Search results for: patient dose optimization
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7507

Search results for: patient dose optimization

6937 Topology Optimization of Heat and Mass Transfer for Two Fluids under Steady State Laminar Regime: Application on Heat Exchangers

Authors: Rony Tawk, Boutros Ghannam, Maroun Nemer

Abstract:

Topology optimization technique presents a potential tool for the design and optimization of structures involved in mass and heat transfer. The method starts with an initial intermediate domain and should be able to progressively distribute the solid and the two fluids exchanging heat. The multi-objective function of the problem takes into account minimization of total pressure loss and maximization of heat transfer between solid and fluid subdomains. Existing methods account for the presence of only one fluid, while the actual work extends optimization distribution of solid and two different fluids. This requires to separate the channels of both fluids and to ensure a minimum solid thickness between them. This is done by adding a third objective function to the multi-objective optimization problem. This article uses density approach where each cell holds two local design parameters ranging from 0 to 1, where the combination of their extremums defines the presence of solid, cold fluid or hot fluid in this cell. Finite volume method is used for direct solver coupled with a discrete adjoint approach for sensitivity analysis and method of moving asymptotes for numerical optimization. Several examples are presented to show the ability of the method to find a trade-off between minimization of power dissipation and maximization of heat transfer while ensuring the separation and continuity of the channel of each fluid without crossing or mixing the fluids. The main conclusion is the possibility to find an optimal bi-fluid domain using topology optimization, defining a fluid to fluid heat exchanger device.

Keywords: topology optimization, density approach, bi-fluid domain, laminar steady state regime, fluid-to-fluid heat exchanger

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6936 Iot-Based Interactive Patient Identification and Safety Management System

Authors: Jonghoon Chun, Insung Kim, Jonghyun Lim, Gun Ro

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We believe that it is possible to provide a solution to reduce patient safety accidents by displaying correct medical records and prescription information through interactive patient identification. Our system is based on the use of smart bands worn by patients and these bands communicate with the hybrid gateways which understand both BLE and Wifi communication protocols. Through the convergence of low-power Bluetooth (BLE) and hybrid gateway technology, which is one of short-range wireless communication technologies, we implement ‘Intelligent Patient Identification and Location Tracking System’ to prevent medical malfunction frequently occurring in medical institutions. Based on big data and IOT technology using MongoDB, smart band (BLE, NFC function) and hybrid gateway, we develop a system to enable two-way communication between medical staff and hospitalized patients as well as to store locational information of the patients in minutes. Based on the precise information provided using big data systems, such as location tracking and movement of in-hospital patients wearing smart bands, our findings include the fact that a patient-specific location tracking algorithm can more efficiently operate HIS (Hospital Information System) and other related systems. Through the system, we can always correctly identify patients using identification tags. In addition, the system automatically determines whether the patient is a scheduled for medical service by the system in use at the medical institution, and displays the appropriateness of the medical treatment and the medical information (medical record and prescription information) on the screen and voice. This work was supported in part by the Korea Technology and Information Promotion Agency for SMEs (TIPA) grant funded by the Korean Small and Medium Business Administration (No. S2410390).

Keywords: BLE, hybrid gateway, patient identification, IoT, safety management, smart band

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6935 Nursing Experience for a Lung Cancer Patient Undergoing First Time Concurrent Chemotherapy and Radiation Therapy

Authors: Hui Ling Chen

Abstract:

This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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6934 A Case Study on Effectiveness of Hijamah (Wet Cupping) on Numbness of Foot in Diabetic Patient

Authors: Nafdha Thajudeen

Abstract:

Hijamah therapy is one of the leading alternative & complementary modalities in the World. It is a kind of detoxification, rejuvenation, and blood purification method. It comes under Ilaj bil Tadbeer (Regimental therapy) in the Unani medical system. In diabetes, hands and foot care in people is very important because of slow blood circulation, where blood sometimes is not able to fully penetrate the capillaries. Hijamah therapy works upon the following two principles- Tanqiyae Mawad (Evacuation of morbid humor) and Imalae Mawad (Diversion of humor). The aim of this study was to find out the effectiveness of hijamah therapy on the numbness of legs in a diabetic patient. This case study was carried out in Ayurvedic Research Hospital (Non-Communicable Diseases), Ninthavur, Sri Lanka. A 63 years old female diabetic patient came to the clinic with the complain of numbness in both feet for one year. The treatment history of the patient revealed that she had taken western medicine for her complaints for 7 months. In her first visit, wet cupping was done on local and distal points. The patient said there was a remarkable improvement; internal medicines were given to keep the sugar level in normal with some external applications. Every week, wet cupping was done on the same points, with repeating the same medicines. Foot numbness was fully cured within one month. The finding of this study shows that the complaint of numbness in the diabetic patient was treated with hijamah therapy with internal & external medicine. This case study can be concluded as hijamah therapy is very effective in treating diabetic numbness. This single case study may be the entrance for future clinical studies

Keywords: Hijamah therapy, Ilaj bil thadbeer, diabetes, numbness

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6933 Protective Effect of Herniarin on Ionizing Radiation-Induced Impairments in Brain

