Search results for: medical safety

Authors: Bărbuță Alina

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The inter-causal relationship between social inequalities and the digital divide raises the relation issue of gender and information and communication technologies (ICT) - a key element in achieving sustainable development. In preparing generations as future digital citizens and for active socio-economic participation, ICT plays a key role in respecting gender equality. Although several studies over the years have shown that gender plays an important role in digital exclusion, in recent years, many studies with a focus on economically developed or developing countries identify an improvement in these aspects and a gap narrowing. By measuring students' digital competencies level, this paper aims to identify and analyse the existing gender digital inequalities among students. Our analyses are based on a sample of 1526 middle school students residing in rural areas from Republic of Moldova (54.2% girls, mean age 14,00, SD = 1.02). During the online survey they filled in a questionnaire adapted from the (yDSI) ”The Youth Digital Skills Indicator”. The instrument measures the level of five digital competence areas indicated in The European Digital Competence Framework (DigiCom 2.3.). Our results, based on t-test, indicate that depending on gender, there are no statistically significant differences regarding the levels of digital skills in 3 areas: Information navigation and processing; Communication and interaction; Problem solving. However, were identified significant differences in the level of digital skills in the area of ”Digital content creation” [t(1425) = 4.20, p = .000] and ”Safety” [t(1421) = 2.49, p = .000], with higher scores recorded by girls. Our results contradicts the general stereotype regarding the low level of digital competence among girls, in our sample girls scores being on pear with boys and even bigger in knowledge related to digital content creation and online safety skills. Additional investigations related to boys competence on digital safety are necessary as the implication of their low scores on this dimension may suggest boys exposure to digital threats.

Keywords: digital divide, education, gender digital divide, digital literacy, remote learning

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Authors: Aboubakr Gambo, Adama Diaw, Tobias Wunscher

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This study attempts to identify factors affecting rural households’ resilience to food insecurity in Niger. For this, we first create a resilience index by using Principal Component Analysis on the following five variables at the household level: income, food expenditure, duration of grain held in stock, livestock in Tropical Livestock Units and number of farms exploited and second apply Structural Equation Modelling to identify the determinants. Data from the 2010 National Survey on Households’ Vulnerability to Food Insecurity done by the National Institute of Statistics is used. The study shows that asset and social safety nets indicators are significant and have a positive impact on households’ resilience. Climate change approximated by long-term mean rainfall has a negative and significant effect on households’ resilience to food insecurity. The results indicate that to strengthen households’ resilience to food insecurity, there is a need to increase assistance to households through social safety nets and to help them gather more resources in order to acquire more assets. Furthermore, early warning of climatic events could alert households especially farmers to be prepared and avoid important losses that they experience anytime an uneven climatic event occur.

Keywords: food insecurity, principal component analysis, structural equation modelling, resilience

Procedia PDF Downloads 344

Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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Authors: Hana Rabbouch

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In recent years, there has been considerable growth of denoising techniques mainly devoted to medical imaging. This important evolution is not only due to the progress of computing techniques, but also to the emergence of multi-resolution analysis (MRA) on both mathematical and algorithmic bases. In this paper, a comparative study is conducted between the two best-known MRA-based decomposition techniques: the Empirical Mode Decomposition (EMD) and the Discrete Wavelet Transform (DWT). The comparison is carried out in a framework of multi-scale denoising, where a Non-Local Means (NLM) filter is performed scale-by-scale to a sample of benchmark medical images. The results prove the effectiveness of the multiscaled denoising, especially when the NLM filtering is coupled with the EMD.

Keywords: medical imaging, non local means, denoising, multiscaled analysis, empirical mode decomposition, wavelets

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Authors: Ibtihal D. Mustafa, Mawia A. Hassan

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Tumor segmentation from MRI image is important part of medical images experts. This is particularly a challenging task because of the high assorting appearance of tumor tissue among different patients. MRI images are advance of medical imaging because it is give richer information about human soft tissue. There are different segmentation techniques to detect MRI brain tumor. In this paper, different procedure segmentation methods are used to segment brain tumors and compare the result of segmentations by using correlation and structural similarity index (SSIM) to analysis and see the best technique that could be applied to MRI image.

