transmission, and b) SINR-MP protocols route discovery process is multipath which discovers more than one SINR based route between a given source destination pair. The multiple routes selected by our SINR-MP protocol are node-disjoint in nature which increases their robustness against link failures, as failure of one route will not affect the other route. The secondary route is very useful in situations where the primary route is broken because we can now use the secondary route without causing a new route discovery process. Due to this, the network overhead caused by a route discovery process is avoided. This increases the network performance greatly. The proposed SINR-MP routing protocol is implemented in the trail version of network simulator called Qualnet.Keywords: ad hoc networks, quality of service, video streaming, H.264/SVC, multiple routes, video traces
Procedia PDF Downloads 249198 Pulmonary Hydatid Cyst in a 13-Year-Old Child: A Case Report
Authors: Ghada Esheba, Bayan Hafiz, Ashwaq Al-Qarni, Abdulelah AlMalki, Esraa Kaheel
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Hydatid disease is caused by genus Echinococcus, it is transmitted to human through sheep and cattle. People who lived in an endemic area should be suspected to have the disease. Pulmonary hydatid disease can be presented by respiratory manifestations as in our case. We report a case of child, 13 years old, who was presented by shortness of breath and non-productive cough 2 months ago. The patient had an attack of hemoptysis 3 months ago but there is no history of fever, other constitutional symptoms or any medical illness. The patient has had a close contact with a horse. On examination, the patient was oriented and vitally stable. Both side of chest were moving equally with decrease air entry on the left side of the chest. Cervical lymph node enlargement was also detected. The case was provisionally diagnosed as tuberculosis. The x-ray was normal, while CT scan showed two cysts in the left side. The patient was treated surgically with resection of both cysts without lobectomy. Broncho-alveolar lavage was done and together with plural effusion and both cysts were sent for histopathology. The patient received the following medication: albendazole 200MG/BID/Orally for 30 days and Cefuroxime 250MG/Q12H/Orally for 10 days.Keywords: Echinococcus granulosus, hydatid disease, pediatrics, pulmonary hydatid cyst
Procedia PDF Downloads 272197 Leakage Current Analysis of FinFET Based 7T SRAM at 32nm Technology
Authors: Chhavi Saxena
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FinFETs can be a replacement for bulk-CMOS transistors in many different designs. Its low leakage/standby power property makes FinFETs a desirable option for memory sub-systems. Memory modules are widely used in most digital and computer systems. Leakage power is very important in memory cells since most memory applications access only one or very few memory rows at a given time. As technology scales down, the importance of leakage current and power analysis for memory design is increasing. In this paper, we discover an option for low power interconnect synthesis at the 32nm node and beyond, using Fin-type Field-Effect Transistors (FinFETs) which are a promising substitute for bulk CMOS at the considered gate lengths. We consider a mechanism for improving FinFETs efficiency, called variable supply voltage schemes. In this paper, we’ve illustrated the design and implementation of FinFET based 4x4 SRAM cell array by means of one bit 7T SRAM. FinFET based 7T SRAM has been designed and analysis have been carried out for leakage current, dynamic power and delay. For the validation of our design approach, the output of FinFET SRAM array have been compared with standard CMOS SRAM and significant improvements are obtained in proposed model.Keywords: FinFET, 7T SRAM cell, leakage current, delay
Procedia PDF Downloads 455196 An Automatic Generating Unified Modelling Language Use Case Diagram and Test Cases Based on Classification Tree Method
Authors: Wassana Naiyapo, Atichat Sangtong
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The processes in software development by Object Oriented methodology have many stages those take time and high cost. The inconceivable error in system analysis process will affect to the design and the implementation process. The unexpected output causes the reason why we need to revise the previous process. The more rollback of each process takes more expense and delayed time. Therefore, the good test process from the early phase, the implemented software is efficient, reliable and also meet the user’s requirement. Unified Modelling Language (UML) is the tool which uses symbols to describe the work process in Object Oriented Analysis (OOA). This paper presents the approach for automatically generated UML use case diagram and test cases. UML use case diagram is generated from the event table and test cases are generated from use case specifications and Graphic User Interfaces (GUI). Test cases are derived from the Classification Tree Method (CTM) that classify data to a node present in the hierarchy structure. Moreover, this paper refers to the program that generates use case diagram and test cases. As the result, it can reduce work time and increase efficiency work.Keywords: classification tree method, test case, UML use case diagram, use case specification
