Search results for: patient monitoring

Authors: Qasim Khan, Furkan Ahmad, Asfar A. Khan, M. Saad Alam, Faiz Ahmad

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In this paper, partial discharge analysis is performed in cavities artificially created in insulation. The setup is according with Cigre-II Method. Circular Samples created from Perspex Sheet with different configuration with changing number of cavities. Assessment of insulation health can be performed by Partial Discharge measurement as this has been found to be important means of condition monitoring. The experiments are done using MPD 540, which is a modern partial discharge measurement system. By analyzing the PD activity obtained for various voids/cavities, it is observed that the PD voltages show variation for cavity’s diameter, depth even for its ratios. This can be employed for scrutiny of insulation system.

Keywords: partial discharges, condition monitoring, insulation defects, degradation and corrosion, PMMA

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Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons

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Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.

Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team

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Authors: Nir Nissim, Erez Shalom, Tomer Lancewiki, Yuval Elovici, Yuval Shahar

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Background: A Medical Device (MD) is an instrument, machine, implant, or similar device that includes a component intended for the purpose of the diagnosis, cure, treatment, or prevention of disease in humans or animals. Medical devices play increasingly important roles in health services eco-systems, including: (1) Patient Diagnostics and Monitoring; Medical Treatment and Surgery; and Patient Life Support Devices and Stabilizers. MDs are part of the medical device eco-system and are connected to the network, sending vital information to the internal medical information systems of medical centers that manage this data. Wireless components (e.g. Wi-Fi) are often embedded within medical devices, enabling doctors and technicians to control and configure them remotely. All these functionalities, roles, and uses of MDs make them attractive targets of cyber-attacks launched for many malicious goals; this trend is likely to significantly increase over the next several years, with increased awareness regarding MD vulnerabilities, the enhancement of potential attackers’ skills, and expanded use of medical devices. Significance: We propose to develop and implement Cyber-Med, a unique collaborative project of Ben-Gurion University of the Negev and the Clalit Health Services Health Maintenance Organization. Cyber-Med focuses on the development of a comprehensive detection framework that relies on a critical attack repository that we aim to create. Cyber-Med will allow researchers and companies to better understand the vulnerabilities and attacks associated with medical devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The Cyber-Med detection framework will consist of two independent, but complementary detection approaches: one for known attacks, and the other for unknown attacks. These modules incorporate novel ideas and algorithms inspired by our team's domains of expertise, including cyber security, biomedical informatics, and advanced machine learning, and temporal data mining techniques. The establishment and maintenance of Cyber-Med’s up-to-date attack repository will strengthen the capabilities of Cyber-Med’s detection framework. Major Findings: Based on our initial survey, we have already found more than 15 types of vulnerabilities and possible attacks aimed at MDs and their eco-system. Many of these attacks target individual patients who use devices such pacemakers and insulin pumps. In addition, such attacks are also aimed at MDs that are widely used by medical centers such as MRIs, CTs, and dialysis engines; the information systems that store patient information; protocols such as DICOM; standards such as HL7; and medical information systems such as PACS. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched against MDs. Very little research has been conducted in order to protect these devices from cyber-attacks, since most of the development and engineering efforts are aimed at the devices’ core medical functionality, the contribution to patients’ healthcare, and the business aspects associated with the medical device.

Keywords: medical device, cyber security, attack, detection, machine learning

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Authors: Lea B. Milan

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This descriptive study evaluated the existing Food Safety Management in Central Elementary School Canteens of Region 3. It made used of survey questionnaires, interview guide questions and validated knowledge test on food for data gathering. Results of the study revealed that school principals and canteen managers shared responsibilities in food safety management of school canteen. It also showed that the schools applied different methods of communication, monitoring and evaluation of food safety management. The study further revealed that implementation of monitoring and evaluation of food safety compliance are not being practiced in all elementary schools in the region. The study also showed that school canteens in the Region 3 do not have the thermometers and timers to use to conduct proper monitoring of foods during storage, preparation and serving. It was also found out from the study that canteen personnel lacks the basic knowledge and trainings on food safety. Potential source of physical, chemical and biological hazards that could contaminate foods were also found present in the canteen facilities of the elementary schools in the region. Moreover, evaluation showed that the existing implementation of food safety management in the Central Elementary School Canteens of Region 3 were below the expected level and the need to strengthen the appreciation and advocacy on food safety management in school canteens of Region 3 is still wanting.

