Search results for: medication error

Authors: S. Boulenouar, M. Sefir, M. Benahmed

Abstract:

All facilities need medication and other pharmaceuticals for their operation. Management and supply is therefore to provide the different services of the facility goods and services in required quantity and quality. The permanent availability of drugs in the facilities is very difficult because most face many difficulties at the inventory management and drug supplies. Therefore, it is necessary for each health facility to know the causes for the malfunction of its management system to cope with them. It is in this context that we have undertaken to conduct this study to know the causes which should be taken into consideration by the concerned authorities to carry out their mission, which is to provide quality health care for the population. In terms of financial resources, the budget for medicines represents a significant part of the budget of the pharmacy. Our study shows that the share of the hospital budget reserved for the drugs procurement represent on average 70% of the budget of the pharmacy. The results show a state of lack of anticancer drugs at Oran teaching hospital. The analysis of the management process allowed us to know the level that the problem of stock-outs of anti-cancer drugs is at. Suggestions were made to that effect to improve the availability for these products and to respond better to the needs of patients.

Keywords: anticancer drugs, health care facility, budget, hospital pharmacist, hospital service

Procedia PDF Downloads 447

Authors: Chen Jun-Hong, He Pu, Tao Wen-Quan

Abstract:

Proton exchange membrane fuel cell (PEMFC) is the most promising future energy source owing to its low operating temperature, high energy efficiency, high power density, and environmental friendliness. In this paper, a comprehensive PEMFC system control-oriented model is developed in the Matlab/Simulink environment, which includes the hydrogen supply subsystem, air supply subsystem, and thermal management subsystem. Besides, Improved Artificial Bee Colony (IABC) is used in the parameter identification of PEMFC semi-empirical equations, making the maximum relative error between simulation data and the experimental data less than 0.4%. Operation temperature is essential for PEMFC, both high and low temperatures are disadvantageous. In the thermal management subsystem, water pump and fan are both controlled with the PID controller to maintain the appreciate operation temperature of PEMFC for the requirements of safe and efficient operation. To improve the control effect further, fuzzy control is introduced to optimize the PID controller of the pump, and the Radial Basis Function (RBF) neural network is introduced to optimize the PID controller of the fan. The results demonstrate that Fuzzy-PID and RBF-PID can achieve a better control effect with 22.66% decrease in Integral Absolute Error Criterion (IAE) of T_st (Temperature of PEMFC) and 77.56% decrease in IAE of T_in (Temperature of inlet cooling water) compared with traditional PID. In the end, a novel thermal management structure is proposed, which uses the cooling air passing through the main radiator to continue cooling the secondary radiator. In this thermal management structure, the parasitic power dissipation can be reduced by 69.94%, and the control effect can be improved with a 52.88% decrease in IAE of T_in under the same controller.

Keywords: PEMFC system, parameter identification, temperature control, Fuzzy-PID, RBF-PID, parasitic power

Procedia PDF Downloads 86

Authors: Shofiayuningtyas Luftiani

Abstract:

Some private schools in Indonesia started integrating the online program Gizmos in the teaching-learning process. Gizmos was developed to supplement the existing curriculum by integrating it into the instructional programs. The program has some features using an inquiry-based simulation, in which students conduct exploration by using a worksheet while teachers use the teacher guidelines to direct and assess students’ performance In this study, the discussion about Gizmos highlights its features as the assessment media of mathematics learning for secondary school students. The discussion is based on the case study and literature review from the Indonesian context. The purpose of applying Gizmos as an assessment media refers to the diagnostic assessment. As a part of the diagnostic assessment, the teachers review the student exploration sheet, analyze particularly in the students’ difficulties and consider findings in planning future learning process. This assessment becomes important since the teacher needs the data about students’ persistent weaknesses. Additionally, this program also helps to build student’ understanding by its interactive simulation. Currently, the assessment over-emphasizes the students’ answers in the worksheet based on the provided answer keys while students perform their skill in translating the question, doing the simulation and answering the question. Whereas, the assessment should involve the multiple perspectives and sources of students’ performance since teacher should adjust the instructional programs with the complexity of students’ learning needs and styles. Consequently, the approach to improving the assessment components is selected to challenge the current assessment. The purpose of this challenge is to involve not only the cognitive diagnosis but also the analysis of skills and error. Concerning the selected setting for this diagnostic assessment that develops the combination of cognitive diagnosis, skills analysis and error analysis, the teachers should create an assessment rubric. The rubric plays the important role as the guide to provide a set of criteria for the assessment. Without the precise rubric, the teacher potentially ineffectively documents and follows up the data about students at risk of failure. Furthermore, the teachers who employ the program of Gizmos as the diagnostic assessment might encounter some obstacles. Based on the condition of assessment in the selected setting, the obstacles involve the time constrain, the reluctance of higher teaching burden and the students’ behavior. Consequently, the teacher who chooses the Gizmos with those approaches has to plan, implement and evaluate the assessment. The main point of this assessment is not in the result of students’ worksheet. However, the diagnostic assessment has the two-stage process; the process to prompt and effectively follow-up both individual weaknesses and those of the learning process. Ultimately, the discussion of Gizmos as the media of the diagnostic assessment refers to the effort to improve the mathematical learning process.

