Search results for: home hospitalization
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1641

Search results for: home hospitalization

861 Relationship between Different Heart Rate Control Levels and Risk of Heart Failure Rehospitalization in Patients with Persistent Atrial Fibrillation: A Retrospective Cohort Study

Authors: Yongrong Liu, Xin Tang

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Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.

Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study

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860 Investigating the Multipurpose, Usage, and Application of Bamboo in Abuja, Nigeria’s Federal Capital Territory

Authors: Michael Adedotun Oke

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In Nigeria, Bamboo is one of the most socioeconomically beneficial farming crops, with yearly investment returns of up to N1.6 million. Growing bamboo is a fantastic long-term investment. It may self-renew for up to 70 years and is durable, long-lasting, and environmentally friendly; through an oral interview with the sellers, usage examples, and visual depiction to support those examples, The paper was able to discuss the different uses for bamboo. The various field observations in Federal Capital Territory, including the electric poles, buildings, paper production, and decoration, from picture frames to room dividing screens, bamboo can make some elegant and exotic decorations for the home, building, furniture, cooking, agriculture, instrument, in construction for flooring, roofing designing, scaffolding, garden planting, even to control erosion and slope stabilization in erosion are observed. The use of it is multiplexed with straightforward man-made technology, in contrast. 'This study wants more innovative practices that will be able to make it lucrative for business purposes and sustainability of the process. Although there are various uses and requirements for growing bamboo successfully, it is advised to receive the proper training and in-depth understanding of the growth and management procedures. Consult an experienced bamboo farmer for help.

Keywords: bamboo, use, Nigeria, socioeconomically

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859 A Survey of Recognizing of Daily Living Activities in Multi-User Smart Home Environments

Authors: Kulsoom S. Bughio, Naeem K. Janjua, Gordana Dermody, Leslie F. Sikos, Shamsul Islam

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The advancement in information and communication technologies (ICT) and wireless sensor networks have played a pivotal role in the design and development of real-time healthcare solutions, mainly targeting the elderly living in health-assistive smart homes. Such smart homes are equipped with sensor technologies to detect and record activities of daily living (ADL). This survey reviews and evaluates existing approaches and techniques based on real-time sensor-based modeling and reasoning in single-user and multi-user environments. It classifies the approaches into three main categories: learning-based, knowledge-based, and hybrid, and evaluates how they handle temporal relations, granularity, and uncertainty. The survey also highlights open challenges across various disciplines (including computer and information sciences and health sciences) to encourage interdisciplinary research for the detection and recognition of ADLs and discusses future directions.

Keywords: daily living activities, smart homes, single-user environment, multi-user environment

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858 Assigning Moral Positions Caused by Environmental Degradation in San Buenaventura Public Housing Complex in Ixtapaluca, State of Mexico, Mexico

Authors: Ángel O. Aldape, José M. Bustos, José G. Guízar

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Building companies providing public housing in Mexico, such as INFONAVIT, Casas GEO, Casas ARA, among others, provide low-interest home loans for thousands of Mexican families and individuals to buy a home. However, once this goal is achieved, these companies are not responsible for the care and maintenance of green areas and waste collection services because, technically, it is the local municipalities’ responsibility to provide these services to the community. However, this does not always occur with local municipalities. To study this problem, the San Buenaventura public housing complex was selected. This housing complex is located in the municipality of Ixtapaluca, State of Mexico (Estado de Mexico), Mexico. To our best knowledge, there are currently no formal studies about San Buenaventura that can offer effective options and/or better ways of sorting and disposing households’ wastes, as well as improving local green areas (community gardens and parks). Only a few web-blogs and periodical reports have addressed these serious problems that directly affect the social and psychological well-being of residents. The main goal of this research project aims to improve our understanding towards the existing ontological elements that emerge from residents’ discourses (in the form of informal talks and gossip) and discover the socio-physical elements that they use to assign moral positions onto others or onto themselves. The theoretical framework used in this study is based on two constructionist theories: positioning theory and site ontology. The first theory offered the opportunity to explore the rights, duties, and obligations assigned to a social role (or moral position) of the participants. The second theory provided a constructionist philosophical base that includes various socio-physical elements that are considered to assign personal or community meanings to particular contexts. Both theories contributed to defining personal dispositions and/or attitudes to carry out concrete social action or practice. The theoretical framework was guided by a relativistic ontology that allowed the researcher to better interpret the reality of the participants of this study. A descriptive-interpretative methodology was used, and two qualitative methods were arranged based on the theoretical framework proposed as follows: a semi-structured focus group interview, and direct observations. The semi-structured focus group was carried out with four residents of San Buenaventura and covert observations of public spaces and houses were carried out. These were analysed and interpreted by the researcher and assisted by NVivo software. The results suggest that the participants assigned moral traits of responsibility to other residents regarding the problem of the neglect of the green areas and waste pollution. The results suggest that all participants agreed to assign moral traits to other residents making them liable for the environmental degradation and the decay of green areas. They neither assigned any moral duty nor responsible moral traits onto themselves towards environmental protection or destruction. Overall, the participants in this study pointed out that external ontological elements such as the local government, infrastructure or cleaning services were not main cause of these environmental problems but rather the general lack of moral duty and disposition of other residents.

