Search results for: characteristic of medical equipment

Authors: W. Ling, Mohamed Saufi Bin Awang

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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.

Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis

Procedia PDF Downloads 187

Authors: Faiza Marrium, Masood Rabbani, Ali Ahmad Sheikh, Muhammad Yasin Tipu Javed Muhammad, Sohail Raza

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More than 75% diseases spreading in the past 10 years in human population globally are linked to veterinary sector. Veterinary diagnostic labs are the powerful ally for diagnosis, prevention and monitoring of animal diseases in any country. In order to avoid detrimental effects of errors in disease diagnostic and biorisk management, there is a dire need to establish quality control system. In current study, 3 private and 6 public sectors veterinary diagnostic labs were selected for survey. A questionnaire survey in biorisk management guidelines of CWA 15793 was designed to find quality control breaches in lab design, personal, equipment and consumable, quality control measures adopted in lab, waste management, environmental monitoring and customer care. The data was analyzed through frequency distribution statistically by using (SPSS) version 18.0. A non-significant difference was found in all parameters of lab design, personal, equipment and consumable, quality control measures adopted in lab, waste management, environmental monitoring and customer care with an average percentage of 46.6, 57.77, 52.7, 55.5, 54.44, 48.88 and 60, respectively. A non-significant difference among all nine labs were found, with highest average compliance percentage of all parameters are lab 2 (78.13), Lab 3 (70.56), Lab 5 (57.51), Lab 6 (56.37), Lab 4 (55.02), Lab 9 (49.58), Lab 7 (47.76), Lab 1 (41.01) and Lab 8 (36.09). This study shows that in Lahore district veterinary diagnostic labs are not giving proper attention to quality of their system and there is no significant difference between setups of private and public sector laboratories. These results show that most of parameters are between 50 and 80 percent, which needs some work and improvement as per WHO criteria.

Keywords: veterinary lab, quality management system, accreditation, regulatory body, disease identification

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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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Authors: Branimir Skoric

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Over the past two decades, number of international travels rose significantly in the United Kingdom and Worldwide in the shape of business travels and holiday travels as well. The fact that elderly people travel a lot, more than ever before increased the needs for medical evacuations (repatriations) back home if they fell ill abroad or had any kind of accident. This paper concerns medical evacuations of patients on the way back home to the United Kingdom (United Kingdom Residents) and their specific medical needs during short-haul or long-haul commercial scheduled flight and ground transportation to the final destination regardless whether it was hospital or usual place of residence. Particular medical need during medical evacuations is oxygen supply and it can be supplied via portable oxygen concentrator, pulse flow oxygenator or continuous free flow oxygenator depending on the main diagnosis and patient’s comorbidities. In this retrospective study, patients were divided into two groups. One group was consisted of patients suffering from cardio-respiratory diagnoses as primary illness. Another Group consisted of patients suffering from noncardiac illnesses who have other problems including any kind of physical injury. Needs for oxygen and type of supply were carefully considered in regards of duration of the flight, standard airline cabin pressure and results described in this retrospective study.

Keywords: commercial flight, elderly travellers, medical evacuations, oxygen

Procedia PDF Downloads 142

Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: bilingual, English, medicine, doctor

