Search results for: wireless patient monitoring

Authors: Varsha Kheradiya, Ganga Prasad Pandey

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The use of wearable antennas is rising because wireless devices become small. The wearable antenna is part of clothes used in communication applications, including energy harvesting, medical application, navigation, and tracking. In current years, Antennas embroidered on clothes, conducting antennas based on fabric, polymer embedded antennas, and inkjet-printed antennas are all attractive ways. Also shows the analysis required for wearable antennas, such as wearable antennae interacting with the human body. The primary requirements for the antenna are small size, low profile minimizing radiation absorption by the human body, high efficiency, structural integrity to survive worst situations, and good gain. Therefore, research in energy harvesting, biomedicine, and military application design is increasingly favoring flexible wearable antennas. Textile materials that are effectively used for designing and developing wearable antennas for body area networks. The wireless body area network is primarily concerned with creating effective antenna systems. The antenna should reduce their size, be lightweight, and be adaptable when integrated into clothes. When antennas integrate into clothes, it provides a convenient alternative to those fabricated using rigid substrates. This paper presents a study of U slot loaded wearable textile antenna. U slot patch antenna design is illustrated for wideband from 1GHz to 6 GHz using textile material jeans as substrate and pure copper polyester taffeta fabric as conducting material. This antenna design exhibits dual band results for WLAN at 2.4 GHz and 3.6 GHz frequencies. Also, study U slot position horizontal and vertical shifting. Shifting the horizontal positive X-axis position of the U slot produces the third band at 5.8 GHz.

Keywords: microstrip patch antenna, textile material, U slot wearable antenna, wireless body area network

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Authors: Luz Yoali Alfaro Luna, Angélica Hernández Rayas, Teodoro Córdova Fraga

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This work characterizes and calibrates a fluxgate 539 magnetometer sensor, implementing a real-time monitoring interface to measure magnetic fields with high precision. The objective is to develop an innovative prototype integrating the Fluxgate 539 sensor, a WX-DC2412 power supply, and an Arduino UNO. Methods include interface programming and data conversion to Gauss units. The results show accurate measurements after calibrating the sensor, establishing a foundation for further research in magnetobiology.

Keywords: calibration, fluxgate 539, magnetobiology, magnetic field measurement, monitoring interface, sensor characterization

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Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

Procedia PDF Downloads 115

Authors: Chejarla Raghunathababu, E. Logashanmugam

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An antenna is an assortment of linked devices that function together to transmit and receive radio waves as a single antenna. Antennas occur in a variety of sizes and forms, but the microstrip patch antenna outperforms other types in terms of effectiveness and prediction. These antennas are easy to generate with discreet benefits. Nevertheless, the antenna's effectiveness will be affected because of the patch's shape above a thick dielectric substrate. As a result, a double-pole rectangular microstrip antenna with nanofillers was suggested in this study. By employing nano-composite substances (Fumed Silica and Aluminum Oxide), which are composites of graphene with nanofillers, the physical characteristics of the microstrip antenna, that is, the elevation of the microstrip antenna substrate and the width of the patch microstrip antenna have been improved in this research. The surface conductivity of graphene may be modified to function at specific frequencies. In order to prepare for future wireless communication technologies, a microstrip patch antenna operating at 93 GHz resonant frequency is constructed and investigated. The goal of this study was to reduce VSWR and increase gain. The simulation yielded results for the gain and VSWR, which were 8.26 dBi and 1.01, respectively.

Keywords: graphene, microstrip patch antenna, substrate material, wireless communication, nanocomposite material

Procedia PDF Downloads 111

Authors: G. Massaad, E. Roziere, A. Loukili, L. Izoret

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Based on the monitoring of mass, hydrostatic weighing, and the amount of leached OH- we deduced the nature of leached and precipitated minerals, the amount of lost aggregates and the evolution of porosity and cracking during the sulphate attack. Using these information, we are able to draw the volume / mass changes brought by mineralogical variations and cracking of the cement matrix. Then we defined a new performance indicator, the averaged density, capable to resume along the test of sulphate attack the occurred physicochemical variation occurred in the cementitious matrix and then highlight.