Keywords: conversation, environment, housing, moral, ontology, position, public, site, talks

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857 The Effectiveness of Homeschooling: A Stakeholder's Perception in East London Education District

Authors: N. M. Zukani, E. O. Adu

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Homeschooling has been a primary method for parents to educate their children. It has become a growing educational phenomenon across the globe. However, homeschooling is, therefore, an alternative form of education in which children are instructed at home rather than in mainstream schools. This study evaluated the effectiveness of homeschooling in East London Education District, looking at the stakeholder’s perceptions, reviewing issues that impact on this as reflected in literature. This is a qualitative study done in selected homeschools. Semi structured interviews were used as a form of collecting data. Data was scrutinized and grouped into themes. The study revealed the importance of differentiation of instruction, and the need for flexibility in the process of homeschooling for children who faced difficulties, special needs in learning in mainstream schooling. It is therefore concluded that the participants in the study clearly showed that homeschooling is an educational choice for parents who have concerns about the quality of education of their children. Furthermore, homeschooling has the potential to be the most learner centered, nurturing educational approach. It was recommended that an effective homeschooling practice mainly, the practice should consider attention to children-parent’s goals and learning structure. Although homeschooling looks at how to overcome the drawbacks of mainstream schooling, there are also cases that reflected, the incompetency of parents or tutors conducting the homeschooling and also a need for the support material and other educational supports from the government.

Keywords: homeschooling, effectiveness, stakeholders, parents, perception

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856 Control of an Outbreak of Vancomycin-Resistant Enterococci in a Tunisian Teaching Hospital

Authors: Hela Ghali, Sihem Ben Fredj, Mohamed Ben Rejeb, Sawssen Layouni, Salwa Khefacha, Lamine Dhidah, Houyem Said Laatiri

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Background: Antimicrobial resistance is a growing threat to public health and motivates to improve prevention and control programs both at international (WHO) and national levels. Despite their low pathogenicity, vancomycin-resistant enterococci (VRE) are common nosocomial pathogens in several countries. The high potential for transmission of VRE between patients and the threat to send its resistance genes to other bacteria such as staphylococcus aureus already resistant to meticilin, justify strict control measures. Indeed, in Europe, the proportion of Enterococcus faecium responsible for invasive infections, varies from 1% to 35% in 2011 and less than 5% were resistant to vancomycin. In addition, it represents the second cause of urinary tract and wound infections and the third cause of nosocomial bacteremia in the United States. The nosocomial outbreaks of VRE have been mainly described in intensive care services, hematology-oncology and haemodialysis. An epidemic of VRE has affected our hospital and the objective of this work is to describe the measures put in place. Materials/Methods: Following the alert given by the service of plastic surgery concerning a patient carrier of VRE, a team of the prevention and healthcare security service (doctor + technician) made an investigation. A review of files was conducted to draw the synoptic table and the table of cases. Results: By contacting the microbiology laboratory, we have identified four other cases of VRE and who were hospitalized in Medical resuscitation department (2 cases, one of them was transferred to the Physical rehabilitation department), and Nephrology department (2 cases). The visit has allowed to detect several malfunctions in professional practice. A crisis cell has allowed to validate, coordinate and implement control measures following the recommendations of the Technical Center of nosocomial infections. In fact, the process was to technically isolate cases in their sector of hospitalization, to restrict the use of antibiotics, to strength measures of basic hygiene, and to make a screening by rectal swab for both cases and contacts (other patients and health staff). These measures have helped to control the situation and no other case has been reported for a month. 2 new cases have been detected in the intensive care unit after a month. However, these are short-term strategies, and other measures in the medium and long term should be taken into account in order to face similar outbreaks. Conclusion: The efforts to control the outbreak were not efficient since 2 new cases have been reported after a month. Therefore, a continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of VRE.