Procedia PDF Downloads 162195 Advanced Hybrid Particle Swarm Optimization for Congestion and Power Loss Reduction in Distribution Networks with High Distributed Generation Penetration through Network Reconfiguration
Authors: C. Iraklis, G. Evmiridis, A. Iraklis
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Renewable energy sources and distributed power generation units already have an important role in electrical power generation. A mixture of different technologies penetrating the electrical grid, adds complexity in the management of distribution networks. High penetration of distributed power generation units creates node over-voltages, huge power losses, unreliable power management, reverse power flow and congestion. This paper presents an optimization algorithm capable of reducing congestion and power losses, both described as a function of weighted sum. Two factors that describe congestion are being proposed. An upgraded selective particle swarm optimization algorithm (SPSO) is used as a solution tool focusing on the technique of network reconfiguration. The upgraded SPSO algorithm is achieved with the addition of a heuristic algorithm specializing in reduction of power losses, with several scenarios being tested. Results show significant improvement in minimization of losses and congestion while achieving very small calculation times.Keywords: congestion, distribution networks, loss reduction, particle swarm optimization, smart grid
Procedia PDF Downloads 445194 Nanomaterials Based Biosensing Chip for Non-Invasive Detection of Oral Cancer
Authors: Suveen Kumar
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Oral cancer (OC) is the sixth most death causing cancer in world which includes tumour of lips, floor of the mouth, tongue, palate, cheeks, sinuses, throat, etc. Conventionally, the techniques used for OC detection are toluidine blue staining, biopsy, liquid-based cytology, visual attachments, etc., however these are limited by their highly invasive nature, low sensitivity, time consumption, sophisticated instrument handling, sample processing and high cost. Therefore, we developed biosensing chips for non-invasive detection of OC via CYFRA-21-1 biomarker. CYFRA-21-1 (molecular weight: 40 kDa) is secreted in saliva of OC patients which is a non-invasive biological fluid with a cut-off value of 3.8 ng mL-1, above which the subjects will be suffering from oral cancer. Therefore, in first work, 3-aminopropyl triethoxy silane (APTES) functionalized zirconia (ZrO2) nanoparticles (APTES/nZrO2) were used to successfully detect CYFRA-21-1 in a linear detection range (LDR) of 2-16 ng mL-1 with sensitivity of 2.2 µA mL ng-1. Successively, APTES/nZrO2-RGO was employed to prevent agglomeration of ZrO2 by providing high surface area reduced graphene oxide (RGO) support and much wider LDR (2-22 ng mL-1) was obtained with remarkable limit of detection (LOD) as 0.12 ng mL-1. Further, APTES/nY2O3/ITO platform was used for oral cancer bioseneor development. The developed biosensor (BSA/anti-CYFRA-21-1/APTES/nY2O3/ITO) have wider LDR (0.01-50 ng mL-1) with remarkable limit of detection (LOD) as 0.01 ng mL-1. To improve the sensitivity of the biosensing platform, nanocomposite of yattria stabilized nanostructured zirconia-reduced graphene oxide (nYZR) based biosensor has been developed. The developed biosensing chip having ability to detect CYFRA-21-1 biomolecules in the range of 0.01-50 ng mL-1, LOD of 7.2 pg mL-1 with sensitivity of 200 µA mL ng-1. Further, the applicability of the fabricated biosensing chips were also checked through real sample (saliva) analysis of OC patients and the obtained results showed good correlation with the standard protein detection enzyme linked immunosorbent assay (ELISA) technique.Keywords: non-invasive, oral cancer, nanomaterials, biosensor, biochip
Procedia PDF Downloads 127193 GATA3-AS1 lncRNA as a Predictive Biomarker for Neoadjuvant Chemotherapy Response in Locally Advanced Luminal B Breast Cancer: An RNA ISH Study
Authors: Tania Vasquez Mata, Luis A. Herrera, Cristian Arriaga Canon
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Background: Locally advanced breast cancer of the luminal B phenotype, poses challenges due to its variable response to neoadjuvant chemotherapy. A predictive biomarker is needed to identify patients who will not respond to treatment, allowing for alternative therapies. This study aims to validate the use of the lncRNA GATA3-AS1, as a predictive biomarker using RNA in situ hybridization. Research aim: The aim of this study is to determine if GATA3-AS1 can serve as a biomarker for resistance to neoadjuvant chemotherapy in patients with locally advanced luminal B breast cancer. Methodology: The study utilizes RNA in situ hybridization with predesigned probes for GATA3-AS1 on Formalin-Fixed Paraffin-Embedded tissue sections. The samples underwent pretreatment and protease treatment to enable probe penetration. Chromogenic detection and signal evaluation were performed using specific criteria. Findings: Patients who did not respond to neoadjuvant chemotherapy showed a 3+ score for GATA3-AS1, while those who had a complete response had a 1+ score. Theoretical importance: This study demonstrates the potential clinical utility of GATA3-AS1 as a biomarker for resistance to neoadjuvant chemotherapy. Identifying non-responders early on can help avoid unnecessary treatment and explore alternative therapy options. Data collection and analysis procedures: Tissue samples from patients with locally advanced luminal B breast cancer were collected and processed using RNA in situ hybridization. Signal evaluation was conducted under a microscope, and scoring was based on specific criteria. Questions addressed: Can GATA3-AS1 serve as a predictive biomarker for neoadjuvant chemotherapy response in locally advanced luminal B breast cancer? Conclusion: The lncRNA GATA3-AS1 can be used as a biomarker for resistance to neoadjuvant chemotherapy in patients with locally advanced luminal B breast cancer. Its identification through RNA in situ hybridization of tissue obtained from the initial biopsy can aid in treatment decision-making.Keywords: biomarkers, breast neoplasms, genetics, neoadjuvant therapy, tumor