Keywords: MRI, segmentation, correlation, structural similarity

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Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang

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Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.

Keywords: acute hepatitis, medical resource cost, artificial neural network, support vector regression

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Authors: Mohammed Bakhit Kashoob, Mohammed Salim Al-Maashani, Ahmed Abdullah Al-Marhoon

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The use of Geographic Information System (GIS) tools in the analysis of traffic crash data can help to identify locations or hotspots with high instances or risk of traffic crashes. The identification of traffic crash hotspots can effectively improve road safety measures. Mapping of road traffic crash hotspots can help the concerned authorities to give priority and take targeted measures and improvements to the road structure at these locations to reduce traffic crashes and fatalities. In Oman, there are countless rural roads that have more risks for traveling vehicles compared to urban roads. The likelihood of traffic crashes as well as fatality rate may increase with the presence of risks that are associated with the rural type of community. In this paper, the traffic crash hotspots on rural roads in Oman are specified using spatial analysis methods in GIS and traffic crash data. These hotspots are ranked based on the frequency of traffic crash occurrence (i.e., number of traffic crashes) and the rate of fatalities. The result of this study presents a map visualization of locations on rural roads with high traffic crashes and high fatalities rates.

Keywords: road safety, rural roads, traffic crash, GIS tools

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Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

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Authors: Yan-Lin Liu, Cheng-Ting Shih, Jay Wu

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Tablet devices have been introduced into the medical environment in recent years. The performance of display can be varied based on the use of different hardware specifications and types of display technologies. Therefore, the differences between tablet devices and medical diagnostic LCDs have to be verified to ensure that image quality is not jeopardized for clinical diagnosis in a picture archiving and communication system (PACS). In this study, a set of randomized object test patterns (ROTPs) were developed, which included randomly located spheres in abdominal CT images. Five radiologists were asked to independently review the CT images on different generations of iPads and a diagnostic monochrome medical LCD monitor. Receiver operating characteristic (ROC) analysis was performed by using a five-point rating scale, and the average area under curve (AUC) and average reading time (ART) were calculated. The AUC values for the second generation iPad, iPad mini, iPad Air, and monochrome medical monitor were 0.712, 0.717, 0.725, and 0.740, respectively. The differences between iPads were not significant. The ARTs were 177 min and 127 min for iPad mini and medical LCD monitor, respectively. A significant difference appeared (p = 0.04). The results show that the iPads were slightly inferior to the monochrome medical LCD monitor. However, tablet devices possess advantages in portability and versatility, which can improve the convenience of rapid diagnosis and teleradiology. With advances in display technology, the applicability of tablet devices and mobile devices may be more diversified in PACS.

Keywords: tablet devices, PACS, receiver operating characteristic, LCD monitor

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Authors: Yousef Almutairi, Yajue Wu

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Various large-scale trends have characterized the current century thus far, including increasing shifts towards urbanization and greater movement. It is predicted that there will be 9.3 billion people on Earth in 2050 and that over two-thirds of this population will be city dwellers. Moreover, in larger cities worldwide, mass transportation systems, including underground systems, have grown to account for the majority of travel in those settings. Underground networks are vulnerable to fires, however, endangering travellers’ safety, with various examples of fire outbreaks in this setting. This study aims to increase knowledge of the impacts of extreme climatic conditions on fires, including the role of the high ambient temperatures experienced in Middle Eastern countries and specifically in Saudi Arabia. This is an element that is not always included when assessments of fire safety are made (considering visibility, temperatures, and flows of smoke). This paper focuses on a tunnel within Riyadh’s underground system as a case study and includes simulations based on computational fluid dynamics using ANSYS Fluent, which investigates the impact of various ventilation systems while identifying smoke density, speed, pressure and temperatures within this tunnel.