Keywords: monitoring strategy, performance indicator, sulphate attack, mechanism of degradation

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Authors: Pascal Mwenge, Tumisang Seodigeng

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The combination of world population and the third industrial revolution led to high demand for fuels. On the other hand, the decrease of global fossil 8fuels deposits and the environmental air pollution caused by these fuels has compounded the challenges the world faces due to its need for energy. Therefore, new forms of environmentally friendly and renewable fuels such as biodiesel are needed. The primary analytical techniques for methanolysis yield monitoring have been chromatography and spectroscopy, these methods have been proven reliable but are more demanding, costly and do not provide real-time monitoring. In this work, the in situ monitoring of biodiesel from sunflower oil using FTIR (Fourier Transform Infrared) has been studied; the study was performed using EasyMax Mettler Toledo reactor equipped with a DiComp (Diamond) probe. The quantitative monitoring of methanolysis was performed by building a quantitative model with multivariate calibration using iC Quant module from iC IR 7.0 software. 15 samples of known concentrations were used for the modelling which were taken in duplicate for model calibration and cross-validation, data were pre-processed using mean centering and variance scale, spectrum math square root and solvent subtraction. These pre-processing methods improved the performance indexes from 7.98 to 0.0096, 11.2 to 3.41, 6.32 to 2.72, 0.9416 to 0.9999, RMSEC, RMSECV, RMSEP and R2Cum, respectively. The R² value of 1 (training), 0.9918 (test), 0.9946 (cross-validation) indicated the fitness of the model built. The model was tested against univariate model; small discrepancies were observed at low concentration due to unmodelled intermediates but were quite close at concentrations above 18%. The software eliminated the complexity of the Partial Least Square (PLS) chemometrics. It was concluded that the model obtained could be used to monitor methanol of sunflower oil at industrial and lab scale.

Keywords: biodiesel, calibration, chemometrics, methanolysis, multivariate analysis, transesterification, FTIR

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Authors: Florge Francis A. Sy

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Physicians develop emotional and psychological distress after facing a patient’s death. This can result in stress or burnout. Coping mechanisms in dealing with these deaths may be maladaptive. Determining grief, emotional impact, and coping strategies in physicians is necessary to identify those needing intervention. This can be done by employing validated assessment tools such as the Texas Revised Inventory of Grief (TRIG) scale, Impact of Events Scale (IES), and BriefCOPE tool, respectively. This prospective, observational study was done in a private hospital in Cebu City. Fifty-five internal medicine residents were included and tasked to answer a survey based on their most memorable patient death encounter. The TRIG, IES, and BriefCOPE scores were determined. Participants were divided into severe grief and non-severe grief based on TRIG scores, low-impact, moderate-impact, and high-impact based on IES, and low-use, moderate-use, and high-use based on the BriefCOPE. The differences in the groups’ characteristics were statistically determined, and a p-value of < 0.05 was significant. The participants’ average age was 28.45 years. Most were female and single. Most belonged to the non-severe group based on TRIG, a moderate-impact group based on the IES, and high-use group based on the BriefCOPE. However, 21.8% reported severe grief, 27.3% reported high-impact, and 10.9% had low use of coping strategies. The proportion of residents who encountered CPR prior to the patient’s death was greater in the severe group. Proportions of both high-impact and non-high impact groups were comparable. The proportion of female residents was higher in the high-use group. There were a number of residents who reported severe grief, high emotional impact, and low coping strategies. This highlights the need for interventions such as debriefing after CPR or formal training in residency programs in dealing with emotional burden to counteract maladaptive coping behaviors and prevent negative outcomes.

Keywords: residents, grief, emotional impact, coping, patient death

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Authors: Michael K. O. Ayomoh, Oyindamola A. Omotuyi

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Autonomous mobile robots deployed to explore or operate in a never explored or an abandoned sub-surface mine requires extreme effectiveness in coordination and communication. In a bid to transmit information from the depth of the mine to the external surface in real-time and amidst diverse physical, chemical and virtual impediments, the concept of unified cooperative robots is seen to be a proficient approach. This paper presents an effective [human → robot → task] coordination framework for effective exploration of an abandoned underground mine. The problem addressed in this research is basically the development of a globalized optimization model premised on time series differentiation and geometrical configurations for effective positioning of the two classes of robots in the cooperation namely the outermost stationary master (OSM) robots and the innermost dynamic task (IDT) robots for effective bi-directional signal transmission. In addition, the synchronization of a vision system and wireless communication system for both categories of robots, fiber optics system for the OSM robots in cases of highly sloppy or vertical mine channels and an autonomous battery recharging capability for the IDT robots further enhanced the proposed concept. The OSM robots are the master robots which are positioned at strategic locations starting from the mine open surface down to its base using a fiber-optic cable or a wireless communication medium all subject to the identified mine geometrical configuration. The OSM robots are usually stationary and function by coordinating the transmission of signals from the IDT robots at the base of the mine to the surface and in a reverse order based on human decisions at the surface control station. The proposed scheme also presents an optimized number of robots required to form the cooperation in a bid to reduce overall operational cost and system complexity.