Procedia PDF Downloads 57192 Decode and Forward Cooperative Protocol Enhancement Using Interference Cancellation
Authors: Siddeeq Y. Ameen, Mohammed K. Yousif
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Cooperative communication systems are considered to be a promising technology to improve the system capacity, reliability and performances over fading wireless channels. Cooperative relaying system with a single antenna will be able to reach the advantages of multiple antenna communication systems. It is ideally suitable for the distributed communication systems; the relays can cooperate and form virtual MIMO systems. Thus the paper will aim to investigate the possible enhancement of cooperated system using decode and forward protocol. On decode and forward an attempt to cancel or at least reduce the interference instead of increasing the SNR values is achieved. The latter can be achieved via the use group of relays depending on the channel status from source to relay and relay to destination respectively. In the proposed system, the transmission time has been divided into two phases to be used by decode and forward protocol. The first phase has been allocated for the source to transmit its data whereas the relays and destination nodes are in receiving mode. On the other hand, the second phase is allocated for the first and second groups of relay nodes to relay the data to the destination node. Simulations results have shown an improvement in performance is achieved compared to the conventional decode and forward in terms of BER and transmission rate.Keywords: cooperative systems, decode and forward, interference cancellation, virtual MIMO
Procedia PDF Downloads 323191 Case Report: Clinical Improvement of Forbrain Neurologic Signs in 3- Month- Old Persian Mastiff Dog with Calvarial Hyperostosis Syndrome after Corticosteroid, Antiepileptic and Antibiotic Therapy
Authors: Hamidreza Jahani, Zahra Salehzadeh, Ehsan Amini, Mohsen Tohidifar
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Calvarial Hyperostosis Syndrome (CHS) is a benign bone disease of the skull. It is a non-neoplastic and proliferative bone disease, and the main feature of the disease is progressive and asymmetrical bone involvement. CHS is mostly reported in young male and female bullmastiff dogs and less frequently in other breeds. The etiology of CHS is unknown. This is the first case report of CHS in Iran. A 3-month-old male Persian Mastiff was presented with chief complaints of multiple episodes of seizure, pacing, bizarre behavior, delayed growth, head pressing, and difficulty in opening the mouth. Central blindness and open fontanelles were observed in clinical examination. No abnormality was found in the complete blood count and routine blood biochemical tests. CT scan findings include cortical thickening of frontal and parietal bones and enlargement of the left retropharyngeal lymph node. For treatment, oral clindamycin for two weeks, prednisolone and phenobarbital for one month, respectively, were administrated, and the case showed improvement after a week and recovered after one month.Keywords: calvarial hyperostosis, Persian Mastiff, frontal bone, seizure
Procedia PDF Downloads 135190 Performance Evaluation of Clustered Routing Protocols for Heterogeneous Wireless Sensor Networks
Authors: Awatef Chniguir, Tarek Farah, Zouhair Ben Jemaa, Safya Belguith
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Optimal routing allows minimizing energy consumption in wireless sensor networks (WSN). Clustering has proven its effectiveness in organizing WSN by reducing channel contention and packet collision and enhancing network throughput under heavy load. Therefore, nowadays, with the emergence of the Internet of Things, heterogeneity is essential. Stable election protocol (SEP) that has increased the network stability period and lifetime is the first clustering protocol for heterogeneous WSN. SEP and its descendants, namely SEP, Threshold Sensitive SEP (TSEP), Enhanced TSEP (ETSSEP) and Current Energy Allotted TSEP (CEATSEP), were studied. These algorithms’ performance was evaluated based on different metrics, especially first node death (FND), to compare their stability. Simulations were conducted on the MATLAB tool considering two scenarios: The first one demonstrates the fraction variation of advanced nodes by setting the number of total nodes. The second considers the interpretation of the number of nodes while keeping the number of advanced nodes permanent. CEATSEP outperforms its antecedents by increasing stability and, at the same time, keeping a low throughput. It also operates very well in a large-scale network. Consequently, CEATSEP has a useful lifespan and energy efficiency compared to the other routing protocol for heterogeneous WSN.Keywords: clustering, heterogeneous, stability, scalability, IoT, WSN