Keywords: hospitals, nosocomial infection, outbreak, vancomycin-resistant enterococci

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855 Study of Early Diagnosis of Oral Cancer by Non-invasive Saliva-On-Chip Device: A Microfluidic Approach

Authors: Ragini Verma, J. Ponmozhi

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The oral cavity is home to a wide variety of microorganisms that lead to various diseases and even oral cancer. Despite advancements in the diagnosis and detection at the initial phase, the situation hasn’t improved much. Saliva-on-a-chip is an innovative point-of-care platform for early diagnosis of oral cancer and other oral diseases in live and dead cells using a microfluidic device with a current perspective. Some of the major challenges, like real-time imaging of the oral cancer microbes, high throughput values, obtaining a high spatiotemporal resolution, etc. were faced by the scientific community. Integrated microfluidics and microscopy provide powerful approaches to studying the dynamics of oral pathology, microbe interaction, and the oral microenvironment. Here we have developed a saliva-on-chip (salivary microbes) device to monitor the effect on oral cancer. Adhesion of cancer-causing F. nucleatum; subsp. Nucleatum and Prevotella intermedia in the device was observed. We also observed a significant reduction in the oral cancer growth rate when mortality and morbidity were induced. These results show that this approach has the potential to transform the oral cancer and early diagnosis study.

Keywords: microfluidic device, oral cancer microbes, early diagnosis, saliva-on-chip

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854 Sleep Quality as Perceived by Critically Ill Patients at El Manial University Hospitals

Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

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853 An Intelligent Watch-Over System Using an IoT Device, for Elderly People Living by Themselves

Authors: Hideo Suzuki, Yuya Kiyonobu, Kotaro Matsushita, Masaki Hanada, Rie Suzuki, Noriko Niijima, Noriko Uosaki, Tadao Nakamura

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People often worry about their elderly family members who are living by themselves or staying alone somewhere. An intelligent watch-over system for such elderly people, using a Raspberry Pi IoT device, has been newly developed to monitor those who live or stay separately from their families and alert them if a problem occurs. The system consists of motion sensors and temperature-humidity combined sensors that are located at seven points within an elderly person's home. The intelligent algorithms of the system detect signs and the possibility of unhealthy situations arising for the elderly relative; e.g., an unusually long bathing time, or a visit to a restroom, too high a room temperature, etc., by using data cached by the sensors above, at seven points within their house. The system gives more consideration to the elderly person's privacy, by using the sensors above, instead of using cameras and microphones placed around the house. The system invented and described here, can send a Twitter direct message to designated family members when an elderly relative is possibly in an unhealthy condition. Thus the system helps decrease family members' anxieties regarding their elderly relatives and increases their sense of security.

Keywords: elderly person, IoT device, Raspberry Pi, watch-over system

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852 Creating Trauma-Sensitive Yoga Programs for University Students With Stress and Anxiety: Lessons From a Program in the United States

Authors: Jessica Gladden

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Anxiety remains one of the most common mental health disorders in the United States. Many university students report having a high level of anxiety, with additional life stressors that might include being away from home for the first time, being around unfamiliar people, having new expectations placed on them, and often have financial struggles. Universities have the ability and opportunity to form programs that can involve students with activities that reduce stress and teach coping skills. This research includes one example of using a somatic based group format of yoga to teach these skills and assist students in applying these strategies to their daily lives. This study compared a group of 17 students participating in weekly yoga classes to 34 students who did not attend the program. The students who attended the program reported a larger reduction of anxiety on both the BAI and GAD-7 than the control group, and verbally reported additional benefits in relaxation and coping skills. This presentation will review the results of the program as well as detailing the steps taken in creating a yoga program for university students with stress and anxiety. This will include a discussion on the components of trauma-sensitive yoga and the concerns and strategies to consider when developing a program for students.

Keywords: yoga, trauma-sensitive yoga, anxiety, students

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851 Design and Implement a Remote Control Robot Controlled by Zigbee Wireless Network

Authors: Sinan Alsaadi, Mustafa Merdan

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Communication and access systems can be made with many methods in today’s world. These systems are such standards as Wifi, Wimax, Bluetooth, GPS and GPRS. Devices which use these standards also use system resources excessively in direct proportion to their transmission speed. However, large-scale data communication is not always needed. In such cases, a technology which will use system resources as little as possible and support smart network topologies has been needed in order to enable the transmissions of such small packet data and provide the control for this kind of devices. IEEE issued 802.15.4 standard upon this necessity and enabled the production of Zigbee protocol which takes these standards as its basis and devices which support this protocol. In our project, this communication protocol was preferred. The aim of this study is to provide the immediate data transmission of our robot from the field within the scope of the project. In addition, making the communication with the robot through Zigbee Protocol has also been aimed. While sitting on the computer, obtaining the desired data from the region where the robot is located has been taken as the basis. Arduino Uno R3 microcontroller which provides the control mechanism, 1298 shield as the motor driver.