Keywords: sub-surface mine, wireless communication, outermost stationary master robots, inner-most dynamic robots, fiber optic

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Authors: Jaspinder Kaur, Jatinder Pal Singh

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Introduction- Delusional parasitosis is a rare psychotic illness characterized by a fixed belief of manifesting a parasite in a body when in reality, it was not. Also known as Ekbom syndrome or delusional infestations, or acarophobia. Although the patient has no primary skin pathology, but all skin findings were secondary to skin manipulation by the patient itself, which is why up to 90% of patients first seek consultation from a dermatologist. Most commonly, it was seen in older people with female to male ratio is 2:1. For treatment, the patient first need to be investigated to rule all other possible causes, as Delusional parasitosis can be caused by Vitamin B12 deficiency, pellagra, hepatic and renal disease, diabetes mellitus, multiple sclerosis, and leprosy. When all possible causes ruled out, psychiatric referral to be done. Rule out other psychiatric comorbidities, and treatment should be done accordingly. Patient with delusional parasitosis responds well to second generation antipsychotics and need to continuous medication over years, and relapse is likely if treatment is stopped. Case Presentation- A 79-year-old female, belonging to lower socio-economic status, presented with complaints of itching sensation with erythematous patches over the scalp and multiple scratch excoriations lesion over the scalp, face and neck from the past 7-8 months. She had a feeling of small insect crawling under her skin and scalp area. To reduce the itching and kill the insect, she would scratch and squeeze her skin repeatedly. When the family tried to give her explanation that there was no insect in her body, she would not get convinced, rather got angry and abuse family members for not believing her. Gradually, her sleep would remain disturbed, she would be seen awake at night, seen to be scratching her skin, pull her scalp hair, even squeeze out her healed lesions. She collected her skin debris, scalp hairs and look out for insect. Because of her continuous illness, the patient started to remain sad and had crying spells. Her appetite decreased. She became socially isolated and stopped doing her activities of daily living. Family member’s first consulted dermatologist, investigated thoroughly with routine investigations, autoimmune and malignancy workup. As all investigations were normal, following which patient was referred for psychiatric evaluation. The patient was started on Tablet Olanzapine 2.5 mg, gradually increased to 7.5 mg. Over 1 month, there was reduction in itching, skin pricking. Lesions were gradually healed, and the patient continued to take other dermatological medications and ointment and was in regular follow up with psychiatric liaison from past 2 months with 70-80 % improvement in her symptoms. Conclusion- Delusional parasitosis is a psychiatric disorder of insidious onset, seen commonly in middle and old age people. Both psychiatric and dermatology consultation liaison will help the patient for an early diagnosis and adequate treatment. If a primary psychiatric diagnosis, the patient respond well to second generation antipsychotics but always require a further evaluation and treatment management if it is secondary to some physical or other psychiatric comorbidity.

Keywords: delusional parasitosis, delusional infestations, rare, primary psychiatric diagnosis, antipsychotic agents

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Authors: Elisabete Alberdi, Irantzu Álvarez, Nerea Astigarraga, Heber Hernández

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The purpose of this research work is to study the emissions of certain substances that contribute to air pollution and, as far as possible, to try to eliminate or reduce them, to avoid damage to both health and the environment. This work focuses on analyzing and comparing air quality in 2019 and 2020 in the Autonomous Community of the Basque Country, especially near the UPV/EHU campuses. We use Geostatistics to develop a spatial model and to analyse the levels of pollutants in those areas where the scope of the monitoring stations is limited. Finally, different more sustainable transport alternatives for users have been proposed.

