Search results for: medication errors

Authors: Tadesse Melaku Abegaz, Akshaya Srikanth Bahagavathula, Abdulla Shehab Sheab, Asim Hassen

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Objectives: Non-adherence and discontinuation of anticoagulant therapy lead to increased ischemic stroke risk and contributes to suboptimal outcomes of the anticoagulant treatment. This systematic review and meta-analysis were aimed to investigate the adherence to NOACs and adverse events in patients with AF. Methods: Original research articles conducted on patients with AF and using any NOACs (dabigatran, rivoraxaban and apixaban) reporting adherence for at least 35 days were included. Scientific databases including PubMed, Web of Science, and Google Scholar were searched using MeSH keywords to obtaining literature researched between 2008 to till June, 2016. Study characteristics, patient’s sociodemographic and clinical characteristics, medication adherence levels and bleeding events reported were recorded. Results: The overall sample size of the six studies is 1,640,157, with CHADS2 scores < 2 in 551 patients, CHADS2-VASc ≥ 2 in 62,232 AF patients. Three-forth [75.6% (95%CI= 66.5-84.8), p < 0.001] are adherent to NOACs. However, a higher rate [72.7% (62.5-82.9), p < 0.001] of adherence was observed with Dabigatran than Apixaban [59.9% (3.2-123.1), p=0.063] and Rivaroxaban [59.3% (38.7-80.0), p<0.001]. Sub-group analysis revealed that nearly 57% of the AF patients on NOACs have CHADS2 scores < 2 and 20% of these patients were non-adherent to NOACs. Overall bleeding events rate associated with NOACs non-adherent AF patients was found to be 7.5% (0.2-14.8), p=0.045. However, nearly 11.2% of AF patients experienced bleeding events were non-adherent to NOAC medications. A higher proportion of bleeding events were noticed with Dabigatran (14.7%). Conclusions: Adherence rates, while uniformly suboptimal, nevertheless varied considerably, lowest at 59.3% for rivaroxaban and 59.9% for apixaban, followed by dabigatran (75.6%). Overall bleeding events associated with NOACs rates were 7.5%. However, lower adherence to NOACs was associated with worse outcomes among patients with greater stroke risk.

Keywords: atrial fibrillation, bleeding events, meta-analysis, novel oral anticoagulants

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Edlira Donefski, Lorenc Ekonomi, Tina Donefski

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Edgeworth approximation is one of the most important statistical methods that has a considered contribution in the reduction of the sum of standard deviation of the independent variables’ coefficients in a Quantile Regression Model. This model estimates the conditional median or other quantiles. In this paper, we have applied approximating statistical methods in an economical problem. We have created and generated a quantile regression model to see how the profit gained is connected with the realized sales of the cosmetic products in a real data, taken from a local business. The Linear Regression of the generated profit and the realized sales was not free of autocorrelation and heteroscedasticity, so this is the reason that we have used this model instead of Linear Regression. Our aim is to analyze in more details the relation between the variables taken into study: the profit and the finalized sales and how to minimize the standard errors of the independent variable involved in this study, the level of realized sales. The statistical methods that we have applied in our work are Edgeworth Approximation for Independent and Identical distributed (IID) cases, Bootstrap version of the Model and the Edgeworth approximation for Bootstrap Quantile Regression Model. The graphics and the results that we have presented here identify the best approximating model of our study.

Keywords: bootstrap, edgeworth approximation, IID, quantile

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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Authors: Maya Agarwala

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Objectives: Audit the quality of clinical photographs taken for Orthodontic patients at Queen’s hospital, Romford. Design and setting: All Orthodontic photographs are taken in the Medical Photography Department at Queen’s Hospital. Retrospective audit with data collected between January - March 2023. Gold standard: Institute of Medical Illustrators (IMI) standard 12 photographs: 6 extraoral and 6 intraoral. 100% of patients to have the standard 12 photographs meeting a satisfactory diagnostic quality. Materials and methods: 30 patients randomly selected. All photographs analysed against the IMI gold standard. Results: A total of 360 photographs were analysed. 100% of the photographs had the 12 photographic views. Of which, 93.1% met the gold standard. Of the extraoral photos: 99.4% met the gold standard, 0.6% had incorrect head positioning. Of the intraoral photographs: 87.2% met the gold standard. The most common intraoral errors were: the presence of saliva pooling (7.2%), insufficient soft tissue retraction (3.3%), incomplete occlusal surface visibility (2.2%) and mirror fogging (1.1%). Conclusion: The gold standard was not met, however the overall standard of Orthodontic photographs is high. Further training of the Medical Photography team is needed to improve the quality of photographs. Following the training, the audit will be repeated. High-quality clinical photographs are an important part of clinical record keeping.