Keywords: food safety management, food safety school catering, food safety, school food safety management

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Authors: Mbonigaba Swale

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Malaria is an infection or disease caused by parasites (Plasmodium Falciparum — causes severe Malaria, plasmodium Vivax, Plasmodium Ovale, and Plasmodium Malariae), transmitted by bites of infected anopheles (female) mosquitoes to humans. These vectors comprise of two types in Africa, particularly in Uganda, i.e. anopheles fenestus and Anopheles gambaie (‘example Anopheles arabiensis,,); feeds on man inside the house mainly at dusk, mid-night and dawn and rests indoors and makes them effective transmitters (vectors) of the disease. People in both urban and rural areas have consistently become prone to repetitive attacks of malaria, causing a lot of deaths and significantly increasing the poverty levels of the rural poor. Malaria is a national problem; it causes a lot of maternal pre-natal and antenatal disorders, anemia in pregnant mothers, low birth weights for the newly born, convulsions and epilepsy among the infants. Cumulatively, it kills about one million children every year in sub-Saharan Africa. It has been estimated to account for 25-35% of all outpatient visits, 20-45% of acute hospital admissions and 15-35% of hospital deaths. Uganda is the leading victim country, for which Rakai and Masaka districts are the most affected. So, it is not clear whether these abhorrent situations and episodes of recurrences and failure to cure from the disease are a result of poor diagnosis, prescription and dosing, treatment habits and compliance of the patients to the drugs or the ethical domain of the stake holders in relation to the main stream methodology of malaria management. The research is aimed at offering an alternative approach to manage and deal absolutely with problem by using a knowledge based software model of Artificial Intelligence (Al) that is capable of performing common-sense and cognitive reasoning so as to take decisions like the human brain would do to provide instantaneous expert solutions so as to avoid speculative simulation of the problem during differential diagnosis in the most accurate and literal inferential aspect. This system will assist physicians in many kinds of medical diagnosis, prescribing treatments and doses, and in monitoring patient responses, basing on the body weight and age group of the patient, it will be able to provide instantaneous and timely information options, alternative ways and approaches to influence decision making during case analysis. The computerized system approach, a new model in Uganda termed as “Software Aided Treatment” (SAT) will try to change the moral and ethical approach and influence conduct so as to improve the skills, experience and values (social and ethical) in the administration and management of the disease and drugs (combination therapy and generics) by both the patient and the health worker.

Keywords: knowledge based software, management, treatment, diagnosis

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Authors: Jan Gayl Barcelon, N. Gorgonio

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Renal tubular acidosis, a medical condition that involves the accumulation of acid in the body due to failure of the kidneys to maintain normal urine and blood pH, is rarely encountered in pregnancy. The effect of renal tubular acidosis in pregnancy is not fully established. It may worsen during pregnancy and cause maternal and fetal morbidity. A 30-year-old primigravida was diagnosed with renal tubular acidosis at age 7, but due to uncontrolled disease progression, she developed rickets at age 10. She was first seen in our institution at eight weeks gestation and maintained on bicarbonate and potassium supplementation. At 26 weeks gestation, she was diagnosed with polyhydramnios, causing on and off irregular uterine contractions. At 30 weeks gestation, despite oral Nifedipine, premature labor was uncontrolled; hence she was admitted for tocolysis. With elevated creatinine (123 umol/L) and a normal blood urea nitrogen level (6.70 mmol/L), she was referred to Nephrology Service, which cleared the patient prior to MgSO₄ drip. Dosing of 4g MgSO₄ over 20 minutes followed by a maintenance of 2g/hour x 24 hours for neuroprotection and tocolysis was ordered. Two hours after MgSO₄ drip initiation, hematuria developed with adequate urine output. The infusion was immediately stopped. The serum magnesium level was high normal at 6.7 mEq/L. After 4 hours of renal clearance, the repeat serum magnesium level was normal (2.7 mEq/L) and with clear urine output. The patient was then given Nifedipine 30mg/tab, 3x a day which controlled the uterine contractions. At 37 weeks gestation, the patient delivered via primary low transverse Cesarean Section to a live female with a birthweight of 2470gm, appropriate for gestational age. The use of MgSO₄ for the control of premature labor in patients with chronic renal disease secondary to renal tubular can cause hematuria.

