Search results for: time to surgery

Authors: Priyanka Sharma, Manoj Jais, Poonam Gupta, Suraiya K. Ansari, Ravinder Kaur

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Introduction: As much as the Health Care is necessary for the population, so is the management of the Biomedical waste produced. Biomedical waste is a wide terminology used for the waste material produced during the diagnosis, treatment or immunization of human beings and animals, in research or in the production or testing of biological products. Biomedical waste management is a chain of processes from the point of generation of Biomedical waste to its final disposal in the correct and proper way, assigned for that particular type of waste. Any deviation from the said processes leads to improper disposal of Biomedical waste which itself is a major health hazard. Proper segregation of Biomedical waste is the key for Biomedical Waste management. Improper disposal of BMW can cause sharp injuries which may lead to HIV, Hepatitis-B virus, Hepatitis-C virus infections. Therefore, proper disposal of BMW is of upmost importance. Health care establishments segregate the Biomedical waste and dispose it as per the Biomedical waste management rules in India. Objectives: This study was done to observe the current trends of Biomedical waste generated in a tertiary care Hospital in Delhi. Methodology: Biomedical waste management rounds were conducted in the hospital wards. Relevant details were collected and analysed and sites with maximum Biomedical waste generation were identified. All the data was cross checked with the commons collection site. Results: The total amount of waste generated in the hospital during January 2014 till December 2014 was 6,39,547 kg, of which 70.5% was General (non-hazardous) waste and the rest 29.5% was BMW which consisted highly infectious waste (12.2%), disposable plastic waste (16.3%) and sharps (1%). The maximum quantity of Biomedical waste producing sites were Obstetrics and Gynaecology wards with a total Biomedical waste production of 45.8%, followed by Paediatrics, Surgery and Medicine wards with 21.2 %, 4.6% and 4.3% respectively. The maximum average Biomedical waste generated was by Obstetrics and Gynaecology ward with 0.7 kg/bed/day, followed by Paediatrics, Surgery and Medicine wards with 0.29, 0.28 and 0.18 kg/bed/day respectively. Conclusions: Hospitals should pay attention to the sites which produce a large amount of BMW to avoid improper segregation of Biomedical waste. Also, induction and refresher training Program of Biomedical waste management should be conducted to avoid improper management of Biomedical waste. Healthcare workers should be made aware of risks of poor Biomedical waste management.

Keywords: biomedical waste, biomedical waste management, hospital-tertiary care, New Delhi

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Authors: Lu Zhao, Nadir Farhi, Zoi Christoforou, Nadia Haddadou

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The safety test of deploying intelligent connected vehicles (ICVs) on the road network is a critical challenge. Road traffic network simulation can be used to test the functionality of ICVs, which is not only time-saving and less energy-consuming but also can create scenarios with car collisions. However, the relationship between different human driver behaviors and the car-collision occurrences has been not understood clearly; meanwhile, the procedure of car-collisions generation in the traffic numerical simulators is not fully integrated. In this paper, we propose an approach to identify specific driver profiles from real driven data; then, we replicate them in numerical traffic simulations with the purpose of generating inter-vehicular collisions. We proposed three profiles: (i) 'aggressive': short time-headway, (ii) 'inattentive': long reaction time, and (iii) 'normal' with intermediate values of reaction time and time-headway. These three driver profiles are extracted from the NGSIM dataset and simulated using the intelligent driver model (IDM), with an extension of reaction time. At last, the generation of inter-vehicular collisions is performed by varying the percentages of different profiles.

Keywords: vehicular collisions, human driving behavior, traffic modeling, car-following models, microscopic traffic simulation

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Authors: Philippe Judlin, Olivier Morel

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Background: In France, the resident curriculum (RC) in Obstetrics and Gynecology (OBGYN) takes five years. In the course of the last 15 years, this RC has undergone major changes, characterized mainly by successive reductions of work hours. The program used to comprise long and frequent shifts, huge workload, poor supervision and erratic theoretical teaching. A decade ago, the French Ministry of Heath recommended a limitation of shift duration up to 24 hours and a minimum of 11 hours off duty between shifts. Last year, in order to comply with European Union directives, new recommendations have further limited residents’ work hours to 48 hours per week. Methods: Assessment of the residency program adjustments recently made to accommodate the recommendations while improving the training quality in resorting to new methods. Results: The challenge facing program directors was to provide an all-encompassing curriculum to OBGYN residents despite fewer work hours. Program has been dramatically redesigned, and several measures have been put in place: -The resident rotation system has been redesigned. Residents used to make 6-month rotations between 10-12 Departments of OBGYN or Surgery. Fewer Departments, those providing the best teaching, have been kept in the new RC. -Extensive inhouse supervision has been implemented for all kinds of clinical activities. Effectual supervision of residents has proved to be an effective tool to improve the quality of training. -The tutorship system, with academic members individually overseeing residents during their curriculum, has been perfected. It allows a better follow-up of residents’ progresses during the 5-year program. -The set up of an extensive program of lectures encompassing all maters in Obstetrics & Gynecology. These mandatory lectures are available online in a dedicated website. Therefore, face-to-face lectures have been limited in order to fit in the 48-hour limit. -The use of simulation has been significantly increased in obstetrics, materno-fetal medicine and surgery (stressing especially laparoscopic training). -Residents’ feedback has been taken into account in the setup of the new RC. Conclusion: This extensive overhaul of the Obstetrics and Gynecology RC has been in place since last year only. Nevertheless, the new program seems to adequately take into account the new recommendations while providing a better and more consistent teaching to the OBGYN residents.

