Search results for: advanced encryption standard
6438 Utilization of Standard Paediatric Observation Chart to Evaluate Infants under Six Months Presenting with Non-Specific Complaints
Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes
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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart
Procedia PDF Downloads 2526437 Dynamics of Mach Zehnder Modulator in Open and Closed Loop Bias Condition
Authors: Ramonika Sengupta, Stuti Kachhwaha, Asha Adhiya, K. Satya Raja Sekhar, Rajwinder Kaur
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Numerous efforts have been done in the past decade to develop the methods of secure communication that are free from interception and eavesdropping. In fiber optic communication, chaotic optical carrier signals are used for data encryption in secure data transmission. Mach-Zehnder Modulators (MZM) are the key components for generating the chaotic signals to be used as optical carriers. This paper presents the dynamics of a lithium niobate MZM modulator under various biasing conditions. The chaotic fluctuations of the intensity of a laser diode have been generated using the electro-optic MZM modulator operating in a highly nonlinear regime. The modulator is driven in closed loop by its own output at an earlier time. When used as an electro-optic oscillator employing delayed feedback, the MZM displays a wide range of output waveforms of varying complexity. The dynamical behavior of the system ranges from periodic to nonlinear oscillations. The nonlinearity displayed by the system is reproducible and is easily controllable. In this paper, we demonstrate a wide variety of optical signals generated by MZM using easily controllable device parameters in both open and close loop bias conditions.Keywords: chaotic carrier, fiber optic communication, Mach-Zehnder modulator, secure data transmission
Procedia PDF Downloads 2726436 AI Peer Review Challenge: Standard Model of Physics vs 4D GEM EOS
Authors: David A. Harness
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Natural evolution of ATP cognitive systems is to meet AI peer review standards. ATP process of axiom selection from Mizar to prove a conjecture would be further refined, as in all human and machine learning, by solving the real world problem of the proposed AI peer review challenge: Determine which conjecture forms the higher confidence level constructive proof between Standard Model of Physics SU(n) lattice gauge group operation vs. present non-standard 4D GEM EOS SU(n) lattice gauge group spatially extended operation in which the photon and electron are the first two trace angular momentum invariants of a gravitoelectromagnetic (GEM) energy momentum density tensor wavetrain integration spin-stress pressure-volume equation of state (EOS), initiated via 32 lines of Mathematica code. Resulting gravitoelectromagnetic spectrum ranges from compressive through rarefactive of the central cosmological constant vacuum energy density in units of pascals. Said self-adjoint group operation exclusively operates on the stress energy momentum tensor of the Einstein field equations, introducing quantization directly on the 4D spacetime level, essentially reformulating the Yang-Mills virtual superpositioned particle compounded lattice gauge groups quantization of the vacuum—into a single hyper-complex multi-valued GEM U(1) × SU(1,3) lattice gauge group Planck spacetime mesh quantization of the vacuum. Thus the Mizar corpus already contains all of the axioms required for relevant DeepMath premise selection and unambiguous formal natural language parsing in context deep learning.Keywords: automated theorem proving, constructive quantum field theory, information theory, neural networks
Procedia PDF Downloads 1796435 ALEF: An Enhanced Approach to Arabic-English Bilingual Translation
Authors: Abdul Muqsit Abbasi, Ibrahim Chhipa, Asad Anwer, Saad Farooq, Hassan Berry, Sonu Kumar, Sundar Ali, Muhammad Owais Mahmood, Areeb Ur Rehman, Bahram Baloch
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Accurate translation between structurally diverse languages, such as Arabic and English, presents a critical challenge in natural language processing due to significant linguistic and cultural differences. This paper investigates the effectiveness of Facebook’s mBART model, fine-tuned specifically for sequence-tosequence (seq2seq) translation tasks between Arabic and English, and enhanced through advanced refinement techniques. Our approach leverages the Alef Dataset, a meticulously curated parallel corpus spanning various domains to capture the linguistic richness, nuances, and contextual accuracy essential for high-quality translation. We further refine the model’s output using advanced language models such as GPT-3.5 and GPT-4, which improve fluency, coherence, and correct grammatical errors in translated texts. The fine-tuned model demonstrates substantial improvements, achieving a BLEU score of 38.97, METEOR score of 58.11, and TER score of 56.33, surpassing widely used systems such as Google Translate. These results underscore the potential of mBART, combined with refinement strategies, to bridge the translation gap between Arabic and English, providing a reliable, context-aware machine translation solution that is robust across diverse linguistic contexts.Keywords: natural language processing, machine translation, fine-tuning, Arabic-English translation, transformer models, seq2seq translation, translation evaluation metrics, cross-linguistic communication
Procedia PDF Downloads 86434 Product Line Design with Customization in the Presence of Demand Uncertainty
Authors: Parisa Bagheri Tookanlou
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In this paper, we analyze a product line design problem faced by a manufacturing firm where the product line consists of a customized product in addition to a standard product and is offered in a market in which customers are heterogeneous on aesthetic attributes of the product. The customization level of a product is defined by the fraction of aesthetic attributes of the product that the manufacturer chooses to customize. In contrast to the existing literature on product line design that predominantly assumes deterministic demand, we consider the presence of demand uncertainty and frame the product line design problem in a single period (news vendor) setting. We examine the effect of demand uncertainty on product line decisions. Furthermore, we also examine how product line decisions are influenced by channel structure. While we use the centralized channel as a benchmark, we consider the decentralized dual channel where the customized product is sold through an online channel owned by the manufacturer and the standard product is sold through a retailer. We introduce a supply contract between the manufacturer and the retailer for improving channel efficiency and coordinate the distribution channel.Keywords: product line design, demand uncertainty, customization level, distribution channel