Keywords: ZigBee, wireless network, remote monitoring, smart home, agricultural industry

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850 Consumer Ethnocentrism: A Dynamic Literature Review from 1987-2015

Authors: Thi Phuong Chi Nguyen

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Although consumer ethnocentrism has been widely studied in academic research since 1987, somehow it is still considered as a new and unknown concept in marketing theory and practice. By analyzing the content, three mainstreams of consumer ethnocentrism were found including economic, management and marketing approaches. The present study indicated that the link between consumer ethnocentrism and consumer behaviours varies across countries. Consumers in developing countries might be both patriotic about their home countries and curious about foreign cultures at the same time. The most important finding is identifying three main periods in the chronological development of consumer ethnocentrism research. The first period, spanning from 1987 to 1995, was characterized by the introduction of the consumer ethnocentrism concepts and scales, the unidimensionality and the adaptation of the standard CETSCALE version. The second period 1996-2005 witnessed the replication of CETSCALE in various fields, as well as an increase in the volume of researches in developing and emerging countries; the exploration of determinants and the begin of multidimensionality. In the third period from 2006 to present, all variables related to CET were syntherized within the theory of planne behavior. Consumer ethnocentrism analyses were conducted even in less-developed countries and in groups of countries within longitudinal studies. The results from this study showed many inadequacies relating to consumer ethnocentrism in the context of globalisation for further researches to examine.

Keywords: CETSCALE, consumer behavior, consumer ethnocentrism, business, marketing

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849 Social Inclusion of Rural Elderly Left Behind by Internal Labor Migration: A Case Study in a Chinese Rural Village in Anhui Province

Authors: Lei Liu

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Since the famous opening up and reform strategy of China, lots of migrants have flowed from rural areas to urban areas. In this paper, the author investigates the rural elderly left behind, which are defined aged people left alone at home while their adult children have to migrant outside. This phenomenon is a quite general and serious social problem that cannot be ignored, accompanied by the process of urbanization and regional transferring of rural labor. The Chinese internal migration not only exerts great influence to China’s economy and urbanization but also obviously reduces the labor and care to rural aged people. Contrary to assumptions in some migration and aging studies, which show the inevitable negative effects of migration upon the old age care, the author highlights unique features in their daily strategies of house holding to integrate into society with the analysis of the conception of social inclusion. Through life history interviews with elderly left behind in one rural village, this article sheds light on three different factors of social inclusion, namely, economic inclusion, social identity and political inclusion and shows its necessaries to fully understand the status of the social wellbeing of rural elderly left behind.

Keywords: labor migration, elderly left behind, social inclusion, rural China

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848 The Impact of Locations on the Perception of the Same Product: An Application to Motor Industry

Authors: Anna Claudia Pellicelli, Silvia Procacci

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The study aims to demonstrate how different locations, where the same product is unveiled and tested, can provide a different result in terms of perception by the same kind of people. The experiment was done in occasion of the presentation of a new bike. A group of dealers has been invited in Lloret de Mar, two persons from the headquarter were present to run the presentation, together with an outsourced trainer. Half day dedicated to the theoretical presentation and half day to the test of the new bike on the road, including the test of its direct competitors. The same presentation, organized in the same way, has been delivered in Italy, in 4 locations often used to run business meetings with dealers. In the end of all days of the presentation, dealers had to fill a questionnaire regarding the evaluation of the different bikes tested. The result of the questionnaire showed how the group invited in Spain rated much higher the new bike compared with the dealers testing the bike in locations already known and close to their home. So, in terms of business strategy, it is important to take into account how the location and the way of presenting any product or service can have a favourable impact on the people we want to convince. The next step of the experiment will be to cross check the sales of that bike with the dealers and measure if there is a relation between the top sellers and the one that appreciated the bike the most, in Spain. It would mean that they were able to transfer to customers the same good feelings and impressions they had in Spain.

Keywords: product presentation, locations, emotional effect, business strategy

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847 The Effect of Benson Relaxation Method on Quality of Life in Hemodialysis Patients in 2012-2013, Kermanshah, Iran

Authors: Fateme Hadadian, Behnam Khaledi Paveh, Hosein Feizi

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Background: High number of patients with end-stage renal disease worldwide, and Iran and the patients required hemodialysis, As well as symptoms and treatment process and its impact on quality of life The researcher had to take a step towards solving these problems. Methods: In randomized clinical trial in 60 hemodialysis patients admitted to hospital hemodialysis Imam Reza (AS) were studied. Using questionnaires dialysis patients' QOL, quality of life was measured in patients and controls were divided randomly into two groups. Benson's relaxation method for the experimental group and two months at home, once per day, respectively and the control group received no special action. Immediately after the end of the period with was used for evaluating the quality of life in both the experimental and control groups were survey and data using independent t-test were used for statistical analysis. Results: The general dimensions of quality of life scores before and after intervention, there was significant difference (P=0/001). But this difference was not significant after QOL (P=0/2). Between QOL scores before and after treatment between the two groups was statistically significant (P=0/02). Conclusion: Benson relaxation has the desired effect on quality of life in hemodialysis patients and can be used as a useful method to enhance the quality of life in hemodialysis patients, implementation and training will be given.