Keywords: education, laparoscopy, residency, simulation

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Authors: Md Al Masum Bhuiyan, Maria C. Mariani, Osei K. Tweneboah

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In the present work, we develop a technique for estimating the volatility of financial time series by using stochastic differential equation. Taking the daily closing prices from developed and emergent stock markets as the basis, we argue that the incorporation of stochastic volatility into the time-varying parameter estimation significantly improves the forecasting performance via Maximum Likelihood Estimation. While using the technique, we see the long-memory behavior of data sets and one-step-ahead-predicted log-volatility with ±2 standard errors despite the variation of the observed noise from a Normal mixture distribution, because the financial data studied is not fully Gaussian. Also, the Ornstein-Uhlenbeck process followed in this work simulates well the financial time series, which aligns our estimation algorithm with large data sets due to the fact that this algorithm has good convergence properties.

Keywords: financial time series, maximum likelihood estimation, Ornstein-Uhlenbeck type models, stochastic volatility model

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Authors: Xinyuan Y. Song, Kai Kang

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Joint models for analyzing longitudinal and survival data are widely used to investigate the relationship between a failure time process and time-variant predictors. A common assumption in conventional joint models in the survival analysis literature is that all predictors are observable. However, this assumption may not always be supported because unobservable traits, namely, latent variables, which are indirectly observable and should be measured through multiple observed variables, are commonly encountered in the medical, behavioral, and financial research settings. In this study, a joint modeling approach to deal with this feature is proposed. The proposed model comprises three parts. The first part is a dynamic factor analysis model for characterizing latent variables through multiple observed indicators over time. The second part is a random coefficient trajectory model for describing the individual trajectories of latent variables. The third part is a proportional hazard model for examining the effects of time-invariant predictors and the longitudinal trajectories of time-variant latent risk factors on hazards of interest. A Bayesian approach coupled with a Markov chain Monte Carlo algorithm to perform statistical inference. An application of the proposed joint model to a study on the Alzheimer's disease neuroimaging Initiative is presented.

Keywords: Bayesian analysis, joint model, longitudinal data, time-to-event data

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Authors: Jason Clarke, Michaela Porubanova, Angela Mazzoli, Gulsah Kut

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What accounts for our perception that time inexorably passes in one direction, from the past to the future, the so-called arrow of time, given that the laws of physics permit motion in one temporal direction to also happen in the reverse temporal direction? Modern physics says that the reason for time’s unidirectional physical arrow is the relationship between time and entropy, the degree of disorder in the universe, which is evolving from low entropy (high order; thermal disequilibrium) toward high entropy (high disorder; thermal equilibrium), the second law of thermodynamics. Accordingly, our perception of the direction of time, from past to future, is believed to emanate as a result of the natural evolution of entropy from low to high, with low entropy defining our notion of ‘before’ and high entropy defining our notion of ‘after’. Here we explored this proposed relationship between entropy and the perception of time’s arrow. We predicted that if the brain has some mechanism for detecting entropy, whose output feeds into processes involved in constructing our perception of the direction of time, presentation of violations to the expectation that low entropy defines ‘before’ and high entropy defines ‘after’ would alert this mechanism, leading to measurable behavioral effects, namely a disruption in duration perception. To test this hypothesis, participants were shown briefly-presented (1000 ms or 500 ms) computer-generated visual dynamic events: novel 3D shapes that were seen either to evolve from whole figures into parts (low to high entropy condition) or were seen in the reverse direction: parts that coalesced into whole figures (high to low entropy condition). On each trial, participants were instructed to reproduce the duration of their visual experience of the stimulus by pressing and releasing the space bar. To ensure that attention was being deployed to the stimuli, a secondary task was to report the direction of the visual event (forward or reverse motion). Participants completed 60 trials. As predicted, we found that duration reproduction was significantly longer for the high to low entropy condition compared to the low to high entropy condition (p=.03). This preliminary data suggests the presence of a neural mechanism that detects entropy, which is used by other processes to construct our perception of the direction of time or time’s arrow.