Keywords: hematuria, magnesium sulfate, premature labor, renal tubular acidosis

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Authors: Amir AlAmeeri, Mohamed Ibrahim

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Various data points are constantly being measured in the production system, and due to the nature of the wells, these data points, such as pressure, temperature, water cut, etc.., fluctuations are constant, which requires high frequency monitoring and collection. It is a very difficult task to analyze these parameters manually using spreadsheets and email. An automated system greatly enhances efficiency, reduce errors, the need for constant emails which take up disk space, and frees up time for the operator to perform other critical tasks. Various production data is being recorded in an oil field, and this huge volume of data can be seen as irrelevant to some, especially when viewed on its own with no context. In order to fully utilize all this information, it needs to be properly collected, verified and stored in one common place and analyzed for surveillance and monitoring purposes. This paper describes how data is recorded by different parties and departments in the field, and verified numerous times as it is being loaded into a repository. Once it is loaded, a final check is done before being entered into a production monitoring system. Once all this is collected, various calculations are performed to report allocated production. Calculated production data is used to report field production automatically. It is also used to monitor well and surface facility performance. Engineers can use this for their studies and analyses to ensure field is performing as it should be, predict and forecast production, and monitor any changes in wells that could affect field performance.

Keywords: automation, oil production, Cheleken, exploration and production (E&P), Caspian Sea, allocation, forecast

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Authors: Omojokun G. Aju, Adedayo O. Sule

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ZigBee wireless sensor and control network is one of the most popularly deployed wireless technologies in recent years. This is because ZigBee is an open standard lightweight, low-cost, low-speed, low-power protocol that allows true operability between systems. It is built on existing IEEE 802.15.4 protocol and therefore combines the IEEE 802.15.4 features and newly added features to meet required functionalities thereby finding applications in wide variety of wireless networked systems. ZigBee‘s current focus is on embedded applications of general-purpose, inexpensive, self-organising networks which requires low to medium data rates, high number of nodes and very low power consumption such as home/industrial automation, embedded sensing, medical data collection, smart lighting, safety and security sensor networks, and monitoring systems. Although the ZigBee design specification includes security features to protect data communication confidentiality and integrity, however, when simplicity and low-cost are the goals, security is normally traded-off. A lot of researches have been carried out on ZigBee technology in which emphasis has mainly been placed on ZigBee network performance characteristics such as energy efficiency, throughput, robustness, packet delay and delivery ratio in different scenarios and applications. This paper investigate and analyse the data accuracy, network implementation difficulties and security challenges of ZigBee network applications in star-based and mesh-based topologies with emphases on its home monitoring application using the ZigBee ProBee ZE-10 development boards for the network setup. The paper also expose some factors that need to be considered when designing ZigBee network applications and suggest ways in which ZigBee network can be designed to provide more resilient to network attacks.

Keywords: home monitoring, IEEE 802.14.5, topology, wireless security, wireless sensor network (WSN), ZigBee

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Authors: Caglayan Hizal, Kutay Yuceturk, Ertugrul Turker Uzun, Hasan Ceylan, Engin Aktas, Gursoy Turan

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Monitoring concepts for structural systems have been investigated by researchers for decades since such tools are quite convenient to determine intervention planning of structures. Despite the considerable development in this regard, the efficient use of monitoring data in reliability assessment, and prediction models are still in need of improvement in their efficiency. More specifically, reliability-based seismic risk assessment of engineering structures may play a crucial role in the post-earthquake decision-making process for the structures. After an earthquake, professionals could identify heavily damaged structures based on visual observations. Among these, it is hard to identify the ones with minimum signs of damages, even if they would experience considerable structural degradation. Besides, visual observations are open to human interpretations, which make the decision process controversial, and thus, less reliable. In this context, when a continuous monitoring system has been previously installed on the corresponding structure, this decision process might be completed rapidly and with higher confidence by means of the observed data. At this stage, the Structural Health Monitoring (SHM) procedure has an important role since it can make it possible to estimate the system reliability based on a recursively updated mathematical model. Therefore, integrating an SHM procedure into the reliability assessment process comes forward as an important challenge due to the arising uncertainties for the updated model in case of the environmental, material and earthquake induced changes. In this context, this study presents a case study on SHM-integrated reliability assessment of the continuously monitored progressively damaged systems. The objective of this study is to get instant feedback on the current state of the structure after an extreme event, such as earthquakes, by involving the observed data rather than the visual inspections. Thus, the decision-making process after such an event can be carried out on a rational basis. In the near future, this can give wing to the design of self-reported structures which can warn about its current situation after an extreme event.