Procedia PDF Downloads 131189 Rethinking Everyday Urban Spaces Using Principles of Resilient Urbanism: A Case of Flooding in Thiruvalla
Authors: Prejily Thomas John
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Flooding of urban areas often has an adverse impact on the dense population residing in cities. The vulnerable areas are the most affected due to flooding, which even results in loss of life. The increasing trend of urban floods is a universal phenomenon and leads to a vital loss in the physical, economic, social, and environmental dimensions. The shift from floods being natural disasters to man-made disasters due to unplanned urban growth is evident from national and international reports. Thiruvalla, bordered by the Manimala River in the Pathanamthitta district, is an important urban node and a drainage point of various estuaries. The city is often faced with flash floods and overflow from rivers since it is a low-lying land. The need for urban flood resilience for planned urban development is a necessity for livability in consideration of the topography. The paper focuses on developing an urban design framework in everyday urban spaces through the principles of resilient urbanism. The principles guide the creation of flood-resilient spaces and productive urban landscapes for the city to enable better and safer living conditions. A flood-resilient city not only prepares the city for disasters but also improves the ecological and economic conditions.Keywords: everyday urban spaces, flood resilience, resilient urbanism, productive urban landscapes
Procedia PDF Downloads 80188 Catamenial Pneumothorax: Report of Two Cases and Review of the Local Literature
Authors: Angeli Marie P. Lagman, Nephtali M. Gorgonio
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Catamenial pneumothorax is defined as a recurrent accumulation of air in the pleural cavity, which occurs in the period of 72 hours before or after menses. In a menstruating woman presenting with the difficulty of breathing and chest pain with concomitant radiographic evidence of pneumothorax, a diagnosis of catamenial pneumothorax should be entertained. Two cases of catamenial pneumothorax were reported in our local literature. This report added two more cases. The first case is 45 years old G1P1, while the second case is 46 years old G2P2. These two patients had a history of pelvic endometriosis in the past. All other signs and symptoms were similar to the previously reported cases. All patients presented with difficulty of breathing associated with chest pain. Imaging studies showed right-sided pneumothorax in all patients. Intraoperatively, subpleural bleb, diaphragmatic fenestrations, and endometriotic implants were found. Three patients underwent video-assisted thoracosurgery (VATS), while one patient underwent open thoracotomy with pleurodesis. Histopathology revealed endometriosis in only two patients. All patients received postoperative hormonal therapy, and there were no recurrences noted in all patients. Endometriosis-related catamenial pneumothorax is a rare condition that needs early recognition of the symptoms. Several theories may be involved to explain the pathogenesis of catamenial pneumothorax. Two cases show a strong significant association between a history of pelvic endometriosis and the development of catamenial pneumothorax, while one case can be explained by the hormonal theory. The difficulty of breathing and chest pain in relation to menses may prompt early diagnosis. One case has shown that pneumothorax may occur even after menstruation. A biopsy of the endometrial implants may not always show endometrial glands and stroma, nor will immunostaining, which will not always show estrogen and progesterone receptors. Video-assisted thoracoscopic surgery is the gold standard in the diagnosis and treatment of catamenial pneumothorax. Postoperative hormonal suppression will further reduce the disease recurrence and facilitate the effectiveness of the surgical treatment.Keywords: catamenial pneumothorax, endometriosis, menstruation, video assisted thoracosurgery
Procedia PDF Downloads 105187 Computational Aerodynamic Shape Optimisation Using a Concept of Control Nodes and Modified Cuckoo Search
Authors: D. S. Naumann, B. J. Evans, O. Hassan
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This paper outlines the development of an automated aerodynamic optimisation algorithm using a novel method of parameterising a computational mesh by employing user–defined control nodes. The shape boundary movement is coupled to the movement of the novel concept of the control nodes via a quasi-1D-linear deformation. Additionally, a second order smoothing step has been integrated to act on the boundary during the mesh movement based on the change in its second derivative. This allows for both linear and non-linear shape transformations dependent on the preference of the user. The domain mesh movement is then coupled to the shape boundary movement via a Delaunay graph mapping. A Modified Cuckoo Search (MCS) algorithm is used for optimisation within the prescribed design space defined by the allowed range of control node displacement. A finite volume compressible NavierStokes solver is used for aerodynamic modelling to predict aerodynamic design fitness. The resulting coupled algorithm is applied to a range of test cases in two dimensions including the design of a subsonic, transonic and supersonic intake and the optimisation approach is compared with more conventional optimisation strategies. Ultimately, the algorithm is tested on a three dimensional wing optimisation case.Keywords: mesh movement, aerodynamic shape optimization, cuckoo search, shape parameterisation
