Search results for: digital patient passport

Authors: Itsuo Yokoyama, Rikako Kikuti, Miti Sekikawa, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Vascular access for hemodialysis therapy is often difficult, even for experienced medical personnel. Ultrasound guided needle placement have been performed occasionally but is not always helpful in certain cases with complicated vascular anatomy. Obtaining precise anatomical knowledge of the vascular structure is important to prevent access-related complications. With augmented reality (AR) device such as AR glasses, the virtual vascular structure is shown superimposed on the actual patient vessels, thus enabling the operator to maneuver catheter placement easily with free both hands. We herein report our method of AR guided vascular access method in dialysis treatment Methods: Three dimensional (3D) object of the arm with arteriovenous fistula is computer graphically created with 3D software from the data obtained by computer tomography, ultrasound echogram, and image scanner. The 3D vascular object thus created is viewed on the screen of the AR digital display device (such as AR glass or iPad). The picture of the vascular anatomical structure becomes visible, which is superimposed over the real patient’s arm, thereby the needle insertion be performed under the guidance of AR visualization with ease. By this method, technical difficulty in catheter placement for dialysis can be lessened and performed safely. Considerations: Virtual reality technology has been applied in various fields and medical use is not an exception. Yet AR devices have not been widely used among medical professions. Visualization of the virtual vascular object can be achieved by creation of accurate three dimensional object with the help of computer graphical technique. Although our experience is limited, this method is applicable with relative easiness and our accumulating evidence has suggested that our method of vascular access with the use of AR can be promising.

Keywords: abdominal-aorta, calcification, extraskeletal, dialysis, computer graphics, 3DCG, CT, calcium, phosphorus

Procedia PDF Downloads 128

Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

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The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

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Authors: Anna Ghosh, Dominic Shields, Ceri McIntosh, Stephen Crank

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A 29-year-old male was a referral to the maxillofacial unit following a referral from his general dental practitioner via a routine pathway regarding a large periapical lesion on the LR4 with root resorption. The patient was asymptomatic, the LR4 vital and unrestored, and this was an incidental finding at a routine check-up. The patient's past medical history was unremarkable. Examination revealed no extra or intra-oral pathology and non-mobile teeth. No focal neurology was detected. An orthopantogram demonstrated a well-defined unilocular corticated radiolucency associated with the LR4. The root appeared shortened with the radiolucency between the root and a radio-opacity, possibly representing the displacement of the apical tip of the tooth. It was recommended that the referring general practitioner should proceed with orthograde root canal therapy, after which time exploration, enucleation, and retrograde root filling of the LR4 would be carried out by a maxillofacial unit. The patient was reviewed six months later where, due to the COVID-19 pandemic, the patient had been unable to access general dental services for the root canal treatment. He was still entirely asymptomatic. A one-year review was planned in the hope this would allow time for the orthograde root canal therapy to be completed. At this review, the orthograde root canal therapy had still not been completed. Interestingly, a repeat orthopantogram revealed a significant reduction in size with good bony infill and a significant reduction in the size of the lesion. Due to the ongoing delays with primary care dental therapy, the patient was subsequently internally referred to the restorative dentistry department for care. The patient was seen again by oral and maxillo-facial surgery in mid-2022 where he still reports this tooth as asymptomatic with no focal neurology. The patient's history was fully reviewed, and noted that 15 years previously, the patient underwent open reduction and internal fixation of a left angle of mandible fracture. Temporary IMF involving IMF screws and fixation wires were employed to maintain occlusion during plating and subsequently removed post-operatively. It is proposed that the radiolucency was, as a result of the IMF screw placement, penetrating the LR4 root resulting in resorption of the tooth root and development of a radiolucency. This case highlights the importance of careful screw size and physical site location, and placement of IMF screws, as there can be permeant damage to a patient’s dentition.

Keywords: facial trauma, inter-maxillary fixation, mandibular radiolucency, oral and maxillo-facial surgery

Procedia PDF Downloads 121

Authors: Zeynep Turhan

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Digital tools can improve knowledge and awareness of strategies and skills for healthy and respectful intimate relationships. The website of the Healthy and Respectful Relationship Program has been developed and included five key videos about how to build healthy intimate relationships. This study examined the perspectives about informative videos by focusing on how individuals learn new information or challenge their preconceptions or attitudes regarding male privilege and women's oppression. Five individuals who received no-contact orders and attended group intervention were the sample of this study. The observation notes were the major methodology examining how participants responded to video tools. The data analysis method was the interpretative phenomenological analysis. The results showed that many participants found the tools useful in learning the types of violence and communication strategies. Nevertheless, obstacles to implementing some techniques were found in their relationships. These digital tools might enhance healthy and respectful relationships despite some limitations.