Keywords: air quality, pollutants, monitoring stations, environment, geostatistics

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Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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Authors: S. Vanker, A. Aaver, A. Roio, L. Nuut

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To be sure about the effective and less effective/ineffective approaches to course instruction, we hold the opinion that the faculty members need regular feedback from their students in order to be aware of how well or unwell their teaching styles have worked when instructing the courses. It can be confirmed without a slightest hesitation that undergraduate students’ motivated-ness can be sustained when continually improving the quality of teaching and properly sequencing the academic courses both, in the curricula and timetables. At Estonian Aviation Academy, four different forms of feedback are used: Lecture monitoring, questionnaires for all students, study information system subject monitoring and direct feedback received by the lecturer. Questionnaires for all students are arranged once during a study year and separately for the first year and senior students. The results are discussed in academic departments together with student representatives, analyzed with the teaching staff and, if needed, improvements are suggested. In addition, a monitoring system is planned where a lecturer acts in both roles – as an observer and as the lecturer. This will foster better exchange of experience and through this help to make the whole study process more interesting.

Keywords: learner motivation, feedback, student support, undergraduate education

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Authors: Vasudha Hegde, Narendra Chaulagain, H. M. Ravikumar, Sonu Mishra, Siva Yellampalli

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Acoustic sensors are extensively used in recent days not only for sensing and condition monitoring applications but also for small scale energy harvesting applications to power wireless sensor networks (WSN) due to their inherent advantages. The natural frequency of the structure plays a major role in energy harvesting applications since the sensor key element has to operate at resonant frequency. In this paper, circular diaphragm based MEMS acoustic sensor is modelled by Lumped Element Model (LEM) and the natural frequency is compared with the simulated model using Finite Element Method (FEM) tool COMSOL Multiphysics. The sensor has the circular diaphragm of 3000 µm radius and thickness of 30 µm to withstand the high SPL (Sound Pressure Level) and also to withstand the various fabrication steps. A Piezoelectric ZnO layer of thickness of 1 µm sandwiched between two aluminium electrodes of thickness 0.5 µm and is coated on the diaphragm. Further, a channel with radius 3000 µm radius and length 270 µm is connected at the bottom of the diaphragm. The natural frequency of the structure by LEM method is approximately 16.6 kHz which is closely matching with that of simulated structure with suitable approximations.

Keywords: acoustic sensor, diaphragm based, lumped element modeling (LEM), natural frequency, piezoelectric

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Authors: Myoung-Jin Lee, Sung-Jin Lee, Young-Kon Park, Jin-Wook Kim, Bo-Kyoung Kim, Song-Hun Chong, Sun-Il Kim

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Currently, sinkholes may occur due to natural or unknown causes. When the sinkhole is an instantaneous phenomenon, most accidents occur because of significant damage. Thus, methods of monitoring are being actively researched, such that the impact of the accident can be mitigated. A sinkhole can severely affect and wreak havoc in community-based facilities such as a city railway construction. Therefore, the development of a laser / scanning system and an image-based tunnel is one method of pre-monitoring that it stops the accidents. The laser scanning is being used but this has shortcomings as it involves the development of expensive equipment. A laser / videobased scanning tunnel is being developed at Korea Railroad Research Institute. This is designed to automatically operate the railway. The purpose of the scanning is to obtain an image of the city such as of railway structures (stations, tunnel). At the railway structures, it has developed 3D laser scanning that can find a micro-crack can not be distinguished by the eye. An additional aim is to develop technology to monitor the status of the railway structure without the need for expensive post-processing of 3D laser scanning equipment, by developing corresponding software.

Keywords: 3D laser scanning, sinkhole, tunnel, city railway construction

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Authors: João Filipe Papel, Tatsuji Munaka

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With society's aging and the number of elderly with dementia rising, researchers have been actively studying how to support the elderly in the early stages of dementia with the objective of allowing them to have a better life quality and as much as possible independence. To make this possible, most researchers in this field are using the Internet Of Things to monitor the elderly activities and assist them in performing them. The most common sensor used to monitor the elderly activities is the Camera sensor due to its easy installation and configuration. The other commonly used sensor is the sound sensor. However, we need to consider privacy when using these sensors. This research aims to develop a system capable of predicting the early stages of dementia based on monitoring and controlling the elderly activities of daily living. To make this system possible, some issues need to be addressed. First, the issue related to elderly privacy when trying to detect their Activities of Daily Living. Privacy when performing detection and monitoring Activities of Daily Living it's a serious concern. One of the purposes of this research is to achieve this detection and monitoring without putting the privacy of the elderly at risk. To make this possible, the study focuses on using an approach based on using Magnet Sensors to collect binary data. The second is to use the data collected by monitoring Activities of Daily Living to predict the early stages of Dementia. To make this possible, the research team suggests developing a proprietary ontology combined with both data-driven and knowledge-driven.