Keywords: time perception, entropy, temporal illusions, duration perception

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Authors: J. F. Viljoen, Catherine Foxcroft

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Expert sight readers rely on their ability to recognize patterns in scores, their inner hearing and prediction skills in order to perform complex sight reading exercises. They also have the ability to observe deviations from expected patterns in musical scores. This increases the “Eye-hand span” (reading ahead of the point of playing) in order to process the elements in the score. The study aims to investigate the gaze patterns of expert and non-expert sight readers focusing on key and time signatures. 20 musicians were tasked with playing 12 sight reading examples composed for one hand and five examples composed for two hands to be performed on a piano keyboard. These examples were composed in different keys and time signatures and included accidentals and changes of time signature to test this theory. Results showed that the experts fixate more and for longer on key and time signatures as well as deviations in examples for two hands than the non-expert group. The inverse was true for the examples for one hand, where expert sight readers showed fewer and shorter fixations on key and time signatures as well as deviations. This seems to suggest that experts focus more on the key and time signatures as well as deviations in complex scores to facilitate sight reading. The examples written for one appeared to be too easy for the expert sight readers, compromising gaze patterns.

Keywords: cognition, eye tracking, musical notation, sight reading

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Authors: Tamrat Tesfaye, Tilahun Seyoum, K. Shabaridharan

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The objective of this paper was to determine the effect of NaOH concentration, soaking time, soaking temperature and their interaction on percentage yield of fibre extract using Response Surface Methodology (RSM). A Box-Behnken design was employed to optimize the extraction process of cellulosic fibre from sugar cane by-product bagasse using low alkaline extraction technique. The quadratic model with the optimal technological conditions resulted in a maximum fibre yield of 56.80% at 0.55N NaOH concentration, 4 h steeping time and 60ᵒC soaking temperature. Among the independent variables concentration was found to be the most significant (P < 0.005) variable and the interaction effect of concentration and soaking time leads to securing the optimized processes.

Keywords: sugarcane bagasse, low alkaline, Box-Behnken, fibre

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Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: Alaa T. Ali, Nevine H. Kheir El Din, Ehab S. Abdelhamid, Ahmed E. Amr

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Objective: Severe alveolar bone resorption is usually associated with a deficient amount of soft tissues. soft tissue expansion is introduced to provide an adequate amount of soft tissue over the grafted area. This study aimed to assess the efficacy of sub-periosteal self-inflating osmotic tissue expanders used as preparatory surgery before horizontal alveolar ridge augmentation using autogenous onlay block bone graft. Methods: A prospective randomized controlled clinical trial was performed. Sixteen partially edentulous patients demanding horizontal bone augmentation in the anterior maxilla were randomly assigned to horizontal ridge augmentation with autogenous bone block grafts harvested from the mandibular symphysis. For the test group, soft tissue expanders were placed sub-periosteally before horizontal ridge augmentation. Impressions were taken before and after STE, and the cast models were optically scanned and superimposed to be used for volumetric analysis. Horizontal ridge augmentation was carried out after STE completion. For the control group, a periosteal releasing incision was performed during bone augmentation procedures. Implants were placed in both groups at re-entry surgery after six months period. A core biopsy was taken. Histomorphometric assessment for newly formed bone surface area, mature collagen area fraction, the osteoblasts count, and blood vessel count were performed. The change in alveolar ridge width was evaluated through bone caliper and CBCT. Results: Soft tissue expander successfully provides a Surplus amount of soft tissues in 5 out of 8 patients in the test group. Complications during the expansion period were perforation through oral mucosa occurred in two patients. Infection occurred in one patient. The mean soft tissue volume gain was 393.9 ± 322mm. After 6 months. The mean horizontal bone gains for the test and control groups were 3.14 mm and 3.69 mm, respectively. Conclusion: STE with a sub-periosteal approach is an applicable method to achieve an additional soft tissue and to reduce bone block graft exposure and wound dehiscence.

Keywords: soft tissue expander, ridge augmentation, block graft, symphysis bone block

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Authors: Mariette Swanepoel, Terry Ellapen, Henriette Hammil, Juandre Williams, Timothy Qumbu

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The biomechanical consequence of pes planus is a topic seldom reviewed in regards to energy expenditure and predisposition to injury. However its comprehension in the field of foot rehabilitation, pre-and post-surgery is fundamental to successful patient management. This short communication unites the present literature to provide the reader with better insight on the consequence of pes planus, foot mechanics and its predisposition to injury at the foot and tibiofemoral joint. Further, the consideration of synergistic dominance of the foot invertors to compensate for the ineffective torque production of the fibularis longus due pes planus is presented.