Procedia PDF Downloads 1866433 Evidence of Climate Change from Statistical Analysis of Temperature and Rainfall Data of Kaduna State, Nigeria
Authors: Iliya Bitrus Abaje
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This study examines the evidence of climate change scenario in Kaduna State from the analysis of temperature and rainfall data (1976-2015) from three meteorological stations along a geographic transect from the southern part to the northern part of the State. Different statistical methods were used in determining the changes in both the temperature and rainfall series. The result of the linear trend lines revealed a mean increase in average temperature of 0.73oC for the 40 years period of study in the State. The plotted standard deviation for the temperature anomalies generally revealed that years of temperatures above the mean standard deviation (hotter than the normal conditions) in the last two decades (1996-2005 and 2006-2015) were more than those below (colder than the normal condition). The Cramer’s test and student’s t-test generally revealed an increasing temperature trend in the recent decades. The increased in temperature is an evidence that the earth’s atmosphere is getting warmer in recent years. The linear trend line equation of the annual rainfall for the period of study showed a mean increase of 316.25 mm for the State. Findings also revealed that the plotted standard deviation for the rainfall anomalies, and the 10-year non-overlapping and 30-year overlapping sub-periods analysis in all the three stations generally showed an increasing trend from the beginning of the data to the recent years. This is an evidence that the study area is now experiencing wetter conditions in recent years and hence climate change. The study recommends diversification of the economic base of the populace with emphasis on moving away from activities that are sensitive to temperature and rainfall extremes Also, appropriate strategies to ameliorate the scourge of climate change at all levels/sectors should always take into account the recent changes in temperature and rainfall amount in the area.Keywords: anomalies, linear trend, rainfall, temperature
Procedia PDF Downloads 3186432 Assesments of Some Environment Variables on Fisheries at Two Levels: Global and Fao Major Fishing Areas
Authors: Hyelim Park, Juan Martin Zorrilla
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Climate change influences very widely and in various ways ocean ecosystem functioning. The consequences of climate change on marine ecosystems are an increase in temperature and irregular behavior of some solute concentrations. These changes would affect fisheries catches in several ways. Our aim is to assess the quantitative contribution change of fishery catches along the time and express them through four environment variables: Sea Surface Temperature (SST4) and the concentrations of Chlorophyll (CHL), Particulate Inorganic Carbon (PIC) and Particulate Organic Carbon (POC) at two spatial scales: Global and the nineteen FAO Major Fishing Areas divisions. Data collection was based on the FAO FishStatJ 2014 database as well as MODIS Aqua satellite observations from 2002 to 2012. Some data had to be corrected and interpolated using some existing methods. As the results, a multivariable regression model for average Global fisheries captures contained temporal mean of SST4, standard deviation of SST4, standard deviation of CHL and standard deviation of PIC. Global vector auto-regressive (VAR) model showed that SST4 was a statistical cause of global fishery capture. To accommodate varying conditions in fishery condition and influence of climate change variables, a model was constructed for each FAO major fishing area. From the management perspective it should be recognized some limitations of the FAO marine areas division that opens to possibility to the discussion of the subdivision of the areas into smaller units. Furthermore, it should be treated that the contribution changes of fishery species and the possible environment factor for specific species at various scale levels.Keywords: fisheries-catch, FAO FishStatJ, MODIS Aqua, sea surface temperature (SST), chlorophyll, particulate inorganic carbon (PIC), particulate organic carbon (POC), VAR, granger causality
Procedia PDF Downloads 4846431 Health-Related QOL of Motorists with Spinal Cord Injury in Japan
Authors: Hiroaki Hirose, Hiroshi Ikeda, Isao Takeda
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The Japanese version of the SF-36 has been employed to assess individuals’ health-related QOL (HRQOL). This study aimed to clarify the HRQOL of motorists with a spinal cord injury, in order to compare these individuals' SF-36 scores and national standard values. A total of 100 motorists with a spinal cord injury participated in this study. Participants’ HRQOL was evaluated using the Japanese version of the SF-36 (second edition). The score for each subscale was standardized based on data on the Japanese population. The average scores for NPF, NRP, NBP, NGH, NVT, NSF, NRE, and NMH were 10.9, 41.8, 45.9, 47.1, 46.1, 46.7, 46.0, and 47.4 points, respectively. Subjects showed significantly lower scores for NPF and NRP compared with national standard values, which were both ≤ 45.0 points, but relatively normal scores for the other items: NBP, NGH, NVT, NSF, NRE and NMH (> 45.0 points). The average scores for PCS, MCS and RCS were 21.9, 56.0, and 50.0 points, respectively. Subjects showed a significantly lower PCS score (≤ 20.0 points); however, the MCS score was higher (> 55.0 points) along with a relatively normal RCS score in these individuals (= 50.0 points).Keywords: health-related QOL, HRQOL, SF-36, motorist, spinal cord injury, Japan
Procedia PDF Downloads 3346430 Chemical and Physical Properties and Biocompatibility of Ti–6Al–4V Produced by Electron Beam Rapid Manufacturing and Selective Laser Melting for Biomedical Applications
Authors: Bing–Jing Zhao, Chang-Kui Liu, Hong Wang, Min Hu
