Search results for: teaching and learning clinical practicum

Authors: Kamal Kaushik, Dandpani Epili, Ajay G. V., Ashutosh, S. Pradhaan

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Introduction: Radiation therapy has come a long way over a period of decades, from 2-dimensional radiotherapy to intensity-modulated radiation therapy (IMRT) or VMAT. For advanced radiation therapy, we need better patient position reproducibility to deliver precise and quality treatment, which raises the need for better image guidance technologies for precise patient positioning. This study presents a two tattoo simulation with roll correction technique which is comparable to other advanced patient positioning techniques. Objective: This is a site-specific study is aimed to perform a comparison between various treatment positioning techniques used for the treatment of patients of Ca- Breast undergoing radiotherapy. In this study, we are comparing 5 different positioning methods used for the treatment of ca-breast, namely i) Vacloc with 3 tattoos, ii) Breast board with three tattoos, iii) Thermoplastic cast with three fiducials, iv) Breast board with a thermoplastic mask with 3 tattoo, v) Breast board with 2 tattoos – A roll correction method. Methods and material: All in one (AIO) solution immobilization was used in all patient positioning techniques for immobilization. The process of two tattoo simulations includes positioning of the patient with the help of a thoracic-abdomen wedge, armrest & knee rest. After proper patient positioning, we mark two tattoos on the treatment side of the patient. After positioning, place fiducials as per the clinical borders markers (1) sternum notch (lower border of clavicle head) (2) 2 cm below from contralateral breast (3) midline between 1 & 2 markers (4) mid axillary on the same axis of 3 markers (Marker 3 & 4 should be on the same axis). During plan implementation, a roll depth correction is applied as per the anterior and lateral positioning tattoos, followed by the shifts required for the Isocentre position. The shifts are then verified by SSD on the patient surface followed by radiographic verification using Cone Beam Computed Tomography (CBCT). Results: When all the five positioning techniques were compared all together, the produced shifts in Vertical, Longitudinal and lateral directions are as follows. The observations clearly suggest that the Longitudinal average shifts in two tattoo roll correction techniques are less than every other patient positioning technique. Vertical and lateral Shifts are also comparable to other modern positioning techniques. Concluded: The two tattoo simulation with roll correction technique provides us better patient setup with a technique that can be implemented easily in most of the radiotherapy centers across the developing nations where 3D verification techniques are not available along with delivery units as the shifts observed are quite minimal and are comparable to those with Vacloc and modern amenities.

Keywords: Ca. breast, breast board, roll correction technique, CBCT

Procedia PDF Downloads 114

Authors: Madeline Tagg, Choihoong Mui, Elizabeth Lek, Jide Menakaya

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Introduction: Simulation technology is used by neonatal teams to learn and refresh skills and gain the knowledge and confidence to care for sick neonates. In-situ simulation is considered superior to laboratory-based programmes as it closely mirrors real life situations. This study reports our experience of running regular laboratory-based simulation sessions for senior clinicians and nurses and its impact on their knowledge, skills and confidence. Methods: A before and after questionnaire survey was carried out on senior clinicians and nurses that attended a scheduled laboratory-based simulation session. Participants were asked to document their expectations before a 3-hour monthly laboratory programme started and invited to feedback their reflections at the end of the session. The session included discussion of relevant clinical guidelines, immersion in a scenario and video led debrief. The results of the survey were analysed in three skills based categories - improved, no change or a worsened experience. Results: 45 questionnaires were completed and analysed. Of these 25 (55%) were completed by consultants seven and six by nurses and trainee doctors respectively, and seven respondents were unknown. 40 (88%) rated the session overall and guideline review as good/excellent, 39 respondents (86%) rated the scenario session good/excellent and 40/45 fed back a good/excellent debrief session. 33 (73%) respondents completed the before and after questionnaire. 21/33 (63%) reflected an improved knowledge, skill or confidence in caring for sick new-bon babies, eight respondents reported no change and four fed back a worse experience after the session. Discussion: Most respondents found the laboratory based structured simulation session beneficial for their professional development. They valued equally the whole content of the programme such as guideline review and equipment training as well as the simulation and debrief sessions. Two out three participants stated their knowledge of caring for sick new-born babies had been transformed positively by the session. Sessions where simulation equipment failed or relevant staff were absent contributed to a poor educational experience. Summary: A regular structured laboratory-based simulation programme with a rich content is a credible educational resource for improving the knowledge, skills and confidence of senior clinicians caring for sick new born babies.

Keywords: knowledge, laboratory based, neonates, simulation

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Authors: M. Younus, Muhammad Shafique, M. Athar Khan, Tanveer Akhtar , M. Moeen Athar

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A total of 48 apparently healthy weaned sheep lambs (Ovis aries) of 8-10 weeks old weighing 7-10 Kg were purchased from the contractors, maintained in the experimental station of University of the Punjab, Quaid-e-Azam Campus at Lahore, Pakistan. They were dewormed against nematodes with levamisole (ICI) at recommended dose rates. The feces were tested against the parasitic eggs, no helminths ova were seen. All the 48 sheep lambs were divided into two groups i.e. group A & group B. Group 'A' comprising of 40 sheep, kept as infected groups whereas group 'B' comprising of 08 sheep & kept as a new infected control group. Each sheep lamb of group A was given 3-4 fresh gravid segments contains 2-3 thousand eggs of Echinococcus granulosus. These were collected from experimentally infected dogs by feeding fresh hydrated cysts collected from liver & lungs of sheep after slaughtering. Each lamb was fed with fresh gravid segments for a total period of 5 days or each alternate day. Coagulated blood was collected before the start of infected diet and after every month by jugular phlebotomy of each sheep lamb from the infected & new infected control group. One lamb each from group A & group B was slaughtered at the end of each month for the presence of macroscopic hydatid cyst in viscera & abdominal cavity. After 180 days of the experiment, hydatid cysts were confirmed in the abdominal cavity. Hematological parameters of zero days & then at the end of every month revealed that there was a gradual increase (PL 0.05) in the White Blood Cell (WBC), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC) and Erythrocyte Sedimentation Rates (ESR). The increasing trend was probably due to inflammatory response and lytic effect of the newly developing E. granulosus hydatid cysts. The red blood cell (RBC), Hemoglobin (HB), Packed Cell Volume (PCV) and Mean Corpuscular Hemoglobin (MCH) infected groups were decreased significantly as compared to the control group (PL 0.05). The experiment was terminated at the end of the 7th month. It can be concluded that Echinococcus granulosus can damage livestock and other intermediate hosts such as horses, the development of hydatid cysts affect the organs due to the growing cysts pressuring the organ tissues. Parts of the tissue die, which impairs the functioning of the affected organ. The clinical signs depend on the affected organ. The major damage for livestock is organ condemnation at slaughter.