Keywords: healthy relationship, digital tools, intimate partner violence, perpetrators, video interventions

Procedia PDF Downloads 78

Authors: Aya Al Masri, Stefaan Carpentier, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis and ulceration to appear. In order to prevent these deterministic effects, an accurate calculation of the patient skin-dose mapping is essential. For most machines, the 'Dose Area Product (DAP)' and fluoroscopy time are the only information available for the operator. These two parameters are a very poor indicator of the peak skin dose. We developed a mathematical model that reconstructs the magnitude (delivered dose), shape, and localization of each irradiation field on the patient skin. In case of critical dose exceeding, the system generates warning alerts. We present the results of its comparison with clinical studies. Materials and methods: Two series of comparison of the skin-dose mapping of our mathematical model with clinical studies were performed: 1. At a first time, clinical tests were performed on patient phantoms. Gafchromic films were placed on the table of the IR machine under of PMMA plates (thickness = 20 cm) that simulate the patient. After irradiation, the film darkening is proportional to the radiation dose received by the patient's back and reflects the shape of the X-ray field. After film scanning and analysis, the exact dose value can be obtained at each point of the mapping. Four experimentation were performed, constituting a total of 34 acquisition incidences including all possible exposure configurations. 2. At a second time, clinical trials were launched on real patients during real 'Chronic Total Occlusion (CTO)' procedures for a total of 80 cases. Gafchromic films were placed at the back of patients. We performed comparisons on the dose values, as well as the distribution, and the shape of irradiation fields between the skin dose mapping of our mathematical model and Gafchromic films. Results: The comparison between the dose values shows a difference less than 15%. Moreover, our model shows a very good geometric accuracy: all fields have the same shape, size and location (uncertainty < 5%). Conclusion: This study shows that our model is a reliable tool to warn physicians when a high radiation dose is reached. Thus, deterministic effects can be avoided.

Keywords: clinical experimentation, interventional radiology, mathematical model, patient's skin-dose mapping.

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Authors: Lise P. Labéjof, Krisnayne S. Ribeiro, Nicolle P. dos Santos

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An unrecorded experiment of use of the smartphone as a tool for practical classes of histology is presented in this article. Behavior, learning of the students of three science courses at the University were analyzed and compared as well as the mode of teaching of this discipline and the appreciation of the students, using either digital photographs taken by phone or drawings for record microscopic observations, analyze and interpret histological sections of human or animal tissues.

Keywords: cell phone, digital micrographies, learning of sciences, teaching practices

Procedia PDF Downloads 581

Authors: O. Iyare, A. H. Afolayan, O. T. Oluwadare, B. K. Alese

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Access to advanced medical services has been one of the medical challenges faced by our present society especially in distant geographical locations which may be inaccessible. Then the need for telemedicine arises through which live videos of a doctor can be streamed to a patient located anywhere in the world at any time. Patients’ medical records contain very sensitive information which should not be made accessible to unauthorized people in order to protect privacy, integrity and confidentiality. This research work focuses on a more robust security measure which is biometric (fingerprint) as a form of access control to data of patients by the medical specialist/practitioner.

Keywords: biometrics, telemedicine, privacy, patient information

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Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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Authors: Parveen Kumar

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The cope the rapid change of technology and to control the ephemeral rate of information generation, librarians along with their professional colleagues need to equip themselves as per the requirement of the electronic information society. E-learning is purely based on computer and communication technologies. The terminologies like computer based learning. It is the delivery of content via all electronic media through internet, internet, Extranets television broadcast, CD-Rom documents, etc. E-learning poses lot of issues in the transformation of literature or knowledge from the conventional medium to ICT based format and web based services.

Keywords: e-learning, digital libraries, online learning, electronic information society

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Authors: Tebogo Sethibe, Jabulile Mabuza

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The COVID-19 pandemic has been commonly referred to as a ‘black swan event’; it has changed the world, from how people live, learn, work and socialise. It is believed that the pandemic has fast-tracked the adoption of technology in many organisations to ensure business continuity and business sustainability; broadly said, the pandemic has fast-tracked digital transformation (DT) in different organisations. This paper aims to study the impact of the COVID-19 pandemic on DT in organisations in South Africa by focusing on the changes in IT capabilities in the DT framework. The research design is qualitative. The data collection was through semi-structured interviews with information communication technology (ICT) leaders representing different organisations in South Africa. The data were analysed using the thematic analysis process. The results from the study show that, in terms of ICT in the organisation, the pandemic had a direct and positive impact on ICT strategy and ICT operations. In terms of IT capability transformation, the pandemic resulted in the optimisation and expansion of existing IT capabilities in the organisation and the building of new IT capabilities to meet emerging business needs. In terms of the focus of activities during the pandemic, there seems to be a split in organisations between the primary focus being on ‘digital IT’ or ‘traditional IT’. Overall, the findings of the study show that the pandemic had a positive and significant impact on DT in organisations. However, a definitive conclusion on this would require expanding the scope of the research to all the components of a comprehensive DT framework. This study is significant because it is one of the first studies to investigate the impact of the COVID-19 pandemic on organisations, on ICT in the organisation, on IT capability transformation and, to a greater extent, DT. The findings from the study show that in response to the pandemic, there is a need for: (i) agility in organisations; (ii) organisations to execute on their existing strategy; (iii) the future-proofing of IT capabilities; (iv) the adoption of a hybrid working model; and for (v) organisations to take risks and embrace new ideas.