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Electron beam rapid manufacturing (EBRM) or Selective laser melting is an additive manufacturing process that uses 3D CAD data as a digital information source and energy in the form of a high-power laser beam or electron beam to create three-dimensional metal parts by fusing fine metallic powders together.Object:The present study was conducted to evaluate the mechanical properties ,the phase transformation,the corrosivity and the biocompatibility of Ti-6Al-4V by EBRM,SLM and forging technique.Method: Ti-6Al-4V alloy standard test pieces were manufactured by EBRM, SLM and forging technique according to AMS4999,GB/T228 and ISO 10993.The mechanical properties were analyzed by universal test machine. The phase transformation was analyzed by X-ray diffraction and scanning electron microscopy. The corrosivity was analyzed by electrochemical method. The biocompatibility was analyzed by co-culturing with mesenchymal stem cell and analyzed by scanning electron microscopy (SEM) and alkaline phosphatase assay (ALP) to evaluate cell adhesion and differentiation, respectively. Results: The mechanical properties, the phase transformation, the corrosivity and the biocompatibility of Ti-6Al-4V by EBRM、SLM were similar to forging and meet the mechanical property requirements of AMS4999 standard. aphase microstructure for the EBM production contrast to the a’phase microstructure of the SLM product. Mesenchymal stem cell adhesion and differentiation were well. Conclusion: The property of the Ti-6Al-4V alloy manufactured by EBRM and SLM technique can meet the medical standard from this study. But some further study should be proceeded in order to applying well in clinical practice.Keywords: 3D printing, Electron Beam Rapid Manufacturing (EBRM), Selective Laser Melting (SLM), Computer Aided Design (CAD)
Procedia PDF Downloads 4546429 Determination of Iodine and Heavy Metals in Two Brands of Iodised Salt
Authors: Z. O. Apotiola, J. F. Fashakin
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A study was conducted to investigate the storage stability of Mr Chef and Annapurna salts. The salts were bought from Mile 12 market in Lagos State and were stored for a period of six months. The stability of the iodine content was then investigated by storing some at ambient temperature (24-30oC) and some at atmospheric temperature (21-35 oC), and from each storage condition, a sample each was taken every month to analyze for the iodine and moisture contents. The result shows that there was a significant difference between Mr Chef and the standard and Annapurna and the standard. The iodine content of Mr Chef stored at ambient and atmospheric temperature decreases progressively from 48.70±0.00-37.00±0.00 and 47.60±0.00-11.60±0.00 respectively. And that of Annapurna at both ambient and atmospheric temperature also decreases progressively from 47.60±0.00-36.60±0.00 and 47.60±0.00-10.60±0.00 respectively. Also, the moisture content of both salts at the zero month to the sixth month both at room temperature and atmospheric temperature increases from 1.11±0.00-1.70±0.00 and 1.11±0.00-2.40±0.00 respectively. The results of the heavy metals shows that only Copper, Zinc and Cobalt were detected at the first and the sixth month in both Mr Chef and Annapurna which ranges from 0.15±0.00-0.38±0.00 and 0.18±0.00 - 3.50±0.00 respectively. Hence, the stability of iodine in salt is influenced by the storage conditions it is subjected to and the length of time it is been stored.Keywords: salt, iodine, stability, ambient, atmospheric temperature
Procedia PDF Downloads 5786428 Facility Layout Improvement: Based on Safety and Health at Work and Standards of Food Production Facility
Authors: Asifa Fitriani, Galih Prakoso
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This study aims to improve the design layout of a Micro, Small and Medium Enterprises (SMEs) to minimize material handling and redesigning the layout of production facilities based on the safety and health and standards of food production facilities. Problems layout in the one of chip making industry mushrooms in Indonesia is cross movement between work stations, work accidents, and the standard of facilities that do not conform with the standards of the food industry. Improvement layout design using CORELAP and 5S method to give recommendation and implementation of occupational health and safety standards of food production facilities. From the analysis, improved layout using CORELAP provide a smaller displacement distance is 155.84 meters from the initial displacement distance of 335.9 meters, and providing a shorter processing time than the original 112.726 seconds to 102.831 seconds. 5S method also has recommended the completion of occupational health and safety issues as well as the standard means of food production by changing the working environment better.Keywords: Layout Design, Corelap, 5S
Procedia PDF Downloads 5336427 Study on Measuring Method and Experiment of Arc Fault Detection Device
Authors: Yang Jian-Hong, Zhang Ren-Cheng, Huang Li
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Arc fault is one of the main inducements of electric fires. Arc Fault Detection Device (AFDD) can detect arc fault effectively. Arc fault detections and unhooking standards are the keys to AFDD practical application. First, an arc fault continuous production system was developed, which could count the arc half wave number. Then, Combining with the UL1699 standard, ignition probability curve of cotton and unhooking time of various currents intensity were obtained by experiments. The combustion degree of arc fault could be expressed effectively by arc area. Experiments proved that electric fires would be misjudged or missed only using arc half wave number as AFDD unhooking basis. At last, Practical tests were carried out on the self-developed AFDD system. The result showed that actual AFDD unhooking time was the sum of arc half wave cycling number, Arc wave identification time and unhooking mechanical operation time And the first two shared shorter time. Unhooking time standard depended on the shortest mechanical operation time.Keywords: arc fault detection device, arc area, arc half wave, unhooking time, arc fault
Procedia PDF Downloads 5086426 Completion of the Modified World Health Organization (WHO) Partograph during Labour in Public Health Institutions of Addis Ababa, Ethiopia
Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha
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Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia
Procedia PDF Downloads 3486425 A Challenge to Acquire Serious Victims’ Locations during Acute Period of Giant Disasters
Authors: Keiko Shimazu, Yasuhiro Maida, Tetsuya Sugata, Daisuke Tamakoshi, Kenji Makabe, Haruki Suzuki