Procedia PDF Downloads 337186 On-Site Coaching on Freshly-Graduated Nurses to Improves Quality of Clinical Handover and to Avoid Clinical Error
Authors: Sau Kam Adeline Chan
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World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error
Procedia PDF Downloads 148185 Practical Skill Education for Doctors in Training: Economical and Efficient Methods for Students to Receive Hands-on Experience
Authors: Nathaniel Deboever, Malcolm Breeze, Adrian Sheen
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Basic surgical and suturing techniques are a fundamental requirement for all doctors. In order to gain confidence and competence, doctors in training need to obtain sufficient teaching and just as importantly: practice. Young doctors with an apt level of expertise on these simple surgical skills, which are often used in the Emergency Department, can help alleviate some pressure during a busy evening. Unfortunately, learning these skills can be quite difficult during medical school or even during junior doctor years. The aim of this project was to adequately train medical students attending University of Sydney’s Nepean Clinical School through a series of workshops highlighting practical skills, with hopes to further extend this program to junior doctors in the hospital. The sessions instructed basic skills via tutorials, demonstrations, and lastly, the sessions cemented these proficiencies with practical sessions. During such an endeavor, it is fundamental to employ models that appropriately resemble what students will encounter in the clinical setting. The sustainability of workshops is similarly important to the continuity of such a program. To address both these challenges, the authors have developed models including suturing platforms, knot tying, and vessel ligation stations, as well as a shave and punch biopsy models and ophthalmologic foreign body device. The unique aspect of this work is that we utilized hands-on teaching sessions, to address a gap in doctors-in-training and junior doctor curriculum. Presented to you through this poster are our approaches to creating models that do not employ animal products and therefore do not necessitate particular facilities or discarding requirements. Covering numerous skills that would be beneficial to all young doctors, these models are easily replicable and affordable. This exciting work allows for countless sessions at low cost, providing enough practice for students to perform these skills confidently as it has been shown through attendee questionnaires.Keywords: medical education, surgical models, surgical simulation, surgical skills education
Procedia PDF Downloads 157184 Using Multiomic Plasma Profiling From Liquid Biopsies to Identify Potential Signatures for Disease Diagnostics in Late-Stage Non-small Cell Lung Cancer (NSCLC) in Trinidad and Tobago
Authors: Nicole Ramlachan, Samuel Mark West
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Lung cancer is the leading cause of cancer-associated deaths in North America, with the vast majority being non-small cell lung cancer (NSCLC), with a five-year survival rate of only 24%. Non-invasive discovery of biomarkers associated with early-diagnosis of NSCLC can enable precision oncology efforts using liquid biopsy-based multiomics profiling of plasma. Although tissue biopsies are currently the gold standard for tumor profiling, this method presents many limitations since these are invasive, risky, and sometimes hard to obtain as well as only giving a limited tumor profile. Blood-based tests provides a less-invasive, more robust approach to interrogate both tumor- and non-tumor-derived signals. We intend to examine 30 stage III-IV NSCLC patients pre-surgery and collect plasma samples.Cell-free DNA (cfDNA) will be extracted from plasma, and next-generation sequencing (NGS) performed. Through the analysis of tumor-specific alterations, including single nucleotide variants (SNVs), insertions, deletions, copy number variations (CNVs), and methylation alterations, we intend to identify tumor-derived DNA—ctDNA among the total pool of cfDNA. This would generate data to be used as an accurate form of cancer genotyping for diagnostic purposes. Using liquid biopsies offer opportunities to improve the surveillance of cancer patients during treatment and would supplement current diagnosis and tumor profiling strategies previously not readily available in Trinidad and Tobago. It would be useful and advantageous to use this in diagnosis and tumour profiling as well as to monitor cancer patients, providing early information regarding disease evolution and treatment efficacy, and reorient treatment strategies in, timethereby improving clinical oncology outcomes.Keywords: genomics, multiomics, clinical genetics, genotyping, oncology, diagnostics
Procedia PDF Downloads 160183 Autoimmune Diseases Associated with Celiac Disease in Adults
Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia
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Introduction: Celiac disease (CD) is an immune-mediated small intestinal disorder that occurs in genetically susceptible people. It is significantly associated with other autoimmune disorders represented mainly by type 1 diabetes and autoimmune dysthyroidism. The aim of our study is to determine the prevalence and the type of the various autoimmune diseases associated with CD in adult patients. Material and methods: This is a retrospective study including patients diagnosed with CD, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and January 2016. The diagnosis of CD was confirmed by serological tests and duodenal biopsy. The screening of autoimmune diseases was based on physical examination, biological and serological tests. Results: Sixty five patients with a female predominance were included, 48women (73.8%) and 17 men (26.2%). The mean age was 31.8 years (17-75). A family history of CD or other autoimmune diseases was present in 5 and 10 patients respectively. Clinical presentation of CD was made by recurrent abdominal pain in 49 cases, diarrhea in 29 cases, bloating in 17 cases, constipation in 25 cases and vomiting in 8 cases. Autoimmune diseases associated with CD were found in 30 cases (46.1%): type 1 diabetes in 15 patients attested by the positivity of anti-GAD antibodies in 11 cases and anti-IA2 in 4 cases, Hashimoto thyroiditis in 8 cases confirmed by the positivity of anti-TPO antibodies, Addison's disease in 2 patients, Anemia of Biermer in 2 patients, autoimmune hepatitis, Systemic erythematosus lupus, Gougerot Sjögren syndrome, rheumatoid arthritis, Vitiligo and antiphospholipid syndrome in one patient each. CD was associated with more than one autoimmune disease defining multiple autoimmune syndrome in 2 female patients. The first patient had Basedow disease, Addison disease and type 1 diabetes. The second patient had systemic erythematosus lupus and Gougerot Sjögren syndrome. Conclusion: In our study autoimmune diseases were associated with CD in 46.1% of cases and were dominated by diabetes and dysthroidism. After establishing the diagnosis of CD the search of associated autoimmune diseases is necessary in order to avoid any therapeutic delay which can alter the prognosis of the patient.Keywords: association, autoimmune thyroiditis, celiac disease, diabetes
Procedia PDF Downloads 283182 A Distributed Cryptographically Generated Address Computing Algorithm for Secure Neighbor Discovery Protocol in IPv6
Authors: M. Moslehpour, S. Khorsandi
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Due to shortage in IPv4 addresses, transition to IPv6 has gained significant momentum in recent years. Like Address Resolution Protocol (ARP) in IPv4, Neighbor Discovery Protocol (NDP) provides some functions like address resolution in IPv6. Besides functionality of NDP, it is vulnerable to some attacks. To mitigate these attacks, Internet Protocol Security (IPsec) was introduced, but it was not efficient due to its limitation. Therefore, SEND protocol is proposed to automatic protection of auto-configuration process. It is secure neighbor discovery and address resolution process. To defend against threats on NDP’s integrity and identity, Cryptographically Generated Address (CGA) and asymmetric cryptography are used by SEND. Besides advantages of SEND, its disadvantages like the computation process of CGA algorithm and sequentially of CGA generation algorithm are considerable. In this paper, we parallel this process between network resources in order to improve it. In addition, we compare the CGA generation time in self-computing and distributed-computing process. We focus on the impact of the malicious nodes on the CGA generation time in the network. According to the result, although malicious nodes participate in the generation process, CGA generation time is less than when it is computed in a one-way. By Trust Management System, detecting and insulating malicious nodes is easier.Keywords: NDP, IPsec, SEND, CGA, modifier, malicious node, self-computing, distributed-computing
Procedia PDF Downloads 278181 An Enhanced Hybrid Backoff Technique for Minimizing the Occurrence of Collision in Mobile Ad Hoc Networks
Authors: N. Sabiyath Fatima, R. K. Shanmugasundaram
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In Mobile Ad-hoc Networks (MANETS), every node performs both as transmitter and receiver. The existing backoff models do not exactly forecast the performance of the wireless network. Also, the existing models experience elevated packet collisions. Every time a collision happens, the station’s contention window (CW) is doubled till it arrives at the utmost value. The main objective of this paper is to diminish collision by means of contention window Multiplicative Increase Decrease Backoff (CWMIDB) scheme. The intention of rising CW is to shrink the collision possibility by distributing the traffic into an outsized point in time. Within wireless Ad hoc networks, the CWMIDB algorithm dynamically controls the contention window of the nodes experiencing collisions. During packet communication, the backoff counter is evenly selected from the given choice of [0, CW-1]. At this point, CW is recognized as contention window and its significance lies on the amount of unsuccessful transmission that had happened for the packet. On the initial transmission endeavour, CW is put to least amount value (C min), if transmission effort fails, subsequently the value gets doubled, and once more the value is set to least amount on victorious broadcast. CWMIDB is simulated inside NS2 environment and its performance is compared with Binary Exponential Backoff Algorithm. The simulation results show improvement in transmission probability compared to that of the existing backoff algorithm.Keywords: backoff, contention window, CWMIDB, MANET