Keywords: hemodialysis, quality of life, Benson muscle relaxation, biomedicine

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846 Using the Combination of Food Waste and Animal Waste as a Reliable Energy Source in Rural Guatemala

Authors: Jina Lee

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Methane gas is a common byproduct in any process of rot and degradation of organic matter. This gas, when decomposition occurs, is emitted directly into the atmosphere. Methane is the simplest alkane hydrocarbon that exists. Its chemical formula is CH₄. This means that there are four atoms of hydrogen and one of carbon, which is linked by covalent bonds. Methane is found in nature in the form of gas at normal temperatures and pressures. In addition, it is colorless and odorless, despite being produced by the rot of plants. It is a non-toxic gas, and the only real danger is that of burns if it were to ignite. There are several ways to generate methane gas in homes, and the amount of methane gas generated by the decomposition of organic matter varies depending on the type of matter in question. An experiment was designed to measure the efficiency, such as a relationship between the amount of raw material and the amount of gas generated, of three different mixtures of organic matter: 1. food remains of home; 2. animal waste (excrement) 3. equal parts mixing of food debris and animal waste. The results allowed us to conclude which of the three mixtures is the one that grants the highest efficiency in methane gas generation and which would be the most suitable for methane gas generation systems for homes in order to occupy less space generating an equal amount of gas.

Keywords: alternative energy source, energy conversion, methane gas conversion system, waste management

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845 The Robotic Factor in Left Atrial Myxoma

Authors: Abraham J. Rizkalla, Tristan D. Yan

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Atrial myxoma is the most common primary cardiac tumor, and can result in cardiac failure secondary to obstruction, or systemic embolism due to fragmentation. Traditionally, excision of atrial an myxoma has been performed through median sternotomy, however the robotic approach offers several advantages including less pain, improved cosmesis, and faster recovery. Here, we highlight the less well recognized advantages and technical aspects to robotic myxoma resection. This video-presentation demonstrates the resection of a papillary subtype left atrial myxoma using the DaVinci© Xi surgical robot. The 10x magnification and 3D vision allows for the interface between the tumor and the interatrial septum to be accurately dissected, without the need to patch the interatrial septum. Several techniques to avoid tumor fragmentation and embolization are demonstrated throughout the procedure. The tumor was completely excised with clear margins. There was no atrial septal defect or mitral valve injury on post operative transesophageal echocardiography. The patient was discharged home on the fourth post-operative day. This video-presentation highlights the advantages of the robotic approach in atrial myxoma resection compared with sternotomy, as well as emphasizing several technical considerations to avoid potential complications.

Keywords: cardiac surgery, left atrial myxoma, cardiac tumour, robotic resection

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844 The X-Ray Response Team: Building a National Health Pre-Hospital Service

Authors: Julian Donovan, Jessica Brealey, Matthew Bowker, Marianne Feghali, Gregory Smith, Lee Thompson, Deborah Henderson

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This article details the development of the X-ray response team (XRT), a service that utilises innovative technology to safely deliver acute and elective imaging and medical assessment service in the pre-hospital and community setting. This involves a partnership between Northumbria Healthcare NHS Foundation Trust’s Radiology and Emergency Medicine departments and the North East Ambulance Service to create a multidisciplinary prehospital team. The team committed to the delivery of a two-day acute service every week, alongside elective referrals, starting in November 2020. The service was originally made available to a 15-mile radius surrounding the Northumbria Hospital. Due to demand, this was expanded to include the North Tyneside and Northumberland regions. The target population was specified as frail and vulnerable patients, as well as those deemed to benefit from staying in their own environment. Within the first two months, thirty-six percent of patients assessed were able to stay at home due to the provision of off-site imaging. In the future, this service aims to allow patient transfer directly to an appropriate ward or clinic, bypassing the emergency department to improve the patient journey and reduce emergency care pressures.