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Authors: Ayami Umemura

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Without exception, all the bodies dissected in the gross anatomical practices are bodies that have lived irreplaceable lives, laughing and talking with family and friends. While medical education aims to cultivate medical knowledge that is universally applicable to all human bodies, it relies on a unique, irreplaceable, and singular entity. In this presentation, we will explore the ``irreplaceable relationship'' that is cultivated between medical students and anonymous cadavers during gross anatomical practices, drawing on Emmanuel Levinas's ``ethics of the face'' and Martin Buber's discussion of “I-Thou.'' Through this, we aim to present ``a different ethic'' that emerges only in the context of face-to-face relationships, which differs from the generalized, institutionalized, mass-produced ethics like seen in so-called ``ethics codes.'' Since the 1990s, there has been a movement around the world to use gross anatomical practices as an "educational tool" for medical professionalism and medical ethics, and some educational institutions have started disclosing the actual names, occupations, and places of birth of corpses to medical students. These efforts have also been criticized because they lack medical calmness. In any case, the issue here is that this information is all about the past that medical students never know directly. The critical fact that medical students are building relationships from scratch and spending precious time together without any information about the corpses before death is overlooked. Amid gross anatomical practices, a medical student is exposed to anonymous cadavers with faces and touching and feeling them. In this presentation, we will examine a collection of essays written by medical students on gross anatomical practices collected by the Japanese Association for Volunteer Body Donation from medical students across the country since 1978. There, we see the students calling out to the corpse, being called out to, being encouraged, superimposing the carcasses on their own immediate family, regretting parting, and shedding tears. Then, medical students can be seen addressing the dead body in the second person singular, “you.” These behaviors reveal an irreplaceable relationship between the anonymous cadavers and the medical students. The moment they become involved in an irreplaceable relationship between “I and you,” an accidental and anonymous encounter becomes inevitable. When medical students notice being the inevitable takers of voluntary and addressless gifts, they pledge to become “Good Doctors” owing the anonymous persons. This presentation aims to present “a different ethic” based on uniqueness and irreplaceability that comes from the faces of the others embedded in each context, which is different from “routine” and “institutionalized” ethics. That can only be realized ``because of anonymity''.

Keywords: anonymity, irreplaceability, uniqueness, singularlity, emanuel levinas, martin buber, alain badiou, medical education

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Authors: Shilpa Kulkarni, Sujata Patrikar

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A single-mode fiber directional coupler is modeled and simulated for its application in medical field. Various fiber devices based on evanescent field absorption, interferometry, couplers, resonators, tip coated fibers, etc, have been developed so far, suitable for medical application. This work focuses on the possibility of sensing by single mode fiber directional coupler. In the preset work, a fiber directional coupler is modeled to detect the changes taking place in the surrounding medium optoelectronically. In this work, waveguiding characteristics of the fiber are studied in depth. The sensor is modeled and simulated by finding photocurrent, sensitivity and detection limit by varying various parameters of the directional coupler. The device is optimized for the best possible output. It is found that the directional coupler shows measurable photocurrents and good sensitivity with coupling length in micrometers. It is thus a miniature device, hence, suitable for medical applications.

Keywords: single mode fiber directional coupler, modeling and simulation of fiber directional coupler sensor, biomolecular sensing, medical sensor device

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Authors: M. McHugh, D. Lillis

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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: agile, applications, FDA, medical, mobile, regulations, software engineering, standards

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Authors: Amhimmid Mohammed Saffour, Mustafa Mohamed Abdullah

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The use of computers for handling image data in the healthcare is growing. However, the amount of data produced by modern image generating techniques is vast. This data might be a problem from a storage point of view or when the data is sent over a network. This paper using wavelet transform technique for medical images compression. MATLAB program, are designed to evaluate medical images storage and transmission time problem at Sebha Medical Center Libya. In this paper, three different Computed Tomography images which are abdomen, brain and chest have been selected and compressed using wavelet transform. Objective evaluation has been performed to measure the quality of the compressed images. For this evaluation, the results show that the Peak Signal to Noise Ratio (PSNR) which indicates the quality of the compressed image is ranging from (25.89db to 34.35db for abdomen images, 23.26db to 33.3db for brain images and 25.5db to 36.11db for chest images. These values shows that the compression ratio is nearly to 30:1 is acceptable.

Keywords: medical image, Matlab, image compression, wavelet's, objective evaluation

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Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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Authors: Anne M. Denton, Rahul Gomes, David W. Franzen