Keywords: orthodontics, paediatric, photography, audit

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Authors: Mohammad Anwar, Shah Waliullah

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This study investigated panel data regression models. This paper used Bayesian and classical methods to study the impact of institutions on economic growth from data (1990-2014), especially in developing countries. Under the classical and Bayesian methodology, the two-panel data models were estimated, which are common effects and fixed effects. For the Bayesian approach, the prior information is used in this paper, and normal gamma prior is used for the panel data models. The analysis was done through WinBUGS14 software. The estimated results of the study showed that panel data models are valid models in Bayesian methodology. In the Bayesian approach, the effects of all independent variables were positively and significantly affected by the dependent variables. Based on the standard errors of all models, we must say that the fixed effect model is the best model in the Bayesian estimation of panel data models. Also, it was proved that the fixed effect model has the lowest value of standard error, as compared to other models.

Keywords: Bayesian approach, common effect, fixed effect, random effect, Dynamic Random Effect Model

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Authors: Ruxandra Barbulescu, Daniel Ioan, Gabriela Ciuprina

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The saltatory conduction is the way the action potential is transmitted along a myelinated axon. The potential diffuses along the myelinated compartments and it is regenerated in the Ranvier nodes due to the ion channels allowing the flow across the membrane. For an efficient simulation of populations of neurons, it is important to use reduced order models both for myelinated compartments and for Ranvier nodes and to have control over their accuracy and inner parameters. The paper presents a reduced order model of this neural system which allows an efficient simulation method for the saltatory conduction in myelinated axons. This model is obtained by concatenating reduced order linear models of 1D myelinated compartments and nonlinear 0D models of Ranvier nodes. The models for the myelinated compartments are selected from a series of spatially distributed models developed and hierarchized according to their modeling errors. The extracted model described by a nonlinear PDE of hyperbolic type is able to reproduce the saltatory conduction with acceptable accuracy and takes into account the finite propagation speed of potential. Finally, this model is again reduced in order to make it suitable for the inclusion in large-scale neural circuits.

Keywords: action potential, myelinated segments, nonlinear models, Ranvier nodes, reduced order models, saltatory conduction

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Authors: Syed Nauman Bin Asghar Bukhari, Mohtashim Mansoor, Mohammad Nouman

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Engine test-Bed system is a fundamental tool to measure dynamic parameters, economic performance, and reliability of an aircraft Engine, and its automation and accuracy directly influences the precision of acquired and analysed data. In this paper, we present the design of digital Data Acquisition (DAQ) system for a vintage aircraft engine test bed that lacks the capability of displaying all the analyzed parameters at one convenient location (one panel-one screen). Recording such measurements in the vintage test bed is not only time consuming but also prone to human errors. Digitizing such measurement system requires a Data Acquisition (DAQ) system capable of recording these parameters and displaying them on one screen-one panel monitor. The challenge in designing upgrade to the vintage systems arises with a need to build and integrate digital measurement system from scratch with a minimal budget and modifications to the existing vintage system. The proposed design not only displays all the key performance / maintenance parameters of the gas turbine engines for operator as well as quality inspector on separate screens but also records the data for further processing / archiving.