Keywords: dementia, activity recognition, magnet sensors, ontology, data driven and knowledge driven, IoT, activities of daily living

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Authors: Boxiang Zhuang

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This study analyzes the clinical manifestations, hearing rehabilitation methods and outcomes of a complex case of neurofibromatosis type II (NF2). Methods: The clinical manifestations, medical history, clinical data, surgical methods and postoperative hearing rehabilitation outcomes of an NF2 patient were analyzed to determine the hearing reconstruction method and postoperative effect for a special type of NF2 acoustic neuroma. Results: The patient had bilateral acoustic neuromas with profound sensorineural hearing loss in both ears. Peripheral blood genetic testing did not reveal pathogenic gene mutations, suggesting mosaicism. The patient had an intracochlear schwannoma in the right ear and severely impaired vision in both eyes. Cochlear implantation with tumor retention was performed in the right ear. After 2 months of family-based auditory and speech rehabilitation, the Categories of Auditory Performance (CAP) score improved from 0 to 5. Conclusion: NF2 has complex clinical manifestations and poor prognosis. For NF2 patients with intracochlear tumors, cochlear implantation with tumor retention can be used to reconstruct hearing.

Keywords: NF2, intracochlear schwannoma, hearing reconstruction, cochlear implantation

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Authors: Joel M. De La Rosa R.

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In this paper, the results obtained when monitoring the horizontal deformations of the soil mass are detailed, during each of the construction stages of several vertical shafts located in the soft soils of the Valley of Mexico, by means of the flotation method. From the analysis of these results, the magnitude and percentage relationship with respect to the diameter and depth of excavation of the horizontal deformations that occurred during the monitoring period is established. Based on the horizontal deformation monitoring system and the information provided by the supervisor's site log, the construction stages that have the greatest impact on deformations are established. Additionally, an analysis of the deformations is carried out, which takes into account the resistance and deformability characteristics of the excavated soils, as well as the prevailing hydraulic conditions. This work will allow construction engineers and institutions in charge of infrastructure works in the Valley of Mexico to establish permissible ranges for horizontal deformations that can occur in very soft and saturated soils, during the different construction stages; improving response protocols to potentially dangerous behaviors.

Keywords: vertical shaft, flotation method, very soft clays, construction supervision

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Authors: Yoshitaka Ooya, Daishuke Furuya, Manabu Nemoto

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Some countries such as Canada and Australia have mandatory bicycle helmet laws for all citizens and age groups. As of 2008 Japan has also adopted a helmet law but it is restricted to people 13 years old and under. People over 13 years of age are not required to wear helmets in Japan. Currently, the rate that people 0-13 years old actually wear helmets is low. In 2013 a number of patients came to Saitama University Hospital International Medical Center for treatment due to bicycle-related trauma. The total number of patients was 89 (55 male and 34 female). The average age of the patients was 40.9 years old (eldest; 83 y/o, median; 40 y/o, youngest; 1 y/o with a standard deviation ± 2.8). 54 of these patients (61%) experienced head trauma as well as some experiencing multiple injuries associated with their accident. 13 patients were wearing helmets, 50 patients were not wearing helmets and it is unknown if the remaining 26 patients were wearing helmets. This information was acquired from the patient`s medical charts. Only one patient who was wearing a helmet had a severe head injury, and this patient also experienced other multiple injuries. 17 patients who were not wearing helmets had severe head injuries and out of the 17, two had multiple injuries. The mechanism for injury varied. 12 patients were injured in an accident with a vehicle, only one of which was wearing a helmet. This patient also had multiple injuries. Of the other 11 patients, two had multiple injuries. The remaining patient`s injuries were caused by other accidents (3; fell over while riding, 2; crashed into an inanimate object, 1; collided with a motorcycle). The ladder of which had a severe head injury. All of these patients had light energy accidents and were all over 13 years of age. In Japan it is not mandatory for people over the age of 13 years to wear a bicycle helmet. Research shows that light energy accidents were mostly present in people over the age of 13, to which the law does not require the wearing of helmets. It is important that all people in all age groups be required to wear helmets when operating a bicycle to reduce the rate of light energy severe head injuries.