Keywords: echinococcus granulosus, hydatidosis, sheep, hematology

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Authors: Sushma Ghogale

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With a surge in user-generated content or feedback or reviews on the internet, it has become possible and important to know consumers' opinions about products and services. This data is important for both potential customers and businesses providing the services. Data from social media is attracting significant attention and has become the most prominent channel of expressing an unregulated opinion. Prospective customers look for reviews from experienced customers before deciding to buy a product or service. Several websites provide a platform for users to post their feedback for the provider and potential customers. However, the biggest challenge in analyzing such data is in extracting latent features and providing term-level analysis of the data. This paper proposes an approach to use topic modeling to classify the reviews into topics and conduct sentiment analysis to mine the opinions. This approach can analyse and classify latent topics mentioned by reviewers on business sites or review sites, or social media using topic modeling to identify the importance of each topic. It is followed by sentiment analysis to assess the satisfaction level of each topic. This approach provides a classification of hotel reviews using multiple machine learning techniques and comparing different classifiers to mine the opinions of user reviews through sentiment analysis. This experiment concludes that Multinomial Naïve Bayes classifier produces higher accuracy than other classifiers.

Keywords: latent Dirichlet allocation, topic modeling, text classification, sentiment analysis

Procedia PDF Downloads 87

Authors: Zeynep Yazgan, Gökhan Aygün, Reyhan Çalışkan

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Objective: Invasive fungal infections are a serious threat in terms of morbidity and mortality, especially in immunocompromised patients. The most frequently isolated agents are Aspergillus genus fungi, and sensitivity to azoles, which are the first choice in treatment, decreases. In our study, we aimed to investigate the use of the agar plate screening method as a fast, easy, and practical method in determining azole resistance in Aspergillus spp. species. Methods: Our study was conducted with 125 Aspergillus spp. isolates produced from various clinical samples. Aspergillus spp. isolates were identified by conventional methods and azole resistance was determined by gradient test and agar plate screening method. Broth microdilution method was applied to resistant isolates, and CypA-L98H and CypA-M220 mutations in the cyp51A gene were investigated. Results: In our study, 55 A. fumigatus complex (44%), 42 A. flavus (33.6%), 6 A. terreus (5%), 4 A. niger (3%) and 18 Aspergillus spp. (14%) were identified. With the gradient test method, resistance to VOR and POS was detected in 1 (1.8%) of A.fumigatus isolates, and resistance to ITR was detected in 3 (5.45%). With the agar plate method, 1 of the A.fumigatus isolates (1.8%) had VOR, ITR, POS, 1 of the A.terreus isolates (16.7%) had VOR, 1 of the A.niger isolates (25%) had ITR. Resistance to VOR and POS was detected in 2 Aspergillus spp. isolates (11%), and resistance to ITR was detected in 1 (5.6%). Sensitivity and specificity were determined as 100% for VOR and POS in A. fumigatus species, 33.3% and 100% for ITR, respectively, 100% for ITR in A. flavus species, and 100% for ITR and POS in A. terreus species. By broth microdilution method in 7 isolates in which resistance was detected by gradient test and/or agar plate screening method; 1 A.fumigatus resistant to ITR, VOR, POS, 2 A.fumigatus resistant to ITR, 2 Aspergillus spp. ITR, VOR, POS MICs were determined as 2µg/ml and 8µg/ml, 8µg/ml and >32µg/ml, 0.5µg/ml and 4µg/ml, respectively. CypA-L98H mutations were detected in 5 of these isolates, CypA-M220 mutations were detected in 6, and no mutation was detected in 1. CypA-L98H and CypA-M220 mutations were detected in 1 isolate for which resistance was not detected. Conclusion: The need for rapid antifungal susceptibility screening tests is increasing in the treatment of aspergillosis. Although the sensitivity of the agar plate method was determined to be 33.3% for A.fumigatus ITR in our study, its sensitivity and specificity were determined to be 100% for ITR, VOR, and POS in other species. The low sensitivity value detected for A.fumigatus showed that agar plate drug concentrations should be updated in accordance with the latest regulations of EUCAST guidelines. The CypA-L98H and CypA-M220 mutations detected in our study suggested that the distribution of azole resistance-related mutations in different regions in our country should be investigated. In conclusion, it is thought that the agar plate method, which can be easily applied to detect azole resistance, is a fast and practical method in routine use and can contribute to both the determination of effective treatment strategies and the generation of epidemiological data.