Keywords: frailty, imaging, pre-hospital, X-ray

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843 Gas Flaring in the Niger Delta Nigeria: An Act of Inhumanity to Man and His Environment

Authors: Okorowo Cyril Agochi

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The Niger Delta Region of Nigeria is home to about 20 million people and 40 different ethnic groups. The region has an area of seventy thousand square kilometers (70,000 KM2) of wetlands, formed primarily by sediments deposition and makes up 7.5 percent of Nigeria's total landmass. The notable ecological zones in this region includes: coastal barrier islands; mangrove swamp forests; fresh water swamps; and lowland rainforests. This incredibly naturally-endowed ecosystem region, which contains one of the highest concentrations of biodiversity on the planet, in addition to supporting abundant flora and fauna, is threatened by the inhuman act known as gas flaring. Gas flaring is the combustion of natural gas that is associated with crude oil when it is pumped up from the ground. In petroleum-producing areas such as the Niger Delta region of Nigeria where insufficient investment was made in infrastructure to utilize natural gas, flaring is employed to dispose of this associated gas. This practice has impoverished the communities where it is practiced, with attendant environmental, economic and health challenges. This paper discusses the adverse environmental and health implication associated with the practice, the role of Government, Policy makers, Oil companies and the Local communities aimed at bring this inhuman practice to a prompt end.

Keywords: natural combustion, emission, environment, flaring, gas, health, Niger Delta

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842 Manual to Automated Testing: An Effort-Based Approach for Determining the Priority of Software Test Automation

Authors: Peter Sabev, Katalina Grigorova

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Test automation allows performing difficult and time consuming manual software testing tasks efficiently, quickly and repeatedly. However, development and maintenance of automated tests is expensive, so it needs a proper prioritization what to automate first. This paper describes a simple yet efficient approach for such prioritization of test cases based on the effort needed for both manual execution and software test automation. The suggested approach is very flexible because it allows working with a variety of assessment methods, and adding or removing new candidates at any time. The theoretical ideas presented in this article have been successfully applied in real world situations in several software companies by the authors and their colleagues including testing of real estate websites, cryptographic and authentication solutions, OSGi-based middleware framework that has been applied in various systems for smart homes, connected cars, production plants, sensors, home appliances, car head units and engine control units (ECU), vending machines, medical devices, industry equipment and other devices that either contain or are connected to an embedded service gateway.

Keywords: automated testing, manual testing, test automation, software testing, test prioritization

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841 Bacterial Contamination of Kitchen Sponges and Cutting Surfaces and Disinfection Procedures

Authors: Hayyan I Al Taweil

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Background: The most common of bacterium in kitchen sponges and cutting surfaces which can play a task within the cross-contamination of foods, fomites and hands by foodborne pathogens. Aims and Objectives: This study investigated the incidence of bacterium in kitchen Sponge, and cutting surfaces. Material and methods: a complete of twenty four kitchen Sponges were collected from home kitchens and therefore the numbers of mesotrophic microorganism, coliform microorganism, E. coli, Salmonella, genus {pseudomonas|bacteria genus} and staphylococci in every kitchen Sponges were determined. Microbiological tests of all sponges for total mesophilic aerobic microorganism, S. aureus, Pseudomonas, Salmonella spp., and E. coli were performed on days 3, 7, and 14 by sampling. The sponges involved in daily use in kitchens countenosely with the dishwasher detergent a minimum of doubly daily Results: Results from the overall mesophilic aerobic microorganism, indicate a major increase within the variety of log CFU/ml. the amount of E. coli was reduced, Salmonella spp. was stabled, S. aureus was enhanced from the sponges throughout fourteen days. Genus Pseudomonas was enhanced and was the dominant micro flora within the sponges throughout fourteen days.

Keywords: Kitchen Sponges, Microbiological Contamination, Disinfection; cutting surface; , Cross-Contamination

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840 A Review of Current Trends in Grid Balancing Technologies

Authors: Kulkarni Rohini D.

Abstract:

While emerging as plausible sources of energy generation, new technologies, including photovoltaic (PV) solar panels, home battery energy storage systems, and electric vehicles (EVs), are exacerbating the operations of power distribution networks for distribution network operators (DNOs). Renewable energy production fluctuates, stemming in over- and under-generation energy, further complicating the issue of storing excess power and using it when necessary. Though renewable sources are non-exhausting and reoccurring, power storage of generated energy is almost as paramount as to its production process. Hence, to ensure smooth and efficient power storage at different levels, Grid balancing technologies are consequently the next theme to address in the sustainable space and growth sector. But, since hydrogen batteries were used in the earlier days to achieve this balance in power grids, new, recent advancements are more efficient and capable per unit of storage space while also being distinctive in terms of their underlying operating principles. The underlying technologies of "Flow batteries," "Gravity Solutions," and "Graphene Batteries" already have entered the market and are leading the race for efficient storage device solutions that will improve and stabilize Grid networks, followed by Grid balancing technologies.