Keywords: condition assessment, vibration-based SHM, reliability analysis, seismic risk assessment

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Authors: K. Prabhu, K. Dinesh, M. Ranjani, M. Suhitha

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During the tough times of covid, those people who were hospitalized found it difficult to always convey what they wanted to or needed to the attendee. Sometimes the attendees might also not be there. In that case, the patients can use simple hand gestures to control electrical appliances (like its set it for a zero watts bulb)and three other gestures for voice note intimation. In this AI-based hand recognition project, NodeMCU is used for the control action of the relay, and it is connected to the firebase for storing the value in the cloud and is interfaced with the python code via raspberry pi. For three hand gestures, a voice clip is added for intimation to the attendee. This is done with the help of Google’s text to speech and the inbuilt audio file option in the raspberry pi 4. All the five gestures will be detected when shown with their hands via the webcam, which is placed for gesture detection. The personal computer is used for displaying the gestures and for running the code in the raspberry pi imager.

Keywords: nodeMCU, AI technology, gesture, patient

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Authors: Nancy N. Sharmila, Aparna Mishra

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Hemiparesis affects almost 80% of stroke patients each year. It is marked by paralysis or weakness on one half of the body. Our model provides both assistance and physical therapy for hemiparesis patients for swift recovery. In order to accomplish our goal a force is provided that pulls the forearm up (as in flexing the arm), and pushes the forearm down (as in extending the arm), which will also assist the user during ADL (Activities of Daily Living). The model consists of a mechanical component which is placed around the patient’s bicep and an EMG control circuit to assist patients in daily activities, which makes it affordable and easy to use. In order to enhance the neuromuscular system’s effectiveness in synchronize the movement, proprioceptive neuromuscular facilitation (PNF) concept is used. The EMG signals are acquired from the unaffected arm as an input to drive the orthosis. This way the patient is invigorated to use the orthosis for regular exercise.

Keywords: EMG, hemiparesis, orthosis, rehabilitation

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Authors: Stepan Kuchar, Martin Golasowski, Radim Vavrik, Michal Podhoranyi, Boris Sir, Jan Martinovic

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The main goal of this article is to describe the online flood monitoring and prediction system Floreon+ primarily developed for the Moravian-Silesian region in the Czech Republic and the basic process it uses for running automatic rainfall-runoff and hydrodynamic simulations along with their calibration and uncertainty modeling. It takes a long time to execute such process sequentially, which is not acceptable in the online scenario, so the use of high-performance computing environment is proposed for all parts of the process to shorten their duration. Finally, a case study on the Ostravice river catchment is presented that shows actual durations and their gain from the parallel implementation.

Keywords: flood prediction process, high performance computing, online flood prediction system, parallelization

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Authors: Nuhi Arslani, Stojan Potrc, Timotej Mikuljan

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Background: In Department of Abdominal and General Surgery of University Medical Centre Maribor, we treated 578 patients for rectal cancer between 2004 and 2014. During and after treatment we especially concentrated on monitoring local and systemic complications. Methods: For analysis, we used data gathered from preoperative diagnostic tests, reports gathered during operation, reports from the pathohistologic review, and reports on complications after surgery and follow up. Results: In the case of 573 (out of 578) patients (99.1%) we performed resection. R0 was achieved in 551 patients (96,1%). R1 was achieved in 8 patients (1,4%). R2 was achieved in 14 patients (2,4%). Local complications were reported in 78 (13.5%) patients and systemic complications were reported in 68 (11.7%). We would like to point out the low number of local and systemic complications. Conclusions: With advances in surgical techniques, with a multimodal-multidisciplinary approach and with the use of total mesorectal excision we experienced a significant improvement in reducing the number of local and systemic complications in patients with rectal cancer. However, there still remains the question for truly optimal care for each patient with rectal cancer and his quality of life after surgical treatment.