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In this paper, we report how to acquire serious victims’ locations in the Acute Stage of Large-scale Disasters, in an Emergency Information Network System designed by us. The background of our concept is based on the Great East Japan Earthquake occurred on March 11th, 2011. Through many experiences of national crises caused by earthquakes and tsunamis, we have established advanced communication systems and advanced disaster medical response systems. However, Japan was devastated by huge tsunamis swept a vast area of Tohoku causing a complete breakdown of all the infrastructures including telecommunications. Therefore, we noticed that we need interdisciplinary collaboration between science of disaster medicine, regional administrative sociology, satellite communication technology and systems engineering experts. Communication of emergency information was limited causing a serious delay in the initial rescue and medical operation. For the emergency rescue and medical operations, the most important thing is to identify the number of casualties, their locations and status and to dispatch doctors and rescue workers from multiple organizations. In the case of the Tohoku earthquake, the dispatching mechanism and/or decision support system did not exist to allocate the appropriate number of doctors and locate disaster victims. Even though the doctors and rescue workers from multiple government organizations have their own dedicated communication system, the systems are not interoperable.Keywords: crisis management, disaster mitigation, messing, MGRS, military grid reference system, satellite communication system
Procedia PDF Downloads 2366424 Validation of the Formula for Air Attenuation Coefficient for Acoustic Scale Models
Authors: Katarzyna Baruch, Agata Szelag, Aleksandra Majchrzak, Tadeusz Kamisinski
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Methodology of measurement of sound absorption coefficient in scaled models is based on the ISO 354 standard. The measurement is realised indirectly - the coefficient is calculated from the reverberation time of an empty chamber as well as a chamber with an inserted sample. It is crucial to maintain the atmospheric conditions stable during both measurements. Possible differences may be amended basing on the formulas for atmospheric attenuation coefficient α given in ISO 9613-1. Model studies require scaling particular factors in compliance with specified characteristic numbers. For absorption coefficient measurement, these are for example: frequency range or the value of attenuation coefficient m. Thanks to the possibilities of modern electroacoustic transducers, it is no longer a problem to scale the frequencies which have to be proportionally higher. However, it may be problematic to reduce values of the attenuation coefficient. It is practically obtained by drying the air down to a defined relative humidity. Despite the change of frequency range and relative humidity of the air, ISO 9613-1 standard still allows the calculation of the amendment for little differences of the atmospheric conditions in the chamber during measurements. The paper discusses a number of theoretical analyses and experimental measurements performed in order to obtain consistency between the values of attenuation coefficient calculated from the formulas given in the standard and by measurement. The authors performed measurements of reverberation time in a chamber made in a 1/8 scale in a corresponding frequency range, i.e. 800 Hz - 40 kHz and in different values of the relative air humidity (40% 5%). Based on the measurements, empirical values of attenuation coefficient were calculated and compared with theoretical ones. In general, the values correspond with each other, but for high frequencies and low values of relative air humidity the differences are significant. Those discrepancies may directly influence the values of measured sound absorption coefficient and cause errors. Therefore, the authors made an effort to determine an amendment minimizing described inaccuracy.Keywords: air absorption correction, attenuation coefficient, dimensional analysis, model study, scaled modelling
Procedia PDF Downloads 4216423 Chinese Language Teaching as a Second Language: Immersion Teaching
Authors: Lee Bih Ni, Kiu Su Na
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This paper discusses the Chinese Language Teaching as a Second Language by focusing on Immersion Teaching. Researchers used narrative literature review to describe the current states of both art and science in focused areas of inquiry. Immersion teaching comes with a standard that teachers must reliably meet. Chinese language-immersion instruction consists of language and content lessons, including functional usage of the language, academic language, authentic language, and correct Chinese sociocultural language. Researchers used narrative literature reviews to build a scientific knowledge base. Researchers collected all the important points of discussion, and put them here with reference to the specific field where this paper is originally based on. The findings show that Chinese Language in immersion teaching is not like standard foreign language classroom; immersion setting provides more opportunities to teach students colloquial language than academic. Immersion techniques also introduce a language’s cultural and social contexts in a meaningful and memorable way. It is particularly important that immersion teachers connect classwork with real-life experiences. Immersion also includes more elements of discovery and inquiry based learning than do other kinds of instructional practices. Students are always and consistently interpreted the conclusions and context clues.Keywords: a second language, Chinese language teaching, immersion teaching, instructional strategies
Procedia PDF Downloads 4526422 Enhancing Robustness in Federated Learning through Decentralized Oracle Consensus and Adaptive Evaluation
Authors: Peiming Li
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This paper presents an innovative blockchain-based approach to enhance the reliability and efficiency of federated learning systems. By integrating a decentralized oracle consensus mechanism into the federated learning framework, we address key challenges of data and model integrity. Our approach utilizes a network of redundant oracles, functioning as independent validators within an epoch-based training system in the federated learning model. In federated learning, data is decentralized, residing on various participants' devices. This scenario often leads to concerns about data integrity and model quality. Our solution employs blockchain technology to establish a transparent and tamper-proof environment, ensuring secure data sharing and aggregation. The decentralized oracles, a concept borrowed from blockchain systems, act as unbiased validators. They assess the contributions of each participant using a Hidden Markov Model (HMM), which is crucial for evaluating the consistency of participant inputs and safeguarding against model poisoning and malicious activities. Our methodology's distinct feature is its epoch-based training. An epoch here refers to a specific training phase where data is updated and assessed for quality and relevance. The redundant oracles work in concert to validate data updates during these epochs, enhancing the system's resilience to security threats and data corruption. The effectiveness of this system was tested using the Mnist dataset, a standard in machine learning for benchmarking. Results demonstrate that our blockchain-oriented federated learning approach significantly boosts system resilience, addressing the common challenges of federated environments. This paper aims to make these advanced concepts accessible, even to those with a limited background in blockchain or federated learning. We provide a foundational understanding of how blockchain technology can revolutionize data integrity in decentralized systems and explain the role of oracles in maintaining model accuracy and reliability.Keywords: federated learning system, block chain, decentralized oracles, hidden markov model