Keywords: digital transformation, COVID-19, bimodal-IT, digital transformation framework

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Authors: G. Fitzpatrick, S. O. Chonghaile, D. Harmon

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Objective: Chronic pain patients represent a unique challenge in the Emergency Department. Very little literature has been published regarding this group of patients. Our aim was to determine the attitude of patients with chronic pain to the Emergency Department in order to improve and streamline their future visits. Methods: A two-year survey was carried out on Chronic Pain Patients regarding their Emergency Department Attendances. Patients attending the Pain Clinic in Croom Hospital, Co. Limerick were asked to complete a 20-part questionnaire regarding their experiences of visiting the Emergency Department in the preceding year. 46 questionnaires were completed. Results: Unbearable breakthrough pain was the main reason for visiting the Emergency Department. More than half (54%) of those surveyed were not satisfied with the treatment received. Problems indicated included under-treatment of pain (59%), a sense of being under undue suspicion of drug-seeking behaviour (33%) and a perception that the patient themselves understood their condition better than the treating doctor (76%). Paracetamol, NSAIDs, or time off work comprised 72% of the treatments offered – all of which could have been provided by their General Practitioner. Only 4% were offered a nerve block. 67% felt that the creation of personalised Patient Plans, consisting of an agreed plan between the patient, their pain specialist, and the Emergency Department, would expedite their trip through the Emergency Department. Conclusions: Chronic pain patients generally have a negative experience in the ED. Possible future solutions include increasing our empathy and levels of knowledge, provision of nerve blocks in the ED, and use of personalised “Patient Plans” to streamline the treatment pathway for this group of patients.

Keywords: chronic pain, survey, patients, emergency department

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Authors: Lodgaard Eirin, Myklebust Odd, Eleftheriadis Ragnhild

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Continuous improvement is becoming increasingly a prerequisite for manufacturing companies to remain competitive in a global market. In addition, future survival and success will depend on the ability to manage the forthcoming digitalization transformation in the industry 4.0 era. Industry 4.0 promises substantially increased operational effectiveness, were all equipment are equipped with integrated processing and communication capabilities. Subsequently, the interplay of human and technology will evolve and influence the range of worker tasks and demands. Taking into account these changes, the concept of continuous improvement must evolve accordingly. Based on a case study from manufacturing industry, the purpose of this paper is to point out what the concept of continuous improvement will meet and has to take into considering when entering the 4th industrial revolution. In the past, continuous improvement has the focus on a culture of sustained improvement targeting the elimination of waste in all systems and processes of an organization by involving everyone. Today, it has to be evolved into the forthcoming digital transformation and the increased interplay of human and digital communication system to reach its full potential. One main findings of this study, is how digital communication systems will act as an enabler to strengthen the continuous improvement process, by moving from collaboration within individual teams to interconnection of teams along the product value chain. For academics and practitioners, it will help them to identify and prioritize their steps towards an industry 4.0 implementation integrated with focus on continuous improvement.

Keywords: continuous improvement, digital communication system, human-machine-interaction, industry 4.0, team perfomance

Procedia PDF Downloads 188

Authors: Lucy Tsado

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As cybercrime and cyberattacks continue to increase, the need to respond will follow suit. When cybercrimes occur, the duty to respond sometimes falls on law enforcement. However, criminal justice students are not taught concepts in cybersecurity and digital forensics. There is, therefore, an urgent need for many more institutions to begin teaching cybersecurity and related courses to social science students especially criminal justice students. However, many faculty in universities, colleges, and high schools are not equipped to teach these courses or do not have the knowledge and resources to teach important concepts in cybersecurity or digital forensics to criminal justice students. This research intends to develop curricula and training programs to equip faculty with the skills to meet this need. There is a current call to involve non-technical fields to fill the cybersecurity skills gap, according to experts. There is a general belief among non-technical fields that cybersecurity education is only attainable within computer science and technologically oriented fields. As seen from current calls, this is not entirely the case. Transitioning into the field is possible through curriculum development, training, certifications, internships and apprenticeships, and competitions. There is a need to identify how a cybersecurity eco-system can be created at a university to encourage/start programs that will lead to an interest in cybersecurity education as well as attract potential students. A short-term strategy can address this problem through curricula development, while a long-term strategy will address developing training faculty to teach cybersecurity and digital forensics. Therefore this research project addresses this overall problem in two parts, through curricula development for the criminal justice discipline; and training of faculty in criminal justice to teaching the important concepts of cybersecurity and digital forensics.