Keywords: diagnostic assessment, error analysis, Gizmos online program, skills analysis

Procedia PDF Downloads 183

Authors: Sridhar Rapuru, D. Mallikarjunreddy, Rajanarendra Sai

Abstract:

In this reign of the internet, the access of any multimedia file to the users at any time with a superior quality is needed. To achieve this goal, it is very important to have a good network without any interruptions between the satellites along with various earth stations. For that purpose, a high speed inter-satellite optical wireless communication system (IsOWC) is designed with space and polarization diversity techniques. IsOWC offers a high bandwidth, small size, less power requirement and affordable when compared with the present microwave satellite systems. To improve the efficiency and to reduce the propagation delay, inter-satellite link is established between the satellites. High accurate tracking systems are required to establish the reliable connection between the satellites as they have their own orbits. The only disadvantage of this IsOWC system is laser beam width is narrower than the RF because of this highly accurate tracking system to meet this requirement. The satellite uses the 'ephemerides data' for rough pointing and tracking system for fine pointing to the other satellite. In this proposed IsOWC system, laser light is used as a wireless connectedness between the source and destination and free space acts as the channel to carry the message. The proposed system will be designed, simulated and analyzed for 6000km with an improvement of data rate over previously existing systems. The performance parameters of the system are Q-factor, eye opening, bit error rate, etc., The proposed system for Inter-satellite Optical Wireless Communication System Design Using Diversity Techniques finds huge scope of applications in future generation communication purposes.

Keywords: inter-satellite optical wireless system, space and polarization diversity techniques, line of sight, bit error rate, Q-factor

Procedia PDF Downloads 270

Authors: Adrian W. Egger, Savvas P. Triantafyllou, Eleni N. Chatzi

Abstract:

The scaled boundary finite element method (SBFEM) is a semi-analytical numerical method, which introduces a scaling center in each element’s domain, thus transitioning from a Cartesian reference frame to one resembling polar coordinates. Consequently, an analytical solution is achieved in radial direction, implying that only the boundary need be discretized. The only limitation imposed on the resulting polygonal elements is that they remain star-convex. Further arbitrary p- or h-refinement may be applied locally in a mesh. The polygonal nature of SBFEM elements has been exploited in quadtree meshes to alleviate all issues conventionally associated with hanging nodes. Furthermore, since in 2D this results in only 16 possible cell configurations, these are precomputed in order to accelerate the forward analysis significantly. Any cells, which are clipped to accommodate the domain geometry, must be computed conventionally. However, since SBFEM permits polygonal elements, significantly coarser meshes at comparable accuracy levels are obtained when compared with conventional quadtree analysis, further increasing the computational efficiency of this scheme. The generalized stress intensity factors (gSIFs) are computed by exploiting the semi-analytical solution in radial direction. This is initiated by placing the scaling center of the element containing the crack at the crack tip. Taking an analytical limit of this element’s stress field as it approaches the crack tip, delivers an expression for the singular stress field. By applying the problem specific boundary conditions, the geometry correction factor is obtained, and the gSIFs are then evaluated based on their formal definition. Since the SBFEM solution is constructed as a power series, not unlike mode superposition in FEM, the two modes contributing to the singular response of the element can be easily identified in post-processing. Compared to the extended finite element method (XFEM) this approach is highly convenient, since neither enrichment terms nor a priori knowledge of the singularity is required. Computation of the gSIFs by SBFEM permits exceptional accuracy, however, when combined with hybrid quadtrees employing linear elements, this does not always hold. Nevertheless, it has been shown that crack propagation schemes are highly effective even given very coarse discretization since they only rely on the ratio of mode one to mode two gSIFs. The absolute values of the gSIFs may still be subject to large errors. Hence, we propose a post-processing scheme, which minimizes the error resulting from the approximation space of the cracked element, thus limiting the error in the gSIFs to the discretization error of the quadtree mesh. This is achieved by h- and/or p-refinement of the cracked element, which elevates the amount of modes present in the solution. The resulting numerical description of the element is highly accurate, with the main error source now stemming from its boundary displacement solution. Numerical examples show that this post-processing procedure can significantly improve the accuracy of the computed gSIFs with negligible computational cost even on coarse meshes resulting from hybrid quadtrees.

Keywords: linear elastic fracture mechanics, generalized stress intensity factors, scaled finite element method, hybrid quadtrees

Procedia PDF Downloads 146

Authors: Takuro Kida, Yuichi Kida

Abstract:

We show a base of the new trend of algorithm mathematically that treats a historical reason of continuous discrimination in the world as well as its solution by introducing new concepts of parallel world that includes an invisible set of errors as its companion. With respect to a matrix operator-filter bank that the matrix operator-analysis-filter bank H and the matrix operator-sampling-filter bank S are given, firstly, we introduce the detailed algorithm to derive the optimum matrix operator-synthesis-filter bank Z that minimizes all the worst-case measures of the matrix operator-error-signals E(ω) = F(ω) − Y(ω) between the matrix operator-input-signals F(ω) and the matrix operator-output signals Y(ω) of the matrix operator-filter bank at the same time. Further, feedback is introduced to the above approximation theory and it is indicated that introducing conversations with feedback does not superior automatically to the accumulation of existing knowledge of signal prediction. Secondly, the concept of category in the field of mathematics is applied to the above optimum signal approximation and is indicated that the category-based approximation theory is applied to the set-theoretic consideration of the recognition of humans. Based on this discussion, it is shown naturally why the narrow perception that tends to create isolation shows an apparent advantage in the short term and, often, why such narrow thinking becomes intimate with discriminatory action in a human group. Throughout these considerations, it is presented that, in order to abolish easy and intimate discriminatory behavior, it is important to create a parallel world of conception where we share the set of invisible error signals, including the words and the consciousness of both worlds.