Keywords: local complications, rectal cancer, resection, systemic complications

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Authors: Rui-heng Ray Huang

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This study compares the syntax and semantics of two kinds of passives in Mandarin Chinese: bèi passives and yóu passives. To express a Chinese equivalent for ‘The thief was taken away by the police,’ either bèi or yóu can be used, as in Xiǎotōu bèi/yóu jǐngchá dàizǒu le. It is shown in this study that bèi passives and yóu passives differ semantically and syntactically. The semantic observations are based on the theta theory, dealing with thematic roles. On the other hand, the syntactic analysis draws heavily upon the generative grammar, looking into thematic structures. The findings of this study are as follows. First, the core semantics of bèi passives is centered on the Patient NP in the subject position. This Patient NP is essentially an Affectee, undergoing the outcome or consequence brought up by the action represented by the predicate. This may explain why in the sentence Wǒde huà bèi/*yóu tā niǔqū le ‘My words have been twisted by him/her,’ only bèi is allowed. This is because the subject NP wǒde huà ‘my words’ suffers a negative consequence. Yóu passives, in contrast, place the semantic focus on the post-yóu NP, which is not an Affectee though. Instead, it plays a role which has to take certain responsibility without being affected in a way like an Affectee. For example, in the sentence Zhèbù diànyǐng yóu/*bèi tā dānrèn dǎoyǎn ‘This film is directed by him/her,’ only the use of yóu is possible because the post-yóu NP tā ‘s/he’ refers to someone in charge, who is not an Affectee, nor is the sentence-initial NP zhèbù diànyǐng ‘this film’. When it comes to the second finding, the syntactic structures of bèi passives and yóu passives differ in that the former involve a two-place predicate while the latter a three-place predicate. The passive morpheme bèi in a case like Xiǎotōu bèi jǐngchá dàizǒu le ‘The thief was taken away by the police’ has been argued by some Chinese syntacticians to be a two-place predicate which selects an Experiencer subject and an Event complement. Under this analysis, the initial NP xiǎotōu ‘the thief’ in the above example is a base-generated subject. This study, however, proposes that yóu passives fall into a three-place unergative structure. In the sentence Xiǎotōu yóu jǐngchá dàizǒu le ‘The thief was taken away by the police,’ the initial NP xiǎotōu ‘the thief’ is a topic which serves as a Patient taken by the verb dàizǒu ‘take away.’ The subject of the sentence is assumed to be an Agent, which is in a null form and may find its reference from the discourse or world knowledge. Regarding the post-yóu NP jǐngchá ‘the police,’ its status is dual. On the one hand, it is a Patient introduced by the light verb yóu; on the other, it is an Agent assigned by the verb dàizǒu ‘take away.’ It is concluded that the findings in this study contribute to better understanding of what makes the distinction between the two kinds of Chinese passives.

Keywords: affectee, passive, patient, unergative

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Authors: Namugenyi Ephrance Eunice, Julianne Sansa Otim, Marco Zennaro, Stephen D. Wolthusen

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The Internet of Things (IoT) is a network of connected data processing devices, mechanical and digital machinery, items, animals, or people that may send data across a network without requiring human-to-human or human-to-computer interaction. Each component has sensors that can pick up on specific phenomena, as well as processing software and other technologies that can link to and communicate with other systems and/or devices over the Internet or other communication networks and exchange data with them. IoT is increasingly being used in fields other than consumer electronics, such as public safety, emergency response, industrial automation, autonomous vehicles, the Internet of Medical Things (IoMT), and general environmental monitoring. Consumer-based IoT applications, like smart home gadgets and wearables, are also becoming more prevalent. This paper presents the main IoT deployment areas for environmental monitoring in developing regions and the backhaul options suitable for them. A detailed review of each of the list of papers selected for the study is included in section III of this document. The study includes an overview of existing IoT deployments, the underlying communication architectures, protocols, and technologies that support them. This overview shows that Low Power Wireless Area Networks (LPWANs), as summarized in Table 1, are very well suited for monitoring environment architectures designed for remote locations. LoRa technology, particularly the LoRaWAN protocol, has an advantage over other technologies due to its low power consumption, adaptability, and suitable communication range. The prevailing challenges of the different architectures are discussed and summarized in Table 3 of the IV section, where the main problem is the obstruction of communication paths by buildings, trees, hills, etc.