Authors: Sophio Kalmakhelidze, Eka Shekiladze, Tamar Sanikidze, Mikheil Gogebashvili, Nazi Ivanishvili

Abstract:

Radiation-induced various degrees of brain injury and cognitive impairment have been described after cranial radiotherapy of brain tumors. High doses of ionizing radiation have a severe impact on the central nervous system, resulting in morphological and behavioral impairments. Structures of the limbic system are especially sensitive to radiation exposure. Hence, compounds or drugs that can reduce radiation-induced impairments can be used as promising antioxidants or radioprotectors. In our study Mice whole-body irradiation with 137Cs was performed at a dose rate of 1,1 Gy/min for a total dose of 5 Gy with a “Gamma-capsule-2”. Irradiated mice were treated with Herniarin (20 mg/kg) for five days before irradiation and the same dose was administrated after one hour of irradiation. The immediate and delayed effects of ionizing radiation, as well as, protective effect of Herniarin was evaluated during early and late post-irradiation periods. The results reveal that ionizing radiation (5 Gy) alters the structure of the hippocampus in adult mice during the late post-irradiation period resulting in the decline of memory formation and learning process. Furthermore, Simple Coumarin-Herniarin reveals a radiosensitizing effect reducing morphological and behavioral alterations.

Keywords: ionizing radiation, cognitive impairments, hippocampus, limbic system, Herniarin

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6932 Q-Efficient Solutions of Vector Optimization via Algebraic Concepts

Authors: Elham Kiyani

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In this paper, we first introduce the concept of Q-efficient solutions in a real linear space not necessarily endowed with a topology, where Q is some nonempty (not necessarily convex) set. We also used the scalarization technique including the Gerstewitz function generated by a nonconvex set to characterize these Q-efficient solutions. The algebraic concepts of interior and closure are useful to study optimization problems without topology. Studying nonconvex vector optimization is valuable since topological interior is equal to algebraic interior for a convex cone. So, we use the algebraic concepts of interior and closure to define Q-weak efficient solutions and Q-Henig proper efficient solutions of set-valued optimization problems, where Q is not a convex cone. Optimization problems with set-valued maps have a wide range of applications, so it is expected that there will be a useful analytical tool in optimization theory for set-valued maps. These kind of optimization problems are closely related to stochastic programming, control theory, and economic theory. The paper focus on nonconvex problems, the results are obtained by assuming generalized non-convexity assumptions on the data of the problem. In convex problems, main mathematical tools are convex separation theorems, alternative theorems, and algebraic counterparts of some usual topological concepts, while in nonconvex problems, we need a nonconvex separation function. Thus, we consider the Gerstewitz function generated by a general set in a real linear space and re-examine its properties in the more general setting. A useful approach for solving a vector problem is to reduce it to a scalar problem. In general, scalarization means the replacement of a vector optimization problem by a suitable scalar problem which tends to be an optimization problem with a real valued objective function. The Gerstewitz function is well known and widely used in optimization as the basis of the scalarization. The essential properties of the Gerstewitz function, which are well known in the topological framework, are studied by using algebraic counterparts rather than the topological concepts of interior and closure. Therefore, properties of the Gerstewitz function, when it takes values just in a real linear space are studied, and we use it to characterize Q-efficient solutions of vector problems whose image space is not endowed with any particular topology. Therefore, we deal with a constrained vector optimization problem in a real linear space without assuming any topology, and also Q-weak efficient and Q-proper efficient solutions in the senses of Henig are defined. Moreover, by means of the Gerstewitz function, we provide some necessary and sufficient optimality conditions for set-valued vector optimization problems.

Keywords: algebraic interior, Gerstewitz function, vector closure, vector optimization

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6931 Early Outcomes and Lessons from the Implementation of a Geriatric Hip Fracture Protocol at a Level 1 Trauma Center

Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

Abstract:

Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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6930 Open Fields' Dosimetric Verification for a Commercially-Used 3D Treatment Planning System

Authors: Nashaat A. Deiab, Aida Radwan, Mohamed Elnagdy, Mohamed S. Yahiya, Rasha Moustafa

Abstract:

This study is to evaluate and investigate the dosimetric performance of our institution's 3D treatment planning system, Elekta PrecisePLAN, for open 6MV fields including square, rectangular, variation in SSD, centrally blocked, missing tissue, square MLC and MLC shaped fields guided by the recommended QA tests prescribed in AAPM TG53, NCS report 15 test packages, IAEA TRS 430 and ESTRO booklet no.7. The study was performed for Elekta Precise linear accelerator designed for clinical range of 4, 6 and 15 MV photon beams with asymmetric jaws and fully integrated multileaf collimator that enables high conformance to target with sharp field edges. Seven different tests were done applied on solid water equivalent phantom along with 2D array dose detection system, the calculated doses using 3D treatment planning system PrecisePLAN, compared with measured doses to make sure that the dose calculations are accurate for open fields including square, rectangular, variation in SSD, centrally blocked, missing tissue, square MLC and MLC shaped fields. The QA results showed dosimetric accuracy of the TPS for open fields within the specified tolerance limits. However large square (25cm x 25cm) and rectangular fields (20cm x 5cm) some points were out of tolerance in penumbra region (11.38 % and 10.9 %, respectively). For the test of SSD variation, the large field resulted from SSD 125 cm for 10cm x 10cm filed the results recorded an error of 0.2% at the central axis and 1.01% in penumbra. The results yielded differences within the accepted tolerance level as recommended. Large fields showed variations in penumbra. These differences between dose values predicted by the TPS and the measured values at the same point may result from limitations of the dose calculation, uncertainties in the measurement procedure, or fluctuations in the output of the accelerator.

