Search results for: patient monitoring

Authors: Karl Mabiala Dondia, Jing Ma

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In recent years, networks based on the 802.11 standards have gained a prolific deployment. The reason for this massive acceptance of the technology by both home users and corporations is assuredly due to the "plug-and-play" nature of the technology and the mobility. The lack of physical containment due to inherent nature of the wireless medium makes maintenance very challenging from a security standpoint. This study examines via continuous monitoring various predictable threats that 802.11 networks can face, how they are executed, where each attack may be executed and how to effectively defend against them. The key goal is to identify the key components of an effective wireless security policy.

Keywords: wireless LAN, IEEE 802.11 standards, continuous monitoring, security policy

Procedia PDF Downloads 380

Authors: Amreth Chandrasehar

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Machine Learning (ML) Models are developed and run in production to solve various use cases that help organizations to be more efficient and help drive the business. But this comes at a massive development cost and lost business opportunities. According to the Gartner report, 85% of data science projects fail, and one of the factors impacting this is not paying attention to Model Observability. Model Observability helps the developers and operators to pinpoint the model performance issues data drift and help identify root cause of issues. This paper focuses on providing insights into incorporating model observability in model development and operationalizing it in production.

Keywords: model observability, monitoring, drift detection, ML observability platform

Procedia PDF Downloads 112

Authors: Sania Bashir

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A promising approach to healthcare delivery, telemedicine makes use of communication technology to reach out to remote regions of the world, allowing for beneficial interactions between diabetic patients and healthcare professionals as well as the provision of affordable and easily accessible medical care. The emergence of contemporary care models, fueled by the pervasiveness of mobile devices, provides better information, offers low cost with the best possible outcomes, and is known as digital health. It involves the integration of collected data using software and apps, as well as low-cost, high-quality outcomes. The goal of this study is to assess how well telemedicine works for diabetic patients and how it impacts their HbA1c levels. A questionnaire-based survey of 300 diabetics included 150 patients in each of the groups receiving usual care and via telemedicine. A descriptive and observational study that lasted from September 2021 to May 2022 was conducted. HbA1c has been gathered for both categories every three months. A remote monitoring tool has been used to assess the efficacy of telemedicine and continuing therapy instead of the customary three monthly meetings like in-person consultations. The patients were (42.3) 18.3 years old on average. 128 men were outnumbered by 172 women (57.3% of the total). 200 patients (66.6%) have type 2 diabetes, compared to over 100 (33.3%) candidates for type 1. Despite the average baseline BMI being within normal ranges at 23.4 kg/m², the mean baseline HbA1c (9.45 1.20) indicates that glycemic treatment is not well-controlled at the time of registration. While patients who use telemedicine experienced a mean percentage change of 10.5, those who visit the clinic experienced a mean percentage change of 3.9. Changes in HbA1c are dependent on several factors, including improvements in BMI (61%) after 9 months of research and compliance with healthy lifestyle recommendations for diet and activity. More compliance was achieved by the telemedicine group. It is an undeniable reality that patient-physician communication is crucial for enhancing health outcomes and avoiding long-term issues. Telemedicine has shown its value in the management of diabetes and holds promise as a novel technique for improved clinical-patient communication in the twenty-first century.

Keywords: diabetes, digital health, mobile app, telemedicine

Procedia PDF Downloads 91

Authors: Moulfi Bouchra, Ferouani Souheyla, Ziani Kerarti Djalal, Moulessehoul Wassila

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The wireless body network (WBAN) is the most interesting network these days and especially with the appearance of contagious illnesses such as covid 19, which require surveillance in the house. In this article, we have designed a circular microstrip antenna. Gold is the material used respectively for the patch and the ground plane and Gallium (εr=12.94) is chosen as the dielectric substrate. The dimensions of the antenna are 82.10*62.84 μm2 operating at a frequency of 3.85 THz. The proposed, designed antenna has a return loss of -46.046 dB and a gain of 3.74 dBi, and it can measure various physiological parameters and sensors that help in the overall monitoring of an individual's health condition.