Keywords: Aspergillus, agar plate, azole resistance, cyp51A, cypA-L98H, cypA-M220

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Authors: Maris Eugênia Dela Rosa, Ana Luiza Menegatti Pavan, Marcela De Oliveira, Diana Rodrigues De Pina, Luis Carlos Vulcano

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In medical veterinary as well as in human medicine, radiological study is essential for a safe diagnosis in clinical practice. Thus, the quality of radiographic image is crucial. In last year’s there has been an increasing substitution of image acquisition screen-film systems for computed radiology equipment (CR) without technical charts adequacy. Furthermore, to carry out a radiographic examination in veterinary patient is required human assistance for restraint this, which can compromise image quality by generating dose increasing to the animal, for Occupationally Exposed and also the increased cost to the institution. The image optimization procedure and construction of radiographic techniques are performed with the use of homogeneous phantoms. In this study, we sought to develop a homogeneous phantom of canine chest to be applied to the optimization of these images for the CR system. In carrying out the simulator was created a database with retrospectives chest images of computed tomography (CT) of the Veterinary Hospital of the Faculty of Veterinary Medicine and Animal Science - UNESP (FMVZ / Botucatu). Images were divided into four groups according to the animal weight employing classification by sizes proposed by Hoskins & Goldston. The thickness of biological tissues were quantified in a 80 animals, separated in groups of 20 animals according to their weights: (S) Small - equal to or less than 9.0 kg, (M) Medium - between 9.0 and 23.0 kg, (L) Large – between 23.1 and 40.0kg and (G) Giant – over 40.1 kg. Mean weight for group (S) was 6.5±2.0 kg, (M) 15.0±5.0 kg, (L) 32.0±5.5 kg and (G) 50.0 ±12.0 kg. An algorithm was developed in Matlab in order to classify and quantify biological tissues present in CT images and convert them in simulator materials. To classify tissues presents, the membership functions were created from the retrospective CT scans according to the type of tissue (adipose, muscle, bone trabecular or cortical and lung tissue). After conversion of the biologic tissue thickness in equivalent material thicknesses (acrylic simulating soft tissues, bone tissues simulated by aluminum and air to the lung) were obtained four different homogeneous phantoms, with (S) 5 cm of acrylic, 0,14 cm of aluminum and 1,8 cm of air; (M) 8,7 cm of acrylic, 0,2 cm of aluminum and 2,4 cm of air; (L) 10,6 cm of acrylic, 0,27 cm of aluminum and 3,1 cm of air and (G) 14,8 cm of acrylic, 0,33 cm of aluminum and 3,8 cm of air. The developed canine homogeneous phantom is a practical tool, which will be employed in future, works to optimize veterinary X-ray procedures.

Keywords: radiation protection, phantom, veterinary radiology, computed radiography

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Authors: Mohammad Bakhshandeh

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Structural Health Monitoring (SHM) is a crucial and necessary practice that plays a vital role in ensuring the safety and integrity of critical structures, and in particular, bridges. The continuous monitoring of bridges for signs of damage or degradation through Bridge Health Monitoring (BHM) enables early detection of potential problems, allowing for prompt corrective action to be taken before significant damage occurs. Although all monitoring techniques aim to provide accurate and decisive information regarding the remaining useful life, safety, integrity, and serviceability of bridges, understanding the development and propagation of damage is vital for maintaining uninterrupted bridge operation. Over the years, extensive research has been conducted on BHM methods, and experts in the field have increasingly adopted new methodologies. In this article, we provide a comprehensive exploration of the various BHM approaches, including sensor-based, non-destructive testing (NDT), model-based, and artificial intelligence (AI)-based methods. We also discuss the challenges associated with BHM, including sensor placement and data acquisition, data analysis and interpretation, cost and complexity, and environmental effects, through an extensive review of relevant literature and research studies. Additionally, we examine potential solutions to these challenges and propose future research ideas to address critical gaps in BHM.

Keywords: structural health monitoring (SHM), bridge health monitoring (BHM), sensor-based methods, machine-learning algorithms, and model-based techniques, sensor placement, data acquisition, data analysis

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Authors: Araceli Martínez Ortiz

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An educational research effort is analyzed using systems theory to document the power of collective impact when addressing multiple factors contributing towards the retention of students majoring in science, technology, engineering and mathematics (STEM) academic programs. This research promotes understanding on how networked communities may work effectively toward a shared vision and mutually aligned activities that result in sustained, large scale change. The actions of a team of researchers in their third year of collaboration are presented to describe a model that positively aligns work efforts resulting in greater total gains. The goals of the multiple programs managed by the funded program team are to: 1) expand the number of students who choose to study a STEM field of study; 2) promote student collaborative learning; 3) support faculty understanding of the funds of knowledge of diverse students and 4) establish innovative and robust STEM education research that will lead to the development of nationally replicable, scalable models for broadening participation in STEM. The impacts of this research effort are measured through quantitative statistical analysis of the changes in second-year STEM undergraduate student retention rates and representation rates of women, Hispanics and African American STEM majors.

Keywords: collaborative impact, diversity, student retention, systems theory, STEM education

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Authors: Ahmad Abu-Akel, Emilie De Montpellier, Sophie Von Bentivegni, Lyn Luechinger, Alessandro Ishii, Christine Mohr