Keywords: quality assurance, dose calculation, 3D treatment planning system, photon beam

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6929 Correlations between Folate, Homocysteine Levels, and Markers of Brain Atrophy in Elderly Male and Female Rats

Authors: Fatimah A. Alhomaid, Nadia H. Mahmoud, Maha A. Al-Qaraawi

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The present study was designed to induce hyperhomocysteinemia (HHcy) in elderly male and female rats. Also,to evaluate, the effect of (HHcy) as a risk factor for cerebrovascular disease and brain atrophy and folate supplementation on serum levels of Hcy, total cholesterol, low density lipoprotein cholesterol (LDLc), high density lipoprotein cholesterol (HDLc), triglycerides, pyridoxal phosphate , folate also, histopathological examination of brain and cerebrovascular vessels In this work 50 male and 50 female elderly albino rats were used and divided into five groups. The first group served as control, the second and third group received two different dose of L-methionine, the fourth and fifth group received fortified diet with folate powder plus L-methionine. Our results showed that homocysteine levels in male and female rats that received low and high dose of methionine were higher than in the control group, while the levels of folate significantly decreased in male rats only. Induced hyperhomocysteinemia in elderly male and female rats led to significant increase in serum level of cholesterol, LDLc and triglycerides but serum level of HDLc were significantly lower in methionine treated male and female rats than in control. Our results showed that a strong positive correlation between all these parameters and homocysteine except HDLc levels which correlate negatively to Hcy levels. Administration of folate to methionine treated male rats led to insignificant changes in the level of cholesterol when compared to control group but this level was found to be significantly decrease in female rats received small dose of methionine. When the level of cholesterol compared to the same dose of methionine treated group we found a significant decrease in both male and female rats. LDLc and triglycerides level significantly decrease in male rats only versus the control rats, while when compared to low and high dose of methionine a significant decreased occurs. A significant increase in serum level of HDLc in male and female rats when compared to both control and methionine treated groups. In male and female rats supplemented with folate we found an increased serum levels of folate when compared to rats received both dose of methionine. The levels of pyridoxal phosphate significantly decreased in all treated rats compared to the control group and its level were increased with supplementation of folate versus the rats received small and large dose of methionine. It can be concluded that hyperhomocysteinemia may be an additional risk factor for cerebrovascular atherosclesosis and brain atrophy in elderly people and diatery supplementation with folate blocking the activity of homocysteine and may be considered as a therapeutic possibility.

Keywords: hyperhomocysteinemia, brain atrophy, cerebrovascular, L-methionine, pyridoxal phosphate

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6928 Portfolio Optimization with Reward-Risk Ratio Measure Based on the Mean Absolute Deviation

Authors: Wlodzimierz Ogryczak, Michal Przyluski, Tomasz Sliwinski

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In problems of portfolio selection, the reward-risk ratio criterion is optimized to search for a risky portfolio with the maximum increase of the mean return in proportion to the risk measure increase when compared to the risk-free investments. In the classical model, following Markowitz, the risk is measured by the variance thus representing the Sharpe ratio optimization and leading to the quadratic optimization problems. Several Linear Programming (LP) computable risk measures have been introduced and applied in portfolio optimization. In particular, the Mean Absolute Deviation (MAD) measure has been widely recognized. The reward-risk ratio optimization with the MAD measure can be transformed into the LP formulation with the number of constraints proportional to the number of scenarios and the number of variables proportional to the total of the number of scenarios and the number of instruments. This may lead to the LP models with huge number of variables and constraints in the case of real-life financial decisions based on several thousands scenarios, thus decreasing their computational efficiency and making them hardly solvable by general LP tools. We show that the computational efficiency can be then dramatically improved by an alternative model based on the inverse risk-reward ratio minimization and by taking advantages of the LP duality. In the introduced LP model the number of structural constraints is proportional to the number of instruments thus not affecting seriously the simplex method efficiency by the number of scenarios and therefore guaranteeing easy solvability. Moreover, we show that under natural restriction on the target value the MAD risk-reward ratio optimization is consistent with the second order stochastic dominance rules.