Keywords: cybersecurity education, criminal justice, curricula development, nontechnical cybersecurity, cybersecurity, digital forensics

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Authors: Moshmi Sangavarapu

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The US healthcare industry has undergone tremendous digital transformation in recent years, but critical care access to lower-income ethnicities is still in its nascency. This population has historically showcased substantial hesitation to seek any medical assistance. While the lack of sufficient financial resources plays a critical role, the existing cultural and knowledge barriers also contribute significantly to widening the access gap. It is imperative to break these barriers to ensure timely access to therapeutic procedures that can save important lives! Based on ongoing research, healthcare access barriers can be best addressed by tapping the untapped potential of caregiver communities first. They play a critical role in patients’ diagnoses, building healthcare knowledge and instilling confidence in required therapeutic procedures. Recent technological advancements have opened many avenues by developing smart ways of reaching the large caregiver community. A digitized go-to-market strategy featuring connected media coupled with smart IoT devices and geo-location targeting can be collectively leveraged to reach this key audience group. AI/ML algorithms can be thoroughly trained to identify relevant data signals from users' location and browsing behavior and determine useful marketing touchpoints. The web behavior can be further assimilated with natural language processing to identify contextually relevant interest topics and decipher potential caregivers on digital avenues to serve that brand message. In conclusion, grasping the true health access journey of any lower-income ethnic group is important to design beneficial touchpoints that can alleviate patients’ concerns and allow them to break their own access barriers and opt for timely and quality healthcare.

Keywords: healthcare access, market access, diversity barriers, patient journey

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Authors: Marat Kozhomberdiev

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The research will investigate the modern corporate finance management technologies currently used in the era of digitalization of the global economy and the degree to which financial institutions are utilizing these new technologies in the field of corporate finance management in Kyrgyzstan. The main purpose of the research is to reveal the role of financial management technologies as joint service centers, intercompany banks, specialized payment centers in the third-world country. Particularly, the analysis of the implacability of automated corporate finance management systems such as enterprise resource planning system (ERP) and treasury management system (TMS) will be carried out. Moreover, the research will investigate the role of cloud accounting systems in corporate finance management in Kyrgyz banks and whether it has any impact on the field of improving corporate finance management. The study will utilize a data collection process via surveying 3 banks in Kyrgyzstan, namely Mol-Bulak, RSK, and KICB. The banks were chosen based on their ownerships, such as state banks, private banks with local authorized capital, and private bank with international capital. The regression analysis will be utilized to reveal the correlation between the ownership of the bank and the use of new financial management technologies. The research will provide policy recommendations to both private and state banks on developing strategies for switching and utilizing modern corporate finance management technologies in their daily operations.

Keywords: digital economy, corporate finance, digital environment, digital technologies, cloud technologies, financial management

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Authors: Katharina Kargel, Frederic Vobbe

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Sexualized violence against children and adolescents using digital media poses particular challenges for practitioners with a focus on crisis intervention (social work, psychotherapy, law enforcement). The technical delimitation of violence increases the burden on those affected and increases the complexity of interdisciplinary cooperation. Urgently needed recommendations for practical action do not yet exist in Germany. Funded by the Federal Ministry of Education and Research, these recommendations for action are being developed in the HUMAN project together with science and practice. The presentation introduces the participatory approach of the HUMAN project. We discuss the application-oriented, casuistic approach of the project and present its results using the example of concrete case-based recommendations for Action. The participants will be presented with concrete prototypical case studies from the project, which will be used to illustrate quality criteria for crisis intervention in cases of sexualized violence using digital media. On the basis of case analyses, focus group interviews and interviews with victims of violence, we present the six central challenges of sexualized violence with the use of digital media, namely: • Diffusion (Ambiguities regarding the extent and significance of violence) , • Transcendence (Space and time independence of the dynamics of violence, omnipresence), • omnipresent anxiety (considering diffusion and transcendence), • being haunted (repeated confrontation with digital memories of violence or the perpetrator), • disparity (conflicts of interpretative power between those affected and the social environment) • simultaneity (of all other factors). We point out generalizable principles with which these challenges can be dealt with professionally. Dealing professionally with sexualized violence using digital media requires a stronger networking of professional actors. A clear distinction must be made between their own mission and the mission of the network partners. Those affected by violence must be shown options for crisis intervention in the context of the aid networks. The different competencies and the professional mission of the offers of help are to be made transparent. The necessity of technical possibilities for deleting abuse images beyond criminal prosecution will be discussed. Those affected are stabilized by multimodal strategies such as a combination of rational emotive therapy, legal support and technical assistance.