Keywords: fire, subway tunnel, CFD, mechanical ventilation, smoke, temperature, harsh weather

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Authors: Wan Shan Chiang, Charn Ting Wang, Wei-Chih Kan, Hui-Chen Huang

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Dialysis patients have risk in Zoster virus because of low immune. Valacyclovir (product name: Valtex) 500mg/tab, an anti-zoster virus medicine, is digested in kidney and it has side-effect of nervous system in patients with malfunction kidneys. Although the clinical basis of the proposed administration, we found that patients still have side effects. So we want to explore the appropriate dose of peritoneal dialysis patients. We read small samples of case reports and analyze 8 cases in our hospital, some patients’ Kt/v, match the standard of dialysis, and still go to the toilet, they still have side effect seriously with 500mg portion. The solution to this includes stopping medicine, reduction of medicine, increase of liquid change and timely hemodialysis and all of them speed up the recovery. The safety of medication needs extra attention of medical care employee. If they can tell the doctor if the patient has urine or not in his or her Kt/v, the doctor can prescribe the medicine accordingly. About the limitation, due to the lack of cases and related pharmacokinetics numbers. Therefore, for peritoneal patients, we think 500mg/48hoursis the saves. We also want to remind pharmaceuticals to revise the portion taken by patients, so that the doctor may judge the use.

Keywords: herpes zoster, Valacyclovir, peritoneal dialysis, health education

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Authors: Rami Faraj, Cezary Graczykowski, Błażej Popławski, Grzegorz Mikułowski, Rafał Wiszowaty

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Progress in the field of sensors, electronics and computing results in more and more often applications of adaptive techniques for dynamic response mitigation. When it comes to systems excited with mechanical impacts, the control system has to take into account the significant limitations of actuators responsible for system adaptation. The paper provides a comprehensive discussion of the problem of appropriate design and implementation of adaptation techniques and mechanisms. Two case studies are presented in order to compare completely different adaptation schemes. The first example concerns a double-chamber pneumatic shock absorber with a fast piezo-electric valve and parameters corresponding to the suspension of a small unmanned aerial vehicle, whereas the second considered system is a safety air cushion applied for evacuation of people from heights during a fire. For both systems, it is possible to ensure adaptive performance, but a realization of the system’s adaptation is completely different. The reason for this is technical limitations corresponding to specific types of shock-absorbing devices and their parameters. Impact mitigation using a pneumatic shock absorber corresponds to much higher pressures and small mass flow rates, which can be achieved with minimal change of valve opening. In turn, mass flow rates in safety air cushions relate to gas release areas counted in thousands of sq. cm. Because of these facts, both shock-absorbing systems are controlled based on completely different approaches. Pneumatic shock-absorber takes advantage of real-time control with valve opening recalculated at least every millisecond. In contrast, safety air cushion is controlled using the semi-passive technique, where adaptation is provided using prediction of the entire impact mitigation process. Similarities of both approaches, including applied models, algorithms and equipment, are discussed. The entire study is supported by numerical simulations and experimental tests, which prove the effectiveness of both adaptive impact mitigation techniques.

Keywords: adaptive control, adaptive system, impact mitigation, pneumatic system, shock-absorber

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Authors: Davaanyam Surenjav, Chinzolboo Dandarbaatar, Ganbold Batkhuyag

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Primate city induced rapid urbanization has been become one of the main challenges in sustainable development in Mongolia like other developing countries since transition to market economy in 1990. According due to statistical yearbook, population number of Ulaanbaatar city has increased from 0.5 million to 1.5 million for last 30 years and contains now almost half (47%) of total Mongolian population. Rural-Ulaanbaatar and local Cities-Ulaanbaatar city migration leads to social issues like uncontrolled urbanization, income inequality, poverty, overwork of public service, economic over cost for redevelopment and limitation of transport and environmental degradation including air, noise, water and soil pollution. Most thresholds of all of the sustainable urban development main and sub-indicators over exceeded from safety level to unsafety level in Ulaanbaatar. So, there is an urgent need to remove migration pull factors including some administrative and high education functions from Ulaanbaatar city to its satellite cities or secondary cities. Moreover, urban smart transport system and green and renewable energy technologies should be introduced to urban development master plan of Ulaanbaatar city.