Keywords: pes planus, fibularis longus, synergistic dominance, injury

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Authors: N. Kh. Gomidze, I. N. Jabnidze, K. A. Makharadze

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The influence of inhomogeneities of plasma and statistical characteristics on the propagation of signal is very actual in wireless communication systems. While propagating in the media, the deformation and evaluation of the signal in time and space take place and on the receiver we get a deformed signal. The present article is dedicated to studying the space-time evolution of rectangular, sinusoidal, exponential and bi-exponential impulses via numerical experiment in the collisional, cold plasma. The presented method is not based on the Fourier-presentation of the signal. Analytically, we have received the general image depicting the space-time evolution of the radio impulse amplitude that gives an opportunity to analyze the concrete results in the case of primary impulse.

Keywords: collisional, cold plasma, rectangular pulse signal, impulse envelope

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Authors: Ricardo Daziano

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In the analysis and planning of the mobility ecosystem, preferences for ride-hailing over incumbent street-hailing services need better understanding. In this paper, a seminonparametric discrete choice model that allows for flexible preference heterogeneity is fitted with data from a discrete choice experiment among adult commuters in Montreal, Canada (N=760). Participants chose among Uber, Teo (a local electric ride-hailing service that was in operation when data was collected in 2018), and a standard taxi when presented with information about cost, time (on-trip, waiting, walking), powertrain of the car (gasoline/hybrid) for Uber and taxi, and whether the available electric Teo was a Tesla (which was one of the actual features of the Teo fleet). The fitted flexible model offers several behavioral insights. Waiting time for ride-hailing services is associated with a statistically significant but low marginal disutility. For other time components, including on-ride, and street-hailing waiting and walking the estimates of the value of time show an interesting pattern: whereas in a conditional logit on-ride time reductions are valued higher, in the flexible LML specification means of the value of time follow the expected pattern of waiting and walking creating a higher disutility. At the same time, the LML estimates show the presence of important, multimodal unobserved preference heterogeneity.

Keywords: discrete choice, electric taxis, ridehailing, semiparametrics

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Authors: Mohammed H. Rady, Mohd Sukri Mustapa, S Shamsudin, M. A. Lajis, A. Wagiman

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The present study is aimed at investigating microhardness and density of aluminium alloy chips when subjected to various settings of preheating temperature and preheating time. Three values of preheating temperature were taken as 450 °C, 500 °C, and 550 °C. On the other hand, three values of preheating time were chosen (1, 2, 3) hours. The influences of the process parameters (preheating temperature and time) were analyzed using Design of Experiments (DOE) approach whereby full factorial design with center point analysis was adopted. The total runs were 11 and they comprise of two factors of full factorial design with 3 center points. The responses were microhardness and density. The results showed that the density and microhardness increased with decreasing the preheating temperature. The results also found that the preheating temperature is more important to be controlled rather than the preheating time in microhardness analysis while both the preheating temperature and preheating time are important in density analysis. It can be concluded that setting temperature at 450 °C for 1 hour resulted in the optimum responses.

Keywords: AA6061, density, DOE, hot extrusion, microhardness

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Authors: Bo Zhang, Ellen S. Wilschut, Dehlia M. C. Willemsen, Marieke H. Martens

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With the rapid development of intelligent transportation systems, automated platooning of trucks is drawing increasing interest for its beneficial effects on safety, energy consumption and traffic flow efficiency. Nevertheless, one major challenge lies in the safe transition of control from the automated system back to the human drivers, especially when they have been inattentive after a long period of highly automated driving. In this study, we investigated driver take-over time after a system initiated request to leave the platooning system Virtual Tow Bar in a non-critical scenario. 22 professional truck drivers participated in the truck driving simulator experiment, and each was instructed to drive under three experimental conditions before the presentation of the take-over request (TOR): driver ready (drivers were instructed to monitor the road constantly), driver not-ready (drivers were provided with a tablet) and eye-shut. The results showed significantly longer take-over time in both driver not-ready and eye-shut conditions compared with the driver ready condition. Further analysis revealed hand movement time as the main factor causing long response time in the driver not-ready condition, while in the eye-shut condition, gaze reaction time also influenced the total take-over time largely. In addition to comparing the means, large individual differences can be found especially in two driver, not attentive conditions. The importance of a personalized driver readiness predictor for a safe transition is concluded.