Keywords: sexualized violence, intervention, digital media, children and youth

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Authors: Okhee Woo

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Purpose: With increasing concern of individual radiation exposure doses, studies analyzing radiation dosage in breast imaging modalities are required. Aim of this study is to compare radiation dosage and image quality between digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM). Methods and Materials: 303 patients (mean age 52.1 years) who studied DBT and FFDM were retrospectively reviewed. Radiation dosage data were obtained by radiation dosage scoring and monitoring program: Radimetrics (Bayer HealthCare, Whippany, NJ). Entrance dose and mean glandular doses in each breast were obtained in both imaging modalities. To compare the image quality of DBT with two-dimensional synthesized mammogram (2DSM) and FFDM, 5-point scoring of lesion clarity was assessed and the better modality between the two was selected. Interobserver performance was compared with kappa values and diagnostic accuracy was compared using McNemar test. The parameters of radiation dosages (entrance dose, mean glandular dose) and image quality were compared between two modalities by using paired t-test and Wilcoxon rank sum test. Results: For entrance dose and mean glandular doses for each breasts, DBT had lower values compared with FFDM (p-value < 0.0001). Diagnostic accuracy did not have statistical difference, but lesion clarity score was higher in DBT with 2DSM and DBT was chosen as a better modality compared with FFDM. Conclusion: DBT showed lower radiation entrance dose and also lower mean glandular doses to both breasts compared with FFDM. Also, DBT with 2DSM had better image quality than FFDM with similar diagnostic accuracy, suggesting that DBT may have a potential to be performed as an alternative to FFDM.

Keywords: radiation dose, DBT, digital mammography, image quality

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Authors: Thaiurie Govender, Shannon Verne

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The Fourth Industrial Revolution has ushered in an era where technology significantly impacts various aspects of life, including higher education. Blended learning, which combines synchronous and asynchronous learning, has gained popularity as a pedagogical approach. However, its effective implementation is a challenge, particularly in the context of the COVID-19 pandemic and technological obstacles faced in South Africa. This study focused on lecturers' teaching and learning practices to implement blended learning, aiming to understand the teaching and learning strategies used with the integration of digital tools to facilitate the blended learning approach within a private higher educational institution in South Africa. Using heutagogy and constructivism theoretical frameworks, the study aimed to uncover insights into the lecturer’s teaching and learning practices to overcome challenges in designing and facilitating blended learning modules. Through a qualitative analysis, the themes of student engagement, teaching and learning strategies, digital tools, and feedback emerged, highlighting the complexities and opportunities in a blended learning classroom. The findings emphasize the importance of tailoring methods to students' needs and subject matter, aligning with constructivist principles. Recommendations include promoting professional development opportunities, addressing infrastructure issues, and fostering a supportive learning environment.

Keywords: blended learning, digital tools, higher education, teaching strategies

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Authors: Murtadha Kareem, Oliver Faust

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Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

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Authors: Victoria H. Hamilton

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Charles Bonnet Syndrome (CBS) is when a person experiences pseudohallucinations that fill in visual information from any type of sight loss. CBS arises from an epiphenomenal process, with the physical actions of sight resulting in the mental formations of images. These pseudohallucinations—referred to as visions by the CBS community—manifest in a wide range of forms, from complex scenes to simple geometric shapes. To share these unique visual experiences, a remote co-creation website was created where CBS participants communicated their lived experiences. This created a reflexive process, and we worked to produce true representations of these interesting and little-known phenomena. Digital reconstruction of the visions is utilised as it echoes the vivid, experiential movie-like nature of what is being perceived. This paper critically analyses co-creation as a method for making digital assets. The implications of the participants' vision impairments and the application of ethical safeguards are examined in this context. Important to note, this research is of a medical syndrome for a non-medical, practice-based design. CBS research to date is primarily conducted by the ophthalmic, neurological, and psychiatric fields and approached with the primary concerns of these specialties. This research contributes a distinct approach incorporating practice-based digital design, autoethnography, and phenomenology. Autoethnography and phenomenology combine as a foundation, with the first bringing understanding and insights, balanced by the second philosophical, bigger picture, and established approach. With further refining, it is anticipated that the research may be applied to other conditions. Conditions where articulating internal experiences proves challenging and the use of digital methods could aid communication. Both the research and CBS communities will benefit from the insights regarding the relationship between cognitive perceptions and the vision process. This research combines the digital visualising of visions with interest in the link between metaphor, embodied cognition, and image. The argument for a link between CBS visions and metaphor may appear evident due to the cross-category mapping of images that is necessary for comprehension. They both are— CBS visions and metaphors—the experience of picturing images, often with lateral connections and imaginative associations.