Keywords: circular patch antenna, Terahertz transmission, WBAN applications, real-time monitoring

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Authors: T. Nishido, S. Fukumoto

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The functions of movable bearings decline due to corrosion and sediments. As the result, they cannot move or rotate according to the behaviors of girders. Because of the constraints, the bending moments are generated by the horizontal reaction forces and the heights of girders. Under these conditions, the authors obtained the following results by analysis and experiment. Tensile stresses due to the moments occurred at temperature fluctuations. The large tensile stresses on concrete slabs around the bearings caused cracks. Even if concrete slabs are newly replaced, cracks will come out again with function declined bearings. The functional declines of bearings are generally found by using displacement gauges. However the method is not suitable for long-term measurements. We focused on the change in the strains at the bearings and the lower flanges near them at temperature fluctuations. It was found that their strains were particularly large when the movements of the bearings were constrained. Therefore, we developed a long-term health monitoring wireless system with FBG (Fiber Bragg Grating) sensors which were attached to bearings and lower flanges. The FBG sensors have the characteristics such as non-electrical influence, resistance to weather, and high strain sensitivity. Such characteristics are suitable for long-term measurements. The monitoring system was inexpensive because it was limited to the purpose of measuring strains and temperature. Engineers can monitor the behaviors of bearings in real time with the wireless system. If an office is away from bridge sites, the system will save traveling time and cost.

Keywords: bridge bearing, concrete slab, 　FBG sensor, health monitoring

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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Authors: Maryam Kiani

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The self-sensing capability opens up new possibilities for structural health monitoring, offering real-time information on the condition and performance of constructions. The synthesis and characterization of these functional 2D material geopolymers will be explored in this study. Various fabrication techniques, including mixing, dispersion, and coating methods, will be employed to ensure uniform distribution and integration of the 2D materials within the geopolymers. The resulting composite materials will be evaluated for their mechanical strength, electrical conductivity, and sensing capabilities through rigorous testing and analysis. The potential applications of these self-sensing geopolymers are vast. They can be used in infrastructure projects, such as bridges, tunnels, and buildings, to provide continuous monitoring and early detection of structural damage or degradation. This proactive approach to maintenance and safety can significantly improve the lifespan and efficiency of constructions, ultimately reducing maintenance costs and enhancing overall sustainability. In conclusion, the development of functional 2D material geopolymers as self-sensing materials presents an exciting advancement in the construction industry. By integrating these innovative materials into structures, we can create a new generation of intelligent, self-monitoring constructions that can adapt and respond to their environment.

Keywords: 2D materials, geopolymers, electrical properties, self-sensing

Procedia PDF Downloads 132

Authors: Behcet Al, Şener Cindoruk, Suat Zengin, Mehmet Murat Oktay, Mehmet Mustafa Sunar, Hatice Eroglu, Cuma Yildirim

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Objective: In present study we aimed to investigate the chronic drug use due to chronic diseases in patients admitted to emergency department. Materials-Methods: 144 patients who applied to emergency department (ED) of medicine school of Gaziantep University between June 2013 and September 2013 with chronic diseases and use chronic drugs were included. Information about drugs used by patients were recorded. Results: Of patients, half were male, half were female, and the mean age was 58 years. The first three common diseases were diabetes mellitus, hypertension and coronary artery diseases. Of patients, %79.2 knew their illness. Fifty patients began to use drug within three months, 36 patient began to use within the last one year. While 42 patients brought all of their drugs with themselves, 17 patients brought along a portion of drugs. While three patients stopped their medication completely, 125 patients received medication on a regular basis. Fifty-two patient described the drugs with names, 13 patients described with their colors, 3 patients described by grammes, 45 patients described with the size of the tablet and 13 patients could not describe the drugs. Ninety-two patients explained which kind of drugs were used for each diseases, 17 patient explained partly, and 35 patients had no idea. Hundred patients received medication by themselves, 44 patients medications were giving by their relatives and med carers. Of medications, 140 were written by doctors directly, three medication were given by pharmacist; and one patient bought the drug by himself. For 11 patients the drugs were not harmonious to their diseases. Fifty-one patients admitted to the ED two times within last week, and 73 admitted two times within last month. Conclusion: The majority of patients with chronic diseases and use chronic drugs know their diseases and use the drugs in order, but do not have enough information about their medication.