Keywords: communication technologies, environmental monitoring, Internet of Things, IoT deployment challenges

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Authors: Azziz Assoumani, Francois Lestremau, Celine Ferret, Benedicte Lepot, Morgane Salomon, Helene Budzinski, Marie-Helene Devier, Pierre Labadie, Karyn Le Menach, Patrick Pardon, Laure Wiest, Emmanuelle Vulliet, Pierre-Francois Staub

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Seven French wastewater treatment plants (WWTP) were monitored for 53 contaminants of emerging concern within a nation-wide monitoring campaign in surface waters, which took place in 2018. The overall objective of the 2018 campaign was to provide the exercise of prioritization of emerging substances, which is being carried out in 2021, with monitoring data. This exercise should make it possible to update the list of relevant substances to be monitored (SPAS) as part of future water framework directive monitoring programmes, which will be implemented in the next water body management cycle (2022). One sampling campaign was performed in October 2018 in the seven WWTP, where affluent and sludge samples were collected. Surface water samples were collected in September 2018 at three to five sites upstream and downstream the point of effluent discharge of each WWTP. The contaminants (36 biocides and 17 surfactants, selected by the Prioritization Experts Committee) were determined in the seven WWTP effluent and sludge samples and in surface water samples by liquid or gas chromatography coupled with tandem mass spectrometry, depending on the contaminant. Nine surfactants and three biocides were quantified at least in one WWTP effluent sample. Linear alkylbenzene sulfonic acids (LAS) and fipronil were quantified in all samples; the LAS were quantified at the highest median concentrations. Twelve surfactants and 13 biocides were quantified in at least one sludge sample. The LAS and didecyldimethylammonium were quantified in all samples and at the highest median concentrations. Higher concentration levels of the substances quantified in WWTP effluent samples were observed in the surface water samples collected downstream the effluents discharge points, compared with the samples collected upstream, suggesting a contribution of the WWTP effluents in the contamination of surface waters.

Keywords: contaminants of emerging concern, effluent, monitoring, river water, sludge

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Authors: A. G. Akhundov

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Issues of obtaining unbiased data on the status of pipeline systems of oil- and oil product transportation become especially important when laying and operating pipelines under severe nature and climatic conditions. The essential attention is paid here to researching exogenous processes and their impact on linear facilities of the pipeline system. Reliable operation of pipelines under severe nature and climatic conditions, timely planning and implementation of compensating measures are only possible if operation conditions of pipeline systems are regularly monitored, and changes of permafrost soil and hydrological operation conditions are accounted for. One of the main reasons for emergency situations to appear is the geodynamic factor. Emergency situations are proved by the experience to occur within areas characterized by certain conditions of the environment and to develop according to similar scenarios depending on active processes. The analysis of natural and technical systems of main pipelines at different stages of monitoring gives a possibility of making a forecast of the change dynamics. The integration of GIS technologies, traditional means of geotechnical monitoring (in-line inspection, geodetic methods, field observations), and remote methods (aero-visual inspection, aero photo shooting, air and ground laser scanning) provides the most efficient solution of the problem. The united environment of geo information system (GIS) is a comfortable way to implement the monitoring system on the main pipelines since it provides means to describe a complex natural and technical system and every element thereof with any set of parameters. Such GIS enables a comfortable simulation of main pipelines (both in 2D and 3D), the analysis of situations and selection of recommendations to prevent negative natural or man-made processes and to mitigate their consequences. The specifics of such systems include: a multi-dimensions simulation of facilities in the pipeline system, math modelling of the processes to be observed, and the use of efficient numeric algorithms and software packets for forecasting and analyzing. We see one of the most interesting possibilities of using the monitoring results as generating of up-to-date 3D models of a facility and the surrounding area on the basis of aero laser scanning, data of aerophotoshooting, and data of in-line inspection and instrument measurements. The resulting 3D model shall be the basis of the information system providing means to store and process data of geotechnical observations with references to the facilities of the main pipeline; to plan compensating measures, and to control their implementation. The use of GISs for geotechnical monitoring of pipeline systems is aimed at improving the reliability of their operation, reducing the probability of negative events (accidents and disasters), and at mitigation of consequences thereof if they still are to occur.