Keywords: flow batteries, grid balancing, hydrogen batteries, power storage, solar

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839 High-Value Health System for All: Technologies for Promoting Health Education and Awareness

Authors: M. P. Sebastian

Abstract:

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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838 The Prevalence and Profile of Extended Spectrum B-Lactamase (ESBL) Producing Enterobacteriaceae Species in the Intensive Care Unit (ICU) Setting of a Tertiary Care Hospital of North India

Authors: Harmeet Pal Singh Dhooria, Deepinder Chinna, UPS Sidhu, Alok Jain

Abstract:

Serious infections caused by gram-negative bacteria are a significant cause of mortality and morbidity in the hospital setting. In acute care facilities like in intensive care units (ICUs), the intensity of antimicrobial use together with a population highly susceptible to infection, creates an environment, which facilitates both emergence and transmission of Extended Spectrum -lactamase (ESBL) producing Enterobacteriaceae species. The study was conducted in the Medical Intensive Care Unit (MICU) and the Pulmonary Critical Care Unit (PCCU) of the Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Out of a total of 1108 samples of urine, blood and respiratory tract secretions received for culture and sensitivity analysis from Medical Intensive Care Unit and Pulmonary Critical Care Unit, a total of 170 isolates of Enterobacteriaceae species were obtained which were then included in our study. Out of these 170 isolates, confirmed ESBL production was seen in 116 (68.24%) cases. E.coli was the most common species isolated (56.47%) followed by Klebsiella (32.94%), Enterobacter (5.88%), Citrobacter (3.53%), Enterobacter (0.59%) and Morganella (0.59%) among the total isolates. The rate of ESBL production was more in Klebsiella (78.57%) as compared to E.coli (60.42%). ESBL producers were found to be significantly more common in patients with prior history of hospitalization, antibiotic use, and prolonged ICU stay. Also significantly increased the prevalence of ESBL related infections was observed in patients with a history of catheterization or central line insertion but not in patients with the history of intubation. Patients who had an underlying malignancy had significantly higher prevalence of ESBL related infections as compared to other co-morbid illnesses. A slightly significant difference in the rate of mortality/LAMA was observed in the ESBL producer versus the non-ESBL producer group. The rate of mortality/LAMA was significantly higher in the ESBL related UTI but not in the ESBL related respiratory tract and bloodstream infections. ESBL producing isolates had significantly higher rates of resistance to Cefepime and Piperacillin/Tazobactum, and to non β-lactum antibiotics like Amikacin and Ciprofloxacin. The level of resistance to Imipenem was lower as compared to other antibiotics. However, it was noted that ESBL producing isolates had higher levels of resistance to Imipenem as compared to non-ESBL producing isolates. Conclusion- The prevalence of ESBL producing organisms was found to be very high (68.24%) among Enterobacteriaceae isolates in our ICU setting as among other ICU care settings around the world.

Keywords: enterobacteriaceae, extended spectrum B-lactamase (ESBL), ICU, antibiotic resistance

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837 Research on Optimization Strategies for the Negative Space of Urban Rail Transit Based on Urban Public Art Planning

Authors: Kexin Chen

Abstract:

As an important method of transportation to solve the demand and supply contradiction generated in the rapid urbanization process, urban rail traffic system has been rapidly developed over the past ten years in China. During the rapid development, the space of urban rail Transit has encountered many problems, such as space simplification, sensory experience dullness, and poor regional identification, etc. This paper, focus on the study of the negative space of subway station and spatial softening, by comparing and learning from foreign cases. The article sorts out cases at home and abroad, make a comparative study of the cases, analysis more diversified setting of public art, and sets forth propositions on the domestic type of public art in the space of urban rail transit for reference, then shows the relationship of the spatial attribute in the space of urban rail transit and public art form. In this foundation, it aims to characterize more diverse setting ways for public art; then suggests the three public art forms corresponding properties, such as static presenting mode, dynamic image mode, and spatial softening mode; finds out the method of urban public art to optimize negative space.

Keywords: diversification, negative space, optimization strategy, public art planning

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836 Analysis of Detection Concealed Objects Based on Multispectral and Hyperspectral Signatures

Authors: M. Kastek, M. Kowalski, M. Szustakowski, H. Polakowski, T. Sosnowski

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Development of highly efficient security systems is one of the most urgent topics for science and engineering. There are many kinds of threats and many methods of prevention. It is very important to detect a threat as early as possible in order to neutralize it. One of the very challenging problems is detection of dangerous objects hidden under human’s clothing. This problem is particularly important for safety of airport passengers. In order to develop methods and algorithms to detect hidden objects it is necessary to determine the thermal signatures of such objects of interest. The laboratory measurements were conducted to determine the thermal signatures of dangerous tools hidden under various clothes in different ambient conditions. Cameras used for measurements were working in spectral range 0.6-12.5 μm An infrared imaging Fourier transform spectroradiometer was also used, working in spectral range 7.7-11.7 μm. Analysis of registered thermograms and hyperspectral datacubes has yielded the thermal signatures for two types of guns, two types of knives and home-made explosive bombs. The determined thermal signatures will be used in the development of method and algorithms of image analysis implemented in proposed monitoring systems.