Keywords: chronic disease, drug use, emergency department, medication

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Authors: Nicolae Constantin, Ştefan Sorohan

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The small and medium wind turbines are running in quite different conditions as compared to the big ones. Consequently, they need also a different approach concerning the structural health monitoring (SHM) issues. There are four main differences between the above mentioned categories: (i) significantly smaller dimensions, (ii) considerably higher rotation speed, (iii) generally small distance between the turbine and the energy consumer and (iv) monitoring assumed in many situations by the owner. In such conditions, nondestructive inspections (NDI) have to be made as much as possible with affordable, yet effective techniques, requiring portable and accessible equipment. Additionally, the turbines and accessories should be easy to mount, dispose and repair. As the materials used for such unit can be metals, composites and combined, the technologies should be adapted accordingly. An example in which the two materials co-exist is the situation in which the damaged metallic skin of a blade is repaired with a composite patch. The paper presents the inspection of the bonding state of the patch, using portable ultrasonic equipment, able to put in place the Lamb wave method, which proves efficient in global and local inspections as well. The equipment is relatively easy to handle and can be borrowed from specialized laboratories or used by a community of small wind turbine users, upon the case. This evaluation is the first in a row, aimed to evaluate efficiency of NDI performed with rather accessible, less sophisticated equipment and related inspection techniques, having field inspection capabilities. The main goal is to extend such inspection procedures to other components of the wind power unit, such as the support tower, water storage tanks, etc.

Keywords: structural health monitoring, small wind turbines, non-destructive inspection, field inspection capabilities

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Authors: Marzieh Ebrahimi, Vahid Changizi, Mohammad Reza Kardan, Seyed Mahdi Hosseini Pooya, Parham Geramifar

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Radiation exposure to the patient's family members is one of the major concerns during thyroid cancer radionuclide therapy. The aim of this study was to measure the total effective dose of the family members by means of thermoluminescence personal dosimeter, and compare with those calculated by analytical methods. Eighty-five adult family members of fifty-one patients volunteered to participate in this research study. Considering the minimum and maximum range of dose rate from 15 µsv/h to 120 µsv/h at patients' release time, the calculated mean and median dose values of family members were 0.45 mSv and 0.28 mSv, respectively. Moreover, almost all family members’ doses were measured to be less than the dose constraint of 5 mSv recommended by Basic Safety Standards. Considering the influence parameters such as patient dose rate and administrated activity, the total effective doses of family members were calculated by TEDE and NRC formulas and compared with those of experimental results. The results indicated that, it is fruitful to use the quantitative calculations for releasing patients treated with I-131 and correct estimation of patients' family doses.

Keywords: effective dose, thermoluminescence, I-131, thyroid cancer

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Authors: B. Kenny

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There is currently no literature comparing undercasts in fracture care. This study is a randomised trial comparing the 4 commonly used undercasts in Australia. These are Webril, Sofban, Goretech and Delta-dry. The ideal undercast should be comfortable for the patient and not cause itchiness. It should be durable enough to withstand daily activities. The clinician/technician should find the undercast easy to apply and remove. It should provide adequate padding without compromising cast mouldability to obtain a good cast index and air index. 18 volunteering medical students were randomly allocated to receive 4 angular casts, one over each elbow and ankle(total of 72 casts). They were blinded to cast type. After an hour their casts were stressed by pouring 20ml Normal Saline onto the skin beneath. Each student filled a questionnaire about comfort, itchiness, weight and water resistance. Subsequently they ranked each cast 1 to 4 based on preference. Our preliminary results show Delta-dry is the most preferred undercast followed by Webril, Sofban and Goretech in that order. Underlay selection is important component of patient care with long immobilsation. Webril or Deltra-dry are by far the most preferred undercasts in our study.