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High-resolution elevation data are becoming increasingly available, but typical approaches for computing topographic features, like slope and curvature, still assume small sliding windows, for example, of size 3x3. That means that the digital elevation model (DEM) has to be resampled to the scale of the landform features that are of interest. Any higher resolution is lost in this resampling. When the topographic features are computed through regression that is performed at the resolution of the original data, the accuracy can be much higher, and the reported result can be adjusted to the length scale that is relevant locally. Slope and variance are calculated for overlapping windows, meaning that one regression result is computed per raster point. The number of window centers per area is the same for the output as for the original DEM. Slope and variance are computed by performing regression on the points in the surrounding window. Such an approach is computationally feasible because of the additive nature of regression parameters and variance. Any doubling of window size in each direction only takes a single pass over the data, corresponding to a logarithmic scaling of the resulting algorithm as a function of the window size. Slope and variance are stored for each aggregation step, allowing the reported slope to be selected to minimize variance. The approach thereby adjusts the effective window size to the landform features that are characteristic to the area within the DEM. Starting with a window size of 2x2, each iteration aggregates 2x2 non-overlapping windows from the previous iteration. Regression results are stored for each iteration, and the slope at minimal variance is reported in the final result. As such, the reported slope is adjusted to the length scale that is characteristic of the landform locally. The length scale itself and the variance at that length scale are also visualized to aid in interpreting the results for slope. The relevant length scale is taken to be half of the window size of the window over which the minimum variance was achieved. The resulting process was evaluated for 1-meter DEM data and for artificial data that was constructed to have defined length scales and added noise. A comparison with ESRI ArcMap was performed and showed the potential of the proposed algorithm. The resolution of the resulting output is much higher and the slope and aspect much less affected by noise. Additionally, the algorithm adjusts to the scale of interest within the region of the image. These benefits are gained without additional computational cost in comparison with resampling the DEM and computing the slope over 3x3 images in ESRI ArcMap for each resolution. In summary, the proposed approach extracts slope and aspect of DEMs at the lengths scales that are characteristic locally. The result is of higher resolution and less affected by noise than existing techniques.

Keywords: high resolution digital elevation models, multi-scale analysis, slope calculation, window-based regression

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Authors: Shajida M., Sakthiyadharshini N. P., Kamalesh S., Aswitha B.

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Natural Language Processing (NLP) continues to play a strategic part in complaint discovery and medicine discovery during the current epidemic. This abstract provides an overview of performance analysis with a combination of visualization and classification techniques of NLP for a medical chatbot. Sentiment analysis is an important aspect of NLP that is used to determine the emotional tone behind a piece of text. This technique has been applied to various domains, including medical chatbots. In this, we have compared the combination of the decision tree with heatmap and Naïve Bayes with Word Cloud. The performance of the chatbot was evaluated using accuracy, and the results indicate that the combination of visualization and classification techniques significantly improves the chatbot's performance.

Keywords: sentimental analysis, NLP, medical chatbot, decision tree, heatmap, naïve bayes, word cloud

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Authors: Barbara Bialecka, Zdzislaw Adamczyk, Magdalena Cempa

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In the work, the results of investigations into the hydrothermal zeolitization of fly ash from hard coal combustion in one of Polish Power Station have been presented. The chemical composition of the ash was determined by the method of X-ray fluorescence (XRF), whereas the phases of both fly ash and the products after synthesis were identified using microscopic observations, X-ray diffraction analysis (XRD) as well as electron scanning microscopy with measurements of the chemical compositions in micro areas (SEM/EDS). The synthesis was carried out with various concentrations of NaOH solution (3M, 4M and 6M) in the following conditions: synthesis temperature – 80ᵒC, synthesis time – 16 hours, volume of NaOH solution – 350ml, fly ash mass – 14g. The main chemical components of fly ash were SiO₂ and Al₂O₃, the contents of which reached 51.62 and 28.14%mas., respectively. The input ash contained mainly such phases as mullite, quarz, magnetite, and glass. The research results indicate that the phase composition of products after zeolitization was differentiated. The material after synthesis in 3M NaOH solution was found to contain mullite, quarz, magnetite, and Na-LSX zeolite. The products of synthesis in 4M NaOH solution were very similar to those in 3M solution (mullite, quarz, magnetite, Na-LSX zeolite), but they additionally contained hydrosodalite. The material after synthesis in 6M NaOH solution contains mullite, quarz, magnetite (similarly to synthesis in 3M and 4M NaOH solition) and additionally hydrosodalite. Therefore, the products of synthesis contain relic components from the fly ash input sample in the form of mullite, quarz, and magnetite, as well as new phases, which are Na-LSX zeolite and hydrosodalite. It should be noted that the products of synthesis in the case of 4M NaOH solution contained both new phases (Na-LSX zeolite and hydrosodalite), while the products from the extreme concentration of NaOH solutions (3M and 6M) contained only one of them. Observations in the scanning electron microscope revealed the new phases’ morphology. It was found that Na-LSX zeolite formed cubic crystals, whereas hydrosodalite formed characteristic aggregations. The results of investigations into the chemical composition in the micro area of phase grains in the products after synthesis reveal some dependencies, among others a characteristic increase in the content of sodium, related to the increased concentration of NaOH solution.