Keywords: Charles Bonnet Syndrome, digital design, visual hallucinations, visual perception

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Authors: Sutinon Yuchomsuk, Satchachon Changthom, Pruet Areesawangvong, Monsiri Jinapen

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Background: Esophageal squamous cell carcinoma can be presented with many symptoms, such as dysphagia or weight loss. However, in some circumstances, rare presentations can be found, e.g., dyspnea, which is more common in pulmonary malignancy. And dyspnea is also one of the most common presentations of COVID-19 infection. So, in this case, we can learn from many points in patient symptoms and findings leading to the diagnosis of esophageal squamous cell carcinoma. Method: This research is a case-report study including one patient from Mahasarakham Hospital, Thailand. Data were collected during December 2021. Result: A 55-year-old Thai male patient with an unknown past medical history presented with dyspnea and shortness of breath for the duration of three days prior to admission. His symptom also included cough, fever, and sore throat. Laboratory results indicated that the patient had COVID-19 pneumonia. Further investigation showed that he had cardiac tamponade and suspected pulmonary/esophageal cancer. Lung biopsy and pericardiocentesis were done, which were positive for carcinoma from pericardial effusion but negative for malignancy from the lung biopsy. Later esophagogastroduodenoscopy was done with endoscopic tissue biopsy; the result was positive for squamous cell carcinoma of the esophagus. Conclusion: Most commonly, esophageal cancer is presented with dysphagia or weight loss. However, in some rare cases, patients can also be presented with dyspnea due to cardiac tamponade. And in recent years, COVID-19 has become a pandemic all over the world, sometimes masking symptoms of other diseases. Such as in this case, the patient didn’t improve after the pneumonia was resolved, which led to the final diagnosis of metastatic esophageal cancer.

Keywords: esophageal cancer, cardiac tamponade, metastatic squamous cell carcinoma, COVID-19 infection

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Authors: S. F. Kanaan, Fatima Al-Kadi, H. Khrais

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Background: Fibromyalgia is a chronic condition that is characterized by chronic pain that limits physical and functional activities. To our best knowledge, there is currently no key physiotherapy approach recommended to reduce pain and improve function. In addition, there are scarce studies that investigated the effect of manual therapy in the management of Fibromyalgia, and no study investigated the efficacy of Mulligan´s mobilization with movement (MWM) in particular. Methods: A 51-year-old female diagnosed with Fibromyalgia for more than a year. The patient was complaining of generalized pain including neck, lower back, shoulders, elbows, hips, and knees. In addition, the patient reported severe limitation in activities and inability to complete her work as a lawyer. The Intervention provided for the patient consisted of 4 sessions (in two weeks) of MWM for neck, lower back, shoulders, elbows, sacroiliac joint, hips, and knees. The Visual Analogue Scale of pain (VAS), Range of Motion (ROM), 10-minute walk test, Roland Morris Low Back Pain and Disability Questionnaire (RMQ), Disability of the Arm, Shoulder and Hand Score (DASH) were collected at the baseline and at the end of treatment. Results: Average improvement of ROM in the neck, lower back, shoulder, elbows, hips, and knees was 45%. VAS scale changed from pre-treatment to post-treatment as the following: neck pain (9 to 0), lower back pain (8 to 1), shoulders pain (8 to 2), elbows pain (7 to 1), and knees pain (9 to 0). The patient demonstrated improvement in all functional scale from pre-intervention to post-intervention: 10-meter walk test (9.8 to 4.5 seconds), RMQ (21 to 11/24), and DASH (88.7% to 40.5%). The patient did not report any side effect of using this approach. Conclusion: Fibromyalgia can cause joint 'faulty position' leading to pain and dysfunction, which can be reversed by using MWM. MWM showed to have clinically significant improvement in ROM, pain, and ability to walk and a clinically significant reduction in disability in only 4 sessions. This work can be expanded in a larger sample.