Keywords: databases, 3D GIS, geotechnical monitoring, pipelines, laser scaning

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Authors: Yrfet Shkreli

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To determine the content of human rights norms in national constitutions, international law - in the form of treaties, declarations and case law from international monitoring bodies, and comparative case law from other countries - is often discussed in the judgments of domestic courts. This paper explores the extent to which international law has influenced domestic human rights case law in Africa. The paper first explores how the human rights provisions of African constitutions came into being before turning to the role played by international law in the constitutional order of various African states and how treaties, declarations and findings of international monitoring bodies have been used in African countries to interpret and expand on constitutional human rights provisions.

Keywords: European Union, global governance, globalization, normative power

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Authors: Ilja Käch, Abdul R. Jandali, Nadja Zechmann-Müller

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Introduction: We discuss the treatment of two young male patients suffering from scaphoid non-union after a traumatic scaphoid fracture. The currently propagated techniques for treating a scaphoid non-union in children are either the operative reconstruction of the scaphoid or the conservative treatment with splinting in a scaphoid cast. Cases: In the first case, we operated on a 13 years old male patient with a posttraumatic scaphoid non-union in the middle third with a humpback deformity. We resected the middle third of the scaphoid and grafted the defect with an iliac crest bone, and the DISI-Deformity was reduced. Fixation was performed with K-Wires and immobilisation in a scaphoid cast. In the second case a 13 years old male patient also with a posttraumatic scaphoid non-union in the middle third and humpback deformity, DISI-deformity, was treated conservatively. Immobilisation in a scaphoid cast for four months was performed. Results: Operative: One year postoperatively the patient achieved a painless free arc of motion. Flexion/Extension 70/0/60°, Radial-/Ulnarduction 30/0/30° and Pro-/Supination 90/0/90°. The computer tomogram showed complete consolidation and bony fusion of the iliac crest bone. Conservative: Six to eight months after conservative treatment the patient demonstrated painless motion and AROM Flexion/Extension 80/0/80°, Radial-/Ulnarduction and Pro-/Supination in maximum range. Complete consolidation in the computer tomogram with persistent humpback- and DISI deformity. Conclusion: In the literature, both techniques are described, either the operative scaphoid reconstruction or the conservative treatment with splinting. In our cases, both the operative and conservative treatments showed comparable good results. However, the humpback- and DISI deformity can only be addressed with a surgical approach.

Keywords: scaphoid, non-union, trauma, operative vs. non operative

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Authors: Weidong Xia, Malgorzata Kolotylo, Xuan Tan

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This study examines the key factors that influence general practitioners’ learning and transfer of specialized arthritis knowledge and self-care techniques to patients during normal patient visits. Drawing on the theory of planed behavior and using matched survey data collected from general practitioners before and after training sessions provided by specialized orthopedic physicians, the study suggests that the general practitioner’s intention to use and transfer learned knowledge was influenced mainly by intrinsic motivation, organizational learning culture and absorptive capacity, but was not influenced by extrinsic motivation. The results provide both theoretical and practical implications.

Keywords: empirical study, healthcare knowledge management, patient self-care, physician knowledge transfer

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Authors: Rong-Terng Juang

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Autonomous vehicles offer the possibility of significant benefits to social welfare. However, fully automated cars might not be going to happen in the near further. To speed the adoption of the self-driving technologies, many governments worldwide are passing laws requiring data recorders for the testing of autonomous vehicles. Currently, the self-driving vehicle, (e.g., shuttle bus) has to be monitored from a remote control center. When an autonomous vehicle encounters an unexpected driving environment, such as road construction or an obstruction, it should request assistance from a remote operator. Nevertheless, large amounts of data, including images, radar and lidar data, etc., have to be transmitted from the vehicle to the remote center. Therefore, this paper proposes a data compression method of in-vehicle networks for remote monitoring of autonomous vehicles. Firstly, the time-series data are rearranged into a multi-dimensional signal space. Upon the arrival, for controller area networks (CAN), the new data are mapped onto a time-data two-dimensional space associated with the specific CAN identity. Secondly, the data are sampled based on differential sampling. Finally, the whole set of data are encoded using existing algorithms such as Huffman, arithmetic and codebook encoding methods. To evaluate system performance, the proposed method was deployed on an in-house built autonomous vehicle. The testing results show that the amount of data can be reduced as much as 1/7 compared to the raw data.

Keywords: autonomous vehicle, data compression, remote monitoring, controller area networks (CAN), Lidar

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, Antibiotic misuse, Iraq, Prescribing

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Authors: Mamatha M. N.