Keywords: Na-LSX, fly ash, hydrosodalite, zeolite

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Authors: Jinan Fiaidhi, Sabah Mohammed

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Cross-domain learning in the medical field is a research challenge as many conditions, like in oncology imaging, use different imaging modalities. Moreover, in most of the medical learning applications, the sample training size is relatively small. Although few-shot learning (FSL) through the use of a Siamese neural network was able to be trained on a small sample with remarkable accuracy, FSL fails to be effective for use in multiple domains as their convolution weights are set for task-specific applications. In this paper, we are addressing this problem by enabling FSL to possess the ability to shift across domains by designing a two-layer FSL network that can learn individually from each domain and produce a shared features map with extra modulation to be used at the second layer that can recognize important targets from mix domains. Our initial experimentations based on mixed medical datasets like the Medical-MNIST reveal promising results. We aim to continue this research to perform full-scale analytics for testing our cross-domain FSL learning.

Keywords: Siamese neural network, few-shot learning, meta-learning, metric-based learning, thick data transformation and analytics

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Authors: Salman Imran, Chris Healey

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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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Authors: Mostosi C., Stéphenne J., Kempeneers E.

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Introduction: Refuellers from Brussels South Charleroi Airport (BSCA) expressed concerns about the risks involved in handling JET-A1 fuel. The HSE Manager of BSCA, in collaboration with the occupational physician and the industrial hygiene unit of the External Service of Occupational Medicine, decided to assess the toxicological exposure of these workers. Materials and methods: Two measurement methods were used. The first was to assay three types of metabolites in urine to highlight the exposure to xylenes, toluene, and benzene in aircraft fuels. Out of 32 refuellers in the department, 26 participated in the sampling, and 23 samples were exploited. The second method targeted the assessment of environmental exposure to certain potentially hazardous substances that refuellers are likely to breathe in work areas at the airport. It was decided to carry out two ambient air measurement campaigns, using static systems on the one hand and, on the other hand, using individual sensors worn by the refuellers at the level of the respiratory tract. Volatile organic compounds and diesel particles were analyzed. Results: Despite the fears that motivated these analyzes, the overall results showed low levels of exposure, far below the existing limit values, both in air quality and in urinary measurements. Conclusion: These results are comparable to a study carried out in several French airports. The staff could be reassured, and then the medical surveillance was modified by the occupational physician. With the aviation development at BSCA, equipment and methods are evolving. Their exposure will have to be reassessed.

Keywords: refuelling, airport, exposure, fuel, occupational health, air quality

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Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: Muhammad Jamil, Ning He, Wei Zhao

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It is a rough estimation that the aerospace companies received orders of 37000 new aircraft, including the air ambulances, until 2037. And titanium alloys have a 15% contribution in modern aircraft's manufacturing owing to the high strength/weight ratio. Despite their application in the aerospace and medical equipment manufacturing industry, still, their high-speed machining puts a challenge in terms of tool wear, heat generation, and poor surface quality. Among titanium alloys, Ti-6Al-4V is the major contributor to aerospace application. However, its poor thermal conductivity (6.7W/mK) accumulates shear and friction heat at the tool-chip interface zone. To dissipate the heat generation and friction effect, cryogenic cooling, Minimum quantity lubrication (MQL), nanofluids, hybrid cryogenic-MQL, solid lubricants, etc., are applied frequently to underscore their significant effect on improving the machinability of Ti-6Al-4V. Nowadays, hybrid lubri-cooling is getting attention from researchers to explore their effect regarding the hard-to-cut Ti-6Al-4V. Therefore, this study is devoted to exploring the effect of hybrid ethanol-ester oil MQL regarding the cutting temperature, surface integrity, and tool life. As the ethanol provides -OH group and ester oil of long-chain molecules provide a tribo-film on the tool-workpiece interface. This could be a green manufacturing alternative for the manufacturing industry.