Keywords: Gas turbine engine, engine test cell, data acquisition, instrumentation

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Authors: Samuel Quashie

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The importance of theory for PhD construction management research cannot be underestimated, as it requires a sound theoretical basis. Theory efficiency reduces errors in the research problem, solving it by building upon current theory. Provides a structure for examination, enables the efficient development of the construction management field and to it practical real world problems. The aim is to develop the theoretical framework for the application of descriptive theory within the PhD research design To apply the proposed theoretical framework using the case of the topic of ‘integrated management system,’ classifying the phenomena into categories, explore the association between the category–defining attributes and the outcome observed. Forming categorization based upon attributes of phenomena (framework and typologies), and statement of association (models). Predicting (deductive process) and confirming (inductive process). The descriptive theory is important and provides a structure for examination, enables the efficient development of construction management field and to it practical real world problems. In conclusion, the work done in management presents fertile ground for research and theory development.

Keywords: descriptive theory, PhD research design, theoretical framework, construction management

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Authors: Liang Wang, Beste F. Yuksel, David Guy Brizan

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A computational model of affect that can distinguish between spontaneous and posed smiles with no errors on a large, popular data set using deep learning techniques is presented in this paper. A Long Short-Term Memory (LSTM) classifier, a type of Recurrent Neural Network, is utilized and compared to human classification. Results showed that while human classification (mean of 0.7133) was above chance, the LSTM model was more accurate than human classification and other comparable state-of-the-art systems. Additionally, a high accuracy rate was maintained with small amounts of training videos (70 instances). The derivation of important features to further understand the success of our computational model were analyzed, and it was inferred that thousands of pairs of points within the eyes and mouth are important throughout all time segments in a smile. This suggests that distinguishing between a posed and spontaneous smile is a complex task, one which may account for the difficulty and lower accuracy of human classification compared to machine learning models.

Keywords: affective computing, affect detection, computer vision, deep learning, human-computer interaction, machine learning, posed smile detection, spontaneous smile detection

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Authors: Je Young Lee, Hee Sung Kim, Kwang Ho Choi, Joonhoo Lim, Sebum Chun, Hyung Keun Lee

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A purpose of this study is to develop efficient detection method for Global Navigation Satellite Systems (GNSS) applications based on adaptive estimation. Due to dependence of radio frequency signals, GNSS measurements are dominated by systematic errors in receiver’s operating environment. Thus, to utilize GNSS for aerospace or ground vehicles requiring high level of safety, unhealthy measurements should be considered seriously. For the reason, this paper proposes adaptive fault detection method to deal with unhealthy measurements in various harsh environments. By the proposed method, the test statistics for fault detection is generated by estimated measurement noise. Pseudorange and carrier-phase measurement noise are obtained at time propagations and measurement updates in process of Carrier-Smoothed Code (CSC) filtering, respectively. Performance of the proposed method was evaluated by field-collected GNSS measurements. To evaluate the fault detection capability, intentional faults were added to measurements. The experimental result shows that the proposed detection method is efficient in detecting unhealthy measurements and improves the accuracy of GNSS positioning under fault occurrence.

Keywords: adaptive estimation, fault detection, GNSS, residual

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Authors: Mohamed Elhakeem, A. N. Thanos Papanicolaou, Christopher Wilson, Yi-Jia Chang

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In this study, a physically-based, modelling framework was developed to predict saturated hydraulic conductivity (KSAT) dynamics in the Clear Creek Watershed (CCW), Iowa. The modelling framework integrated selected pedotransfer functions and watershed models with geospatial tools. A number of pedotransfer functions and agricultural watershed models were examined to select the appropriate models that represent the study site conditions. Models selection was based on statistical measures of the models’ errors compared to the KSAT field measurements conducted in the CCW under different soil, climate and land use conditions. The study has shown that the predictions of the combined pedotransfer function of Rosetta and the Water Erosion Prediction Project (WEPP) provided the best agreement to the measured KSAT values in the CCW compared to the other tested models. Therefore, Rosetta and WEPP were integrated with the Geographic Information System (GIS) tools for visualization of the data in forms of geospatial maps and prediction of KSAT variability in CCW due to the seasonal changes in climate and land use activities.