Procedia PDF Downloads 636421 Denoising Convolutional Neural Network Assisted Electrocardiogram Signal Watermarking for Secure Transmission in E-Healthcare Applications
Authors: Jyoti Rani, Ashima Anand, Shivendra Shivani
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In recent years, physiological signals obtained in telemedicine have been stored independently from patient information. In addition, people have increasingly turned to mobile devices for information on health-related topics. Major authentication and security issues may arise from this storing, degrading the reliability of diagnostics. This study introduces an approach to reversible watermarking, which ensures security by utilizing the electrocardiogram (ECG) signal as a carrier for embedding patient information. In the proposed work, Pan-Tompkins++ is employed to convert the 1D ECG signal into a 2D signal. The frequency subbands of a signal are extracted using RDWT(Redundant discrete wavelet transform), and then one of the subbands is subjected to MSVD (Multiresolution singular valued decomposition for masking. Finally, the encrypted watermark is embedded within the signal. The experimental results show that the watermarked signal obtained is indistinguishable from the original signals, ensuring the preservation of all diagnostic information. In addition, the DnCNN (Denoising convolutional neural network) concept is used to denoise the retrieved watermark for improved accuracy. The proposed ECG signal-based watermarking method is supported by experimental results and evaluations of its effectiveness. The results of the robustness tests demonstrate that the watermark is susceptible to the most prevalent watermarking attacks.Keywords: ECG, VMD, watermarking, PanTompkins++, RDWT, DnCNN, MSVD, chaotic encryption, attacks
Procedia PDF Downloads 1016420 Enhancing Model Interoperability and Reuse by Designing and Developing a Unified Metamodel Standard
Authors: Arash Gharibi
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Mankind has always used models to solve problems. Essentially, models are simplified versions of reality, whose need stems from having to deal with complexity; many processes or phenomena are too complex to be described completely. Thus a fundamental model requirement is that it contains the characteristic features that are essential in the context of the problem to be solved or described. Models are used in virtually every scientific domain to deal with various problems. During the recent decades, the number of models has increased exponentially. Publication of models as part of original research has traditionally been in in scientific periodicals, series, monographs, agency reports, national journals and laboratory reports. This makes it difficult for interested groups and communities to stay informed about the state-of-the-art. During the modeling process, many important decisions are made which impact the final form of the model. Without a record of these considerations, the final model remains ill-defined and open to varying interpretations. Unfortunately, the details of these considerations are often lost or in case there is any existing information about a model, it is likely to be written intuitively in different layouts and in different degrees of detail. In order to overcome these issues, different domains have attempted to implement their own approaches to preserve their models’ information in forms of model documentation. The most frequently cited model documentation approaches show that they are domain specific, not to applicable to the existing models and evolutionary flexibility and intrinsic corrections and improvements are not possible with the current approaches. These issues are all because of a lack of unified standards for model documentation. As a way forward, this research will propose a new standard for capturing and managing models’ information in a unified way so that interoperability and reusability of models become possible. This standard will also be evolutionary, meaning members of modeling realm could contribute to its ongoing developments and improvements. In this paper, the current 3 of the most common metamodels are reviewed and according to pros and cons of each, a new metamodel is proposed.Keywords: metamodel, modeling, interoperability, reuse
Procedia PDF Downloads 1986419 Development of Soil Test Kits to Determine Organic Matter Available Phosphorus and Exchangeable Potassium in Thailand
Authors: Charirat Kusonwiriyawong, Supha Photichan, Wannarut Chutibutr
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Soil test kits for rapid analysis of the organic matter, available phosphorus and exchangeable potassium were developed to drive a low-cost field testing kit to farmers. The objective was to provide a decision tool for improving soil fertility. One aspect of soil test kit development was ease of use which is a time requirement for completing organic matter, available phosphorus and exchangeable potassium test in one soil sample. This testing kit required only two extractions and utilized no filtration consuming approximately 15 minutes per sample. Organic matter was principally created by oxidizing carbon KMnO₄ using the standard color chart. In addition, modified single extractant (Mehlich I) was applied to extract available phosphorus and exchangeable potassium. Molybdenum blue method and turbidimetric method using standard color chart were adapted to analyze available phosphorus and exchangeable potassium, respectively. Modified single extractant using in soil test kits were highly significant matching with analytical laboratory results (r=0.959** and 0.945** for available phosphorus and exchangeable potassium, respectively). Linear regressions were statistically calculated between modified single extractant and standard laboratory analysis (y=0.9581x-12.973 for available phosphorus and y=0.5372x+15.283 for exchangeable potassium, respectively). These equations were calibrated to formulate a fertilizer rate recommendation for specific corps. To validate quality, soil test kits were distributed to farmers and extension workers. We found that the accuracy of soil test kits were 71.0%, 63.9% and 65.5% for organic matter, available phosphorus, and exchangeable potassium, respectively. The quantitative survey was also conducted in order to assess their satisfaction with soil test kits. The survey showed that more than 85% of respondents said these testing kits were more convenient, economical and reliable than the other commercial soil test kits. Based upon the finding of this study, soil test kits can be another alternative for providing soil analysis and fertility recommendations when a soil testing laboratory is not available.Keywords: available phosphorus, exchangeable potassium, modified single extractant, organic matter, soil test kits