Keywords: hyperspectral detection, nultispectral detection, image processing, monitoring systems

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835 Study on Conservation and Regeneration of the Industrial Buildings

Authors: Rungpansa Noichan, Bart Julian Dewancker

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The conservation and regeneration of historical industrial building is one of the most important issues to be solved in today’s urban development in the world. There are growing numbers of industrial building in which promoting heritage conservation maybe a helpful tool for a sustainable city in social, urban restructuring, environmental and economic component. This paper identifies the key attributes of conservation and regeneration industrial building from the literature, were discussed by reviewing its development at home and abroad. The authors have investigated 93 industrial buildings, which were used as industrial building before and reused into buildings with another function afterward. The data to be discussed below were mainly collected from various publications but also from available internet sources. This study focuses on green transformation, historical culture heritage, transformation techniques, and urban regeneration based on the empirical researches on the historical industrial building and site. Moreover, we focus on social, urban environment and sustainable development. The implications of the study provide suggestions for future improvements in the conservation and regeneration of historical industrial building, and inspire new ways of use, so the building becomes flexible and can consequently be adaptable to changes in order to survive time. Therefore, the building does not take into account only its future impact in the environment and society. Instead, it focuses on its entire life cycle.

Keywords: industrial building, heritage conservation, green transformation, regeneration, sustainable development

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834 Carbon Monoxide Poisoning in Children

Authors: Atitallah Sofien, Bouyahia Olfa, Hadj Salah Ibrahim, Ben Saleh Foued, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Carbon monoxide (CO) poisoning is a common pathology responsible for high morbidity and mortality worldwide. Aim: The purpose of this study was to determine the epidemiological profile of CO poisoning as well as its clinical, paraclinical, therapeutic, and evolutionary aspects. Methods: Our study included observations of CO poisoning in children hospitalized in the pediatric department C of the Children's Hospital in Tunis over a period of 3 years. Results: We have collected 199 cases of CO poisoning in children. The average age was 5.43 years, with a sex ratio of 0.98. The source of CO was inside the home in 73.2% of cases, and it was the gas bath heater in 68.8% of cases. The intoxication was collective in 93.5% of the cases, and it occurred during the month of January in 35.8% of the cases. The clinical manifestations were headaches in 69.5% of cases. The rate of carboxyhemoglobin was pathological in 73.9% of cases. All patients received normobaric oxygen therapy, and only 3.6% of patients had a hyperbaric oxygen therapy session. We did not deplore any case of death in our study. Conclusion: CO poisoning remains a public health problem in Tunisia with high morbidity. The risk of secondary complications, particularly neuropsychiatric, requires clinical and possibly neuroradiological monitoring of these victims.

Keywords: poisoning, carbon monoxide, children, hyperbaric oxygenation

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833 The Use of Stroke Journey Map in Improving Patients' Perceived Knowledge in Acute Stroke Unit

Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon

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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.

Keywords: acute stroke, education, ischemic stroke, knowledge, stroke

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832 Assembly Solution for Modular Buildings: Development of a Plug-In Self-Locking Device Designed for Light-Framed Structures

Authors: Laurence Picard, André Bégin-Drolet, Pierre Blanchet

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The prefabricated construction industry has been operating in North America for several years now and differs from traditional construction by its much shorter project timelines, lower costs, and increased build quality. Faced with the global housing crisis, prefabrication should be the first choice for erecting buildings quickly and at a low cost. However, the reality is quite different; manufacturers focus their operations mainly on single-home construction. This is explained by the lack of a suitable and efficient assembly solution for erecting large-scale buildings. Indeed, it is difficult to maintain the coveted advantages of prefabrication with a laborious on-site assembly and a colossal load of additional operations such as the installation of fasteners and the internal finishing. In the desire to maximize the benefits of prefabrication and make it a smart choice even for large buildings, an automated connection solution is developed. The plug-in self-locking device was developed accordingly to the product design phases: on-site observations, the definition of the problem and product requirements, solution generation, prototyping, fabricating and testing.

Keywords: assembly solution, automation, construction productivity, modular connection, modular buildings, plug-in device, self-lock mechanism

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