Keywords: saturated hydraulic conductivity, pedotransfer functions, watershed models, geospatial tools

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Authors: Robert Jacobsen

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Flood inundation maps (FIMs) are an essential tool in communicating flood threat scenarios to the public as well as in floodplain governance. With an increasing demand for online raster FIMs, the FIM State-of-the-Practice (SOP) is rapidly advancing to meet the dual requirements for high-resolution and high-accuracy—or High-Definition. Importantly, today’s technology also enables the resolution of problems of local—neighborhood-scale—bias errors that often occur in FIMs, even with the use of SOP two-dimensional flood modeling. To facilitate the development of HD-FIMs, a new GIS method--Raster Adjustment with Scenario Profiles, RASPTM—is described for adjusting kernel raster FIMs to match refined scenario profiles. With RASPTM, flood professionals can prepare HD-FIMs for a wide range of scenarios with available kernel rasters, including kernel rasters prepared from vector FIMs. The paper provides detailed procedures for RASPTM, along with an example of applying RASPTM to prepare an HD-FIM for the August 2016 Flood in Louisiana using both an SOP kernel raster and a kernel raster derived from an older vector-based flood insurance rate map. The accuracy of the HD-FIMs achieved with the application of RASPTM to the two kernel rasters is evaluated.

Keywords: hydrology, mapping, high-definition, inundation

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Authors: Ashwag O. Maghraby, Nida N. Khan, Hosnia A. Ahmed, Ghufran N. Brohi, Hind F. Assouli, Jawaher S. Melibari

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The Arabic language is one of the most important languages. Learning it is so important for many people around the world because of its religious and economic importance and the real challenge lies in practicing it without grammatical or syntactical mistakes. This research focused on detecting and correcting the syntactic mistakes of Arabic syntax according to their position in the sentence and focused on two of the main syntactical rules in Arabic: Dual and Plural. It analyzes each sentence in the text, using Stanford CoreNLP morphological analyzer and machine-learning approach in order to detect the syntactical mistakes and then correct it. A prototype of the proposed system was implemented and evaluated. It uses support vector machine (SVM) algorithm to detect Arabic grammatical errors and correct them using the rule-based approach. The prototype system has a far accuracy 81%. In general, it shows a set of useful grammatical suggestions that the user may forget about while writing due to lack of familiarity with grammar or as a result of the speed of writing such as alerting the user when using a plural term to indicate one person.

Keywords: Arabic language acquisition and learning, natural language processing, morphological analyzer, part-of-speech

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Authors: M. P. Sebastian

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Health for all is considered as a sign of well-being and inclusive growth. New healthcare technologies are contributing to the quality of human lives by promoting health education and awareness, leading to the prevention, early diagnosis and treatment of the symptoms of diseases. Healthcare technologies have now migrated from the medical and institutionalized settings to the home and everyday life. This paper explores these new technologies and investigates how they contribute to health education and awareness, promoting the objective of high-value health system for all. The methodology used for the research is literature review. The paper also discusses the opportunities and challenges with futuristic healthcare technologies. The combined advances in genomics medicine, wearables and the IoT with enhanced data collection in electronic health record (EHR) systems, environmental sensors, and mobile device applications can contribute in a big way to high-value health system for all. The promise by these technologies includes reduced total cost of healthcare, reduced incidence of medical diagnosis errors, and reduced treatment variability. The major barriers to adoption include concerns with security, privacy, and integrity of healthcare data, regulation and compliance issues, service reliability, interoperability and portability of data, and user friendliness and convenience of these technologies.

Keywords: big data, education, healthcare, information communication technologies (ICT), patients, technologies

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Authors: Cristiane C. B. Alves, Livia Eisler, Gustavo Mota, Kurt Faltin Jr., Cristina L. F. Ortolani

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The correct positioning of the brackets is essential for the success of orthodontic treatment. Indirect bracket placing technique has the main objective of eliminating the positioning errors, which commonly occur in the technique of direct system of brackets. The objective of this study is to demonstrate that the exact positioning of the brackets is of extreme relevance for the success of the treatment. The present work shows a case report of an adult female patient who attended the clinic with the complaint of being in orthodontic treatment for more than 5 years without noticing any progress. As a result of the intra-oral clinical examination and documentation analysis, a class III malocclusion, an anterior open bite, and absence of all third molars and first upper and lower bilateral premolars were observed. For the treatment, the indirect bonding technique with self-ligating ceramic braces was applied. The preparation of the trays was done after the intraoral digital scanning and printing of models with a 3D printer. Brackets were positioned virtually, using a specialized software. After twelve months of treatment, correction of the malocclusion was observed, as well as the closing of the anterior open bite. It is concluded that the adequate and precise positioning of brackets is necessary for a successful treatment.