Procedia PDF Downloads 1456418 Relationship between Structure of Some Nitroaromatic Pollutants and Their Degradation Kinetic Parameters in UV-VIS/TIO2 System
Authors: I. Nitoi, P. Oancea, M. Raileanu, M. Crisan, L. Constantin, I. Cristea
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Hazardous organic compounds like nitroaromatics are frequently found in chemical and petroleum industries discharged effluents. Due to their bio-refractory character and high chemical stability cannot be efficiently removed by classical biological or physical-chemical treatment processes. In the past decades, semiconductor photocatalysis has been frequently applied for the advanced degradation of toxic pollutants. Among various semiconductors titania was a widely studied photocatalyst, due to its chemical inertness, low cost, photostability and nontoxicity. In order to improve optical absorption and photocatalytic activity of TiO2 many attempts have been made, one feasible approach consists of doping oxide semiconductor with metal. The degradation of dinitrobenzene (DNB) and dinitrotoluene (DNT) from aqueous solution under UVA-VIS irradiation using heavy metal (0.5% Fe, 1%Co, 1%Ni ) doped titania was investigated. The photodegradation experiments were carried out using a Heraeus laboratory scale UV-VIS reactor equipped with a medium-pressure mercury lamp which emits in the range: 320-500 nm. Solutions with (0.34-3.14) x 10-4 M pollutant content were photo-oxidized in the following working conditions: pH = 5-9; photocatalyst dose = 200 mg/L; irradiation time = 30 – 240 minutes. Prior to irradiation, the photocatalyst powder was added to the samples, and solutions were bubbled with air (50 L/hour), in the dark, for 30 min. Dopant type, pH, structure and initial pollutant concentration influence on the degradation efficiency were evaluated in order to set up the optimal working conditions which assure substrate advanced degradation. The kinetics of nitroaromatics degradation and organic nitrogen mineralization was assessed and pseudo-first order rate constants were calculated. Fe doped photocatalyst with lowest metal content (0.5 wt.%) showed a considerable better behaviour in respect to pollutant degradation than Co and Ni (1wt.%) doped titania catalysts. For the same working conditions, degradation efficiency was higher for DNT than DNB in accordance with their calculated adsobance constants (Kad), taking into account that degradation process occurs on catalyst surface following a Langmuir-Hinshalwood model. The presence of methyl group in the structure of DNT allows its degradation by oxidative and reductive pathways, while DNB is converted only by reductive route, which also explain the highest DNT degradation efficiency. For highest pollutant concentration tested (3 x 10-4 M), optimum working conditions (0.5 wt.% Fe doped –TiO2 loading of 200 mg/L, pH=7 and 240 min. irradiation time) assures advanced nitroaromatics degradation (ηDNB=89%, ηDNT=94%) and organic nitrogen mineralization (ηDNB=44%, ηDNT=47%).Keywords: hazardous organic compounds, irradiation, nitroaromatics, photocatalysis
Procedia PDF Downloads 3176417 The Role of Leadership in Enhancing Health Information Systems to Improve Patient Outcomes in China
Authors: Nisar Ahmad, Xuyi, Ali Akbar
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As healthcare systems worldwide strive for improvement, the integration of advanced health information systems (HIS) has emerged as a pivotal strategy. This study aims to investigate the critical role of leadership in the implementation and enhancement of HIS in Chinese hospitals and how such leadership can drive improvements in patient outcomes and overall healthcare satisfaction. We propose a comprehensive study to be conducted across various hospitals in China, targeting healthcare professionals as the primary population. The research will leverage established theories of transformational leadership and technology acceptance to underpin the analysis. In our approach, data will be meticulously gathered through surveys and interviews, focusing on the experiences and perceptions of healthcare professionals regarding HIS implementation and its impact on patient care. The study will utilize SPSS and SmartPLS software for robust data analysis, ensuring precise and comprehensive insights into the correlation between leadership effectiveness and HIS success. We hypothesize that strong, visionary leadership is essential for the successful adoption and optimization of HIS, leading to enhanced patient outcomes and increased satisfaction with healthcare services. By applying advanced statistical methods, we aim to identify key leadership traits and practices that significantly contribute to these improvements. Our research will provide actionable insights for policymakers and healthcare administrators in China, offering evidence-based recommendations to foster leadership that champions HIS and drives continuous improvement in healthcare delivery. This study will contribute to the global discourse on health information systems, emphasizing the future role of leadership in transforming healthcare environments and outcomes.Keywords: health information systems, leadership, patient outcomes, healthcare satisfaction
Procedia PDF Downloads 356416 Standard Protocol Selection for Acquisition of Breast Thermogram in Perspective of Early Breast Cancer Detection
Authors: Mrinal Kanti Bhowmik, Usha Rani Gogoi Jr., Anjan Kumar Ghosh, Debotosh Bhattacharjee