Keywords: portfolio optimization, reward-risk ratio, mean absolute deviation, linear programming

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6927 Poliovirus Vaccine Immunity among Chronically Malnourished Pakistani Infants: A Randomized Controlled Trial from Developing Country

Authors: Ali Faisal Saleem, Farheen Quadri, Mach Ondrej, Anita Zaidi

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Purpose: Pakistan is the final frontier for a polio-free world. Chronic malnutrition is associated with lack of effective gut immunity, and possibly associated with poliomyelitis in children received multiple OPV. We evaluate IPV dose administered together with OPV results in higher immunogenicity and mucosal immunity compared to OPV alone in chronically malnourished infants. Methods AND Materials: A community-based, unblinded-randomized-trial, conducted in 5 peri-urban, low-middle-income households of Karachi, in infants 9-12 months. Two study groups were non-malnourished (HAZ= -2 or more) and chronic malnourished (HAZ <-2SD), with 2-arms each i) OPV and ii) OPV and IPV. Two blood specimens (2ml) at baseline and at day 28 and two stool specimens (6 gm.) at day 29 and after 7 days. All infants received a bOPV challenge dose after first stool specimen. Calculates sample size was 210 in each arm. Serological (baseline compared to 28 days post-vaccine) and mucosal immunity after one week of bOPV challenge dose were study outcomes. Results: Baseline seroprevalence in malnourished infants were low compared to non-malnourished (P1, P2 and P3 (p=<0.001). There is significant rise in antibody titer and P1 seroprevalence in Mal A and B after receiving study vaccine; much higher in Mal B. Infants randomized to bOPV + IPV study vaccine showed incremental immune response against P1 (Mal B, 92.2%; Nor B, 98.4%), P2 (Mal B, 90.4%; Nor B, 94.7%), and P3 (Mal B, 85.6% and Nor B, 93.5%) was observed. A significant proportion of infants in malnourished (P1, 13%; P2, 24%; P3, 26%) and normally nourished group (P1, 5%; P2, 11%; P3, 14%) were found to be seronegative at baseline. Infants who received BOPV + IPV as their study vaccine showed a very high seroconversion response after vaccine (p=<0.001 for P1, P2 and P3). Majority of the specimens were negative at baseline (Mal A, 2%, Mal B, 1%; Nor A, 2%; Nor B, 1%), and remains negative after bOPV challenge dose (Mal A, 8%, Mal B, 6%; Nor A, 11%; Nor B, 10%). Conclusion: Malnourished-infants have low poliovirus-seroprevalence that increased remarkably after IPV. There is less viral shedding after IPV in infants.

Keywords: chronic malnutrition, infants, IPV, OPV

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6926 Comparison of Parallel CUDA and OpenMP Implementations of Memetic Algorithms for Solving Optimization Problems

Authors: Jason Digalakis, John Cotronis

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Memetic algorithms (MAs) are useful for solving optimization problems. It is quite difficult to search the search space of the optimization problem with large dimensions. There is a challenge to use all the cores of the system. In this study, a sequential implementation of the memetic algorithm is converted into a concurrent version, which is executed on the cores of both CPU and GPU. For this reason, CUDA and OpenMP libraries are operated on the parallel algorithm to make a concurrent execution on CPU and GPU, respectively. The aim of this study is to compare CPU and GPU implementation of the memetic algorithm. For this purpose, fourteen benchmark functions are selected as test problems. The obtained results indicate that our approach leads to speedups up to five thousand times higher compared to one CPU thread while maintaining a reasonable results quality. This clearly shows that GPUs have the potential to acceleration of MAs and allow them to solve much more complex tasks.

Keywords: memetic algorithm, CUDA, GPU-based memetic algorithm, open multi processing, multimodal functions, unimodal functions, non-linear optimization problems

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6925 Feature Selection for Production Schedule Optimization in Transition Mines

Authors: Angelina Anani, Ignacio Ortiz Flores, Haitao Li

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The use of underground mining methods have increased significantly over the past decades. This increase has also been spared on by several mines transitioning from surface to underground mining. However, determining the transition depth can be a challenging task, especially when coupled with production schedule optimization. Several researchers have simplified the problem by excluding operational features relevant to production schedule optimization. Our research objective is to investigate the extent to which operational features of transition mines accounted for affect the optimal production schedule. We also provide a framework for factors to consider in production schedule optimization for transition mines. An integrated mixed-integer linear programming (MILP) model is developed that maximizes the NPV as a function of production schedule and transition depth. A case study is performed to validate the model, with a comparative sensitivity analysis to obtain operational insights.

Keywords: underground mining, transition mines, mixed-integer linear programming, production schedule

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6924 Optimal Hybrid Linear and Nonlinear Control for a Quadcopter Drone

Authors: Xinhuang Wu, Yousef Sardahi

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A hybrid and optimal multi-loop control structure combining linear and nonlinear control algorithms are introduced in this paper to regulate the position of a quadcopter unmanned aerial vehicle (UAV) driven by four brushless DC motors. To this end, a nonlinear mathematical model of the UAV is derived and then linearized around one of its operating points. Using the nonlinear version of the model, a sliding mode control is used to derive the control laws of the motor thrust forces required to drive the UAV to a certain position. The linear model is used to design two controllers, XG-controller and YG-controller, responsible for calculating the required roll and pitch to maneuver the vehicle to the desired X and Y position. Three attitude controllers are designed to calculate the desired angular rates of rotors, assuming that the Euler angles are minimal. After that, a many-objective optimization problem involving 20 design parameters and ten objective functions is formulated and solved by HypE (Hypervolume estimation algorithm), one of the widely used many-objective optimization algorithms approaches. Both stability and performance constraints are imposed on the optimization problem. The optimization results in terms of Pareto sets and fronts are obtained and show that some of the design objectives are competing. That is, when one objective goes down, the other goes up. Also, Numerical simulations conducted on the nonlinear UAV model show that the proposed optimization method is quite effective.