Keywords: mobilization, fibromyalgia, dysfunction, manual therapy

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Authors: Nathan Reeves

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Aim: The aim of this study was to evaluate if there was an impact on student learning when peer role play was substituted for a professional actor in the role of simulated patient in a simulation-based scenario. Method: Third-year exercise science students enrolled in a field project course in 2015 (n=24), and 2016 (n=20) participated in a simulation-based case scenario designed to develop their client-centred exercise prescription skills. During the simulation, students were provided with feedback from the simulated patients. In 2015, three professional actors played the part of the simulated patient, and in 2016 one of the simulated patients was a student from another exercise science cohort (peer role play). The student learning experience, consistency in case fidelity and feedback provided by the simulated patients was evaluated using a 5-point Likert scale survey and collecting phenomenological data. Results: Improvements to student pre and post confidence remained constant between the 2015 and 2016 cohorts (1.04 and 0.85). The perceived usefulness and enjoyability also remained high across the two cohorts (4.96 and 4.71). The feedback provided by all three simulated patients in 2016 was seen to strongly support student learning experience (4.82), and was of a consistent level (4.47). Significance of the findings to allied health: Simulation-based education is rapidly expanding in the curricula across the allied health professions. The simulated patient methodology continues to receive support as a pedagogy to develop a range of clinical skills including communication, engagement and client-centeredness. Upskilling students to peer role play can be a reasonable alternative to engaging paid actors.

Keywords: exercise science, simulation-based learning, simulated patient, peer role play

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Authors: R. Kumaravelu, S. Poornima, Sunil Kumar Kashyap

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The optimized and digitalized restoration of the information from the old and used manual jacquard punched card in textile industry is referred to as Jacquard Punch Card (JPC) reader. In this paper, we present a novel design and development of photo electronics based system for reading old and used punched cards and storing its binary information for transforming them into an effective image file format. In our textile industry the jacquard punched cards holes diameters having the sizes of 3mm, 5mm and 5.5mm pitch. Before the adaptation of computing systems in the field of textile industry those punched cards were prepared manually without digital design source, but those punched cards are having rich woven designs. Now, the idea is to retrieve binary information from the jacquard punched cards and store them in digital (Non-Graphics) format before processing it. After processing the digital format (Non-Graphics) it is converted into an effective image file format through either by Row major or Column major parsing technique.To accomplish these activities, an embedded system based device and software integration is developed. As part of the test and trial activity the device was tested and installed for industrial service at Weavers Service Centre, Kanchipuram, Tamilnadu in India.

Keywords: file system, SPI. UART, ARM controller, jacquard, punched card, photo LED, photo diode

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Authors: Marzena Świgoń

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Nowadays, graduates should be prepared for serious challenges in the internal and external labor market. The notion that a degree is a “passport to employment” has been relegated to the past. In the last few years a phenomenon in the form of the increasing unemployment of highly educated young people in EU countries, including Poland has been observed. Empirical studies were conducted among Polish students in the scope of the so-called self-perceived employability review. In this study, a special scale was used which consisted of 19 statements regarding five components: student’s perception of university; field of study; self-belief; state of the external labor market; and, personal knowledge management. The respondent group consisted of final-year master’s students of International Relations at the University of Warmia and Mazury in Olsztyn, Poland. The findings of the empirical studies were compiled using statistical methods: descriptive statistics and inferential statistics. In general, in light of the conducted studies, the self-perceived employability of the Polish students was not high. Limitations of the studies were discussed, as well as the implications for future research in the scope of the students’ employability.

Keywords: self-perceived employability, students of international relations, university students, students employability

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Authors: Ayanda Magida, Brian Armstrong

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The study aimed to assess the third level of the digital divide among the millennials and post-millennials in South Africa. The millennials are people born from 1981-to 1996, that is, people between the ages of 25-40 years old and post-millennials are people born from 1997 to date. For the study, only post-millennials born between 1997-2003 were included as they were old enough to consent to participation in the study. Data was collected as part of the Ph.D. project that focuses on the relationship between income inequality, the digital divide, and social cohesion in South Africa. The digital divide has three main levels, namely the first, second and third. The first and second focus on access and usage, respectively. The third-level digital divide can be defined as the differences in the benefits associated with being online. The current paper focuses on the third level: the benefits derived by being online using four domains: economic, educational, social, and personal benefits. The economic benefits include income, employment and finance-related activities; the social benefits include socializing belonging, identity, and informal networks. The personal benefits include personal wellbeing and self-actualization. A total of 763 participants completed the survey, and 61.3% were post-millennials between the ages of 18-24 and s 38.6 % were millennials between 25 and 40. The majority of the respondents were female (62%), male (34%) and nonbinary (1%), respectively. Most of the respondents were black, followed by whites, Indians and colored, respectively. Thus, they represented the status of the demographics of the country. Most of the respondents had access to the internet and smartphone. Most expressed that they use laptops (68%) or mobile (71%) to access the internet and 54 % access the internet using wireless/Wi-Fi. There were no differences between the millennial and post-millennial economic and educational benefits of being online. However, the post-millennials were more inclined to use the internet for social and personal benefits than the millennials. This could be attributed to many factors, such as age. The post-millennials are still discovering themselves and therefore would derive social and personal benefits associated with being online. The findings confirm studies that argue that younger generations derive more benefits from being online than the older generation. Based on the findings, it is evident that the post-millennials are not using the internet or online activities for social networks and socializing but can derive economic benefits such as job looking and education benefits from being online. It can be inferred that there are no significant differences between the two groups, and it seems like the third-level digital divide is not evident among the two groups as they both have been able to derive meaningful benefits from being online. Further studies should focus on the third-level divide between the baby boomers and Generation X.