Keywords: hybrid lubri-cooling, surface roughness, tool wear, MQL

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Authors: Ana Belon Hercilla

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The study is developed in “Reactivos Jeans” company, in the city of Arequipa, whose main business is the laundry of garments at an industrial level. In 2012 the company initiated actions to provide a dry cleaning service of alpaca fiber garments, recognizing that this item is in a growth phase in Peru. Additionally this company took the initiative to use a new greenwashing technology which has not yet been developed in the country. To accomplish this, a redesign of both the process and the plant layout was required. For redesigning the plant, the methodology used was the Systemic Layout Planning, allowing this study divided into four stages. First stage is the information gathering and evaluation of the initial situation of the company, for which a description of the areas, facilities and initial equipment, distribution of the plant, the production process and flows of major operations was made. Second stage is the development of engineering techniques that allow the logging and analysis procedures, such as: Flow Diagram, Route Diagram, DOP (process flowchart), DAP (analysis diagram). Then the planning of the general distribution is carried out. At this stage, proximity factors of the areas are established, the Diagram Paths (TRA) is developed, and the Relational Diagram Activities (DRA). In order to obtain the General Grouping Diagram (DGC), further information is complemented by a time study and Guerchet method is used to calculate the space requirements for each area. Finally, the plant layout redesigning is presented and the implementation of the improvement is made, making it possible to obtain a model much more efficient than the initial design. The results indicate that the implementation of the new machinery, the adequacy of the plant facilities and equipment relocation resulted in a reduction of the production cycle time by 75.67%, routes were reduced by 68.88%, the number of activities during the process were reduced by 40%, waits and storage were removed 100%.

Keywords: redesign, time optimization, industrial laundry, greenwashing

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Authors: K. Drabczyk, Z. Starowicz, S. Maleczek, P. Zieba

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The army, police and fire brigade commonly use dedicated equipment based on special textile materials. The properties of these textiles should ensure human life and health protection. Equally important is the ability to use electronic equipment and this requires access to the source of electricity. Photovoltaic cells integrated with such textiles can be solution for this problem in the most of outdoor circumstances. One idea may be to laminate the cells to textile without changing their properties. The main goal of this work was analyzed lamination quality of special designed semi-flexible solar module with special textile materials as a backsheet. In the first step of investigation, the quality of lamination was determined using device equipped with dynamometer. In this work, the crystalline silicon solar cells 50 x 50 mm and thin chemical tempered glass - 62 x 62 mm and 0.8 mm thick - were used. The obtained results showed the correlation between breaking force and type of textile weave and fiber. The breaking force was in the ranges: 4.5-5.5 N, 15-20 N and 30-33 N depending on the type of wave and fiber type. To verify these observations the microscopic and FTIR analysis of fibers was performed. The studies showed the special textile can be used as a backsheet of semi-flexible solar modules. This work presents a new composition of solar module with special textile layer which, to our best knowledge, has not been published so far. Moreover, the work presents original investigations on adhesion of EVA (ethylene-vinyl acetate) polymer to textile with respect to fiber structure of laminated substrate. This work is realized for the GEKON project (No. GEKON2/O4/268473/23/2016) sponsored by The National Centre for Research and Development and The National Fund for Environmental Protection and Water Management.