Keywords: challenge for sustainable urban development, migration factors, primate city , urban safety thresholds

Procedia PDF Downloads 114

Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

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Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

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Authors: Wisit Wichitkosoom

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Objectives: To find out the more effect of early cardiologist consultation using a simple technology on the diagnosis and early proper management of patients with Non-STEMI at emergency department of district hospitals without cardiologist on site before transferred. Methods: A cohort study was performed in Udonthani general hospital at Udonthani province. From 1 October 2012–30 September 2013 with 892 patients diagnosed with Non-STEMI. All patients mean aged 46.8 years of age who had been transferred because of Non-STEMI diagnosed, over a 12 week period of studied. Patients whose transferred, in addition to receiving proper care, were offered a cardiologist consultation with average time to Udonthani hospital 1.5 hour. The main outcome measure was length of hospital stay, mortality at 3 months, inpatient investigation, and transfer rate to the higher facilitated hospital were also studied. Results: Hospital stay was significantly shorter for those didn’t consult cardiologist (hazard ratio 1.19; approximate 95% CI 1.001 to 1.251; p = 0.039). The 136 cases were transferred to higher facilitated hospital. No statistically significant in overall mortality between the groups (p=0.068). Conclusions: Early cardiologist consultant can reduce length of hospital stay for patients with cardiovascular conditions outside of cardiac center. The new basic technology can apply for the safety patient.

Keywords: critical, telemedicine, safety, non STEMI

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Authors: Siti Hikmah Musthar, Ahmad Saifizul, Mohamed Rehan Karim, Jamilah Mohamad, Farah Fazlinda Mohamad

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This paper aims to look at the situation of close following behaviour from the introductory phase before conducting a profound investigation and discussion on this subject. Close following behaviour is known as behaviour during when drivers follow front vehicle with headways lower than two-second. As such, the study of close-following is important due to the degree of negative consequences this behaviour can cause commonly identified as rear-end collision especially when road safety is concerned. This paper presents a preliminary results of close-following behaviour among selected respondents (n=515) in Peninsular Malaysia at selected highways and federal roads. Respondents were interviewed with survey questions tending to examine their actual driving behaviour related to close-following and their perception towards the subject of close following. Selected findings (four selected questions) are discussed in this paper of which identified as essential for deliberation (as opposed to other questions in the survey questionnaire) as far as a preliminary discussion is concerned. Through the statistical test of one-way ANOVA, study found that gender of drivers is not significant to influence drivers to close follow but instead, type of vehicle the respondent drives had more significant to influence drivers to have tendency to perform close following behaviour.

Keywords: close-following, driver behaviour, rear-end crash, road safety

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Authors: Sarah Nasr, Maha M. A. Nasra, Ossama Y. Abdallah

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The present work aimed to prepare Silymarin loaded MCM-41 type mesoporous silica nanoparticles (MSNs) and to assess the system’s solubility enhancement ability on the pharmacodynamic performance of Silymarin as a hepatoprotective agent. MSNs prepared by soft-templating technique, were loaded with Silymarin, characterized for particle size, zeta potential, surface properties, DSC and XRPD. DSC and specific surface area data confirmed deposition of Silymarin in an amorphous state in MSNs’ pores. In-vitro drug dissolution testing displayed enhanced dissolution rate of Silymarin upon loading on MSNs. High dose Acetaminophen was then used to inflict hepatic injury upon albino male Wistar rats simultaneously receiving either free Silymarin, Silymarin loaded MSNs or blank MSNs. Plasma AST, ALT, albumin and total protein and liver homogenate content of TBARs or LDH as measures of antioxidant drug action were assessed for all animal groups. Results showed a significant superiority of Silymarin loaded MSNs to free drug in almost all parameters. Meanwhile prolonged administration of blank MSNs had no evident toxicity on rats.

Keywords: mesoporous silica nanoparticles, safety, solubility enhancement, silymarin

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Authors: Minho Kwon, Jeonghee Lim, Yeongseok Jeong, Donghoon Shin, Kiyoung Kim

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Recently, global warming phenomenon has led to natural disasters caused by global environmental changes, and due to abnormal weather events, the frequency and intensity of heavy rain storm typhoons are increasing. Therefore, it is imperative to prepare for future heavy rain storms and typhoons. This study selects arbitrary target bridges and performs numerical analysis to evaluate the safety of bridge piers in the event that the water level changes. The numerical model is based on two-dimensional surface elements. Actual reinforced concrete was simulated by modeling concrete to include reinforcements, and a contact boundary model was applied between the ground and the concrete. The water level applied to the piers was considered at 18 levels between 7.5 m and 16.1 m. The elastic modulus, compressive strength, tensile strength, and yield strength of the reinforced concrete were calculated using 250 random combinations and numerical analysis was carried out for each water level. In the results of analysis, the bridge exceeded the stated limit at 15.0 m. At the maximum water level of 16.1m, the concrete’s failure rate was 35.2%, but the probability that the reinforcement would fail was 61.2%.