Procedia PDF Downloads 276180 Determination of Community Based Reference Interval of Aspartate Aminotransferase to Platelet Ratio Index (APRI) among Healthy Populations in Mekelle City Tigray, Northern Ethiopia
Authors: Getachew Belay Kassahun
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Background: Aspartate aminotransferase to Platelet Ratio Index (APRI) currently becomes a biomarker for screening liver fibrosis since liver biopsy procedure is invasive and variation in pathological interpretation. Clinical Laboratory Standard Institute recommends establishing age, sex and environment specific reference interval for biomarkers in a homogenous population. The current study was aimed to derive community based reference interval of APRI aged between 12 and 60 years old in Mekelle city Tigrai, Northern Ethiopia. Method: Six hundred eighty eight study participants were collected from three districts in Mekelle city. The 3 districts were selected through random sampling technique and sample size to kebelles (small administration) were distributed proportional to household number in each district. Lottery method was used at household level if more than 2 study participants to each age partition were found. A community based cross sectional in a total of 534 study participants, 264 male and 270 females, were included in the final laboratory and data analysis but around 154 study participants were excluded through exclusion criteria. Aspartate aminotransferase was analyzed through Biosystem chemistry analyzer and Sysmix machine was used to analyze platelet. Man Whitney U test non parametric stastical tool was used to appreciate stastical difference among gender after excluding the outliers through Box and Whisker. Result: The study appreciated stastical difference among gender for APRI reference interval. The combined, male and female reference interval in the current study was 0.098-0.390, 0.133-0.428 and 0.090-0.319 respectively. The upper and lower reference interval of males was higher than females in all age partition and there was no stastical difference (p-value (<0.05)) between age partition. Conclusion: The current study showed using sex specific reference interval is significant to APRI biomarker in clinical practice for result interpretation.Keywords: reference interval, aspartate aminotransferase to platelet ratio Index, Ethiopia, tigray
Procedia PDF Downloads 114179 An Application Framework for Integrating Wireless Sensor and Actuator Networks for Precision Farmingas Web of Things to Cloud Interface Using PaaS
Authors: Sumaya Ismail, Aijaz Ahmad Reshi
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The advances in sensor and embedded technologies have led to rapid developments in Wireless Sensor Networks (WSNs). Presently researchers focus on the integration of WSNs to the Internet for their pervasive availability to access these network resources as the interoperable subsystems. The recent computing technologies like cloud computing has made resource sharing as a converged infrastructure with required service interfaces for the shared resources over the Internet. This paper presents application architecture for wireless Sensor and Actuator Networks (WSANS) following web of things, which allows easy integration of each node to the Internet in order to provide them with web accessibility. The architecture enables the sensors and actuator nodes accessed and controlled using cloud interface on WWW. The application architecture was implemented using existing web and its emerging technologies. In particular, the Representational State Transfer protocol (REST) was extended for the specific requirements of the application. The Cloud computing environment has been used as a development platform for the application to assess the possibility of integrating the WSAN nodes to Cloud services. The mushroom farm environment monitoring and control using WSANs has been taken as a research use case.Keywords: WSAN, REST, web of things, ZigBee, cloud interface, PaaS, sensor gateway
Procedia PDF Downloads 104178 Effect of Psychological Stress to the Mucosal IL-6 and Helicobacter pylori Activity in Functional Dyspepsia and Myocytes
Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin
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Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress
Procedia PDF Downloads 281177 Expression of PGC-1 Alpha Isoforms in Response to Eccentric and Concentric Resistance Training in Healthy Subjects
Authors: Pejman Taghibeikzadehbadr