Keywords: optimal control, many-objective optimization, sliding mode control, linear control, cascade controllers, UAV, drones

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6923 The Bespoke ‘Hybrid Virtual Fracture Clinic’ during the COVID-19 Pandemic: A Paradigm Shift?

Authors: Anirudh Sharma

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Introduction: The Covid-19 pandemic necessitated a change in the manner outpatient fracture clinics are conducted due to the need to reduce footfall in hospital. While studies regarding virtual fracture clinics have shown these to be useful and effective, they focus exclusively on remote consultations. However, our service was bespoke to the patient – either a face-to-face or telephone consultation depending on patient need – a ‘hybrid virtual clinic (HVC).’ We report patient satisfaction and outcomes with this novel service. Methods: Patients booked onto our fracture clinics during the first 2 weeks of national lockdown were retrospectively contacted to assess the mode of consultations (virtual, face-to-face, or hybrid), patient experience, and outcome. Patient experience was assessed using the net promoter (NPS), customer effort (CES) and customer satisfaction scores (CSS), and their likelihood of using the HVC in the absence of a pandemic. Patient outcomes were assessed using the components of the EQ5D score. Results: Of 269 possible patients, 140 patients responded to the questionnaire. Of these, 66.4% had ‘hybrid’ consultations, 27.1% had only virtual consultations, and 6.4% had only face-to-face consultations. The mean overall NPS, CES, and CSS (on a scale of 1-10) were 7.27, 7.25, and 7.37, respectively. The mean likelihood of patients using the HVC in the absence of a pandemic was 6.5/10. Patients who had ‘hybrid’ consultations showed better effort scores and greater overall satisfaction than those with virtual consultations only and also reported superior EQ5D outcomes (mean 79.27 vs. 72.7). Patients who did not require surgery reported increased satisfaction (mean 7.51 vs. 7.08) and were more likely to use the HVC in the absence of a pandemic. Conclusion: Our study indicates that a bespoke HVC has good overall patient satisfaction and outcomes and is a better format of fracture clinic service than virtual consultations alone. It may be the preferred mode for fracture clinics in similar situations in the future. Further analysis needs to be conducted in order to explore the impact on resources and clinician experience of HVC in order to appreciate this new paradigm shift.

Keywords: hybrid virtual clinic, coronavirus, COVID-19, fracture clinic, remote consultation

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6922 Hexavalent Chromium-Induced Changes in Biochemical Parameters of Wistar Albino Rats

Authors: Ounassa Adjroud

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Potassium dichromate (K2Cr2O7) is one of the most toxic elements to which man can be exposed at work or in the environment. The purpose of the current work is to compare the effect of K2Cr2O7 using variations in the dose, route of administration and duration of exposure in male and female Wistar albino rats with a special focus on biochemical parameters. K2Cr2O7 was subcutaneously administered alone (10, 50 and 100 mg/kg body weight) to female Wistar albino rats. Male rats received in their drinking water K2Cr2O7 30 mg/L/day) for 20 consecutive days. The Biochemical parameters were evaluated on days 3, 6 and 21 after subcutaneous (sc.) treatment in female rats and on days 10 and 20 after oral administration in male rats. The subcutaneous (s.c.) administration of 25 mg/kg of K2Cr2O7 to Wistar albino rats induced a slight change in plasma glucose levels during the experiment period. On the contrary, a significant decrease in plasma glucose levels was observed with 50 mg/kg mainly on days 3 (-26%) and 21 (-48%) after treatment compared to controls females rats. On the other hand, the higher dose provoked a significant increase in plasma glucose concentrations on days 6 (+31%) and 21 (+60%). similarly, the lower dose of chromium had no effect on the plasma urea levels. Conversely, a significant increase (122%) in this parameter was obtained during the first three days after treatment. In addition, a significant decrease in plasma glucose levels was observed with 50 mg/kg mainly on days 3 (-26%) and 21 (-48%) after treatment. On the other hand, the higher dose provoked a significant increase in plasma glucose concentrations on days 6 (+31%) and 21 (+60%). similarly, the lower dose of chromium had no effect on the plasma urea levels. Conversely, a significant increase in this parameter (122%) was obtained during the first three days after treatment. In addition, administration of 100 mg/kg of K2Cr2O7 by s.c markedly augmented the levels of plasma urea on days 3 (62%) and 6 (121%). Administration of 30 mg/L/day of K2Cr2O7 in the drinking water induced a significant augmentation in both of plasma glucose (27%) and urea (126%) during the first ten days of treatment. These results suggested that K2Cr2O7 administered subcutaneously or in the drinking water may induce harmful effects on biochemical parameters.