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Convergent and divergent thinking are two main components of creativity that have been viewed as complementary. While divergent thinking refers to the fluency and flexibility of generating new ideas, convergent thinking refers to the ability to systematically apply rules and knowledge to arrive at the optimal solution or idea. These creativity components have been shown to be susceptible to variation in subclinical expressions of autistic and schizotypal traits within the general population. Research, albeit inconclusively, mainly linked positive schizotypal traits with divergent thinking and autistic traits with convergent thinking. However, cumulative evidence suggests that these trait dimensions can co-occur in the same individual more than would be expected by chance and that their concurrent effect can be diametric and even interactive. The current study aimed at investigating the concurrent effect of these trait dimensions on tasks assessing convergent and divergent thinking abilities. We predicted that individuals with high positive schizotypal traits alone would perform particularly well on the divergent thinking task, whilst those with high autistic traits alone would perform particularly well on the convergent thinking task. Crucially, we also predicted that individuals who are high on both autistic and positive schizotypal traits would perform particularly well on both the divergent and convergent thinking tasks. This was investigated in a non-clinical sample of 142 individuals (Males = 45%; Mean age = 21.45, SD = 2.30), sufficient to minimally observe an effect size f² ≥ .10. Divergent thinking was evaluated using the Alternative Uses Task, and convergent thinking with the Anagrams Task. Autistic and schizotypal traits were respectively assessed with the Autism Quotient Questionnaire (AQ) and the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). Regression analyses revealed that the positive association of autistic traits with convergent thinking scores was qualified with an interaction with positive schizotypal traits. Specifically, positive schizotypal traits were negatively associated with convergent thinking scores when AQ scores were relatively low, but this trend was reversed when AQ scores were high. Conversely, the positive effect of AQ scores on convergent thinking progressively increased with increasing positive schizotypal traits. The results of divergent thinking task are currently being analyzed and will be reported at the conference. The association of elevated autistic and positive schizotypal traits with convergent thinking may represent a unique profile of creative thinkers who are able to simultaneously draw on trait-specific advantages conferred by autistic and positively schizotypal traits such as local and global processing. This suggests that main-effect models can tell an incomplete story regarding the effect of autistic and positive schizotypal traits on creativity-related processes. Future creativity research should consider their interaction and the benefits conferred by their co-presence.

Keywords: autism, schizotypy, convergent thinking, divergent thinking, comorbidity

Procedia PDF Downloads 166

Authors: Vu H. N. Khue, Marian Pavelka, Georg Jocher, Jiří Dušek, Le T. Son, Bui T. An, Ho Q. Bang, Pham Q. Huong

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Agriculture is an important economic sector of Vietnam, the most popular of which is wet rice cultivation. These activities are also known as the main contributor to the national greenhouse gas. In order to understand more about greenhouse gas exchange in these activities and to investigate the factors influencing carbon cycling and sequestration in these types of ecosystems, since 2019, the first eddy covariance station has been installed in a paddy field in Long An province, Mekong Delta. The station was equipped with state-of-the-art equipment for CO₂ and CH₄ gas exchange and micrometeorology measurements. In this study, data from the station was processed following the ICOS recommendations (Integrated Carbon Observation System) standards for CO₂, while CH₄ was manually processed and gap-filled using a random forest model from methane-gapfill-ml, a machine learning package, as there is no standard method for CH₄ flux gap-filling yet. Finally, the carbon equivalent (Ce) balance based on CO₂ and CH₄ fluxes was estimated. The results show that in 2020, even though a new water management practice - alternate wetting and drying - was applied to reduce methane emissions, the paddy field released 928 g Cₑ.m⁻².yr⁻¹, and in 2021, it was reduced to 707 g Cₑ.m⁻².yr⁻¹. On a provincial level, rice cultivation activities in Long An, with a total area of 498,293 ha, released 4.6 million tons of Cₑ in 2020 and 3.5 million tons of Cₑ in 2021.

Keywords: eddy covariance, greenhouse gas, methane, rice cultivation, Mekong Delta

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Authors: Chongya Song, Kang Yen, Alexander Pons, Jin Liu

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In the field of machine learning, the ensemble has been employed as a common methodology to improve the performance upon multiple base classifiers. However, the true predictions are often canceled out by the false ones during consensus due to a phenomenon called “curse of correlation” which is represented as the strong interferences among the predictions produced by the base classifiers. In addition, the existing practices are still not able to effectively mitigate the problem of imbalanced classification. Based on the analysis on our experiment results, we conclude that the two problems are caused by some inherent deficiencies in the approach of consensus. Therefore, we create an enhanced ensemble algorithm which adopts a designed rank-based chain-mode consensus to overcome the two problems. In order to evaluate the proposed ensemble algorithm, we employ a well-known benchmark data set NSL-KDD (the improved version of dataset KDDCup99 produced by University of New Brunswick) to make comparisons between the proposed and 8 common ensemble algorithms. Particularly, each compared ensemble classifier uses the same 22 base classifiers, so that the differences in terms of the improvements toward the accuracy and reliability upon the base classifiers can be truly revealed. As a result, the proposed rank-based chain-mode consensus is proved to be a more effective ensemble solution than the traditional consensus approach, which outperforms the 8 ensemble algorithms by 20% on almost all compared metrices which include accuracy, precision, recall, F1-score and area under receiver operating characteristic curve.

Keywords: consensus, curse of correlation, imbalance classification, rank-based chain-mode ensemble

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Authors: Fatemeh Torabi, Jamal El-Den, Narumon Sriratanviriyakul

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Perpetual changes in the workplace and daily business activities bring a need for imbedding organizational knowledge sharing within the organizations’ culture, routines and processes. Organizations should adapt to the changing in the environment in order to survive. Accordingly, the management should promote a knowledge sharing culture which might result in knowledge accumulation, hence better response to these changing environmental conditions. Researchers in the field of strategy and marketing stressed that employees’, as well as the overall performance of the organization, would improve as a result of implementing a knowledge-oriented culture. The research investigated the significant impact of knowledge sharing on market response and the competitiveness of organizations. A knowledge sharing framework was developed based on current literary frameworks with additional constructs such as employees’ learning commitments, experiences and prior knowledge. Linear regression was used to analyze the relationships among dependent and independent variables. The research’s results indicated strong positive correlation between the dependent and independent variables, especially in organizational market sharing. We anticipate that this correlation would improve organizational knowledge sharing related practices and the associated knowledge entities. The research posits the introduced framework could be a solid ground for further investigations on how some organizational factors would influence the organization’s response to the market as well as on competitiveness. Final results support all hypotheses. Finding of this research show that knowledge sharing intention had the significant and positive effect on market response and competitiveness of organizations.