Keywords: signal prediction, pseudo inverse matrix, artificial intelligence, conditional optimization

Procedia PDF Downloads 158

Authors: Wan Shan Chiang, Charn Ting Wang, Wei-Chih Kan, Hui-Chen Huang

Abstract:

Dialysis patients have risk in Zoster virus because of low immune. Valacyclovir (product name: Valtex) 500mg/tab, an anti-zoster virus medicine, is digested in kidney and it has side-effect of nervous system in patients with malfunction kidneys. Although the clinical basis of the proposed administration, we found that patients still have side effects. So we want to explore the appropriate dose of peritoneal dialysis patients. We read small samples of case reports and analyze 8 cases in our hospital, some patients’ Kt/v, match the standard of dialysis, and still go to the toilet, they still have side effect seriously with 500mg portion. The solution to this includes stopping medicine, reduction of medicine, increase of liquid change and timely hemodialysis and all of them speed up the recovery. The safety of medication needs extra attention of medical care employee. If they can tell the doctor if the patient has urine or not in his or her Kt/v, the doctor can prescribe the medicine accordingly. About the limitation, due to the lack of cases and related pharmacokinetics numbers. Therefore, for peritoneal patients, we think 500mg/48hoursis the saves. We also want to remind pharmaceuticals to revise the portion taken by patients, so that the doctor may judge the use.

Keywords: herpes zoster, Valacyclovir, peritoneal dialysis, health education

Procedia PDF Downloads 314

Authors: Othman Maklouf, Abdunnaser Tresh

Abstract:

Land vehicle navigation is subject of great interest today. Global Positioning System (GPS) is the main navigation system for positioning in such systems. GPS alone is incapable of providing continuous and reliable positioning, because of its inherent dependency on external electromagnetic signals. Inertial Navigation (INS) is the implementation of inertial sensors to determine the position and orientation of a vehicle. The availability of low-cost Micro-Electro-Mechanical-System (MEMS) inertial sensors is now making it feasible to develop INS using an inertial measurement unit (IMU). INS has unbounded error growth since the error accumulates at each step. Usually, GPS and INS are integrated with a loosely coupled scheme. With the development of low-cost, MEMS inertial sensors and GPS technology, integrated INS/GPS systems are beginning to meet the growing demands of lower cost, smaller size, and seamless navigation solutions for land vehicles. Although MEMS inertial sensors are very inexpensive compared to conventional sensors, their cost (especially MEMS gyros) is still not acceptable for many low-end civilian applications (for example, commercial car navigation or personal location systems). An efficient way to reduce the expense of these systems is to reduce the number of gyros and accelerometers, therefore, to use a partial IMU (ParIMU) configuration. For land vehicular use, the most important gyroscope is the vertical gyro that senses the heading of the vehicle and two horizontal accelerometers for determining the velocity of the vehicle. This paper presents a field experiment for a low-cost strap down (ParIMU)\GPS combination, with data post processing for the determination of 2-D components of position (trajectory), velocity and heading. In the present approach, we have neglected earth rotation and gravity variations, because of the poor gyroscope sensitivities of our low-cost IMU (Inertial Measurement Unit) and because of the relatively small area of the trajectory.

Keywords: GPS, IMU, Kalman filter, materials engineering

Procedia PDF Downloads 422

Authors: A. Ramachandra Reddy, V. Murugan, Prema Kumari

Abstract:

Residual solvents in Pharmaceutical samples are monitored using gas chromatography with headspace (GC-HS). Based on current regulatory and compendial requirements, measuring the residual solvents are mandatory for all release testing of active pharmaceutical ingredients (API). Generally, isopropyl alcohol is used as the residual solvent in proline and tryptophan; methanol in cysteine monohydrate hydrochloride, glycine, methionine and serine; ethanol in glycine and lysine monohydrate; acetic acid in methionine. In order to have a single method for determining these residual solvents (isopropyl alcohol, ethanol, methanol and acetic acid) in all these 7 amino acids a sensitive and simple method was developed by using gas chromatography headspace technique with flame ionization detection. During development, no reproducibility, retention time variation and bad peak shape of acetic acid peaks were identified due to the reaction of acetic acid with the stationary phase (cyanopropyl dimethyl polysiloxane phase) of column and dissociation of acetic acid with water (if diluent) while applying temperature gradient. Therefore, dimethyl sulfoxide was used as diluent to avoid these issues. But most the methods published for acetic acid quantification by GC-HS uses derivatisation technique to protect acetic acid. As per compendia, risk-based approach was selected as appropriate to determine the degree and extent of the validation process to assure the fitness of the procedure. Therefore, Total error concept was selected to validate the analytical procedure. An accuracy profile of ±40% was selected for lower level (quantitation limit level) and for other levels ±30% with 95% confidence interval (risk profile 5%). The method was developed using DB-Waxetr column manufactured by Agilent contains 530 µm internal diameter, thickness: 2.0 µm, and length: 30 m. A constant flow of 6.0 mL/min. with constant make up mode of Helium gas was selected as a carrier gas. The present method is simple, rapid, and accurate, which is suitable for rapid analysis of isopropyl alcohol, ethanol, methanol and acetic acid in amino acids. The range of the method for isopropyl alcohol is 50ppm to 200ppm, ethanol is 50ppm to 3000ppm, methanol is 50ppm to 400ppm and acetic acid 100ppm to 400ppm, which covers the specification limits provided in European pharmacopeia. The accuracy profile and risk profile generated as part of validation were found to be satisfactory. Therefore, this method can be used for testing of residual solvents in amino acids drug substances.