Keywords: anterior open-bite, CAD/CAM, orthodontics, malocclusion, angle class III

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Authors: Michael Ngongeh Mombe

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This Paper seeks to investigate an assertion made by some colleagues that there is no need paying a human translator to translate their literary texts, that there are softwares such as Reverso that can be used to do the translation. The main objective of this study is to examine the veracity of this assertion using Reverso to translate a literary text without any post-editing by a human translator. The work is based on two theories: Skopos and Communicative theories of translation. The work is a documentary research where data were collected from published documents in libraries, on the internet and from the translation produced by Reverso. We made a comparative text analyses of both source and target texts in a bid to highlight the weaknesses and strengths of the software. Findings of this work revealed that those who advocate the use of only Machine translation do so in ignorance of the translation mistakes usually made by the software. From the review of all the 268 segments of translation, we found out that the translation produced by Reverso is fraught with errors. We therefore recommend the use of human translators to either do the translation of their literary texts or revise the translation produced by machine to conform to the skopos of the work. This paper is based on Reverso translation. Similar works in the near future will be based on the other translation softwares to determine their weaknesses and strengths.

Keywords: machine translation, human translator, Reverso, literary text

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Authors: Joung Hyoun Lee

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Intransitive verbs consist of two subclasses called unergatives and unaccusatives. However, traditionally Italian intransitive verbs have been taught regardless their semantic distinctions and any mention of grammatical terms such as unaccusatives and unergatives even though there is a huge gap between them. This paper aims to explore the teaching of Italian intransitive verbs categorizing them into unaccusatives and unergatives, which is compared with researches on the teaching of English unaccusative and unergative verbs. For this purpose, first, the study analyses various aspects of English vs. Italian unergatives and unaccusatives, and their properties of the constructions. Next, this study highlights the research trend on Korean students' learning errors, which is leaning toward causal analyses of the over passivization of English unaccusative verbs. In order to investigate these issues, 53 students of the Busan University of Foreign Studies, who are studying Italian language as a second language, were surveyed through a grammaticality judgment test divided into 9 sections. As expected, the findings confirmed that the test results of Italian unaccusatives and unergatives showed similar and different aspects comparing to those of English. Moreover, there was a highly affirmative demand for a more careful way of teaching which should be considered both syntactically and semantically according to the grammatical items. The research provides a framework of a more effective and systematic teaching method of Italian intransitive verbs for further research.

Keywords: unaccusative verbs, unergative verbs, agent, patient, theme, overpassivization

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Authors: Richa Mishra, Sonia Munjal

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In this increasingly hectic and competitive climate, employees are expected to manage the resources available to them to perform their work. However, many are wasting the most precious and scarce resource at their disposal, time, by procrastinating on tasks and thereby costing themselves and their organizations. As timely performance is a requirement of most jobs, procrastination is particularly problematic in the workplace. Evidence suggests that procrastination and poor performance go hand-in-hand, as procrastinators miss more deadlines than non-procrastinators and make more errors and work at a slower speed than non-procrastinators when performing timed tasks. This research is hence an effort to add a little in the sparse knowledge base. It is an effort to throw light on the relationship of Levenson’s multi dimensions of locus of control and also an effort to identify if it is one of the causes and of employees procrastination which have not been explored earlier. The study also explores the effect and relationship of multidimensional locus of control and various levels of stress on procrastination. The results of the research have ascertained that there is significant impact of LOC dimensions on the procrastinating behavior of the employees. One of the major findings to emerge from the current research that managers with powerful others as their LOC dimensions were least procrastinating, contradicts the previous research results that external procrastinate more than internals.