Keywords: knowledge management, knowledge sharing, market response, organizational competitiveness

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Authors: Luis Fernando Calvo Prieto, Raul Herrero Martínez, Mónica Santamarta Llorente, Sergio Paniagua Bermejo

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The project that is presented starts from the questioning about the compartmentalization of knowledge that occurs in university higher education. There are several authors who describe the problems associated with this reality (Rodamillans, M) indicating a lack of integration of the knowledge acquired by students throughout the subjects taken in their university degree. Furthermore, this disintegration is accentuated by the enrollment system of some Faculties and/or Schools of Engineering, which allows the student to take subjects outside the recommended curricular path. This problem is accentuated in an ostentatious way when trying to find an integration between humanistic subjects and the world of experimental sciences or engineering. This abrupt separation between humanities and sciences can be observed in any study plan of Spanish degrees. Except for subjects such as economics or English, in the Faculties of Sciences and the Schools of Engineering, the absence of any humanistic content is striking. At some point it was decided that the only value to take into account when designing their study plans was “usefulness”, considering the humanities systematically useless for their training, and therefore banishing them from the study plans. forgetting the role they have on the capacity of both Leadership and Civic Humanism in our professionals of tomorrow. The teaching guides for the different subjects in the branch of science or engineering do not include any competency, not even transversal, related to leadership capacity or the need, in today's world, for social, civic and humanitarian knowledge part of the people who will offer medical, pharmaceutical, environmental, biotechnological or engineering solutions to a society that is generated thanks to more or less complex relationships based on human relationships and historical events that have occurred so far. If we want professionals who know how to deal effectively and rationally with their leadership tasks and who, in addition, find and develop an ethically civic sense and a humanistic profile in their functions and scientific tasks, we must not leave aside the importance that it has, for the themselves, know the causes, facts and consequences of key events in the history of humanity. The words of the humanist Paul Preston are well known: “he who does not know his history is condemned to repeat the mistakes of the past.” The idea, therefore, that today there can be men of science in the way that the scientists of the Renaissance were, becomes, at the very least, difficult to conceive. To think that a Leonardo da Vinci can be repeated in current times is a more than crazy idea; and although at first it may seem that the specialization of a professional is inevitable but beneficial, there are authors who consider (Sánchez Inarejos) that it has an extremely serious negative side effect: the entrenchment behind the different postulates of each area of knowledge, disdaining everything. what is foreign to it.

Keywords: STEM, higher education, social sciences, history

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Authors: Samuel Munaf, Kevin Swingler, Franz Brülisauer, Anthony O’Hare, George Gunn, Aaron Reeves

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Background: Avian influenza, more commonly known as Bird flu, is a viral zoonotic respiratory disease stemming from various species of poultry, including pets and migratory birds. Researchers have purported that the accessibility of health information online, in addition to the low-cost data collection methods the internet provides, has revolutionized the methods in which epidemiological and disease surveillance data is utilized. This paper examines the feasibility of using internet data sources, such as Twitter and livestock forums, for the early detection of the avian flu outbreak, through the use of text mining algorithms and social network analysis. Methods: Social media mining was conducted on Twitter between the period of 01/01/2021 to 31/12/2021 via the Twitter API in Python. The results were filtered firstly by hashtags (#avianflu, #birdflu), word occurrences (avian flu, bird flu, H5N1), and then refined further by location to include only those results from within the UK. Analysis was conducted on this text in a time-series manner to determine keyword frequencies and topic modeling to uncover insights in the text prior to a confirmed outbreak. Further analysis was performed by examining clinical signs (e.g., swollen head, blue comb, dullness) within the time series prior to the confirmed avian flu outbreak by the Animal and Plant Health Agency (APHA). Results: The increased search results in Google and avian flu-related tweets showed a correlation in time with the confirmed cases. Topic modeling uncovered clusters of word occurrences relating to livestock biosecurity, disposal of dead birds, and prevention measures. Conclusions: Text mining social media data can prove to be useful in relation to analysing discussed topics for epidemiological surveillance purposes, especially given the lack of applied research in the veterinary domain. The small sample size of tweets for certain weekly time periods makes it difficult to provide statistically plausible results, in addition to a great amount of textual noise in the data.

Keywords: veterinary epidemiology, disease surveillance, infodemiology, infoveillance, avian influenza, social media

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Authors: Jonas Colin

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Standing at the vanguard of AI development, Alpha represents an unprecedented synthesis of logical rigor and human abstraction, meticulously crafted to mirror the user's unique persona and personality, a feat previously unattainable in AI development. Alpha, an avant-garde artefact in the realm of artificial intelligence, epitomizes a paradigmatic shift in personalized digital interaction, amalgamating user-specific dialogic patterns with the sophisticated algorithmic prowess of OpenAI's GPT-3.5 to engender a platform for enhanced metacognitive engagement and individualized user experience. Underpinned by a sophisticated algorithmic framework, Alpha integrates vast datasets through a complex interplay of neural network models and symbolic AI, facilitating a dynamic, adaptive learning process. This integration enables the system to construct a detailed user profile, encompassing linguistic preferences, emotional tendencies, and cognitive styles, tailoring interactions to align with individual characteristics and conversational contexts. Furthermore, Alpha incorporates advanced metacognitive elements, enabling real-time reflection and adaptation in communication strategies. This self-reflective capability ensures continuous refinement of its interaction model, positioning Alpha not just as a technological marvel but as a harbinger of a new era in human-computer interaction, where machines engage with us on a deeply personal and cognitive level, transforming our interaction with the digital world.

Keywords: chatbot, GPT 3.5, metacognition, symbiose

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Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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Authors: Chih-Chieh Yang, Chung-Neng Huang

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In power system, how to improve the fault diagnosis technology of transmission line has always been the primary goal of power grid operators. In recent years, due to the rise of green energy, the addition of all kinds of distributed power also has an impact on the stability of the power system. Because the smart meters are with the function of data recording and bidirectional transmission, the adaptive Fuzzy Neural inference system, ANFIS, as well as the artificial intelligence that has the characteristics of learning and estimation in artificial intelligence. For transmission network, in order to avoid misjudgment of the fault type and location due to the input of these unstable power sources, combined with the above advantages of smart meter and ANFIS, a method for identifying fault types and location of faults is proposed in this study. In ANFIS training, the bus voltage and current information collected by smart meters can be trained through the ANFIS tool in MATLAB to generate fault codes to identify different types of faults and the location of faults. In addition, due to the uncertainty of distributed generation, a wind power system is added to the transmission network to verify the diagnosis correctness of the study. Simulation results show that the method proposed in this study can correctly identify the fault type and location of fault with more efficiency, and can deal with the interference caused by the addition of unstable power sources.