Keywords: amino acid, head space, gas chromatography, total error

Procedia PDF Downloads 150

Authors: Muhammad Usman Akram

Abstract:

This research work based on GNSS-Aided Photogrammetry for Digital Mapping. It focuses on topographic survey of an area or site which is to be used in future Planning & development (P&D) or can be used for further, examination, exploration, research and inspection. Survey and Mapping in hard-to-access and hazardous areas are very difficult by using traditional techniques and methodologies; as well it is time consuming, labor intensive and has less precision with limited data. In comparison with the advance techniques it is saving with less manpower and provides more precise output with a wide variety of multiple data sets. In this experimentation, Aerial Photogrammetry technique is used where an UAV flies over an area and captures geocoded images and makes a Three-Dimensional Model (3-D Model), UAV operates on a user specified path or area with various parameters; Flight altitude, Ground sampling distance (GSD), Image overlapping, Camera angle etc. For ground controlling, a network of points on the ground would be observed as a Ground Control point (GCP) using Differential Global Positioning System (DGPS) in PPK or RTK mode. Furthermore, that raw data collected by UAV and DGPS will be processed in various Digital image processing programs and Computer Aided Design software. From which as an output we obtain Points Dense Cloud, Digital Elevation Model (DEM) and Ortho-photo. The imagery is converted into geospatial data by digitizing over Ortho-photo, DEM is further converted into Digital Terrain Model (DTM) for contour generation or digital surface. As a result, we get Digital Map of area to be surveyed. In conclusion, we compared processed data with exact measurements taken on site. The error will be accepted if the amount of error is not breached from survey accuracy limits set by concerned institutions.

Keywords: photogrammetry, post processing kinematics, real time kinematics, manual data inquiry

Procedia PDF Downloads 33

Authors: Wesam Rohouma

Abstract:

The aim of this paper is to investigate the use of repetitive controller to regulate the output voltage of three phase four leg matric converter for an Aircraft Ground Power Supply Unit. The proposed controller improve the steady state error and provide good regulation during different loading. Simulation results of 7.5 KW converter are presented to verify the operation of the proposed controller.

Keywords: matrix converter, Power electronics, controller, regulation

Procedia PDF Downloads 1506

Authors: Farzaneh Ziaee, Mohammad Ziaee

Abstract:

N-acetyl-L-cysteine (NAC) is a well-known mucolytic agent, and recently its efficacy has been examined for the prevention and remediation of several diseases such as lung infections caused by Coronavirus. Also, it is administrated as the main antidote in paracetamol overdose and is effective for the treatment of idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD). This medicine is used as an antioxidant to prevent diabetic kidney disease (nephropathy). In this study, a method for the acylation of amino acids is employed to manufacture this drug in a height yield. Regarding this patented path, NAC can be made in a single batch step at ambient pressure and temperature. Moreover, this study offers a technique to make peptide bonds which is of interest for pharmaceutical and medicinal industries. The separation process was undertaken using appropriate solvents to achieve an excellent purification level. The synthesized drug was characterized via proton nuclear magnetic resonance (1H NMR), high-performance liquid chromatography (HPLC), Fourier transform infrared spectroscopy (FT-IR), elemental analysis, and melting point.

Keywords: N-acetylcysteine, synthesis, mucolytic medication, lung anti-inflammatory, COVID-19, antioxidant, pharmaceutical supplement, characterization

Procedia PDF Downloads 194

Authors: Phakamani Xaba, Robert Huberts, Bilainu Oboirien

Abstract:

The present study was aimed at developing & comparing two neural-network-based predictive models to predict shelf-life/product age of South African margarine using free fatty acid (FFA), water droplet size (D3.3), water droplet distribution (e-sigma), moisture content, peroxide value (PV), anisidine valve (AnV) and total oxidation (totox) value as input variables to the model. Brick margarine products which had varying ages ranging from fresh i.e. week 0 to week 47 were sourced. The brick margarine products which had been stored at 10 & 25 °C and were characterized. JMP and MATLAB models to predict shelf-life/ margarine age were developed and their performances were compared. The key performance indicators to evaluate the model performances were correlation coefficient (CC), root mean square error (RMSE), and mean absolute percentage error (MAPE) relative to the actual data. The MATLAB-developed model showed a better performance in all three performance indicators. The correlation coefficient of the MATLAB model was 99.86% versus 99.74% for the JMP model, the RMSE was 0.720 compared to 1.005 and the MAPE was 7.4% compared to 8.571%. The MATLAB model was selected to be the most accurate, and then, the number of hidden neurons/ nodes was optimized to develop a single predictive model. The optimized MATLAB with 10 neurons showed a better performance compared to the models with 1 & 5 hidden neurons. The developed models can be used by margarine manufacturers, food research institutions, researchers etc, to predict shelf-life/ margarine product age, optimize addition of antioxidants, extend shelf-life of products and proactively troubleshoot for problems related to changes which have an impact on shelf-life of margarine without conducting expensive trials.