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In the last few decades, breast thermography has achieved an average sensitivity and specificity of 90% for breast tumor detection. Breast thermography is a non-invasive, cost-effective, painless and radiation-free breast imaging modality which makes a significant contribution to the evaluation and diagnosis of patients, suspected of having breast cancer. An abnormal breast thermogram may indicate significant biological risk for the existence or the development of breast tumors. Breast thermography can detect a breast tumor, when the tumor is in its early stage or when the tumor is in a dense breast. The infrared breast thermography is very sensitive to environmental changes for which acquisition of breast thermography should be performed under strictly controlled conditions by undergoing some standard protocols. Several factors like air, temperature, humidity, etc. are there to be considered for characterizing thermal images as an imperative tool for detecting breast cancer. A detailed study of various breast thermogram acquisition protocols adopted by different researchers in their research work is provided here in this paper. After going through a rigorous study of different breast thermogram acquisition protocols, a new standard breast thermography acquisition setup is proposed here in this paper for proper and accurate capturing of the breast thermograms. The proposed breast thermogram acquisition setup is being built in the Radiology Department, Agartala Government Medical College (AGMC), Govt. of Tripura, Tripura, India. The breast thermograms are captured using FLIR T650sc thermal camera with the thermal sensitivity of 20 mK at 30 degree C. The paper is an attempt to highlight the importance of different critical parameters of breast thermography like different thermography views, patient preparation protocols, acquisition room requirements, acquisition system requirements, etc. This paper makes an important contribution by providing a detailed survey and a new efficient approach on breast thermogram capturing.Keywords: acquisition protocol, breast cancer, breast thermography, infrared thermography
Procedia PDF Downloads 3976415 Wind Wave Modeling Using MIKE 21 SW Spectral Model
Authors: Pouya Molana, Zeinab Alimohammadi
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Determining wind wave characteristics is essential for implementing projects related to Coastal and Marine engineering such as designing coastal and marine structures, estimating sediment transport rates and coastal erosion rates in order to predict significant wave height (H_s), this study applies the third generation spectral wave model, Mike 21 SW, along with CEM model. For SW model calibration and verification, two data sets of meteorology and wave spectroscopy are used. The model was exposed to time-varying wind power and the results showed that difference ratio mean, standard deviation of difference ratio and correlation coefficient in SW model for H_s parameter are 1.102, 0.279 and 0.983, respectively. Whereas, the difference ratio mean, standard deviation and correlation coefficient in The Choice Experiment Method (CEM) for the same parameter are 0.869, 1.317 and 0.8359, respectively. Comparing these expected results it is revealed that the Choice Experiment Method CEM has more errors in comparison to MIKE 21 SW third generation spectral wave model and higher correlation coefficient does not necessarily mean higher accuracy.Keywords: MIKE 21 SW, CEM method, significant wave height, difference ratio
Procedia PDF Downloads 4026414 The Effect of Solid Wastes Disposal at Amokpala Dump Site in Orumba North Local Government Area, Anambra State
Authors: Nwanneka Mmonwuba
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Solid waste disposal to the environment was investigated by analyzing the quality characteristics of waste, air quality, and heavy metal concentration in the soil. The characteristics of waste were analyzed by enumerating the number of houses, hostels, hotels, markets, schools, and industries with the type of waste being discharged or deposited into the dump site. The percentage of waste was estimated with organic ranking first for both wet and dry seasons, 54% and 44%, respectively. The ambient air quality was analyzed using the crown gas monitor analyzer. The analysis showed that the mean concentration of NO₂, SO₂, and Co is 0.74, 0.37, and 47.35 ppm for the wet season and 0.47, 0.35, and 37.65 ppm for the dry season, respectively, and do not conform with the USEPA standard. The chemical analysis of the groundwater sample indicates alkalinity ranging from 7.38 to 9.11. the heavy metals concentration in the soil of cadmium, iron, copper, calcium, and potassium with 0.053, 0.722, 0227, 21.3, and 9.019, respectively, obtained from 0.3 m at the subsurface failed to conform to the NRC (2013) standard. Iron consent in the soil can be corrected using ascorbic acid and soda ash. The permanent reduction of effects is to try relocating people who live very close to the dumpsite, or the dumpsite should be sited elsewhere and replaced with a sanitary landfill.Keywords: solid waste, groundwater, disposal, dumpsite
Procedia PDF Downloads 506413 Investigation on the Performance of Biodiesel and Natural Gas-Fuelled Diesel Engines for Shipboard Application
Authors: Kelvin Datonye Bob-Manuel
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The shipping industry has begun to seriously look at ways of reducing fossil fuel consumption so that current reserves can last longer and operate their ships in a more environmentally friendly way. The concept of Green Shipping or Sustainable Shipping with the use of alternative fuels is now becoming an important issue for ship owners, shipping lines and ship builders globally. This paper provides a critical review of the performance of biodiesel and natural gas-fuelled diesel engines for shipboard application. The emission reduction technique included the use of either neat or emulsified rapeseed methyl ester (RME) for pilot ignition and the emission of NOx, CO2 and SOx were measured at engine speed range of 500 - 1500 r/min. The NOx concentrations were compared with the regulated IMO MARPOL73/78, Annex VI, Tiers I, II, III and United States Environmental Protection Agency (US-EPA) standard. All NOx emissions met Tier I and II levels and the EPA standard for the minimum specification of category 1 engines at higher speed but none met the MARPOL Tier III limit which is for designated Emission Control Areas (ECAs). No trace of soot and SOx emission were observed.Keywords: dual-fuel, biodiesel, natural gas, NOx, SOx, MARPOL 73/78 Annex VI. USEPA Tier 3, EURO V &VI
Procedia PDF Downloads 4176412 Physico-Chemical and Heavy Metals Analysis of Contaminated Ndawuse River in North Central of Nigeria
Authors: Abimbola Motunrayo Enitan, Ibironke Titilayo Enitan, John Odiyo