Keywords: Multidimensional Locus of Control, workplace procrastination, employee behaviour, manufacturing industry

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Authors: Feng Wang, Shencheng Ni, Shuying Han, Shanhong You

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With the development of optical communication, optical performance monitoring (OPM) has received more and more attentions. Since optical signal-to-noise ratio (OSNR) is directly related to bit error rate (BER), it is one of the important parameters in optical networks. Recently, artificial neural network (ANN) has been greatly developed. ANN has strong learning and generalization ability. In this paper, a method of OSNR monitoring based on delay-tap sampling (DTS) and ANN has been proposed. DTS technique is used to extract the eigenvalues of the signal. Then, the eigenvalues are input into the ANN to realize the OSNR monitoring. The experiments of 10 Gb/s non-return-to-zero (NRZ) on–off keying (OOK), 20 Gb/s pulse amplitude modulation (PAM4) and 20 Gb/s return-to-zero (RZ) differential phase-shift keying (DPSK) systems are demonstrated for the OSNR monitoring based on the proposed method. The experimental results show that the range of OSNR monitoring is from 15 to 30 dB and the root-mean-square errors (RMSEs) for 10 Gb/s NRZ-OOK, 20 Gb/s PAM4 and 20 Gb/s RZ-DPSK systems are 0.36 dB, 0.45 dB and 0.48 dB respectively. The impact of chromatic dispersion (CD) on the accuracy of OSNR monitoring is also investigated in the three experimental systems mentioned above.

Keywords: artificial neural network (ANN), chromatic dispersion (CD), delay-tap sampling (DTS), optical signal-to-noise ratio (OSNR)

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Authors: S. H. Jang

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Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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Authors: M. S. Gadala, Khaled Ahmed, Elasadig Mahdi

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In this paper, we introduced a gradient-based inverse solver to obtain the missing boundary conditions based on the readings of internal thermocouples. The results show that the method is very sensitive to measurement errors, and becomes unstable when small time steps are used. The artificial neural networks are shown to be capable of capturing the whole thermal history on the run-out table, but are not very effective in restoring the detailed behavior of the boundary conditions. Also, they behave poorly in nonlinear cases and where the boundary condition profile is different. GA and PSO are more effective in finding a detailed representation of the time-varying boundary conditions, as well as in nonlinear cases. However, their convergence takes longer. A variation of the basic PSO, called CRPSO, showed the best performance among the three versions. Also, PSO proved to be effective in handling noisy data, especially when its performance parameters were tuned. An increase in the self-confidence parameter was also found to be effective, as it increased the global search capabilities of the algorithm. RPSO was the most effective variation in dealing with noise, closely followed by CRPSO. The latter variation is recommended for inverse heat conduction problems, as it combines the efficiency and effectiveness required by these problems.

Keywords: inverse analysis, function specification, neural net works, particle swarm, run-out table

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Authors: Merav Ben Natan, May Revach, Or Sade, Yaniv Yonay, Yaron Berkovich

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Background: The inclusion of nurse practitioners (NPs) specializing in orthopedics holds promise for enhancing the quality of care for orthopedic patients. Understanding patients’ perspectives on this role is crucial for evaluating the feasibility and acceptance of integrating NPs into orthopedic settings. This study aims to explore the receptiveness of orthopedic patients to treatment by orthopedic NPs and examines potential associations between patients’ willingness to engage with NPs, their familiarity with the NP role, perceptions of nursing, and satisfaction with orthopedic nursing care. Methods: This cross-sectional study involved patients admitted to an orthopedic department at a central Israeli hospital between January and February 2023. Data was collected using a validated questionnaire consisting of five sections, reviewed by content experts. Statistical analyses were conducted using SPSS and included descriptive statistics, independent samples t-tests, Pearson correlations, and linear regression. Results: Participants in the study showed a moderate willingness to receive treatment from orthopedic NPs, with more than two-thirds expressing strong openness. Patients were generally receptive to NPs performing various clinical tasks, though there was less enthusiasm for NPs’ involvement in medication management and preoperative evaluations. Positive attitudes towards nurses and familiarity with the NP role were significant predictors of patient receptiveness to NP treatment. Conclusion: Patient acceptance of orthopedic NPs varies across different aspects of care. While there is a general willingness to receive care from NPs, these nuanced preferences must be considered when implementing NPs in orthopedic settings. Awareness and positive perceptions of the NP role play crucial roles in shaping patients’ willingness to engage with NPs.