Keywords: casts, fracture, treatment modality, patient compliance

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Authors: Freda Halim

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Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

Procedia PDF Downloads 150

Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

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High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education

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Authors: Yiannis Vacanas, Kyriacos Themistocleous, Athos Agapiou, Diofantos Hadjimitsis

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Building Information Modelling (BIM) technology is considered by construction professionals as a very valuable process in modern design, procurement and project management. Construction professionals of all disciplines can use a single 3D model which BIM technology provides, to design a project accurately and furthermore monitor the progress of construction works effectively and efficiently. Unmanned Aerial Vehicles (UAVs), a technology initially developed for military applications, is now without any difficulty accessible and has already been used by commercial industries, including the construction industry. UAV technology has mainly been used for collection of images that allow visual monitoring of building and civil engineering projects conditions in various circumstances. UAVs, nevertheless, have undergone significant advances in equipment capabilities and now have the capacity to acquire high-resolution imagery from many angles in a cost effective manner, and by using photogrammetry methods, someone can determine characteristics such as distances, angles, areas, volumes and elevations of an area within overlapping images. In order to examine the potential of using a combination of BIM and UAV technologies in construction project management, this paper presents the results of a case study of a typical road construction project where the combined use of the two technologies was used in order to achieve efficient and accurate as-built data collection of the works progress, with outcomes such as volumes, and production of sections and 3D models, information necessary in project progress monitoring and efficient project management.

Keywords: BIM, project management, project monitoring, UAV

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Authors: Yasmine Abu Adla, Racha Soubra, Milana Kasab, Mohamad O. Diab, Aly Chkeir

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Over the past several years, researchers have shown a great interest in assessing the mobility of elderly people to measure their functional status. Usually, such an assessment is done by conducting tests that require the subject to walk a certain distance, turn around, and finally sit back down. Consequently, this study aims to provide an at home monitoring system to assess the patient’s status continuously. Thus, we proposed a technique to automatically detect when a subject sits down while walking at home. In this study, we utilized a Doppler radar system to capture the motion of the subjects. More than 20 features were extracted from the radar signals, out of which 11 were chosen based on their intraclass correlation coefficient (ICC > 0.75). Accordingly, the sequential floating forward selection wrapper was applied to further narrow down the final feature vector. Finally, 5 features were introduced to the linear discriminant analysis classifier, and an accuracy of 93.75% was achieved as well as a precision and recall of 95% and 90%, respectively.

Keywords: Doppler radar system, stand-to-sit phase, TUG test, machine learning, classification

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Authors: Danika Tynes

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Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory (Rogers, 1962). System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of telehealth (teleradiology, teledermatology, telepathology, telepsychology, and remote monitoring) using multiple logistic regression. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption, remote monitoring in particular. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available foster innovation.

Keywords: adoption, diffusion of innovation theory, remote monitoring, system-level indicators

Procedia PDF Downloads 136

Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: Christian Gabriel Mariveles, Darelle Jay Gallardo, Leslie Dayaoen, Laurenz Paul Diaz

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True experimental research with descriptive analysis was conducted. Utilizing Quicklime (Calcium Oxide) for self-healing properties of coconut husk fibre concrete brick. There are 2 setups established: the first one has the 1:1:2 ratio of calcium oxide, cement and sand, and the second one has a 2:1:2 ratio of the same variables. The bricks are made from the residences along Barangay Greater Lagro. The mixture of sand and cement is mixed with coconut husk fibers and then molded with different ratios in the molder. After the drying of cement, the researchers tested the bricks in the laboratory for compressive strength. The brick with the highest PSI is picked by the researchers to drop into freefall testing, and it makes remarkable remarks as it is deformed after dropping to different heights with a maximum of 20 feet. Unfortunately, the self-healing capabilities were not observed during the 12 weeks of monitoring. However, the brick was weighed after 12 weeks of monitoring, and it increased in weight by 0.030 kg. from 1.833 kg. to 1.863 kg. meaning that this ratio 2 has the potential to self-heal, but 12 weeks of monitoring by the researchers is not enough to conclude that it has a significant difference.