Keywords: ANFIS, fault diagnosis, power system, smart meter

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Authors: Vincent Ballola, Raymund Dilan, Thelma Palaoag

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The Smart Online Library Catalog System with Query Expansion seeks to address the low usage of the library because of the emergence of the Internet. Library users are not accustomed to catalog systems that need a query to have the exact words without any mistakes for decent results to appear. The graphical user interface of the current system has a rather skewed learning curve for users to adapt with. With a simple graphical user interface inspired by Google, users can search quickly just by inputting their query and hitting the search button. Because of the query expansion techniques incorporated into the new system such as stemming, thesaurus search, and weighted search, users can have more efficient results from their query. The system will be adding the root words of the user's query to the query itself which will then be cross-referenced to a thesaurus database to search for any synonyms that will be added to the query. The results will then be arranged by the number of times the word has been searched. Online queries will also be added to the results for additional references. Users showed notable increases in efficiency and usability due to the familiar interface and query expansion techniques incorporated in the system. The simple yet familiar design led to a better user experience. Users also said that they would be more inclined in using the library because of the new system. The incorporation of query expansion techniques gives a notable increase of results to users that in turn gives them a wider range of resources found in the library. Used books mean more knowledge imparted to the users.

Keywords: query expansion, catalog system, stemming, weighted search, usability, thesaurus search

Procedia PDF Downloads 377

Authors: Rachel Cherner

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Introduction: The current study investigates several user characteristics that may predict the adoption of digital mental health supports. The extent to which individual characteristics predict preferences for functional elements of computer-mediated social support (CMSS) platforms and mental health (MH) apps is relatively unstudied. Aims: The present study seeks to illuminate the relationship between broad user characteristics and perceived attraction to CMSS platforms and MH apps. Methods: Participants (n=353) were recruited using convenience sampling methods (i.e., digital flyers, email distribution, and online survey forums). The sample was 68% male, and 32% female, with a mean age of 29. Participant racial and ethnic breakdown was 75% White, 7%, 5% Asian, and 5% Black or African American. Participants were asked to complete a 25-minute self-report questionnaire that included empirically validated measures assessing a battery of characteristics (i.e., subjective levels of anxiety/depression via PHQ-9 (Patient Health Questionnaire 9-item) and GAD-7 (Generalized Anxiety Disorder 7-item); attachment style via MAQ (Measure of Attachment Qualities); personality types via TIPI (The 10-Item Personality Inventory); growth mindset and mental health-seeking attitudes via GM (Growth Mindset Scale) and MHSAS (Mental Help Seeking Attitudes Scale)) and subsequent attitudes toward CMSS platforms and MH apps. Results: A stepwise linear regression was used to test if user characteristics significantly predicted attitudes towards key features of CMSS platforms and MH apps. The overall regression was statistically significant (R² =.20, F(1,344)=14.49, p<.000). Conclusion: This original study examines the clinical and sociocultural factors influencing decisions to use CMSS platforms and MH apps. Findings provide valuable insight for increasing adoption and engagement with digital mental health support. Fostering a growth mindset may be a method of increasing participant/patient engagement. In addition, CMSS platforms and MH apps may empower under-resourced and minority groups to gain basic access to mental health support. We do not assume this final model contains the best predictors of use; this is merely a preliminary step toward understanding the psychology and attitudes of CMSS platform/MH app users.

Keywords: computer-mediated social support platforms, digital mental health, growth mindset, health-seeking attitudes, mental health apps, user characteristics

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Authors: D. F. Carvalho, A. O. Uscamayta, J. C. Guerrero, H. F. Oliveira, P. M. Azevedo-Marques

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The creation of vector contours slices (ROIs) on body silhouettes in oncologic patients is an important step during the radiotherapy planning in clinic and hospitals to ensure the accuracy of oncologic treatment. The radiotherapy planning of patients is performed by complex softwares focused on analysis of tumor regions, protection of organs at risk (OARs) and calculation of radiation doses for anomalies (tumors). These softwares are supplied for a few manufacturers and run over sophisticated workstations with vector processing presenting a cost of approximately twenty thousand dollars. The Brazilian project SIPRAD (Radiotherapy Planning System) presents a proposal adapted to the emerging countries reality that generally does not have the monetary conditions to acquire some radiotherapy planning workstations, resulting in waiting queues for new patients treatment. The SIPRAD project is composed by a set of integrated and interoperabilities softwares that are able to execute all stages of radiotherapy planning on simple personal computers (PCs) in replace to the workstations. The goal of this work is to present an image processing technique, computationally feasible, that is able to perform an automatic contour delineation in patient body silhouettes (SIPRAD-Body). The SIPRAD-Body technique is performed in tomography slices under grayscale images, extending their use with a greedy algorithm in three dimensions. SIPRAD-Body creates an irregular polyhedron with the Canny Edge adapted algorithm without the use of preprocessing filters, as contrast and brightness. In addition, comparing the technique SIPRAD-Body with existing current solutions is reached a contours similarity at least 78%. For this comparison is used four criteria: contour area, contour length, difference between the mass centers and Jaccard index technique. SIPRAD-Body was tested in a set of oncologic exams provided by the Clinical Hospital of the University of Sao Paulo (HCRP-USP). The exams were applied in patients with different conditions of ethnology, ages, tumor severities and body regions. Even in case of services that have already workstations, it is possible to have SIPRAD working together PCs because of the interoperability of communication between both systems through the DICOM protocol that provides an increase of workflow. Therefore, the conclusion is that SIPRAD-Body technique is feasible because of its degree of similarity in both new radiotherapy planning services and existing services.