Keywords: Monte-Carlo method, pier, water level change, limit state

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Authors: Muhammad Umar

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Safety and Assets management is considering a backbone of every department. GIS in the Railway become very important to Manage Assets and Security through Digital Maps and Web based GIS Maps. It provides a complete frame of work to the organization for the management of assets. Pakistan Railway is the most common and safest mode of traveling in Pakistan. Due to ever-increasing demand of transporting huge amount of information generated from various sources and this information must be accurate. This creates problems for Passengers and Administration that causes finical and time loss. GIS Solve this problem by Digital Maps & Database. It provides you a real time Spatial and Statistical analysis that helps you to communicate and exchange the information in a sophisticated way to the users. GIS Based Web system provides a facility to different end user to make query at a time as per requirements. This GIS System provides an advancement in an organization for a complete Monitoring, Safety and Decision System for tracks, Stations and Junctions that further use for the Analysis of different areas i.e. analysis of tracks, junctions and Stations in case of reconstruction, Rescue for rail accidents and Natural disasters .This Research work helps to reduce the financial loss and reduce human mistakes helps you provide a complete security and Management system of assets.

Keywords: Geographical Information System (GIS) for assets management, geo spatial database, railway assets management, Pakistan

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Authors: Chul Park, Youngseok Kim, Sangsik Choi

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This study developed an electric jig for underwater structure inspection in order to solve the problem of the application of side scan sonar to underwater inspection, and analyzed correlations of empirical data in order to enhance sonar data resolution. For the application of tow-typed sonar to underwater structure inspection, an electric jig was developed. In fact, it was difficult to inspect a cross-section at the time of inspection with tow-typed equipment. With the development of the electric jig for underwater structure inspection, it was possible to shorten an inspection time over 20%, compared to conventional tow-typed side scan sonar, and to inspect a proper cross-section through accurate angle control. The indoor test conducted to enhance sonar data resolution proved that a water depth, the distance from an underwater structure, and a filming angle influenced a resolution and data quality. Based on the data accumulated through field experience, multiple regression analysis was conducted on correlations between three variables. As a result, the relational equation of sonar operation according to a water depth was drawn.

Keywords: underwater structure, SONAR, safety inspection, resolution

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Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

Procedia PDF Downloads 75

Authors: Aram Yakoby, Yossef H. Hatzor, Shmulik Pinkert

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This work presents an applied engineering method for evaluating the stability of underground openings under conditions of uncertainty. The developed method is demonstrated by a comprehensive parametric study on a case of large-diameter vertical borehole stability analysis, with uncertainties regarding the in-situ stress distribution. To this aim, a safety factor analysis is performed for the stability of both supported and unsupported boreholes. In the analysis, we used analytic geomechanical calculations and advanced numerical modeling to evaluate the estimated stress field. In addition, the work presents the development of a boundary condition for the numerical model that fits the nature of the problem and yields excellent accuracy. The borehole stability analysis is studied in terms of (1) the stress ratio in the vertical and horizontal directions, (2) the mechanical properties and geometry of the support system, and (3) the parametric sensitivity. The method's results are studied in light of a real case study of an underground waste disposal site. The conclusions of this study focus on the developed method for capturing the parametric uncertainty, the definition of critical geological depths, the criteria for implementing structural support, and the effectiveness of further in-situ investigations.