Keywords: glucose, potassium dichromate, Wistar albino rat, urea

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6921 Clostridium Glycolicum Abdominal Infection in a Patient with Small Bowel Obstruction

Authors: Benedikt Munzar, Jagraj Singh, Alice Mei, David Musheyev, Sandeep Gandhi

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Clostridium glycolicum is a gram-positive, anaerobic, spore-forming rod that is not commonly identified as a primary human pathogen. Here is a case of a 60-year-old patient with a history of opioid use disorder who underwent a number of abdominal surgeries for small bowel obstruction. His hospital course was complicated by Clostridium glycolicum infection resulting in an acute abdomen. The patient clinically improved with antibiotic therapy. A thorough review of the National Institute of Health database revealed that only a small number of cases have been reported since 2007, with the last postsurgical cases documented in 2009 and the last clinical case documented in 2012. Clostridium glycolicum infections have been noted in patients with immunosuppressive conditions or those undergoing medical treatments that compromise immune function. This case was unusual due to the patient being immunocompetent. We suggest that a case of an acute abdomen should consider this organism as an etiological agent.

Keywords: acute abdomen, bacterial infection, clostridium glycolicum, meckel’s diverticulum, pneumoperitoneum, small bowel obstruction

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6920 Dosimetry in Interventional Radiology Examinations for Occupational Exposure Monitoring

Authors: Ava Zarif Sanayei, Sedigheh Sina

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Interventional radiology (IR) uses imaging guidance, including X-rays and CT scans, to deliver therapy precisely. Most IR procedures are performed under local anesthesia and start with a small needle being inserted through the skin, which may be called pinhole surgery or image-guided surgery. There is increasing concern about radiation exposure during interventional radiology procedures due to procedure complexity. The basic aim of optimizing radiation protection as outlined in ICRP 139, is to strike a balance between image quality and radiation dose while maximizing benefits, ensuring that diagnostic interpretation is satisfactory. This study aims to estimate the equivalent doses to the main trunk of the body for the Interventional radiologist and Superintendent using LiF: Mg, Ti (TLD-100) chips at the IR department of a hospital in Shiraz, Iran. In the initial stage, the dosimeters were calibrated with the use of various phantoms. Afterward, a group of dosimeters was prepared, following which they were used for three months. To measure the personal equivalent dose to the body, three TLD chips were put in a tissue-equivalent batch and used under a protective lead apron. After the completion of the duration, TLDs were read out by a TLD reader. The results revealed that these individuals received equivalent doses of 387.39 and 145.11 µSv, respectively. The findings of this investigation revealed that the total radiation exposure to the staff was less than the annual limit of occupational exposure. However, it's imperative to implement appropriate radiation protection measures. Although the dose received by the interventional radiologist is a bit noticeable, it may be due to the reason for using conventional equipment with over-couch x-ray tubes for interventional procedures. It is therefore important to use dedicated equipment and protective means such as glasses and screens whenever compatible with the intervention when they are available or have them fitted to equipment if they are not present. Based on the results, the placement of staff in an appropriate location led to increasing the dose to the radiologist. Manufacturing and installation of moveable lead curtains with a thickness of 0.25 millimeters can effectively minimize the radiation dose to the body. Providing adequate training on radiation safety principles, particularly for technologists, can be an optimal approach to further decreasing exposure.

Keywords: interventional radiology, personal monitoring, radiation protection, thermoluminescence dosimetry

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6919 Supply Chain Resource Optimization Model for E-Commerce Pure Players

Authors: Zair Firdaous, Fourka Mohamed, Elfelsoufi Zoubir

Abstract:

The arrival of e-commerce has changed the supply chain management on the operational level as well as on the organization and strategic and even tactical decisions of the companies. The optimization of resources is an issue that is needed on the tactical and operational strategic plan. This work considers the allocation of resources in the case of pure players that have launched online sales. The aim is to improve the level of customer satisfaction and maintaining the benefits of e-retailer and of its cooperators and reducing costs and risks. We first modeled the B2C chain with all operations that integrates and possible scenarios since online retailers offer a wide selection of personalized service. The personalized services that online shopping companies offer to the clients can be embodied in many aspects, such as the customizations of payment, the distribution methods, and after-sales service choices. Every aspect of customized service has several modes. At that time, we analyzed the optimization problems of supply chain resource in customized online shopping service mode. Then, we realized an optimization model and algorithm for the development based on the analysis of the of the B2C supply chain resources. It is a multi-objective optimization that considers the collaboration of resources in operations, time and costs but also the risks and the quality of services as well as dynamic and uncertain characters related to the request.

Keywords: supply chain resource, e-commerce, pure-players, optimization

Procedia PDF Downloads 246
6918 Optimization of a Convolutional Neural Network for the Automated Diagnosis of Melanoma

Authors: Kemka C. Ihemelandu, Chukwuemeka U. Ihemelandu

Abstract:

The incidence of melanoma has been increasing rapidly over the past two decades, making melanoma a current public health crisis. Unfortunately, even as screening efforts continue to expand in an effort to ameliorate the death rate from melanoma, there is a need to improve diagnostic accuracy to decrease misdiagnosis. Artificial intelligence (AI) a new frontier in patient care has the ability to improve the accuracy of melanoma diagnosis. Convolutional neural network (CNN) a form of deep neural network, most commonly applied to analyze visual imagery, has been shown to outperform the human brain in pattern recognition. However, there are noted limitations with the accuracy of the CNN models. Our aim in this study was the optimization of convolutional neural network algorithms for the automated diagnosis of melanoma. We hypothesized that Optimal selection of the momentum and batch hyperparameter increases model accuracy. Our most successful model developed during this study, showed that optimal selection of momentum of 0.25, batch size of 2, led to a superior performance and a faster model training time, with an accuracy of ~ 83% after nine hours of training. We did notice a lack of diversity in the dataset used, with a noted class imbalance favoring lighter vs. darker skin tone. Training set image transformations did not result in a superior model performance in our study.