Keywords: self healing, coconut husk bricks, research, calcium oxide, utilizing quicklime

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Authors: Evangelia Kotrotsiou, Mairy Gouva, Theodosios Paralikas, Maria Fiaka, Styliani Kotrotsiou, Maria Malliarou

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The purpose of this research is to investigate the way nurses perceive the care provided in comparison to the way patients perceive it, taking into account existing literature. As far as the sample of research is concerned, it has come from the population of nurses working in the General Hospital of Thessaloniki, St. Paul and the patients of its surgical clinic. In the present study, the sample consists of 100 nurses and 88 patients. The questionnaire used was the Caring Nurse-Patient Interactions Scale: 23-Item Version, created by Cossette et al. (2006). In the case of both patients and nurses, a high score was observed in relational care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of providing nursing care. Overall, patients rated higher clinical care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of the clinical care they were given. On the other hand, nurses rated higher comfort care in the case of the frequency of nursing care in everyday practice, as well as relational care in the area of the importance of nursing care in everyday practice.

Keywords: nursing care, patient needs, patient satisfaction, care giving

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Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

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Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality

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Authors: Dalvin D. Hill, Hector M. Castro Garcia

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A growing number of individuals utilize wearable devices on a daily basis. The usage and functionality of these wearable devices vary from user to user. One popular usage of said devices is to track health-related activities that are typically stored on a device’s memory or uploaded to an account in the cloud; based on the current trend, the data accumulated from the wearable device are stored in a standalone location. In many of these cases, this health related datum is not a factor when considering the holistic view of a user’s health lifestyle or record. This health-related data generated from wearable and Internet of Things (IoT) devices can serve as empirical information to a medical provider, as the standalone data can add value to the holistic health record of a patient. This paper proposes a solution to incorporate the data gathered from these wearable and IoT devices, with that a patient’s Personal Health Record (PHR) stored within the confines of a Health Information Exchange (HIE).

Keywords: electronic health record, health information exchanges, internet of things, personal health records, wearable devices, wearables

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Authors: Emma Carr, Bilal Aslam-Pervez, David Laraway

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Litigation against surgeons and hospitals continues to increase in Western countries. While verbal consent is all that is required legally, it has for a long time been considered that written consent offers proof of discussion and interaction between the surgeon and the patient. Inadequate consenting of patients continues in the United Kingdom leaving surgeons and Health Trusts open to litigation. We present a standardised consent form which improves patient autonomy and engagement. The General Medical Council recommends that all material risks relevant to the patient are discussed and recorded prior to undergoing surgery, regardless of how likely they are to occur. Current literature was reviewed to evaluate complications associated with surgical management of mandible fractures. Analysis of risks on 52 consent forms were analysed within the Glasgow OMFS department, leading to a procedure-specific form being designed and implemented. This audit showed that the documentation of risks on consent forms was extremely variable- with uncommon risks not being recorded. Interestingly, not a single consent form was found which highlighted all the risks associated with mandible fractures. Our re-audit data confirms 100% of risks being discussed when a procedure specific form is utilised. Our hope, is to introduce further forms for inclusion on the BAOMS website and peripheral distribution. The forms are quick and easy to print and leave more time for consultation with the patient. Whilst we are under no illusion that the forms may not decrease the incidence of intended litigation, we feel confident that they will decrease the chances of it being successful.

Keywords: consent, litigation, mandible fracture, surgery

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Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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Authors: Bernabeo R. Alberto

Abstract:

Unmanned aerial vehicles (UAV) platforms or remotely piloted aircraft system (Rpas) - with dedicated sensors - are fundamental support to the planning, running, and control of the territory in which public safety is or may be at risk for post-disaster assessments such as flooding or landslides, for searching lost people, for crime and accident scene photography, for assisting traffic control at major events, for teaching geography, history, natural science and all those subjects that require a continuous cyclical process of observation, evaluation and interpretation. Through the use of proximal remote sensing information related to anthropic landscape and nature integration, there is an opportunity to improve knowledge and management decision-making for the safeguarding of the environment, for farming, wildlife management, land management, mapping, glacier monitoring, atmospheric monitoring, for the conservation of archeological, historical, artistic and architectural sites, allowing an exact delimitation of the site in the territory. This paper will go over many different mission types. Within each mission type, it will give a broad overview to familiarize the reader but not make them an expert. It will also give detailed information on the payloads and other testing parameters the Unmanned Aerial Vehicles (UAV) use to complete a mission. The project's goal is to improve satellite maps about the stress of the plants, air quality monitoring, and related health issues.