Keywords: borehole stability, in-situ stress, parametric study, factor of safety

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Authors: Angely Sim Jia Wun, Sasa Arsovski

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Numerous studies have been conducted on the segmentation of medical images. Segmenting the lungs is one of the common research topics in those studies. Our research stemmed from the lack of solutions for automatic bone, airway, and vessel segmentation, despite the existence of multiple lung segmentation techniques. Consequently, currently, available software tools used for medical image segmentation do not provide automatic lung, bone, airway, and vessel segmentation. This paper presents segmentation techniques along with an interactive software tool architecture for segmenting bone, lung, airway, and vessel tissues. Additionally, we propose a method for creating binary masks from automatically generated segments. The key contribution of our approach is the technique for automatic image thresholding using adjustable Hounsfield values and binary mask extraction. Generated binary masks can be successfully used as a training dataset for deep-learning solutions in medical image segmentation. In this paper, we also examine the current software tools used for medical image segmentation, discuss our approach, and identify its advantages.

Keywords: lung segmentation, binary masks, U-Net, medical software tools

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Authors: Liubov Magerramova, Mikhail Petrov, Vladimir Isakov, Liana Shcherbinina, Suren Gukasyan, Daniil Povalyukhin, Olga Klimova-Korsmik, Darya Volosevich

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Aircraft engines are developing along the path of increasing resource, strength, reliability, and safety. The building of gas turbine engine body parts is a complex design and technological task. Particularly complex in the design and manufacturing are the casings of the input stages of helicopter gearboxes and central drives of aircraft engines. Traditional technologies, such as precision casting or isothermal forging, are characterized by significant limitations in parts production. For parts like housing, additive technologies guarantee spatial freedom and limitless or flexible design. This article presents the results of computational and experimental studies. These investigations justify the applicability of additive technologies (AT) to reduce the weight of aircraft housing gearbox parts by up to 32%. This is possible due to geometrical optimization compared to the classical, less flexible manufacturing methods and as-casted aircraft parts with over-insured values of safety factors. Using an example of the body of the input stage of an aircraft gearbox, visualization of the layer-by-layer manufacturing of a part based on thermal deformation was demonstrated.

Keywords: additive technologies, gas turbine engines, topological optimization, synthesis process

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Authors: Szymon Szemik, Małgorzata Kowalska

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Objective: Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK (POLski LEKarz, eng. Polish Physician) study aims to identify and evaluate the quality of life, mental health status, and ever-recognized chronic diseases by simultaneously assessing their determinants in Polish medical students during long-term observation. Material and Methods: The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2). Results: The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. Obtained results confirmed that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domains. Moreover, we observed a significant increase in self-declared scoring of somatic symptoms year by year (from M=4.75 at T1 to M=8.06 at T2, p<0.001) in the GHQ-28 questionnaire survey. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the first year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in meat consumption. Conclusions: The QoL in medical students and selected determinants of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.

Keywords: quality of life, mental health, medical students, follow-up study

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Authors: Mohammad Tahir Yousafzai, Nighat Nisar, Rehana Khalil

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The aim of this study is to assess the practices of sharp injuries and factors leading to it among medical practitioners in slum areas of Karachi, Pakistan. A cross sectional study was conducted in slum areas of Landhi Town Karachi. All medical practitioners (317) running the private clinics in the areas were asked to participate in the study. Data was collected on self administered pre-tested structured questionnaires. The frequency with percentage and 95% confidence interval was calculated for at least one sharp injury (SI) in the last one year. The factors leading to sharp injuries were assessed using multiple logistic regressions. About 80% of private medical practitioners consented to participate. Among these 87% were males and 13% were female. The mean age was 38±11 years and mean work experience was 12±9 years. The frequency of at least one sharp injury in the last one year was 27%(95% CI: 22.2-32). Almost 47% of Sharp Injuries were caused by needle recapping, less work experience, less than 14 years of schooling, more than 20 patients per day, administering more than 30 injections per day, reuse of syringes and needle recapping after use were significantly associated with sharp injuries. Injection practices were found inadequate among private medical practitioners in slum areas of Karachi, and the frequency of Sharp Injuries was found high in these areas. There is a risk of occupational transmission of blood borne infections among medical practitioners warranting an urgent need for launching awareness and training on standard precautions for private medical practitioners in the slum areas of Karachi.