Keywords: bicycle helmet, head trauma, hospital, traumatic situation

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Ana Neves, John Leander, Ignacio Gonzalez, Raid Karoumi

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Systematic monitoring and inspection are needed to assess the present state of a structure and predict its future condition. If an irregularity is noticed, repair actions may take place and the adequate intervention will most probably reduce the future costs with maintenance, minimize downtime and increase safety by avoiding the failure of the structure as a whole or of one of its structural parts. For this to be possible decisions must be made at the right time, which implies using systems that can detect abnormalities in their early stage. In this sense, Structural Health Monitoring (SHM) is seen as an effective tool for improving the safety and reliability of infrastructures. This paper explores the decision-making problem in SHM regarding the maintenance of civil engineering structures. The aim is to assess the present condition of a bridge based exclusively on measurements using the suggested method in this paper, such that action is taken coherently with the information made available by the monitoring system. Artificial Neural Networks are trained and their ability to predict structural behavior is evaluated in the light of a case study where acceleration measurements are acquired from a bridge located in Stockholm, Sweden. This relatively old bridge is presently still in operation despite experiencing obvious problems already reported in previous inspections. The prediction errors provide a measure of the accuracy of the algorithm and are subjected to further investigation, which comprises concepts like clustering analysis and statistical hypothesis testing. These enable to interpret the obtained prediction errors, draw conclusions about the state of the structure and thus support decision making regarding its maintenance.

Keywords: artificial neural networks, clustering analysis, model-free damage detection, statistical hypothesis testing, structural health monitoring

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Authors: Aleksandar Zhelyazkov, Daniele Zonta, Helmut Wenzel, Peter Furtner

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In the current research structural health monitoring is considered for addressing the critical issue of post-earthquake damage detection. A non-standard approach for damage detection via acoustic emission is presented - acoustic emissions are monitored in the low frequency range (up to 120 Hz). Such emissions are termed high-frequency transients. Further a damage indicator defined as the Time-Ratio Damage Indicator is introduced. The indicator relies on time-instance measurements of damage initiation and deformation peaks. Based on the time-instance measurements a procedure for estimation of the maximum drift ratio is proposed. Monitoring data is used from a shaking-table test of a full-scale reinforced concrete bridge pier. Damage of the experimental column is successfully detected and the proposed damage indicator is calculated.

Keywords: acoustic emission, damage detection, shaking table test, structural health monitoring

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Authors: Wisal Alrabadi

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The study's goal was to see how the use of water wireless Aqua Com System and its accompanying music affected the Female Swimming Team at the Faculty of Physical Education's development of dolphin kick movements. To that end, a training program consisting of (12) training units spread out over four weeks, three units per week, was created and applied to a study sample of (10) students from the swimming pool enrolled in the first semester of the academic year 2022. Pre-measuring and timing the movements of dolphins kicking with and without fins above and below, measuring the water's surface over a distance of 25 meters. The results showed that there are statistically significant differences in favor of telemetry from the start within the limits of the area specified for a distance of 15 m after the comparison between the pre and post-measurement using the test (T) of the double samples, and this indicates the impact of the training program using the Aqua Com System in the swimming team(Female) at Faculty of Physical Education, and in light of this a set of recommendations was developed.

Keywords: aqua com system training program, accompanying music, dolphin kick movements, swimming team female

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Authors: Huidan Yu, Anurag Deb, Rou Chen, I-Wen Wang