Keywords: margarine shelf-life, predictive modelling, neural networks, oil oxidation

Procedia PDF Downloads 200

Authors: Hadjer Sadoune, Liza Lamini, Scherazade Krim, Amel Djouadi, Rachida Rihani

Abstract:

Deep neural networks are highly regarded for their accuracy in predicting intricate fermentation processes. Their ability to learn from a large amount of datasets through artificial intelligence makes them particularly effective models. The primary obstacle in improving the performance of these models is to carefully choose the suitable hyperparameters, including the neural network architecture (number of hidden layers and hidden units), activation function, optimizer, learning rate, and other relevant factors. This study predicts biogas production from real wastewater treatment plant data using a sophisticated approach: hybrid Bayesian optimization with a tree-structured Parzen estimator (BO-TPE) for an optimised deep neural network (DNN) model. The plant utilizes an Upflow Anaerobic Sludge Blanket (UASB) digester that treats industrial wastewater from soft drinks and breweries. The digester has a working volume of 1574 m3 and a total volume of 1914 m3. Its internal diameter and height were 19 and 7.14 m, respectively. The data preprocessing was conducted with meticulous attention to preserving data quality while avoiding data reduction. Three normalization techniques were applied to the pre-processed data (MinMaxScaler, RobustScaler and StandardScaler) and compared with the Non-Normalized data. The RobustScaler approach has strong predictive ability for estimating the volume of biogas produced. The highest predicted biogas volume was 2236.105 Nm³/d, with coefficient of determination (R2), mean absolute error (MAE), and root mean square error (RMSE) values of 0.712, 164.610, and 223.429, respectively.

Keywords: anaerobic digestion, biogas production, deep neural network, hybrid bo-tpe, hyperparameters tuning

Procedia PDF Downloads 39

Authors: Hui Liu, Xiaozan Wang, Jiarong Zhong, Ziming Shao

Abstract:

Introduction: Related research shows that students don’t concentrate on teacher’s speaking in the classroom. The d2 attention test is a time-limited test about selective attention. The d2 attention test can be used to evaluate individual selective attention. Purpose: To use the d2 attention test tool to measure the difference between the attention level of the experimental class and the control class before and after Brain-Break and to explore the effect of Brain-Break in the classroom on students' selective attention. Methods: According to the principle of no difference in pre-test data, two classes in the fourth- grade of Shenzhen Longhua Central Primary School were selected. After 20 minutes of class in the third class in the morning and the third class in the afternoon, about 3-minute Brain-Break intervention was performed in the experimental class for 10 weeks. The normal class in the control class did not intervene. Before and after the experiment, the d2 attention test tool was used to test the attention level of the two-class students. The paired sample t-test and independent sample t-test in SPSS 23.0 was used to test the change in the attention level of the two-class classes around 10 weeks. This article only presents results with significant differences. Results: The independent sample t-test results showed that after ten-week of Brain-Break, the missed errors (E1 t = -2.165 p = 0.042), concentration performance (CP t = 1.866 p = 0.05), and the degree of omissions (Epercent t = -2.375 p = 0.029) in experimental class showed significant differences compared with control class. The students’ error level decreased and the concentration increased. Conclusions: Adding Brain-Break interventions in the classroom can effectively improve the attention level of fourth-grade primary school students to a certain extent, especially can improve the concentration of attention and decrease the error rate in the tasks. The new sport's learning model is worth promoting

Keywords: cultural class, micromotor, attention, D2 test

Procedia PDF Downloads 134

Authors: Agnes J. Otjen, Sarah Keller

Abstract:

A Montana university has used applied consumer research in experiential learning with non-profit clients for over a decade. Through trial and error, a successful protocol has been established from problem statement through formative research to integrated marketing campaign execution. In this paper, we describe the protocol and its applications. Analysis was completed to determine the effectiveness of the campaigns and the results of how pre- and post-consumer research mark societal change because of media.

Keywords: consumer, research, marketing, communications

Procedia PDF Downloads 140

Authors: Jelena Maletkovic

Abstract:

Background: Endogenous Cushing’s syndrome is a rare disease, but iatrogenic or drug related Cushing syndrome from glucocorticoid products is commonly seen in clinical practice. With high dose and long term use of glucocorticoids, patients can develop isolated hypothalamic-pituitary-adrenal (HPA) suppression, or HPA axis suppression can be accompanied by overt iatrogenic Cushing’s syndrome. This is a rare case where severe Cushing’s syndrome developed from an unknown medication and was followed by severe and prolonged adrenal insufficiency and multiple potentially fatal complications. Case: This is a 37-year-old woman who is presented to Emergency Room (ER) with shortness of breath and chest pain. Four months prior to this presentation the patient was a generally healthy woman who was looking for improvement in her appearance and visited local Rejuvenation Clinic. After initial consultation with a nurse, she was contacted by a physician over the phone and was advised to start taking multiple injectable medications that will arrive by mail. Medications without any labels on bottles were delivered and the patient started daily intramuscular injections. Over the next two months, she noticed rounding of her face and swelling around her eyes. She gained 20 pounds, mostly abdominal fat and became extremely fatigued. Her muscles on legs were visibly decreasing in size and she felt significant muscle weakness. Unexplained bruising occurred. She started growing hair on face and developed secondary amenorrhea. New severe back pain started. She developed depression and headaches. Finally, over a few days, a number of red-purple stretch marks that were sensitive and painful appeared over her abdomen, upper part of arms and legs. She then became suspicious that these dramatic symptoms are caused by injectable medication and she discontinued injections. Over the next few days she presented to ER with low blood pressure and oxygen saturation of 75%. Studies revealed extensive pneumonia as well as multiple pulmonary emboli. Her white blood count was elevated with 32 000 and she also had acute kidney failure on admission. She was treated for sepsis and was also given stress dose steroids. Steroids were tapered over 48 hours and discontinued. After being discharged to home, on her first visit to endocrinology clinic she had undetectable ACTH of < 2pg/mL and undetectable 8am cortisol of < 0.2mcg/dL. She did not respond to an intramuscular injection of cosyntropin 250mcg and her repeated cortisol after 60 minutes was only 1mcg/dL. The patient was diagnosed with adrenal insufficiency and was started on hydrocortisone 20mg+10mg. It took close to 2 years of slow tapering for recovery of this patient’s HPA axis and resolve all the sequelae from Cushing’s syndrome. Conclusion: Misuse and abuse of glucocorticoids have been present almost since these medications were discovered. This is a rare case where not only severe Cushing’s syndrome in full clinical picture developed but also the patient suffered multiple potentially fatal complications and prolonged adrenal insufficiency. Visits to herbal, rejuvenation, esthetic, and similar clinics are becoming more and more popular and physicians need to be aware of possible non-benign nature of medications that their patients may be using.