Keywords: injection practices, private practitioners, sharp injuries, blood borne infections

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Authors: Alexandra Shipley

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Background: Undergraduate paediatric teaching must overcome two major challenges: 1) balancing patient safety with active student engagement and 2) exposing students to a comprehensive range of pathologies within a relatively short clinical placement. Whilst lectures and shadowing on paediatric wards constitute the mainstay of learning, Simulation and Virtual Reality (VR) are emerging as effective teaching tools, which - immune to the unpredictability and seasonal variation of hospital presentations - could expose students to the entire syllabus more reliably, efficiently, and independently. We aim to evaluate the potential utility of Simulation and VR in addressing gaps within the traditional paediatric curriculum from the perspective of medical students. Summary of Work: Exposure to and perceived utility of various learning opportunities within the Paediatric and Emergency Medicine courses were assessed through a questionnaire completed by 5th year medical students (n=23). Summary of Results: Students reported limited exposure to several common acute paediatric presentations, such as bronchiolitis (41%), croup (32%) or pneumonia (14%), and to clinical emergencies, including cardiac/respiratory arrests or trauma calls (27%). Across all conditions, average self-reported confidence in assessment and management to the level expected of an FY1 is greater amongst those who observed at least one case (e.g. 7.6/10 compared with 3.6/10 for croup). Students rated exposure through Simulation or VR to be of similar utility to witnessing a clinical scenario on the ward. In free text responses, students unanimously favoured being ‘challenged’ through ‘hands-on’ patient interaction over passive shadowing, where it is ‘easy to zone out.’ In recognition of the fact that such independence is only appropriate in certain clinical situations, many students reported wanting more Simulation and VR teaching. Importantly, students raised the necessity of ‘proper debriefs’ after these sessions to maximise educational value. Discussion and Conclusion: Our questionnaire elicited several student-perceived challenges in paediatric education, including incomplete exposure to common pathologies and limited opportunities for active involvement in patient care. Indeed, these experiences seem to be important predictors of confidence. Quantitative and qualitative feedback suggests that VR and Simulation satisfy students’ self-reported appetite for independent engagement with authentic clinical scenarios. Take-aways: Our findings endorse further development of VR and Simulation as high-yield adjuncts to paediatric education.

Keywords: paediatric emergency education, simulation, virtual reality, medical education

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Authors: Ankita Jadon, Sidi Souvi, Nathalie Girault, Denis Petitprez

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Safety requirements for Generation IV nuclear reactor designs, especially the new generation sodium-cooled fast reactors (SFR) require a risk-informed approach to model severe accidents (SA) and their consequences in case of outside release. In SFRs, aerosols are produced during a core disruptive accident when primary system sodium is ejected into the containment and burn in contact with the air; producing sodium aerosols. One of the key aspects of safety evaluation is the in-containment sodium aerosol behavior and their interaction with fission products. The study of the effects of sodium fires is essential for safety evaluation as the fire can both thermally damage the containment vessel and cause an overpressurization risk. Besides, during the fire, airborne fission product first dissolved in the primary sodium can be aerosolized or, as it can be the case for fission products, released under the gaseous form. The objective of this work is to study the interactions between sodium aerosols and fission products (Iodine, toxic and volatile, being the primary concern). Sodium fires resulting from an SA would produce aerosols consisting of sodium peroxides, hydroxides, carbonates, and bicarbonates. In addition to being toxic (in oxide form), this aerosol will then become radioactive. If such aerosols are leaked into the environment, they can pose a danger to the ecosystem. Depending on the chemical affinity of these chemical forms with fission products, the radiological consequences of an SA leading to containment leak tightness loss will also be affected. This work is split into two phases. Firstly, a method to theoretically understand the kinetics and thermodynamics of the heterogeneous reaction between sodium aerosols and fission products: I2 and HI are proposed. Ab-initio, density functional theory (DFT) calculations using Vienna ab-initio simulation package are carried out to develop an understanding of the surfaces of sodium carbonate (Na2CO3) aerosols and hence provide insight on its affinity towards iodine species. A comprehensive study of I2 and HI adsorption, as well as bicarbonate formation on the calculated lowest energy surface of Na2CO3, was performed which provided adsorption energies and description of the optimized configuration of adsorbate on the stable surface. Secondly, the heterogeneous reaction between (I2)g and Na2CO3 aerosols were investigated experimentally. To study this, (I2)g was generated by heating a permeation tube containing solid I2, and, passing it through a reaction chamber containing Na2CO3 aerosol deposit. The concentration of iodine was then measured at the exit of the reaction chamber. Preliminary observations indicate that there is an effective uptake of (I2)g on Na2CO3 surface, as suggested by our theoretical chemistry calculations. This work is the first step in addressing the gaps in knowledge of in-containment and atmospheric source term which are essential aspects of safety evaluation of SFR SA. In particular, this study is aimed to determine and characterize the radiological and chemical source term. These results will then provide useful insights for the developments of new models to be implemented in integrated computer simulation tool to analyze and evaluate SFR safety designs.