Keywords: driving simulation, highly automated driving, take-over time, transition of control, truck platooning

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Authors: Nahed Al-Hajeri

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Time and cost is an integral part of every construction plan and can affect each party’s contractual obligations. The performance of both time and cost are usually important to the client and contractor during the project. Almost all construction projects are experiencing time overrun. These time overruns always contributed as expensive to both client and contractor. Construction of any project inside the gathering centers involves complex management skills related to work force, materials, plant, machineries, new technologies etc. It also involves many agencies interdependent on each other like the vendors, structural and functional designers including various types of specialized engineers and it includes support of contractors and specialized contractors. This paper mainly highlights the types of construction delays due to which project suffer time and cost overrun. This paper also speaks about the delay causes and factors that contribute to the construction sequence delay for the oil and gas projects. Construction delay is supposed to be one of the repeated problems in the construction projects and it has an opposing effect on project success in terms of time, cost and quality. Some effective methods are identified to minimize delays in construction projects such as: 1. Site management and supervision, 2. Effective strategic planning, 3. Clear information and communication channel. Our research paper studies the types of delay with some real examples with statistic results and suggests solutions to overcome this problem.

Keywords: non-compensable delay, delays caused by force majeure, compensable delay, delays caused by the owner or the owner’s representative, non-excusable delay, delay caused by the contractor or the contractor’s representative, concurrent delay, delays resulting from two separate causes at the same time

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Authors: Mohammad Saleem, Neeta Kumar, Anita Sharma, Sazina Muzammil

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It is observed that some of the dental students in our setting take less interest in medical subjects. Various teaching methods are focus of research interest currently and being tried to generate interest among students. An approach of interactive integrated tutorial was used to assess its feasibility in teaching medical subjects to dental undergraduates. The aim was to generate interest and promote active self-learning among students. The objectives were to (1) introduce the integrated interactive learning method through two departments, (2) get feedback from the students and faculty on feasibility and effectiveness of this method. Second-year students in Bachelor of Dental Surgery course were divided into two groups. Each group was asked to study physiology and pathology of a common and important condition (anemia and hypertension) in a week’s time. During the tutorial, students asked questions on physiology and pathology of that condition from each other in the presence of teachers of both physiology and pathology departments. The teachers acted only as facilitators. After the session, the feedback from students and faculty on this alternative learning method was obtained. Results: Majority of the students felt that this method of learning is enjoyable, helped to develop reasoning skills and ability to correlate and integrate the knowledge from two related fields. Majority of the students felt that this kind of learning led to better understanding of the topic and motivated them towards deep learning. Teachers observed that the study promoted interdepartmental cross-discipline collaboration and better students’ linkages. Conclusion: Interactive integrated tutorial is effective in motivating dental students for better and deep learning of medical subjects.

Keywords: active learning, education, integrated, interactive, self-learning, tutorials

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Authors: Sarra Haouala, Issam Doghri

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In this work, a multiscale computational strategy is proposed for the analysis of structures, which are described at a refined level both in space and in time. The proposal is applied to two-phase viscoelastic-viscoplastic (VE-VP) reinforced thermoplastics subjected to large numbers of cycles. The main aim is to predict the effective long time response while reducing the computational cost considerably. The proposed computational framework is a combination of the mean-field space homogenization based on the generalized incrementally affine formulation for VE-VP composites, and the asymptotic time homogenization approach for coupled isotropic VE-VP homogeneous solids under large numbers of cycles. The time homogenization method is based on the definition of micro and macro-chronological time scales, and on asymptotic expansions of the unknown variables. First, the original anisotropic VE-VP initial-boundary value problem of the composite material is decomposed into coupled micro-chronological (fast time scale) and macro-chronological (slow time-scale) problems. The former is purely VE, and solved once for each macro time step, whereas the latter problem is nonlinear and solved iteratively using fully implicit time integration. Second, mean-field space homogenization is used for both micro and macro-chronological problems to determine the micro and macro-chronological effective behavior of the composite material. The response of the matrix material is VE-VP with J2 flow theory assuming small strains. The formulation exploits the return-mapping algorithm for the J2 model, with its two steps: viscoelastic predictor and plastic corrections. The proposal is implemented for an extended Mori-Tanaka scheme, and verified against finite element simulations of representative volume elements, for a number of polymer composite materials subjected to large numbers of cycles.