Keywords: proximal remote sensing, remotely piloted aircraft system, risk, safety, unmanned aerial vehicle

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Authors: Veruska C. Dutra, Afonso R. Aquino

Abstract:

Since the 1980s, global tourism activity has consolidated worldwide to become an important economic contributor, and consequently, the sociocultural and environmental impacts are starting to become evidenced. This raises the need of discussing about actions for sustainable tourism that should be linked not only to the economy, but also to the environment and social aspects. The work that is going to be presented is part of a doctoral research project in Sciences undertaken at the Sao Paulo University, Brazil. It aims to analyze whether the monitoring of the tourism sector with a focus on sustainability is applicable or not, through those indicators, put in a case study in the Jalapão State Park (JSP) conservation unit, in the state of Tocantins, Brazil. This is a study of an interdisciplinary nature that had the deductive method as its guide. We concluded that the key points of the sustainable tourism, when analyzed with the focal point in environmental indicators, are an important evaluation and quantification tool of that activity in the study locus. It displayed itself as an adequate tool for monitoring, thus decoding, the main environmental impacts that occur in tourism regions and their intensity, which is made possible through analysis, and has the objective to trace ways to prevent and correct the presented impacts.

Keywords: indicators, tourism, sustainability, Jalapão

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Authors: Christos Spandonidis, Stefanos Tsantilas, Elias Sedikos, Nektarios Galiatsatos, Fotios Giannopoulos, Panagiotis Papadopoulos, Nikolaos Demagos, Dimitrios Reppas, Christos Giordamlis

Abstract:

In the present paper, a low cost, compact and modular Internet of Things (IoT) platform for air quality monitoring in urban areas is presented. This platform comprises of dedicated low cost, low power hardware and the associated embedded software that enable measurement of particles (PM2.5 and PM10), NO, CO, CO₂ and O₃ concentration in the air, along with relative temperature and humidity. This integrated platform acts as part of a greater air pollution data collecting wireless network that is able to monitor the air quality in various regions and neighborhoods of an urban area, by providing sensor measurements at a high rate that reaches up to one sample per second. It is therefore suitable for Big Data analysis applications such as air quality forecasts, weather forecasts and traffic prediction. The first real world test for the developed platform took place in Thessaloniki, Greece, where 16 devices were installed in various buildings in the city. In the near future, many more of these devices are going to be installed in the greater Thessaloniki area, giving a detailed air quality map of the city.

Keywords: distributed sensor system, environmental monitoring, Internet of Things, smart cities

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Authors: Mohamed R. Mhereeg

Abstract:

The paper discusses the implementation of the MultiAgent classification System (MACS) and utilizing it to provide an automated and accurate classification of end users developing applications in the spreadsheet domain. However, different technologies have been brought together to build MACS. The strength of the system is the integration of the agent technology with the FIPA specifications together with other technologies, which are the .NET widows service based agents, the Windows Communication Foundation (WCF) services, the Service Oriented Architecture (SOA), and Oracle Data Mining (ODM). Microsoft's .NET windows service based agents were utilized to develop the monitoring agents of MACS, the .NET WCF services together with SOA approach allowed the distribution and communication between agents over the WWW. The Monitoring Agents (MAs) were configured to execute automatically to monitor excel spreadsheets development activities by content. Data gathered by the Monitoring Agents from various resources over a period of time was collected and filtered by a Database Updater Agent (DUA) residing in the .NET client application of the system. This agent then transfers and stores the data in Oracle server database via Oracle stored procedures for further processing that leads to the classification of the end user developers.

Keywords: MACS, implementation, multi-agent, SOA, autonomous, WCF

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

Abstract:

Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

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Authors: Poonam Goswami

Abstract:

Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

Abstract:

Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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