Keywords: iatrogenic, Cushing's syndrome, adrenal crisis, steroid abuse

Procedia PDF Downloads 169

Authors: Neha Bhardwaj

Abstract:

In this paper, we consider positive linear operators and study the Voronovskaya type result of the operator then obtain an error estimate in terms of the higher order modulus of continuity of the function being approximated and its A-statistical convergence. Also, we compute the corresponding rate of A-statistical convergence for the linear positive operators.

Keywords: Poisson distribution, Voronovskaya, modulus of continuity, a-statistical convergence

Procedia PDF Downloads 333

Authors: Ella Sèdé Maforikan

Abstract:

Sustained water management requires quantitative information and the knowledge of spatiotemporal dynamics of hydrological system within the basin. This can be achieved through the research. Several studies have investigated both surface water and groundwater in Beterou catchment. However, there are few published papers on the application of the SWAT modeling in Beterou catchment. The objective of this study was to evaluate the performance of SWAT to simulate the water balance within the watershed. The inputs data consist of digital elevation model, land use maps, soil map, climatic data and discharge records. The model was calibrated and validated using the Sequential Uncertainty Fitting (SUFI2) approach. The calibrated started from 1989 to 2006 with four years warming up period (1985-1988); and validation was from 2007 to 2020. The goodness of the model was assessed using five indices, i.e., Nash–Sutcliffe efficiency (NSE), the ratio of the root means square error to the standard deviation of measured data (RSR), percent bias (PBIAS), the coefficient of determination (R²), and Kling Gupta efficiency (KGE). Results showed that SWAT model successfully simulated river flow in Beterou catchment with NSE = 0.79, R2 = 0.80 and KGE= 0.83 for the calibration process against validation process that provides NSE = 0.78, R2 = 0.78 and KGE= 0.85 using site-based streamflow data. The relative error (PBIAS) ranges from -12.2% to 3.1%. The parameters runoff curve number (CN2), Moist Bulk Density (SOL_BD), Base Flow Alpha Factor (ALPHA_BF), and the available water capacity of the soil layer (SOL_AWC) were the most sensitive parameter. The study provides further research with uncertainty analysis and recommendations for model improvement and provision of an efficient means to improve rainfall and discharges measurement data.

Keywords: watershed, water balance, SWAT modeling, Beterou

Procedia PDF Downloads 56

Authors: Olivier Mulisya, Guelord Barasima, Henry Mark Lugobe, Philémon Matumo, Bienfait Mumbere Vahwere, Hilaire Mutuka, Zawadi Léocadie, Wesley Lumika

Abstract:

Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be frequently missed in most poor-resource settings because of poor antenatal coverage, low socioeconomic status in most of the patients as well as lack of adequate medical resources. Clinical diagnosis can be very difficult and an ultrasound scan is very helpful during the early stages of gestation but can also be disappointing in the later stages. We report a case of a 25-year-old woman with severe abdominal pain not amended with any medication. A clinical picture of shock lead to an emergency laparotomy which confirmed the diagnosis of abdominal pregnancy. The ministry of health in developing countries should make an effort to make routine early ultrasounds accessible to pregnant women, and obstetricians should keep in mind the possibility of ectopic pregnancy, irrespective of the gestational age.

Keywords: abdominal pregnancy, live new bron, ultrasound imaging, abdominal pain

Procedia PDF Downloads 99

Authors: B. S.Akhmetov, S. T. Akhmetova, D. N. Nadeyev, V. Yu. Yegorov, V. V. Smogoonov

Abstract:

Estimated probabilities of errors of the first and second kind for nonideal biometrics-neural transducers 256 outputs, the construction of nomograms based error probability of 'own' and 'alien' from the mathematical expectation and standard deviation of the normalized measures Hamming.

Keywords: modeling, errors, probability, biometrics, neural network, authentication

Procedia PDF Downloads 483

Authors: Greg Zimmerman

Abstract:

Background: Major depression is a common illness that affects millions of people globally. It is the leading cause of disability and is projected to become the number one cause of the global burden of disease by 2030. Many of those who suffer from depression also suffer from Irritable Bowel Syndrome (IBS). Acupuncture has been shown to help depression. The aim of this study was to investigate the effectiveness of acupuncture in reducing the risk of IBS in patients with depression. Methods: We enrolled patients diagnosed with depression through the Taiwanese National Health Insurance Research Database (NHIRD). Propensity score matching was used to match equal numbers (n=32971) of the acupuncture cohort and no-acupuncture cohort based on characteristics including sex, age, baseline comorbidity, and medication. The Cox regression model was used to compare the hazard ratios (HRs) of IBS in the two cohorts. Results: The basic characteristics of the two groups were similar. The cumulative incidence of IBS was significantly lower in the acupuncture cohort than in the no-acupuncture cohort (Log-rank test, p<0.001). Conclusion: The results provided real-world evidence that acupuncture may have a beneficial effect on IBS risk reduction in patients with depression.