Keywords: radiotherapy, image processing, DICOM RT, Treatment Planning System (TPS)

Procedia PDF Downloads 281

Authors: Olubiyi Johnson Ezekiel

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Basic science curriculum is an on-going effort towards developing the potential of manner to produce individuals in a holistic and integrated person, who are intellectually, spiritually, emotionally and physically balanced and harmonious. The main focus of this study is to determine the relationship between students’ achievement in junior school certificate examination (JSCE) and senior school basic science achievement test (SSBSAT) on the basis of all the components of basic science. The study employed the descriptive research of the survey type and utilized junior school certificate examination and senior school basic science achievement test(r = .87) scores as instruments. The data collected were subjected to Pearson product moment correlation, Spearman rank correlation, regression analysis and analysis of variance. The result of the finding revealed that the mean effects of the achievement in all the components of basic science on SSBSAT are significantly different from zero. Based on the results of the findings, it was concluded that the relationship between students’ achievement in JSCE and SSBSAT was weak and to achieve a unit increase in the students’ achievement in the SSBSAT when other subjects are held constant, we have to increase the learning of: -physics by 0.081 units; -chemistry by 0.072 units; -biology by 0.025 units and general knowledge by 0.097 units. It was recommended among others, that general knowledge aspect of basic science should be included in either physics or chemistry aspect of basic science.

Keywords: basic science curriculum, students’ achievement, science test, secondary school students

Procedia PDF Downloads 427

Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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Authors: Rida Akzar, Risti Permani, Wahida , Wendy Umberger

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Adoption of farm innovations may increase farm productivity, and therefore improve market access and farm incomes. However, most studies that look at the level and drivers of innovation adoption only focus on a specific type of innovation. Farmers may consider multiple innovation options, and constraints such as budget, environment, scarcity of labour supply, and the cost of learning. There have been some studies proposing different methods to combine a broad variety of innovations into a single measurable index. However, little has been done to compare these methods and assess whether they provide similar information about farmer segmentation by their ‘innovativeness’. Using data from a recent survey of 220 dairy farm households in West Java, Indonesia, this study compares and considers different methods of deriving an innovation index, including expert-weighted innovation index; an index derived from the total number of adopted technologies; and an index of the extent of adoption of innovation taking into account both adoption and disadoption of multiple innovations. Second, it examines the distribution of different farming systems taking into account their innovativeness and farm characteristics. Results from this study will inform policy makers and stakeholders in the dairy industry on how to better design, target and deliver programs to improve and encourage farm innovation, and therefore improve farm productivity and the performance of the dairy industry in Indonesia.

Keywords: adoption, dairy, household survey, innovation index, Indonesia, multiple innovations dairy, West Java

Procedia PDF Downloads 322

Authors: Fharia Tilat Loba

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Studies show that there is a certain group of students who are more vulnerable to bullying due to their physical appearance, disability, sexual preference, race, and lack of social and behavioral skills. Students with autism spectrum disorders (ASD) are one of the most vulnerable groups among these at-risk groups. Researchers suggest that focusing on vulnerable groups of students who can be the target of bullying helps to understand the causes and patterns of aggression, which ultimately helps in structuring intervention programs to reduce bullying. Since Australia ratified the United Nations Convention on the Rights of Persons with Disabilities in 2006, it has been committed to providing an inclusive, safe, and effective learning environment for all children. In addition, the 2005 Disability Standards for Education seeks to ensure that students with disabilities can access and participate in education on the same basis as other students, covering all aspects of education, including harassment and victimization. However, bullying hinders students’ ability to fully participate in schooling. The proposed study aims to synthesize the notions of traditional bullying and cyberbullying and attempts to understand the experiences of students with ASD who are experiencing bullying in their schools. The proposed study will primarily focus on identifying the gaps between policy and practice related to bullying, and it will also attempt to understand the experiences of parents of students with ASD and professionals who have experience dealing with bullying at the school level in Australia. This study is expected to contribute to the theoretical knowledge of the bullying phenomenon and provide a reference for advocacy at the school, organization, and government levels.

Keywords: education policy, bullying, Australia, neurodiversity

Procedia PDF Downloads 41

Authors: Eric Granholm, Christophe Delay, Jason Holden, Peter Link

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Negative symptoms are an important unmet treatment needed for schizophrenia. We conducted an open trial of a novel blended intervention called mobile-assisted cognitive behavior therapy for negative symptoms (mCBTn). mCBTn is a weekly group therapy intervention combining in-person and smartphone-based CBT (CBT2go app) to improve experiential negative symptoms in people with schizophrenia. Both the therapy group and CBT2go app included recovery goal setting, thought challenging, scheduling of pleasurable activities and social interactions, and pleasure savoring interventions to modify defeatist attitudes, a target mechanism associated with negative symptoms, and improve experiential negative symptoms. We tested whether participants with schizophrenia or schizoaffective disorder (N=31) who met prospective criteria for persistent negative symptoms showed improvement in experiential negative symptoms. Retention was excellent (87% at 18 weeks) and severity of defeatist attitudes and motivation and pleasure negative symptoms declined significantly in mCBTn with large effect sizes. We also tested whether pupillary responses, a measure of cognitive effort, predicted improvement in negative symptoms mCBTn. Pupillary responses were recorded at baseline using a Tobii pupillometer during the digit span task with 3-, 6- and 9-digit spans. Mixed models showed that greater dilation during the task at baseline significantly predicted a greater reduction in experiential negative symptoms. Pupillary responses may provide a much-needed prognostic biomarker of which patients are most likely to benefit from CBT. Greater pupil dilation during a cognitive task predicted greater improvement in experiential negative symptoms. Pupil dilation has been linked to motivation and engagement of executive control, so these factors may contribute to benefits in interventions that train cognitive skills to manage negative thoughts and emotions. The findings suggest mCBTn is a feasible and effective treatment for experiential negative symptoms and justify a larger randomized controlled clinical trial. The findings also provide support for the defeatist attitude model of experiential negative symptoms and suggest that mobile-assisted interventions like mCBTn can strengthen and shorten intensive psychosocial interventions for schizophrenia.