Keywords: melanoma, convolutional neural network, momentum, batch hyperparameter

Procedia PDF Downloads 99
6917 Descent Algorithms for Optimization Algorithms Using q-Derivative

Authors: Geetanjali Panda, Suvrakanti Chakraborty

Abstract:

In this paper, Newton-like descent methods are proposed for unconstrained optimization problems, which use q-derivatives of the gradient of an objective function. First, a local scheme is developed with alternative sufficient optimality condition, and then the method is extended to a global scheme. Moreover, a variant of practical Newton scheme is also developed introducing a real sequence. Global convergence of these schemes is proved under some mild conditions. Numerical experiments and graphical illustrations are provided. Finally, the performance profiles on a test set show that the proposed schemes are competitive to the existing first-order schemes for optimization problems.

Keywords: Descent algorithm, line search method, q calculus, Quasi Newton method

Procedia PDF Downloads 394
6916 Penguins Search Optimization Algorithm for Chaotic Synchronization System

Authors: Sofiane Bououden, Ilyes Boulkaibet

Abstract:

In terms of security of the information signal, the meta-heuristic Penguins Search Optimization Algorithm (PeSOA) is applied to synchronize chaotic encryption communications in the case of sensitive dependence on initial conditions in chaotic generator oscillator. The objective of this paper is the use of the PeSOA algorithm to exploring search space with random and iterative processes for synchronization of symmetric keys in both transmission and reception. Simulation results show the effectiveness of the PeSOA algorithm in generating symmetric keys of the encryption process and synchronizing.

Keywords: meta-heuristic, PeSOA, chaotic systems, encryption, synchronization optimization

Procedia PDF Downloads 189
6915 Social Media Marketing Efforts and Hospital Brand Equity: An Empirical Investigation

Authors: Abrar R. Al-Hasan

Abstract:

Despite the widespread use of social media by consumers and marketers, empirical research investigating their economic value in the healthcare industry still lags. This study explores the impact of the use of social media marketing efforts on a hospital's brand equity and, ultimately, consumer response. Using social media data from Twitter and Facebook, along with an online and offline survey methodology, data is analyzed using logistic regression models. A random sample of (728) residents of the Kuwaiti population is used. The results of this study found that social media marketing efforts (SMME) in terms of use and validation lead to higher hospital brand equity and in turn, patient loyalty and patient visit. The study highlights the impact of SMME on hospital brand equity and patient response. Healthcare organizations should guide their marketing efforts to better manage this new way of marketing and communicating with patients to enhance their consumer loyalty and financial performance.

Keywords: brand equity, healthcare marketing, patient visit, social media, SMME

Procedia PDF Downloads 169
6914 Printed Thai Character Recognition Using Particle Swarm Optimization Algorithm

Authors: Phawin Sangsuvan, Chutimet Srinilta

Abstract:

This Paper presents the applications of Particle Swarm Optimization (PSO) Method for Thai optical character recognition (OCR). OCR consists of the pre-processing, character recognition and post-processing. Before enter into recognition process. The Character must be “Prepped” by pre-processing process. The PSO is an optimization method that belongs to the swarm intelligence family based on the imitation of social behavior patterns of animals. Route of each particle is determined by an individual data among neighborhood particles. The interaction of the particles with neighbors is the advantage of Particle Swarm to determine the best solution. So PSO is interested by a lot of researchers in many difficult problems including character recognition. As the previous this research used a Projection Histogram to extract printed digits features and defined the simple Fitness Function for PSO. The results reveal that PSO gives 67.73% for testing dataset. So in the future there can be explored enhancement the better performance of PSO with improve the Fitness Function.

Keywords: character recognition, histogram projection, particle swarm optimization, pattern recognition techniques

Procedia PDF Downloads 469
6913 Nursing Care Experience for a Patient with Type2 Diabetes Mellitus and Hyperglycemic Hyperosmolar State

Authors: Yen-Hsia Lin, Ya-Fang Cheng, Hui-Zhu Chen, Chi-Hui Tiao

Abstract:

This is a case study of a 70-year-old man suffering from Type 2 diabetes mellitus and hyperglycemia hyperosmolarity state. He was admitted into the intensive care unit from the 20th to 26th of October, 2015. After receiving relevant information through open-ended conversations, observation, and physical assessment, as well as the psychological, social and spiritual holistic nursing assessment, several clinical health problems such as unstable blood sugar, impaired skin integrity and lack of self-care management knowledge were identified by the author. During the period of care, the patient was encouraged to share and express his feelings, an active listening and initiating approach from the nursing team had led to the understanding of why the patient refused to use insulin. This knowledge enabled the nursing team to manage patient care by educating the patient with self-care management skills, such as foot wound care and insulin injection skills to slow the deterioration of complications. Also, the implementation of appropriate diet and exercise routine to improve patients’ style. By enhancing self-care ability in diabetic patients, they are able to return home with the skill to improve better quality life style.