Keywords: third-level digital divide, millennials, post-millennials, online activities

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Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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Authors: Claudia Norambuena, Myissa Weiss, Maria Ruiz Maya, Matthew Straley, Elijah Hammond, Benjamin Chesebrough, David Grow

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The purpose of this project is to develop a low-cost, portable sensor device that can be used at home for long-term analysis of gait and balance abnormalities. One area of particular concern involves the asymmetries in movement and balance that can accompany certain types of injuries and/or the associated devices used in the repair and rehabilitation process (e.g. the use of splints and casts) which can often increase chances of falls and additional injuries. This device has the capacity to monitor a patient during the rehabilitation process after injury or operation, increasing the patient’s access to healthcare while decreasing the number of visits to the patient’s clinician. The sensor device may thereby improve the quality of the patient’s care, particularly in rural areas where access to the clinician could be limited, while simultaneously decreasing the overall cost associated with the patient’s care. The device consists of nine interconnected accelerometer/ gyroscope/compass chips (9-DOF IMU, Adafruit, New York, NY). The sensors attach to and are used to determine the orientation and acceleration of the patient’s lower abdomen, C7 vertebra (lower neck), L1 vertebra (middle back), anterior side of each thigh and tibia, and dorsal side of each foot. In addition, pressure sensors are embedded in shoe inserts with one sensor (ESS301, Tekscan, Boston, MA) beneath the heel and three sensors (Interlink 402, Interlink Electronics, Westlake Village, CA) beneath the metatarsal bones of each foot. These sensors measure the distribution of the weight applied to each foot as well as stride duration. A small microntroller (Arduino Mega, Arduino, Ivrea, Italy) is used to collect data from these sensors in a CSV file. MATLAB is then used to analyze the data and output the hip, knee, ankle, and trunk angles projected on the sagittal plane. An open-source program Processing is then used to generate an animation of the patient’s gait. The accuracy of the sensors was validated through comparison to goniometric measurements (±2° error). The sensor device was also shown to have sufficient sensitivity to observe various gait abnormalities. Several patients used the sensor device, and the data collected from each represented the patient’s movements. Further, the sensors were found to have the ability to observe gait abnormalities caused by the addition of a small amount of weight (4.5 - 9.1 kg) to one side of the patient. The user-friendly interface and portability of the sensor device will help to construct a bridge between patients and their clinicians with fewer necessary inpatient visits.

Keywords: biomedical sensing, gait analysis, outpatient, rehabilitation

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Authors: Sara Blanc, José V. Benlloch-Dualde, Laura Grindei, Ana C. Torres, Angélica Monteiro

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This paper presents a study that leads a new experience by introducing digital learning applied to a case study focused on primary and secondary school garden-based education. The approach represents an example of interaction among different education and research agents at different countries and levels, such as universities, public and private research, and schools, to get involved in the implementation of education for sustainable development that will make students become more sensible to natural environment, more responsible for their consumption, more aware about waste reduction and recycling, more conscious of the sustainable use of natural resources and, at the same time, more ‘digitally competent’. The experience was designed attending to the European digital education context and OECD directives in transversal skills education. The paper presents the methodology carried out in the study as well as outcomes obtained from experience.

Keywords: school gardens, primary education, secondary education, science technology and innovation in education, digital learning, sustainable development goals, university, knowledge transference

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Authors: Ihtisham Bukhari

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In the current study, we enrolled a 46, XY phenotypically female patient bearing testes in her inguinal canal. DNA sequencing of the AR gene detected a missense mutation C.1715A > G (p. Y572C) in exon 2 which is already known to cause Complete androgen insensitivity syndrome (CAIS). We further studied the effects of this mutation on the testicular histopathology of the patient. No spermatocytes were seen in the surface spreading of testicular tissues while H&E staining showed that seminiferous tubules predominantly have only Sertoli cells. To confirm this meiotic failure is likely due to the current AR mutation we performed mRNA expression of genes associated with AR pathway, expression and location of the associated proteins in testicular tissues. Western blot and real-time PCR data showed that the patient had high levels of expression of AMH, SOX9, and INNB in testis. Tubules were stained with SOX9 and AMH which revealed Sertoli cell maturation arrest. Therefore, we suggest that AR mutation enhances AMH expression which ultimately leads to failure in the maturation of Sertoli cells and failure in spermatogenesis.

Keywords: androgen receptor, spermatogenesis, infertility, Sertoli cell only syndrome

Procedia PDF Downloads 131