Keywords: acupuncture, depression, irritable bowel syndrome, national health insurance research database, real-world evidence

Procedia PDF Downloads 107

Authors: Carla Pérez-Chirinos Buxadé, Bruno Fernández-Valdés, Mónica Morral-Yepes, Sílvia Tuyà Viñas, Josep Maria Padullés Riu, Gerard Moras Feliu

Abstract:

There is a long way to explore all the possible applications inertial measurement units (IMUs) have in the sports field. The aim of this study was to evaluate the validity of a new application on the use of these wearable sensors, specifically it was to evaluate a magnet-based timing system (M-BTS) for timing gate-to-gate in an alpine ski slalom using the magnetometer embedded in an IMU. This was a validation study. The criterion validity of time measured by the M-BTS was assessed using the 95% error range against actual time obtained from photocells. The experiment was carried out with first-and second-year junior skiers performing a ski slalom on a ski training slope. Eight alpine skiers (17.4 ± 0.8 years, 176.4 ± 4.9 cm, 67.7 ± 2.0 kg, 128.8 ± 26.6 slalom FIS-Points) participated in the study. An IMU device was attached to the skier’s lower back. Skiers performed a 40-gate slalom from which four gates were assessed. The M-BTS consisted of placing four bar magnets buried into the snow surface on the inner side of each gate’s turning pole; the magnetometer built into the IMU detected the peak-shaped magnetic field when passing near the magnets at a certain speed. Four magnetic peaks were detected. The time compressed between peaks was calculated. Three inter-gate times were obtained for each system: photocells and M-BTS. The total time was defined as the time sum of the inter-gate times. The 95% error interval for the total time was 0.050 s for the ski slalom. The M-BTS is valid for timing gate-to-gate in an alpine ski slalom. Inter-gate times can provide additional data for analyzing a skier’s performance, such as asymmetries between left and right foot.

Keywords: gate crossing time, inertial measurement unit, timing system, wearable sensor

Procedia PDF Downloads 184

Authors: Fazel Zinat Motlagh, Reza Chaman, Rashid Ghafari, Zahra Behzad, Ahmad Ali Eslami

Abstract:

Background: Chronic disease management requires the individual to perform several self-care behaviors. Self-efficacy, a widely used psychosocial concept, is associated with the ability to manage chronic disease. In this study, we examine the association between self-efficacy and self-care behaviors related to hypertension. Methods: In this cross-sectional study, conducted in Kohgiluye Boyer Ahmad province, the south of Iran, a total of 1836 hypertension patients, were randomly selected and participated in the study. Self-care behavior was measured with using H-SCALE (Hypertension Self-Care Activity Level Effects). Logistic regression conducted to detect correlation between self-efficacy and adherence to hypertension self-care behaviors. Results: Less than half (40.8%) of the participants reported that they have good self-efficacy to manage hypertension. Good self-efficacy was significantly associated with improve in adherence to medication (95% CI: 1.68, 1.83), eating a low-salt diet (95% CI: 1.44–1.73), physical activity (95% CI: 1.39–1.55), quit smoking (95% CI: 0.38–0.47), and weight management techniques (95% CI: 0.66–0.82). Conclusion: Hypertension self-efficacy was associated with adherence to self-care behaviors among adult with hypertension. According to our finding hypertension is a manageable condition. Self-efficacy is important factor in adherence with self-care behaviors related with hypertension.

Keywords: self-efficacy, hypertension, self-care, Iran

Procedia PDF Downloads 546

Authors: Fadwa Alhalaiqa, Ahmad Al-Nawafleh, Abdul-Monim Batiha, Rami Masadeh, Aida Abd Alrazek

Abstract:

Healthy lifestyle recommendations (e.g. physical inactivity, unhealthy diet, increased cholesterol levels, obesity, and poor stress management) play an important role in controlling BP. This study aimed to assess lifestyle modification factors among patient diagnosed with hypertension. Methods and materials: A cross section-survey design was used. Data was collected by four questionnaires one was the beliefs about medication (BMQ) and rest were developed to collect data about demographics and clinical characteristics and lifestyle modification factors. Results: Total 312 questionnaires had been completed. The participants had a mean age of 57.6 years (SD =11.8). The results revealed that our participants did not follow healthy lifestyle recommendations; for example the means BS level, BMI, and cholesterol levels were 155 mg/dl (SD= 71.9), 29 kg/2m (SD= 5.4) and 197 mg/dl (SD= 86.6) respectively. A significant correlation was shown between age and BP (P= 0.000). Increase in DBP correlates with a significant increase in cholesterol level (P= .002) and BMI (P= .006). Conclusion: Hypertensive patients did not adhere to healthy lifestyle modification factors. Therefore, an urgent action by addressing behavioral risk factors has a positive impact on preventing and controlling hypertension.

Keywords: adherence, healthy lifestyle, hypertension, patients

Procedia PDF Downloads 280

Authors: C. Gopi Jinimole, A. Harsha

Abstract:

For detecting strokes, Computed Tomography (CT) scan is preferred for imaging the abnormalities or infarction in the brain. Because of the problems in the window settings used to evaluate brain CT images, they are very poor in the early stage infarction detection. This paper presents an automatic estimation method for the window settings of the CT images for proper contrast of the hyper infarction present in the brain. In the proposed work the window width is estimated automatically for each slice and the window centre is changed to a new value of 31HU, which is the average of the HU values of the grey matter and white matter in the brain. The automatic window width estimation is based on the average of median of statistical central moments. Thus with the new suggested window centre and estimated window width, the hyper infarction or post-stroke regions in CT brain images are properly detected. The proposed approach assists the radiologists in CT evaluation for early quantitative signs of delayed stroke, which leads to severe hemorrhage in the future can be prevented by providing timely medication to the patients.