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The use of left ventricle assist devices (LVADs) in patients with heart failure has been a proven and effective therapy for patients with severe end-stage heart failure. Due to the limited availability of suitable donor hearts, LVADs will probably become the alternative solution for patient with heart failure in the near future. While the LVAD is being continuously improved toward enhanced performance, increased device durability, reduced size, a better understanding of implantation management becomes critical in order to achieve better long-term blood supplies and less post-surgical complications such as thrombi generation. Important issues related to the LVAD implantation include the location of outflow grafting (OG), the angle of the OG, the combination between LVAD and native heart pumping, uniform or pulsatile flow at OG, etc. We have hypothesized that an optimal implantation of LVAD is patient specific. To test this hypothesis, we employ a novel in-house computational modeling technique, named InVascular, to conduct a systematic evaluation of cardiac output at aortic arch together with other pertinent hemodynamic quantities for each patient under various implantation scenarios aiming to get an optimal implantation strategy. InVacular is a powerful computational modeling technique that integrates unified mesoscale modeling for both image segmentation and fluid dynamics with the cutting-edge GPU parallel computing. It first segments the aortic artery from patient’s CT image, then seamlessly feeds extracted morphology, together with the velocity wave from Echo Ultrasound image of the same patient, to the computation model to quantify 4-D (time+space) velocity and pressure fields. Using one NVIDIA Tesla K40 GPU card, InVascular completes a computation from CT image to 4-D hemodynamics within 30 minutes. Thus it has the great potential to conduct massive numerical simulation and analysis. The systematic evaluation for one patient includes three OG anastomosis (ascending aorta, descending thoracic aorta, and subclavian artery), three combinations of LVAD and native heart pumping (1:1, 1:2, and 1:3), three angles of OG anastomosis (inclined upward, perpendicular, and inclined downward), and two LVAD inflow conditions (uniform and pulsatile). The optimal LVAD implantation is suggested through a comprehensive analysis of the cardiac output and related hemodynamics from the simulations over the fifty-four scenarios. To confirm the hypothesis, 5 random patient cases will be evaluated.

Keywords: graphic processing unit (GPU) parallel computing, left ventricle assist device (LVAD), lumped-parameter model, patient-specific computational hemodynamics

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

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Authors: Mihail Nagea, Olivera Lupescu, Elena Taina Avramescu, Cristina Patru

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Classical education of orthopedic surgeons involves lectures, self study, workshops and cadaver dissections, and sometimes supervised practical training within surgery, which quite seldom gives the young surgeons the feeling of being unable to apply what they have learned especially in surgical practice. The purpose of this paper is to present a different approach from the classical one, which enhances the practical skills of the orthopedic trainees and prepare them for future practice. The paper presents the content of the research project 2015-1-RO01-KA202-015230, ERASMUS+ VET ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery’ which, using e learning as a basic tool , delivers to the trainees not only courses, but especially practical information through videos and case scenarios including gait analysis in order to build patient focused therapeutic plans, adapted to the characteristics of each patient. The outcome of this project is to enhance the practical skills in orthopedic surgery and the results are evaluated following the answers to the questionnaires, but especially the reactions within the case scenarios. The participants will thus follow the idea that any mistake within solving the cases might represent a failure of treating a real patient. This modern approach, besides using interactivity to evaluate the theoretical and practical knowledge of the trainee, increases the sense of responsibility, as well as the ability to react properly in real cases.

Keywords: interdisciplinary approach, gait analysis, orthopedic surgery, vocational training

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Authors: Mahesh S. Harne, Sunil V. Deshmukh

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A continuous passive motion machine improves and helps the patient to restore range of motion in various physiotherapy activities. The paper presents a concept for portable CPM. The device is used for various joint for upper and lower body extremities. The device is designed so that the active and passive motion is incorporated. During development, the physiotherapist and patient need is integrated with designer aspects. Various tools such as Analytical Higher Hierarchy process (AHP) and Quality Function Deployment (QFD) is used to integrate the need at the design stage. With market survey of various commercial CPM the gaps are identified, and efforts are made to fill the gaps with ergonomic need. Indian anthropomorphic dimension is referred. The device is modular to best suit for all the anthropomorphic need of different human. Experimentation is carried under the observation of physiotherapist and doctor on volunteer patient. We reported better results are compare to conventional CPM with comfort and less pain. We concluded that the concept will be helpful to reduces therapy cost and wide utility of device for various joint and physiotherapy exercise.