Keywords: hyperglycemia hyperosmolar state, type2 diabetes Mellitu, diabetes Mellitu foot care, intensive care

Procedia PDF Downloads 144
6912 A New Family of Globally Convergent Conjugate Gradient Methods

Authors: B. Sellami, Y. Laskri, M. Belloufi

Abstract:

Conjugate gradient methods are an important class of methods for unconstrained optimization, especially for large-scale problems. Recently, they have been much studied. In this paper, a new family of conjugate gradient method is proposed for unconstrained optimization. This method includes the already existing two practical nonlinear conjugate gradient methods, which produces a descent search direction at every iteration and converges globally provided that the line search satisfies the Wolfe conditions. The numerical experiments are done to test the efficiency of the new method, which implies the new method is promising. In addition the methods related to this family are uniformly discussed.

Keywords: conjugate gradient method, global convergence, line search, unconstrained optimization

Procedia PDF Downloads 407
6911 IT-Based Global Healthcare Delivery System: An Alternative Global Healthcare Delivery System

Authors: Arvind Aggarwal

Abstract:

We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

Procedia PDF Downloads 176
6910 Optimization of Vertical Axis Wind Turbine Based on Artificial Neural Network

Authors: Mohammed Affanuddin H. Siddique, Jayesh S. Shukla, Chetan B. Meshram

Abstract:

The neural networks are one of the power tools of machine learning. After the invention of perceptron in early 1980's, the neural networks and its application have grown rapidly. Neural networks are a technique originally developed for pattern investigation. The structure of a neural network consists of neurons connected through synapse. Here, we have investigated the different algorithms and cost function reduction techniques for optimization of vertical axis wind turbine (VAWT) rotor blades. The aerodynamic force coefficients corresponding to the airfoils are stored in a database along with the airfoil coordinates. A forward propagation neural network is created with the input as aerodynamic coefficients and output as the airfoil co-ordinates. In the proposed algorithm, the hidden layer is incorporated into cost function having linear and non-linear error terms. In this article, it is observed that the ANNs (Artificial Neural Network) can be used for the VAWT’s optimization.

Keywords: VAWT, ANN, optimization, inverse design

Procedia PDF Downloads 319
6909 Economic Load Dispatch with Valve-Point Loading Effect by Using Differential Evolution Immunized Ant Colony Optimization Technique

Authors: Nur Azzammudin Rahmat, Ismail Musirin, Ahmad Farid Abidin

Abstract:

Economic load dispatch is performed by the utilities in order to determine the best generation level at the most feasible operating cost. In order to guarantee satisfying energy delivery to the consumer, a precise calculation of generation level is required. In order to achieve accurate and practical solution, several considerations such as prohibited operating zones, valve-point effect and ramp-rate limit need to be taken into account. However, these considerations cause the optimization to become complex and difficult to solve. This research focuses on the valve-point effect that causes ripple in the fuel-cost curve. This paper also proposes Differential Evolution Immunized Ant Colony Optimization (DEIANT) in solving economic load dispatch problem with valve-point effect. Comparative studies involving DEIANT, EP and ACO are conducted on IEEE 30-Bus RTS for performance assessments. Results indicate that DEIANT is superior to the other compared methods in terms of calculating lower operating cost and power loss.

Keywords: ant colony optimization (ACO), differential evolution (DE), differential evolution immunized ant colony optimization (DEIANT), economic load dispatch (ELD)

Procedia PDF Downloads 442
6908 The Assessment of Nephrotoxic Effects of Peganum Harmala In Rat

Authors: Amal Yamani, Jaber Elgtou, Aziz Mohammed, Lazaar Jamila, Elachouri Mostafa

Abstract:

Peganum harmala used traditionally as an emenagogue and abortifacient agent in Morocco phytotherapy. Even thought its benefits effects, Peganum harmala remained severely toxic for the organism especially in strong doses. The present study was initiated to evaluate the nephrotoxic effects of aqueous extract of Peganum harmala seeds (PHS). The solution containing aqueous extract of PHS was administered orally by gavage at the dose of 2g/kg body weight during twenty days. Rats were used in this study, two groups were considered, a treated group received an extract of PHS at dose 2g/kg bodyweight and control group received an amount of tap water equivalent to the volume of the vehicle used for the dose of PHS extract. The data we collected showed that aqueous extracts of PHS administered during twenty days induced a significant changes in renal function expressed in decreases of diuresis (from 10 ± 0,58 to 5,33 ± 0,33 ml/24 hours) and the same profile for mean arterial blood pressure (from 125 ± 2,89 to 96,67 ± 6,01 mmHg). The histopathological study showed an alteration of kidney cells in treated group with regard the control group which is not affected. In conclusion: our results indicate that the aqueous extract of PHS induces toxicity may affect severely kidney function and causes renal histopathology.

Keywords: peganum harmala seeds, nephrotoxic, diuresi, histpathology, kidney

Procedia PDF Downloads 296