Keywords: orthopedic nurse practitioners, patient receptiveness, perceptions of nursing, clinical tasks

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Authors: Jacob Nortey

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Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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Authors: Selina Schwaabe

Abstract:

Community pharmacies deliver high-quality health care and are responsible for medication safety. During the pandemic, accessibility to the nearest pharmacy became more essential to get vaccinated against Covid-19 and to get medical aid. The government's goal is to ensure nationwide, reachable, and affordable medical health care services by pharmacies. Therefore, the density of community pharmacies matters. Overall, the density of community pharmacies is fluctuating, with slightly decreasing tendencies in some countries. So far, the literature has shown that changes in the system affect prices and density. However, a European overview of the development of the density of community pharmacies and its triggers is still missing. This research is essential to counteract against decreasing density consulting in a lack of professional health care through pharmacies. The analysis focuses on liberal versus regulated market structures, mail-order prescription drug regulation, and third-party ownership consequences. In a panel analysis, the relative influence of the measures is examined across 27 European countries over the last 21 years. In addition, the paper examines seven selected countries in depth, selected for the substantial variance in their pharmacy system: Germany, Austria, Portugal, Denmark, Sweden, Finland and Poland. Overall, the results show that regulated pharmacy markets have over 10.75 pharmacies/100.000 inhabitants more than liberal markets. Further, mail-order prescription drugs decrease the density by -17.98 pharmacies/100.000 inhabitants. Countries allowing third-party ownership have 7.67 pharmacies/100.000 inhabitants more. The results are statistically significant at a 0.001 level. The output of this analysis recommends regulated pharmacy markets, with a ban on mail-order prescription drugs allowing third-party ownership to support nationwide medical health care through community pharmacies.

Keywords: community pharmacy, market conditions, pharmacy, pharmacy market, pharmacy lobby, prescription, e-prescription, ownership structures

Procedia PDF Downloads 119

Authors: Ganetsou Evanthia, Koutsikos Emmanouil, Austin Anna Maria

Abstract:

Information technology has long served the needs of individuals for learning and entertainment, but much less for children in sickness. The aim of the proposed online video game is to provide immersive learning opportunities as well as essential social and emotional scenarios for hospital-bound children with long-term illness. Online self-paced courses on chosen school subjects, including specialised software and multisensory assessments, aim at enhancing children’s academic achievement and sense of inclusion, while doctor minigames familiarise and educate young patients on their medical conditions. Online ethical dilemmas will offer children opportunities to contemplate on the importance of medical procedures and following assigned medication, often challenging for young patients; they will therefore reflect on their condition, reevaluate their perceptions about hospitalisation, and assume greater personal responsibility for their progress. Children’s emotional and psychosocial needs are addressed by engaging in social conventions, such as interactive, daily, collaborative mini games with other hospitalised peers, like virtual competitive sports games, weekly group psychodrama sessions, and online birthday parties or sleepovers. Social bonding is also fostered by having a virtual pet to interact with and take care of, as well as a virtual nurse to discuss and reflect on the mood of the day, engage in constructive dialogue and perspective taking, and offer reminders. Access to the platform will be available throughout the day depending on the patient’s health status. The program is designed to minimise escapism and feelings of exclusion, and can flexibly be adapted to offer post-treatment and a support online system at home.

Keywords: long-term illness, children, hospital, interactive games, cognitive, socioemotional development

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Authors: N. Borjalilu, P. Rabiei, A. Enjoo

Abstract:

Flight Data Monitoring (FDM) program assists an operator in aviation industries to identify, quantify, assess and address operational safety risks, in order to improve safety of flight operations. FDM is a powerful tool for an aircraft operator integrated into the operator’s Safety Management System (SMS), allowing to detect, confirm, and assess safety issues and to check the effectiveness of corrective actions, associated with human errors. This article proposes a model for safety risk assessment level of flight data in a different aspect of event focus based on fuzzy set values. It permits to evaluate the operational safety level from the point of view of flight activities. The main advantages of this method are proposed qualitative safety analysis of flight data. This research applies the opinions of the aviation experts through a number of questionnaires Related to flight data in four categories of occurrence that can take place during an accident or an incident such as: Runway Excursions (RE), Controlled Flight Into Terrain (CFIT), Mid-Air Collision (MAC), Loss of Control in Flight (LOC-I). By weighting each one (by F-TOPSIS) and applying it to the number of risks of the event, the safety risk of each related events can be obtained.