Keywords: continuous passive motion machine, ergonomics, physiotherapy, quality function deployment

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Authors: Angkrit Phitchayangkoon, Ar-Aishah Dadeh

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Background: A key aim of triage is to identify the patients with high risk of cardiac arrest because they require intensive monitoring, resuscitation facilities, and early intervention. We aimed to identify the predicting factors such as initial vital signs, serum pH, serum lactate level, initial capillary blood glucose, and Modified Early Warning Score (MEWS) which affect the occurrence of cardiac arrest in an emergency department (ED). Methods: We conducted a retrospective data review of ED patients in an emergency department (ED) from 1 August 2014 to 31 July 2016. Significant variables in univariate analysis were used to create a multivariate analysis. Differentiation of predicting factors between cardiac arrest patient and non-cardiac arrest patients for occurrence of cardiac arrest in an emergency department (ED) was the primary outcome. Results: The data of 527 non-trauma patients with Emergency Severity Index (ESI) 1-3 were collected. The factors found to have a significant association (P < 0.05) in the non-cardiac arrest group versus the cardiac arrest group at the ED were systolic BP (mean [IQR] 135 [114,158] vs 120 [90,140] mmHg), oxygen saturation (mean [IQR] 97 [89,98] vs 82.5 [78,95]%), GCS (mean [IQR] 15 [15,15] vs 11.5 [8.815]), normal sinus rhythm (mean 59.8 vs 30%), sinus tachycardia (mean 46.7 vs 21.7%), pH (mean [IQR] 7.4 [7.3,7.4] vs 7.2 [7,7.3]), serum lactate (mean [IQR] 2 [1.1,4.2] vs 7 [5,10.8]), and MEWS score (mean [IQR] 3 [2,5] vs 5 [3,6]). A multivariate analysis was then performed. After adjusting for multiple factors, ESI level 2 patients were more likely to have cardiac arrest in the ER compared with ESI 1 (odds ratio [OR], 1.66; P < 0.001). Furthermore, ESI 2 patients were more likely than ESI 1 patients to have cardiovascular disease (OR, 1.89; P = 0.01), heart rate < 55 (OR, 6.83; P = 0.18), SBP < 90 (OR, 3.41; P = 0.006), SpO2 < 94 (OR, 4.76; P = 0.012), sinus tachycardia (OR, 4.32; P = 0.002), lactate > 4 (OR, 10.66; P = < 0.001), and MEWS > 4 (OR, 4.86; P = 0.028). These factors remained predictive of cardiac arrest at the ED. Conclusion: The factors related to cardiac arrest in the ED are ESI 1 patients, ESI 2 patients, patients diagnosed with cardiovascular disease, SpO2 < 94, lactate > 4, and a MEWS > 4. These factors can be used as markers in the event of simultaneous arrival of many patients and can help as a pre-state for patients who have a tendency to develop cardiac arrest. The hemodynamic status and vital signs of these patients should be closely monitored. Early detection of potentially critical conditions to prevent critical medical intervention is mandatory.

Keywords: cardiac arrest, predicting factor, emergency department, emergency patient

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Authors: Adham M. Salah, Tariq A. Nagem, Raed A. Abd-Alhameed, James M. Noras

Abstract:

Recently, the demand for wireless communications systems to cover more than one frequency band (multi-band) with high data rate has been increased for both fixed and mobile services. Multiple Input Multiple Output (MIMO) technology is one of the significant solutions for attaining these requirements and to achieve the maximum channel capacity of the wireless communications systems. The main issue associated with MIMO antennas especially in portable devices is the compact space between the radiating elements which leads to limit the physical separation between them. This issue exacerbates the performance of the MIMO antennas by increasing the mutual coupling between the radiating elements. In other words, the mutual coupling will be stronger if the radiating elements of the MIMO antenna are closer. This paper presents a low–profile dual-band (2×1) MIMO antenna that works at 2.4GHz, 5.3GHz and 5.8GHz for wireless local area networks (WLAN) applications. A neutralization line (NL) technique for enhancing the isolation has been used by introducing a strip line with a length of λg/4 at the isolation frequency (2.4GHz) between the radiating elements. The overall dimensions of the antenna are 33.5 x 36 x 1.6 mm³. The fabricated prototype shows a good agreement between the simulated and measured results. The antenna impedance bandwidths are 2.38–2.75 GHz and 4.4–6 GHz for the lower and upper band respectively; the reflection coefficient and mutual coupling are better than -25 dB in both lower and higher bands. The MIMO antenna performance characteristics are reported in terms of the scattering parameters, envelope correlation coefficient (ECC), total active reflection coefficient, capacity loss, antenna gain, and radiation patterns. Analysis of these characteristics indicates that the design is appropriate for the WLAN terminal applications.

Keywords: ECC, neutralization line, MIMO antenna, multi-band, mutual coupling, WLAN

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