Keywords: flexible solar modules, lamination process, solar cells, textile for photovoltaics

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Authors: Baluku Nathan

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Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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Authors: Hana Rabbouch

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In recent years, there has been considerable growth of denoising techniques mainly devoted to medical imaging. This important evolution is not only due to the progress of computing techniques, but also to the emergence of multi-resolution analysis (MRA) on both mathematical and algorithmic bases. In this paper, a comparative study is conducted between the two best-known MRA-based decomposition techniques: the Empirical Mode Decomposition (EMD) and the Discrete Wavelet Transform (DWT). The comparison is carried out in a framework of multi-scale denoising, where a Non-Local Means (NLM) filter is performed scale-by-scale to a sample of benchmark medical images. The results prove the effectiveness of the multiscaled denoising, especially when the NLM filtering is coupled with the EMD.

Keywords: medical imaging, non local means, denoising, multiscaled analysis, empirical mode decomposition, wavelets

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Authors: Ibtihal D. Mustafa, Mawia A. Hassan

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Tumor segmentation from MRI image is important part of medical images experts. This is particularly a challenging task because of the high assorting appearance of tumor tissue among different patients. MRI images are advance of medical imaging because it is give richer information about human soft tissue. There are different segmentation techniques to detect MRI brain tumor. In this paper, different procedure segmentation methods are used to segment brain tumors and compare the result of segmentations by using correlation and structural similarity index (SSIM) to analysis and see the best technique that could be applied to MRI image.

Keywords: MRI, segmentation, correlation, structural similarity

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Authors: Dongguk Im, Gunfeel Moon, Younwoo Nam, Kangwoo Chun

Abstract:

Recognition of the needs about protecting environment throughout worldwide is widespread. In the shipping industry, International Maritime Organization (IMO) has been regulating pollutants emitted from ships by MARPOL 73/78. Recently, the Marine Environment Protection Committee (MEPC) of IMO, at its 68th session, approved the definition of Black Carbon (BC) specified by the following physical properties (light absorption, refractory, insolubility and morphology). The committee also agreed to the need for a protocol for any voluntary measurement studies to identify the most appropriate measurement methods. Filter Smoke Number (FSN) based on light absorption is categorized as one of the IMO relevant BC measurement methods. EUROMOT provided a FSN measurement data (measured by smoke meter) of 31 different engines (low, medium and high speed marine engines) of member companies at the 3rd International Council on Clean Transportation (ICCT) workshop on marine BC. From the comparison of FSN, the results indicated that BC emission from low speed marine diesel engines was ranged from 0.009 to 0.179 FSN and it from medium and high speed marine diesel engine was ranged 0.012 to 3.2 FSN. In consideration of measured the low FSN from low speed engine, an experimental study was conducted using both a low speed marine diesel engine (2 stroke, power of 7,400 kW at 129 rpm) and a high speed marine diesel engine (4 stroke, power of 403 kW at 1,800 rpm) under E3 test cycle. The results revealed that FSN was ranged from 0.01 to 0.16 and 1.09 to 1.35 for low and high speed engines, respectively. The measurement equipment (smoke meter) ranges from 0 to 10 FSN. Considering measurement range of it, FSN values from low speed engines are near the detection limit (0.002 FSN or ~0.02 mg/m3). From these results, it seems to be modulated the measurement range of the measurement equipment (smoke meter) for enhancing measurement accuracy of marine BC and evaluation on performance of BC abatement technologies.

Keywords: black carbon, filter smoke number, international maritime organization, marine diesel engine (two and four stroke), particulate matter

Procedia PDF Downloads 269

Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang

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Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.

Keywords: acute hepatitis, medical resource cost, artificial neural network, support vector regression

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Authors: V. Durmus, M. Uydaci

Abstract:

In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

Procedia PDF Downloads 307

Authors: Thi. A. D. Tran, Matthieu Arnold, Dominique Adolphe, Laurence Schcher, Guillaume Reys