Keywords: iodine adsorption, sodium aerosols, sodium cooled reactor, DFT calculations, sodium carbonate

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Authors: Athicha Cherdpunt, Patompong Satapornpong

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The medical cannabis is made up of components also known as cannabinoids, which consists of two ingredients which are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Interestingly, the Cannabinoid can be used for many treatments such as chemotherapy, including nausea and vomiting, cachexia, anorexia nervosa, spinal cord injury and disease, epilepsy, pain, and many others. However, the adverse drug reactions (ADRs) of THC can cause sedation, anxiety, dizziness, appetite stimulation and impairments in driving and cognitive function. Furthermore, genetic polymorphisms of CYP2C9, CYP2C19 and CYP3A4 influenced the THC metabolism and might be a cause of ADRs. Particularly, CYP2C19*17 allele increases gene transcription and therefore results in ultra-rapid metabolizer phenotype (UM). The aim of this study, is to investigate the frequency of CYP2C19*17 alleles in Thai patients who have been treated with medical cannabis. We prospectively enrolled 60 Thai patients who were treated with medical cannabis and clinical data from College of Pharmacy, Rangsit University. DNA of each patient was isolated from EDTA blood, using the Genomic DNA Mini Kit. CYP2C19*17 genotyping was conducted using the real time-PCR ViiA7 (ABI, Foster City, CA, USA). 30 patients with medical cannabis-induced ADRs group, 20 (67%) were female, and 10 (33%) were male, with an age range of 30-69 years. On the other hand, 30 patients without medical cannabis-induced ADRs (control group) consist of 17 (57%) female and 13 (43%) male. The most ADRs for medical cannabis treatment in the case group were dry mouth and dry throat (77%), tachycardia (70%), nausea (30%) and arrhythmia(10%). Accordingly, the case group carried CYP2C19*1/*1 (normal metabolizer) approximately 93%, while 7% patients carrying CYP2C19*1/*17 (ultra rapid metabolizers) exhibited in this group. Meanwhile, we found 90% of CYP2C19*1/*1 and 10% of CYP2C19*1/*17 in control group. In this study, we identified the frequency of CYP2C19*17 allele in Thai population which will support the pharmacogenetics biomarkers for screening and avoid ADRs of medical cannabis treatment.

Keywords: CYP2C19, allele frequency, ultra rapid metabolizer, medical cannabis

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Authors: Homa Parmoon, Narges Hamzeh

Abstract:

Since today's urban spaces are disposed towards behavioral disorders and lack of security, both qualitative and quantitative aspects of security especially social and physical security are considered as basic necessities in urban planning. This research focused on the variable of place of living, examined social security in the old and new textures, and investigated the amount of residents’ social security in Shiraz including safety, financial, emotional and moral security. To this end, two neighborhoods in region 1 of Shiraz- Qasr-Al-Dasht (old texture) and Moalem (new texture)- were examined through a comparative study of 60 samples lived in two neighborhoods. Data were gathered through two-way ANOVA between the variables of residential context and internal and external security. This analysis represents the significance or insignificance of the model as well as the individual effects of each independent variable on the dependent variable. It was tested by ANCOVA and F-test. Research findings indicated place of living has a significant effect on families’ social security. The safety, financial, emotional, and moral security also represented a great impact on social security. As a result, it can be concluded that social security changes with the changing in place of living.

Keywords: social security, damaged area, two-way ANOVA, Shiraz

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