Keywords: F-topsis, fuzzy set, flight data monitoring (FDM), flight safety

Procedia PDF Downloads 157

Authors: Raahil Sheikh, Abhishek Maurya, Priya Gujjar, Himanshu Dwivedi, Prathamesh Minde

Abstract:

UAVs have been an initial member of our environment since it's the first used by Austrian warfare in Venice. At that stage, they were just pilotless balloons equipped with bombs to be dropped on enemy territory. Over time, technological advancements allowed UAVs to be controlled remotely or autonomously. This study shall mainly focus on the intensification of pre-existing manual drones equipping them with a variety of sensors and making them autonomous, and capable, and purposing them for a variety of roles, including thermal sensing, data collection, tracking creatures, forest fires, volcano detection, hydrothermal studies, urban heat, Island measurement, and other environmental research. The system can also be used for reconnaissance, research, 3D mapping, and search and rescue missions. This study mainly focuses on automating tedious tasks and reducing human errors as much as possible, reducing deployment time, and increasing the overall efficiency, efficacy, and reliability of the UAVs. Creation of a comprehensive Ground Control System UI (GCS) enabling less trained professionals to be able to use the UAV with maximum potency. With the inclusion of such an autonomous system, artificially intelligent paths and environmental gusts and concerns can be avoided.

Keywords: UAV, drone, autonomous system, thermal imaging

Procedia PDF Downloads 64

Authors: Othman Maklouf, Abdunnaser Tresh

Abstract:

GPS and inertial navigation system (INS) have complementary qualities that make them ideal use for sensor fusion. The limitations of GPS include occasional high noise content, outages when satellite signals are blocked, interference and low bandwidth. The strengths of GPS include its long-term stability and its capacity to function as a stand-alone navigation system. In contrast, INS is not subject to interference or outages, have high bandwidth and good short-term noise characteristics, but have long-term drift errors and require external information for initialization. A combined system of GPS and INS subsystems can exhibit the robustness, higher bandwidth and better noise characteristics of the inertial system with the long-term stability of GPS. The most common estimation algorithm used in integrated INS/GPS is the Kalman Filter (KF). KF is able to take advantages of these characteristics to provide a common integrated navigation implementation with performance superior to that of either subsystem (GPS or INS). This paper presents a simplified KF algorithm for land vehicle navigation application. In this integration scheme, the GPS derived positions and velocities are used as the update measurements for the INS derived PVA. The KF error state vector in this case includes the navigation parameters as well as the accelerometer and gyroscope error states.

Keywords: GPS, INS, Kalman filter, inertial navigation system

Procedia PDF Downloads 463

Authors: Fathi Ali Swaid

Abstract:

The CBR test is widely used in the assessment of granular materials in base, subbase and subgrade layers of road and airfield pavements. Despite the success of this method, but it depends on a limited numbers of soil samples. This limitation do not adequately account for the spatial variability of soil properties. Thus, assessment is derived using these cursory soil data are likely to contain errors and thus make interpretation and soil characterization difficult. On the other hand quantitative methods of soil inventory at the field scale involve the design and adoption of sampling regimes and laboratory analysis that are time consuming and costly. In the latter case new technologies are required to efficiently sample and observe the soil in the field. This is particularly the case where soil bearing capacity is prevalent, and detailed quantitative information for determining its cause is required. In this paper, an electrical resistivity method DC is described and its application in Elg'deem Dirt road, located in Gasser Ahmad - Misurata, Libya. Results from the DC instrument were found to be correlated with the CBR values (r2 = 0.89). Finally, it is noticed that, the correlation can be used with experience for determining CBR value using basic soil electrical resistivity measurements and checked by few CBR test representing a similar range of CBR.

Keywords: California bearing ratio, basic soil electrical resistivity, CBR, soil, subgrade, new technologies

Procedia PDF Downloads 440