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Background and Aim: PGC-1 alpha is a transcription factor that was first detected in brown adipose tissue. Since its discovery, PGC-1 alpha has been known to facilitate beneficial adaptations such as mitochondrial biogenesis and increased angiogenesis in skeletal muscle following aerobic exercise. Therefore, the purpose of this study was to investigate the expression of PGC-1 alpha isoforms in response to eccentric and concentric resistance training in healthy subjects. Materials and Methods: Ten healthy men were randomly divided into two groups (5 patients in eccentric group - 5 in eccentric group). Isokinetic contraction protocols included eccentric and concentric knee extension with maximum power and angular velocity of 60 degrees per second. The torques assigned to each subject were considered to match the workload in both protocols, with a rotational speed of 60 degrees per second. Contractions consisted of a maximum of 12 sets of 10 repetitions for the right leg, a rest time of 30 seconds between each set. At the beginning and end of the study, biopsy of the lateral broad muscle tissue was performed. Biopsies were performed in both distal and proximal directions of the lateral flank. To evaluate the expression of PGC1α-1 and PGC1α-4 genes, tissue analysis was performed in each group using Real-Time PCR technique. Data were analyzed using dependent t-test and covariance test. SPSS21 software and Exell 2013 software were used for data analysis. Results: The results showed that intra-group changes of PGC1α-1 after one session of activity were not significant in eccentric (p = 0.168) and concentric (p = 0.959) groups. Also, inter-group changes showed no difference between the two groups (p = 0.681). Also, intra-group changes of PGC1α-4 after one session of activity were significant in an eccentric group (p = 0.012) and concentric group (p = 0.02). Also, inter-group changes showed no difference between the two groups (p = 0.362). Conclusion: It seems that the lack of significant changes in the desired variables due to the lack of exercise pressure is sufficient to stimulate the increase of PGC1α-1 and PGC1α-4. And with regard to reviewing the answer, it seems that the compatibility debate has different results that need to be addressed.Keywords: eccentric contraction, concentric contraction, PGC1α-1 و PGC1α-4, human subject
Procedia PDF Downloads 78176 Experimental Study for the Development of a Wireless Communication System in a Solar Central Tower Facility
Authors: Victor H. Benitez, Ramon V. Armas-Flores, Jesus H. Pacheco-Ramirez
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Systems transforming solar energy into electrical power have emerged as a viable source of clean, renewable energy. Solar power tower technology is a good example of this type of system, which consists of several mobile mirrors, called heliostats, which reflect the sun's radiation to the same point, located on top of a tower at the center of heliostat field, for collection or transformation into another type of energy. The so-called Hermosillo’s Solar Platform (Plataforma Solar de Hermosillo, PSH, in Spanish) is a facility constituted with several heliostats, its aim and scope is for research purposes. In this paper, the implementation of a wireless communication system based on intelligent nodes is proposed in order to allow the communication and control of the heliostats in PSH. Intelligent nodes transmit information from one point to another, and can perform other actions that allow them to adapt to the conditions and limitations of a field of heliostats, thus achieving effective communication system. After deployment of the nodes in the heliostats, tests were conducted to measure the effectiveness of the communication, and determine the feasibility of using the proposed technologies. The test results were always positive, exceeding expectations held for its operation in the field of heliostats. Therefore, it was possible to validate the efficiency of the wireless communication system to be implemented in PSH, allowing communication and control of the heliostats.Keywords: heliostat, intelligent node, solar energy, wireless communication
Procedia PDF Downloads 408175 Multi-Level Clustering Based Congestion Control Protocol for Cyber Physical Systems
Authors: Manpreet Kaur, Amita Rani, Sanjay Kumar
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The Internet of Things (IoT), a cyber-physical paradigm, allows a large number of devices to connect and send the sensory data in the network simultaneously. This tremendous amount of data generated leads to very high network load consequently resulting in network congestion. It further amounts to frequent loss of useful information and depletion of significant amount of nodes’ energy. Therefore, there is a need to control congestion in IoT so as to prolong network lifetime and improve the quality of service (QoS). Hence, we propose a two-level clustering based routing algorithm considering congestion score and packet priority metrics that focus on minimizing the network congestion. In the proposed Priority based Congestion Control (PBCC) protocol the sensor nodes in IoT network form clusters that reduces the amount of traffic and the nodes are prioritized to emphasize important data. Simultaneously, a congestion score determines the occurrence of congestion at a particular node. The proposed protocol outperforms the existing Packet Discard Network Clustering (PDNC) protocol in terms of buffer size, packet transmission range, network region and number of nodes, under various simulation scenarios.Keywords: internet of things, cyber-physical systems, congestion control, priority, transmission rate
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