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During daily oral health cares, dental surgeons are in contact with numerous potentially infectious germs from patients' saliva and blood. In order to take into account these risks, a product development process has been unrolled to propose to the dental surgeon a personal protection equipment that is suitable with their expectations in terms of images, protection and comfort. After a consumer study, to evaluate how the users wear the garment and their expectations, specifications have been carried out and technical solutions have been developed in order to answer to the maximum of the desiderata. Thermal studies and comfort studies have been performed. The obtained results lead to define the technical solutions concerning the design of the new scrub. Three main functions have been investigated, the ergonomic aspect, the protection and the thermal comfort. In terms of ergonomic aspect, instrumented garments have been worn and pressure measurements have been done. The results highlight that a raglan shape for the sleeves has to be selected for a better dynamic comfort. Moreover, spray tests helped us to localize the potential contamination area and therefore protection devices have been placed on the garment. Concerning the thermal comfort, an I-R study was conducted in consulting room under the real working conditions; the heating zones have been detected. Based on these results, solutions have been proposed and implemented in a new gown. This new gown is currently composed of three different parts; a protective layer placed in the chest area to avoid contamination; a breathable layer placed in the back and in the armpits and a normal PET/Cotton fabric for the rest of the gown. Through the fitting tests conducted in hospital, it was obtained that the new design was highly appreciated. Some points can nevertheless be further improved. A final product will be produced based on necessary improvements.

Keywords: comfort, dentists, garment, thermal

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Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

Abstract:

Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

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Authors: María González Alriols, Itziar Egües, María A. Andrés, Mirari Antxustegi

Abstract:

Several collaborative learning proposals were prepared to be applied in the laboratory sessions of chemistry in the first course of engineering studies. The aim was to engage the students from the beginning and to avoid absenteeism as well as to reach a more homogeneous level in the class. The students, divided into small groups of four or five mates, were asked to do an exercise before having the practical session in the lab. Precisely, each one of the groups was asked to study the theoretical fundamentals and the practical aspects of one lab session and to prepare a didactical video with this content, including the materials, equipment and reactants required, and the detailed experimental procedure. Furthermore, they should include the performance of the experiment step by step, indicating the faced difficulties and the obtained results and conclusions. After watching the video of this precise activity, the other groups of students would go to the lab to put into practice the session following the commands explained in the video. The evaluation of the video activity that is worth the 50% of the total mark of the laboratory sessions, is done depending on the success that the other groups of students had while doing the practical session that was explained in the video. This means that the successful transmission of knowledge to the rest of the mates in the class through the video was compulsory to pass the practical sessions and the subject. The other 50% of the mark depended on the understanding of the other students’ explanations and the success in the corresponding practical sessions. The experience was found to be very positive, as the engagement level was considerably higher, the absenteeism lower and the attitude in the laboratory much more responsible. The materials, reactants and equipment were used carefully, and no incidents were registered. Furthermore, the fact of having peer experts was useful to encourage critical thinking in a more relaxed way, with the teacher figure in a secondary position. Finally, the academic achievements were satisfactory as well, with a high percentage of students over the level required for passing the subject.

Keywords: collaborative learning, engineering instruction, chemistry, laboratory sessions

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Authors: Taghreed Abu-Salim

Abstract:

This paper develops and investigates a framework for the assessment of customer involvement in the service design process of result oriented product-service systems in order to improve the service offering in a business to business (B2B) context. The framework comprises five main criteria and fifteen sub-criteria that contribute to customer involvement in a hierarchy using a maturity grid to highlight the strengths and weaknesses for each criterion. To develop the customer involvement framework, an extensive literature review related to service design, result oriented product-service system (PSS) and customer involvement in service design was carried out. Key factors that significantly influence customer involvement from industry and literature were identified to develop an initial framework. This framework was tested in six companies from four different sectors of industry: district cooling, medical equipment, transportation and oil storage. Validation of the framework was carried out using expert opinions and industrial case studies. A major contribution of the developed framework includes a hierarchy of appropriate criteria for assessing customer involvement in the service design process within results oriented PSS; the definition of four maturity levels which are suitable to describe the whole spectrum of customer involvement in the service design process; and finally, The paper concludes by enabling service providers to: take proactive decisions; screen and evaluate new services; improve perceived service quality; and provide barriers against imitation.

Keywords: customer involvement, maturity grid, new service development, result oriented product-service system, service design

Procedia PDF Downloads 527