Keywords: asymptotic expansions, cyclic loadings, inclusion-reinforced thermoplastics, mean-field homogenization, time homogenization

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Authors: Maria Medeiros, Suren Surenthiran, Abitha Muralithar, Soushma Seeburuth, Mohammed Mohammed

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Introduction: Appendicitis is the most common surgical emergency globally and can have devastating consequences. Diagnostic imaging in acute appendicitis has become increasingly common in aiding the diagnosis of acute appendicitis. Computerized tomography (CT) and ultrasound (US) are the most commonly used imaging modalities for diagnosing acute appendicitis. Pre-operative imaging has contributed to a reduction of negative appendicectomy rates from between 10-29% to 5%. Literature report CT scan has a diagnostic sensitivity of 94% in acute appendicitis. This clinical audit was conducted to establish if the CT scan's diagnostic yield for acute appendicitis matches the literature. CT scan has a high sensitivity and specificity for diagnosing acute appendicitis and its use can result in a lower negative appendicectomy rate. The aim of this study is to compare the pre-operative imaging findings from CT scans to the histopathology results post-operatively and establish the accuracy of CT scans in aiding the diagnosis of acute appendicitis. Methods: This was a retrospective study focusing on adult presentations to the general surgery department in a district general hospital in central London with an impression of acute appendicitis. We analyzed all patients from July 2022 to December 2022 who underwent a CT scan preceding appendicectomy. Pre-operative CT findings and post-operative histopathology findings were compared to establish the efficacy of CT scans in diagnosing acute appendicitis. Our results were also cross-referenced with pre-existing literature. Data was collected and anonymized using CERNER and analyzed in Microsoft Excel. Exclusion criteria: Children, age <16. Results: 65 patients had CT scans in which the report stated acute appendicitis. Of those 65 patients, 62 patients underwent diagnostic laparoscopies. 100% of patients who underwent an appendicectomy with a pre-operative CT scan showing acute appendicitis had acute appendicitis in histopathology analysis. 3 of the 65 patients who had a CT scan showing appendicitis received conservative treatment. Conclusion: CT scans positive for acute appendicitis had 100% sensitivity and a positive predictive value, which matches published research studies (sensitivity of 94%). The use of CT scans in the diagnostic work-up for acute appendicitis can be extremely helpful in a) confirming the diagnosis and b) reducing the rates of negative appendicectomies and consequently reducing unnecessary operative-associated risks for patients, reducing costs and reducing pressure on emergency theatre lists.

Keywords: acute apendicitis, CT scan, general surgery, imaging

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Authors: Aysegul Sarac

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The aim of this study is to analyze the impacts of integrating agile development principles and practices, in particular to reduce project lead time in a multi-project environment. We analyze Arçelik Washing Machine R&D Center in which multiple projects are conducted by shared resources. In the first part of the study, we illustrate the current waterfall model system by using a value stream map. We define all activities starting from the first idea of the project to the customer and measure process time and lead time of projects. In the second part of the study we estimate potential improvements and select a set of these improvements to integrate agile principles. We aim to develop a future state map and analyze the impacts of integrating lean principles on project lead time. The main contribution of this study is that we analyze and integrate agile product development principles in a real multi-project system.

Keywords: agile project management, multi project system, project lead time, product development

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Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

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Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

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Authors: Sumit Sen, Sohan Khedekar, Umang Shinde, Shivam Bhargava

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This study has been undertaken to investigate whether the deep learning models are able to predict the future stock prices by training the model with the historical stock price data. Since this work required time series analysis, various models are present today to perform time series analysis such as Recurrent Neural Network LSTM, ARIMA and Facebook Prophet. Applying these models the movement of stock price of stocks are predicted and also tried to provide the future prediction of the stock price of a stock. Final product will be a stock price prediction web application that is developed for providing the user the ease of analysis of the stocks and will also provide the predicted stock price for the next seven days.

Keywords: Autoregressive Integrated Moving Average, Deep Learning, Long Short Term Memory, Time-series

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Authors: Raphael C. Zero, Thiago A. S. S. Rocha, Marita V. Cardozo, Caio C. C. Santos, Alisson D. S. Fechis, Antonio C. Shimano, FabríCio S. Oliveira

Abstract:

Biomechanical analysis is an important factor in tissue studies. The objective of this study was to determine the feasibility of a new anatomical technique and quantify the changes in skin and the jejunum resistance of cats’ corpses throughout the process. Eight adult cat cadavers were used. For every kilogram of weight, 120ml of fixative solution (95% 96GL ethyl alcohol and 5% pure glycerin) was applied via the external common carotid artery. Next, the carcasses were placed in a container with 96 GL ethyl alcohol for 60 days. After fixing, all carcasses were preserved in a 30% sodium chloride solution for 60 days. Before fixation, control samples were collected from fresh cadavers and after fixation, three skin and jejunum fragments from each cadaver were tested monthly for strength and displacement until complete rupture in a universal testing machine. All results were analyzed by F-test (P <0.05). In the jejunum, the force required to rupture the fresh samples and the samples fixed in alcohol for 60 days was 31.27±19.14N and 29.25±11.69N, respectively. For the samples preserved in the sodium chloride solution for 30 and 60 days, the strength was 26.17±16.18N and 30.57±13.77N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days was 2.79±0.73mm and 2.80±1.13mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 2.53±1.03mm and 2.83±1.27mm, respectively. There was no statistical difference between the samples (P=0.68 with respect to strength, and P=0.75 with respect to displacement). In the skin, the force needed to rupture the fresh samples and the samples fixed for 60 days in alcohol was 223.86±131.5N and 211.86±137.53N respectively. For the samples preserved in sodium chloride solution for 30 and 60 days, the force was 227.73±129.06 and 224.78±143.83N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days were 3.67±1.03mm and 4.11±0.87mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 4.21±0.93mm and 3.93±0.71mm, respectively. There was no statistical difference between the samples (P=0.65 with respect to strength, and P=0.98 with respect to displacement). The resistance of the skin and intestines of the cat carcasses suffered little change when subjected to alcohol fixation and preservation in sodium chloride solution, each for 60 days, which is promising for use in surgery training. All experimental procedures were approved by the Municipal Legal Department (protocol 02.2014.000027-1). The project was funded by FAPESP (protocol 2015-08259-9).

Keywords: anatomy, conservation, fixation, small animal

Procedia PDF Downloads 298

Authors: Xin Zhao

Abstract:

The project aims to expand the notion of narrative learning and address the importance of learning by reflection in our learning and teaching context at a British university. Drawing on the key concepts such as development ZPD, transition and reflection-in and –on-action, this project analyses the learning experiences of a small sample of Chinese postgraduate students in a British University, who use part-time job experience to develop cross-cultural communication skills. The project adopts a mixed methods approach. Questionnaires and focus group interviews are used to examine the way in which students adapt (or not adapt) to the culture of learning in a British university and develop a renewed sense of self in transitions from one culture to the other. The project also looks at how the students appropriate opportunities for learning not just from classrooms but outside classrooms from everyday encounters. The project aims to address the implication of learning by reflection as development in transition. Time in and for learning, or duration, is taken for granted in theorising narrative learning. The project shall explore this very issue of time in relation to learning by reflection in considering time in/of/for learning as duration.

Keywords: cross-cultural competence, learning by refection, international student transition, part-time work experience

Procedia PDF Downloads 187

Authors: Sung-Wook Shin, Sung-Taek Chung

Abstract:

Hand grip strength has been utilized as an indicator to evaluate the motor ability of hands, responsible for performing multiple body functions. It is, however, difficult to evaluate other factors (other than hand muscular strength) utilizing the hand grip strength only. In this study, we analyzed the motor ability of hands using EMG and the hand grip strength, simultaneously in order to evaluate concentration, muscular strength reaction time, instantaneous muscular strength change, and agility in response to visual reaction. In results, the average time (and their standard deviations) of muscular strength reaction EMG signal and hand grip strength was found to be 209.6 ± 56.2 ms and 354.3 ± 54.6 ms, respectively. In addition, the onset time which represents acceleration time to reach 90% of maximum hand grip strength, was 382.9 ± 129.9 ms.

Keywords: hand grip strength, EMG, visual reaction, endurance

Procedia PDF Downloads 467

Authors: Kazuyoshi Mori

Abstract:

In this paper, we consider the parametrization of the discrete-time systems without the unit-delay element within the framework of the factorization approach. In the parametrization, we investigate the number of required parameters. We consider single-input single-output systems in this paper. By the investigation, we find, on the discrete-time systems without the unit-delay element, three cases that are (1) there exist plants which require only one parameter and (2) two parameters, and (3) the number of parameters is at most three.

Keywords: factorization approach, discrete-time system, parameterization of stabilizing controllers, system without unit-delay

Procedia PDF Downloads 243

Authors: Aritra Majumdar

Abstract:

While organizations strive to expand their new customer base, retaining existing relationships is a key aspect of improving overall profitability and also showcasing how successful an organization is in holding on to its customers. It is an experimentally proven fact that the lion’s share of profit always comes from existing customers. Hence seamless management of renewal journeys across different channels goes a long way in improving trust in the brand. From a quality assurance standpoint, time travel testing provides an approach to both business and technology teams to enhance the customer experience when they look to extend their partnership with the organization for a defined phase of time. This whitepaper will focus on key pillars of time travel testing: time travel planning, time travel data preparation, and enterprise automation. Along with that, it will call out some of the best practices and common accelerator implementation ideas which are generic across verticals like healthcare, insurance, etc. In this abstract document, a high-level snapshot of these pillars will be provided. Time Travel Planning: The first step of setting up a time travel testing roadmap is appropriate planning. Planning will include identifying the impacted systems that need to be time traveled backward or forward depending on the business requirement, aligning time travel with other releases, frequency of time travel testing, preparedness for handling renewal issues in production after time travel testing is done and most importantly planning for test automation testing during time travel testing. Time Travel Data Preparation: One of the most complex areas in time travel testing is test data coverage. Aligning test data to cover required customer segments and narrowing it down to multiple offer sequencing based on defined parameters are keys for successful time travel testing. Another aspect is the availability of sufficient data for similar combinations to support activities like defect retesting, regression testing, post-production testing (if required), etc. This section will talk about the necessary steps for suitable data coverage and sufficient data availability from a time travel testing perspective. Enterprise Automation: Time travel testing is never restricted to a single application. The workflow needs to be validated in the downstream applications to ensure consistency across the board. Along with that, the correctness of offers across different digital channels needs to be checked in order to ensure a smooth customer experience. This section will talk about the focus areas of enterprise automation and how automation testing can be leveraged to improve the overall quality without compromising on the project schedule. Along with the above-mentioned items, the white paper will elaborate on the best practices that need to be followed during time travel testing and some ideas pertaining to accelerator implementation. To sum it up, this paper will be written based on the real-time experience author had on time travel testing. While actual customer names and program-related details will not be disclosed, the paper will highlight the key learnings which will help other teams to implement time travel testing successfully.

Keywords: time travel planning, time travel data preparation, enterprise automation, best practices, accelerator implementation ideas

Procedia PDF Downloads 164

Authors: Vinay P., Srinivas K. S.

Abstract:

Low Light Image Enhancement is of utmost impor- tance in computer vision based tasks. Applications include vision systems for autonomous driving, night vision devices for defence systems, low light object detection tasks. Many of the existing deep learning methods are resource intensive during the inference step and take considerable time for processing. The algorithm should take considerably less than 41 milliseconds in order to process a real-time video feed with 24 frames per second and should be even less for a video with 30 or 60 frames per second. The paper presents a fast and efficient solution which has two main advantages, it has the potential to be used for a real-time video feed, and it can be used in low compute environments because of the lightweight nature. The proposed solution is a pipeline of three steps, the first one is the use of a simple function to map input RGB values to output RGB values, the second is to balance the colors and the final step is to adjust the contrast of the image. Hence a custom dataset is carefully prepared using images taken in low and bright lighting conditions. The preparation of the dataset, the proposed model, the processing time are discussed in detail and the quality of the enhanced images using different methods is shown.

Keywords: low light image enhancement, real-time video, computer vision, machine learning

Procedia PDF Downloads 211

Authors: Amartya Hatua, Trung Nguyen, Andrew Sung

Abstract:

In this paper, we study the information diffusion process on Twitter as a multivariate time series problem. Our model concerns three measures (volume, network influence, and sentiment of tweets) based on 10 features, and we collected 27 million tweets to build our information diffusion time series dataset for analysis. Then, different time series clustering techniques with Dynamic Time Warping (DTW) distance were used to identify different patterns of information diffusion. Finally, we built the information diffusion prediction models for new hashtags which comprise two phrases: The first phrase is recognizing the pattern using k-NN with DTW distance; the second phrase is building the forecasting model using the traditional Autoregressive Integrated Moving Average (ARIMA) model and the non-linear recurrent neural network of Long Short-Term Memory (LSTM). Preliminary results of performance evaluation between different forecasting models show that LSTM with clustering information notably outperforms other models. Therefore, our approach can be applied in real-world applications to analyze and predict the information diffusion characteristics of selected topics or memes (hashtags) in Twitter.

Keywords: ARIMA, DTW, information diffusion, LSTM, RNN, time series clustering, time series forecasting, Twitter

Procedia PDF Downloads 395

Authors: Tushnik Sarkar, Mofazzal H. Khondekar, Subrata Banerjee

Abstract:

This paper investigates the nature of the fluctuation of the daily average Solar wind speed time series collected over a period of 2492 days, from 1^st January, 1997 to 28^th October, 2003. The degree of self-similarity and scalability of the Solar Wind Speed signal has been explored to characterise the signal fluctuation. Multi-fractal Detrended Fluctuation Analysis (MFDFA) method has been implemented on the signal which is under investigation to perform this task. Furthermore, the singularity spectra of the signals have been also obtained to gauge the extent of the multifractality of the time series signal.

Keywords: detrended fluctuation analysis, generalized hurst exponent, holder exponents, multifractal exponent, multifractal spectrum, singularity spectrum, time series analysis

Procedia PDF Downloads 395