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The study assessed quality of surface water across Ndawuse River Phase 1, District of the Federal Capital Territory (FCT), Abuja, Nigeria based on physico-chemical variables that are linked to agrochemical and eutrophication, as well as heavy metals concentrations. In total, sixteen surface water samples were obtained from five locations along the river. The results were compared with the standard limits set by both World Health Organization and Federal Environmental Protection Agency for drinking water. The results obtained indicated that BOD5, turbidity, 0.014-3.511 mg Fe/L and 0.078-0.14 mg Cr/L were all above the standard limits. The results further showed that the quality of surface water is being significantly affected by human activities around the Ndawuse River which could pose an adverse health risk to several communities that rely on these receiving water bodies primarily as their source of water. Therefore, there is a need for strict enforcement of environmental laws considering the physico-chemical analysis.Keywords: Abuja, heavy metals, human exposure risk, Ndawuse River, Nigeria, surface water
Procedia PDF Downloads 2656411 Evaluation of Nuts as a Source of Selenium in Diet
Authors: Renata Markiewicz-Żukowska, Patryk Nowakowski, Sylwia K. Naliwajko, Jakub M. Bołtryk, Katarzyna Socha, Anna Puścion-Jakubik, Jolanta Soroczyńska, Maria H. Borawska
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Selenium (Se) is an essential element for human health. As an integral part of glutathione peroxidase, it has antioxidant, anti-inflammatory and anticancer activities. Unfortunately, Se dietary intake is often insufficient, especially in regions where the soil is low in Se. Therefore, in search for good sources of Se, the content of this element in food products should be monitored. Food product can be considered as a source of Se when its standard portion covers above 15% of recommended daily allowance. In the case of nuts, 42g is recognized as the standard portion. The aim of this study was to determine the Se content in nuts and to answer the question of whether the studied nuts can be considered as a source of Se in the diet. The material for the study consisted of 10 types of nuts (12 samples of each one): almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, peanuts, pecans, pine nuts, pistachios and walnuts. The nuts were mineralized using microwave technique (Berghof, Germany). The content of Se was determined by atomic absorption spectrometry method with electrothermal atomization in a graphite tube with Zeeman background correction (Hitachi, Japan). The accuracy of the method was verified on certified reference material: Simulated Diet D. The statistical analysis was performed using Statistica v. 13.0 software. Statistical significance was determined at p < 0.05 level. The highest content of Se was found in Brazil nuts (4566.21 ± 3393.9 µg/kg) and the lowest in almonds (36.07 ± 18.8 µg/kg). A standard portion (42g) of almonds, brazil nuts, cashews, hazelnuts, macadamia nuts, peanuts, pecans, pine nuts, pistachios and walnuts covers the recommended daily allowance for Se respectively in: 2, 192, 28, 2, 16, 7, 4, 3, 12, 6%. Brazil nuts, cashews and macadamia nuts can be considered as a good source of Se in diet.Keywords: atomic absorption spectrometry, diet, nuts, selenium
Procedia PDF Downloads 1856410 Designing Form, Meanings, and Relationships for Future Industrial Products. Case Study Observation of PAD
Authors: Elisabetta Cianfanelli, Margherita Tufarelli, Paolo Pupparo
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The dialectical mediation between desires and objects or between mass production and consumption continues to evolve over time. This relationship is influenced both by variable geometries of contexts that are distant from the mere design of product form and by aspects rooted in the very definition of industrial design. In particular, the overcoming of macro-areas of innovation in the technological, social, cultural, formal, and morphological spheres, supported by recent theories in critical and speculative design, seems to be moving further and further away from the design of the formal dimension of advanced products. The articulated fabric of theories and practices that feed the definition of “hyperobjects”, and no longer objects describes a common tension in all areas of design and production of industrial products. The latter are increasingly detached from the design of the form and meaning of the same in mass productions, thus losing the quality of products capable of social transformation. For years we have been living in a transformative moment as regards the design process in the definition of the industrial product. We are faced with a dichotomy in which there is, on the one hand, a reactionary aversion to the new techniques of industrial production and, on the other hand, a sterile adoption of the techniques of mass production that we can now consider traditional. This ambiguity becomes even more evident when we talk about industrial products, and we realize that we are moving further and further away from the concepts of "form" as a synthesis of a design thought aimed at the aesthetic-emotional component as well as the functional one. The design of forms and their contents, as statutes of social acts, allows us to investigate the tension on mass production that crosses seasons, trends, technicalities, and sterile determinisms. The design culture has always determined the formal qualities of objects as a sum of aesthetic characteristics functional and structural relationships that define a product as a coherent unit. The contribution proposes a reflection and a series of practical experiences of research on the form of advanced products. This form is understood as a kaleidoscope of relationships through the search for an identity, the desire for democratization, and between these two, the exploration of the aesthetic factor. The study of form also corresponds to the study of production processes, technological innovations, the definition of standards, distribution, advertising, the vicissitudes of taste and lifestyles. Specifically, we will investigate how the genesis of new forms for new meanings introduces a change in the relative innovative production techniques. It becomes, therefore, fundamental to investigate, through the reflections and the case studies exposed inside the contribution, also the new techniques of production and elaboration of the forms of the products, as new immanent and determining element inside the planning process.Keywords: industrial design, product advanced design, mass productions, new meanings
Procedia PDF Downloads 1226409 The Procedural Sedation Checklist Manifesto, Emergency Department, Jersey General Hospital
Authors: Jerome Dalphinis, Vishal Patel
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The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.Keywords: advanced airway skills, checklist, procedural sedation, resuscitation
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