Keywords: computed tomography (CT), hyper infarction or post stroke region, Hounsefield Unit (HU), window centre (WC), window width (WW)

Procedia PDF Downloads 203

Authors: Derick Shi-Chen Ou, Liang-Yu Chen

Abstract:

Background: Acupuncture, a potential alternative, and complementary therapy revealed insufficient evidence in depression treatment. The efficacy of acupuncture treatment was still uncertainty. To evaluate the effect of acupuncture in treating depression, the randomized controlled trials (RCTs) were examined. Methods: RCTs of the acupuncture therapy in treating major depression were searched from MEDLINE from 2007 to 2017. Keywords used for searching strategy included acupuncture, acupoint, and major depressive disorder. Results: Among the nine RCTs, four studies demonstrated great improvement in acupuncture treatment and five studies revealed the effectiveness of acupuncture intervention in medication. General trends suggest that acupuncture treatment is as effective as antidepressants with minimal side effects. Conclusion: Despite the promising results from the RCTs, there are still a variety of limitations, including small sample size, imprecise enrollment criteria, difficulties with blinding, randomization, short duration of study and lack of longitudinal follow-up. Therefore, the evidence that acupuncture as an alternative therapy for depression is inconclusive. More rigorously designed RCTs should be conducted in the future.

Keywords: acupuncture, major depressive disorders, randomized clinical trials, antidepressants

Procedia PDF Downloads 235

Authors: Akhilesh Kumar, Sathyanarayan G., Nirmala S.

Abstract:

An unusual approach is developed to determine the orbit of satellites/space objects. The determination of orbits is considered a boundary value problem and has been solved using the finite difference method (FDM). Only positions of the satellites/space objects are known at two end times taken as boundary conditions. The technique of finite difference has been used to calculate the orbit between end times. In this approach, the governing equation is defined as the satellite's equation of motion with a perturbed acceleration. Using the finite difference method, the governing equations and boundary conditions are discretized. The resulting system of algebraic equations is solved using Tri Diagonal Matrix Algorithm (TDMA) until convergence is achieved. This methodology test and evaluation has been done using all GPS satellite orbits from National Geospatial-Intelligence Agency (NGA) precise product for Doy 125, 2023. Towards this, two hours of twelve sets have been taken into consideration. Only positions at the end times of each twelve sets are considered boundary conditions. This algorithm is applied to all GPS satellites. Results achieved using FDM compared with the results of NGA precise orbits. The maximum RSS error for the position is 0.48 [m] and the velocity is 0.43 [mm/sec]. Also, the present algorithm is applied on the IRNSS satellites for Doy 220, 2023. The maximum RSS error for the position is 0.49 [m], and for velocity is 0.28 [mm/sec]. Next, a simulation has been done for a Highly Elliptical orbit for DOY 63, 2023, for the duration of 6 hours. The RSS of difference in position is 0.92 [m] and velocity is 1.58 [mm/sec] for the orbital speed of more than 5km/sec. Whereas the RSS of difference in position is 0.13 [m] and velocity is 0.12 [mm/sec] for the orbital speed less than 5km/sec. Results show that the newly created method is reliable and accurate. Further applications of the developed methodology include missile and spacecraft targeting, orbit design (mission planning), space rendezvous and interception, space debris correlation, and navigation solutions.

Keywords: finite difference method, grid generation, NavIC system, orbit perturbation

Procedia PDF Downloads 86

Authors: Rahul Malhotra

Abstract:

Fiber based access networks can deliver performance that can support the increasing demands for high speed connections. One of the new technologies that have emerged in recent years is Passive Optical Networks. This paper is targeted to show the simultaneous delivery of triple play service (data, voice and video). The comparative investigation and suitability of various data rates is presented. It is demonstrated that as we increase the data rate, number of users to be accommodated decreases due to increase in bit error rate.

Keywords: BER, PON, TDMPON, GPON, CWDM, OLT, ONT

Procedia PDF Downloads 558

Authors: Neeti Sharma, Harshika Pareek, Prerna Puri, Manika Mohan

Abstract:

The present study is aimed at studying the significant relationship between anxiety and depression in chronic headache patients. Chronic Headache patients coming to the Neurology Unit-1 Outpatient Department of the Sawai Mansingh Hospital (SMS) Jaipur, Rajasthan, were included in this study. The sample consisted of 100 patients (N=100). Initially patients were examined by a physician and then they were assessed for Anxiety and Depression using the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Rating Scale for Depression. The relevant information was recorded on a Performa designed for this purpose comprising of socio-demographic variables like age, gender and triggering factors. The correlation-coefficient indicated a significant positive relationship between the anxiety and depression in chronic headache patients. These findings implicate high prevalence of anxiety and depression in the general population, and also indicate an association between headache and psychological disorders. Many evidences support the anxiety-headache-depression syndrome as a distinct disorder, and the association of co-morbid psychiatric illness with headache intractability. This study highlights the importance of prospective research for studying the developmental course and consequences of headache syndromes. Also, various psychotherapies should be applied to the headache patients so as to treat them, at the onset level of anxiety and depression, with the help of medication.

Keywords: anxiety, chronic headaches, depression, HAM-A, HAM

Procedia PDF Downloads 472