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Traffic problems, congested traffic, and flow management were recognized as major problems mostly in all the areas, which have caused a problem for the ambulance which carries the emergency patient. The proposed paper aims in the development of ambulance which reaches the nearby hospital faster even in heavy traffic scenario. This process is activated by implementing hardware in an ambulance as well as in traffic post thus allowing a smooth flow to the ambulance to reach the hospital in time. 1) The design of the vehicle to have a communication between ambulance and traffic post. 2)Electronic Health Record with Data-acquisition system 3)Telemetry of acquired biological parameters to the nearest hospital. Thus interfacing all these three different modules and integrating them on the ambulance could reach the hospital earlier than the present ambulance. The system is accurate and efficient of 99.8%.

Keywords: bio-telemetry, data acquisition, patient database, automatic traffic control

Procedia PDF Downloads 307

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

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Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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Authors: Johannes Atug, Andreas Radke, Mitchell Tseng, Gunther Reinhart

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In modern supply chains, large numbers of SKU (Stock-Keeping-Unit) need to be timely managed, and any delays in noticing disruptions of items often limit the ability to defer the impact on customer order fulfillment. However, in supply chains of IoT-connected enterprises, the ERP (Enterprise-Resource-Planning), the MES (Manufacturing-Execution-System) and the SCADA (Supervisory-Control-and-Data-Acquisition) systems generate large amounts of data, which generally glean much earlier notice of deviations in the business process steps. That is, analyzing these streams of data with process mining techniques allows the monitoring of the supply chain business processes and thus identification of items that deviate from the standard order fulfillment process. In this paper, a framework to enable event-based SCM (Supply-Chain-Management) processes including an overview of core enabling technologies are presented, which is based on the RAMI (Reference-Architecture-Model for Industrie 4.0) architecture. The application of this framework in the industry is presented, and implications for SCM in industry 4.0 and further research are outlined.

Keywords: cyber-physical production systems, event-based monitoring, supply chain management, RAMI (Reference-Architecture-Model for Industrie 4.0)

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Authors: Gameel Abdelmageed

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Arabs have a rhetorical heritage which has greatly contributed to the monitoring and analyzing of the rhetoric of the Holy Quran, Hadith, and Arabic texts on poetry and oratory. But Arab scholars - as far as the researcher knows – have not contributed to monitoring and analyzing the rhetoric of digital Arabic discourse although it has prominence, particularly in social media and has strong effectiveness in the political and social life of Arab society. This discourse has made its impact by using very new rhetorical techniques in language, voice, image, painting and video clips which are known as “Multimedia” and belong to “Digital Rhetoric”. This study suggests that it is time to draw the attention of Arab scholars and invite them to monitor and analyze the rhetoric of digital Arabic discourse.

Keywords: digital discourse, digital rhetoric, Facebook, social media

Procedia PDF Downloads 361

Authors: J. Luché-Thayer, C. Perronne, C. Meseko

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We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent

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Authors: Kious Mecheri, Hadjadj Abdechafik, Ameur Aissa

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The wear of cutting tool degrades the quality of the product in the manufacturing processes. The online monitoring of the cutting tool wear level is very necessary to prevent the deterioration of the quality of machining. Unfortunately there is not a direct manner to measure the cutting tool wear online. Consequently we must adopt an indirect method where wear will be estimated from the measurement of one or more physical parameters appearing during the machining process such as the cutting force, the vibrations, or the acoustic emission etc. In this work, a neural network system is elaborated in order to estimate the flank wear from the cutting force measurement and the cutting conditions.

Keywords: flank wear, cutting forces, high speed milling, signal processing, neural network

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Authors: Z. Masoumi, B. Moaveni

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This article is about first step of structural health monitoring by identifying structural system in the presence of unknown input. In the structural system identification, identification of structural parameters such as stiffness and damping are considered. In this study, the Kalman filter (KF) design for structural systems with unknown excitation is expressed. External excitations, such as earthquakes, wind or any other forces are not measured or not available. The purpose of this filter is its strengths to estimate the state variables of the system in the presence of unknown input. Also least squares estimation (LSE) method with unknown input is studied. Estimates of parameters have been adopted. Finally, using two examples advantages and drawbacks of both methods are studied.

Keywords: Kalman filter (KF), least square estimation (LSE), structural health monitoring (SHM), structural system identification

Procedia PDF Downloads 306