Keywords: cognitive-behavioral therapy, mobile interventions, negative symptoms, pupillometry schizophrenia

Procedia PDF Downloads 170

Authors: Gina Aurora Necula

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From its transformation into a taboo and its hiding under the so-called “Moldovan language” or under the euphemistic expression “state language” to its regained status recognition as an official language, the Romanian language spoken in the Republic of Moldova has undergone impressive reforms in the last 60 years. Meant to erase the awareness of citizens’ ethnic identity and turn a majority language into a minority one, all the laws and regulations issued on the field succeeded into setting numerous barriers for speakers of Romanian. Either manifested as social constraints or materialized into assumed rejection of mother tongue usage, all these laws have demonstrated their usefulness and major impact on the Romanian-speaking population. This article is the result of our research carried out over 10 years with the support of students, and Moldovan citizens, from the master's degree program "Romanian language - identity and cultural awareness." We present here a retrospective insight of the reforms, laws, and regulations that contributed to the shifted status of the Romanian language from the official language, seen as the language of common use both in the public and private spheres, in the minority language that surrendered its privileged place to the Russian language, firstly in the public sphere, and then, slowly but surely, in the private sphere. Our main goal here is to identify and make speakers understand what the barriers to learning Romanian language are nowadays when the social pressure on using Russian no longer exists.

Keywords: linguistic barriers, lingua franca, private sphere, public sphere, reformation

Procedia PDF Downloads 99

Authors: Aiydh Aljeddani, Fran Martin

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The study mainly aims at exploring and understanding the current practice of social studies and citizenship education curriculum contribution to sustainability literacy and competency of the ninth and tenth grade students in the Saudi general education context. This study stems from a need for conducting research in general education contexts in order to prepare future graduate students who possess fundamental elements of education for sustainable development. To the best of our knowledge, the literature on education for sustainable development reveals that little research has been conducted so far on general education contexts and this study will add new knowledge in the literature. The study is interpretive in nature and employs a qualitative case study approach, and ethnography methodologies to understand deeply this complex educational phenomenon. 167 participants took part in this study, they were from six general education schools and made up of 25 teachers, and 142 students. Document analysis, semi-structured interviews, nominal group technique, and passive participant observation were used in order to gather the data for this study. The outcomes of the study showed the keenness of the Saudi government on promoting and raising awareness education for sustainable development among its younger generation via a sustainable development promoting curriculum. However, applying this vision in a real school setting, particularly via the social studies and citizenship education curriculum in grades nine and ten, has been challenging for different reasons as revealed by this study. First, incorporating sustainability in the social studies and citizenship education curriculum in the Saudi grade ninth and tenth grade, is based on the vision of the Saudi government but the ministry of education’s rules and regulations do not support it. Moreover, the circulars issued by the ministry are also not supportive of teachers and students efforts to implement a sustainable development education curriculum. Second, teachers, as members of this community who play a significant role in achieving the objectives of incorporating sustainability, are often seen as technicians and not as professional human beings. They are confined to the curriculum, the classroom and stripped of their will power by the school management and the educational administration. The subjects, who are students here, are also not prepared nor guided to achieve the objects. In addition, the tools mediated between subjects and objects are not convenient. There were some major challenges regarding the contradictions in incorporating sustainability processes such as demanding creativity from a teacher who is overloaded with tasks irrelevant to teaching and teachers’ training programs not meeting the teachers’ training needs.

Keywords: practice, integrating sustainability, curriculum, educational context

Procedia PDF Downloads 375

Authors: Junior George Martin

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The purpose of this study was to explore college instructors’ integration of technology in their content area curriculum. The instructors indicated that they were in need of additional training to successfully integrate technology in their subject areas. The findings point to the implementation of a proposed the Technological, Pedagogical, and Content Knowledge (TPACK) model professional development workshop to satisfactorily address the weaknesses of the instructors in technology integration. The professional development workshop is proposed as a rational solution to adequately address the instructors’ inability to the successful integration of technology in their subject area in an effort to improve their pedagogy. The intense workshop would last for 5 days and will be designed to provide instructors with training in areas such as a use of technology applications and tools, and using modern methodologies to improve technology integration. Exposing the instructors to the specific areas identified will address the weaknesses they demonstrated during the study. Professional development is deemed the most appropriate intervention based on the opportunities it provides the instructors to access hands-on training to overcome their weaknesses. The purpose of the TPACK professional development workshop will be to improve the competence of the instructors so that they are adequately prepared to integrate technology successfully in their curricula. At the end of the period training, the instructors are expected to adopt strategies that will have a positive impact on the learning experiences of the students.

Keywords: higher education, modern technology tools, professional development, technology integration

Procedia PDF Downloads 295

Authors: Wiesława Klimek-Piotrowska, Mateusz K. Hołda, Mateusz Koziej, Katarzyna Piątek, Jakub Hołda

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Introduction: The coronary sinus venous system (CSVS), which has always been overshadowed by the coronary arterial tree, has recently begun to attract more attention. Since it is a target for clinicians the knowledge of its anatomy is essential. Cardiac resynchronization therapy, catheter ablation of cardiac arrhythmias, defibrillation, perfusion therapy, mitral valve annuloplasty, targeted drug delivery, and retrograde cardioplegia administration are commonly used therapeutic methods involving the CSVS. The great variability in the course of coronary veins and tributaries makes the diagnostic and therapeutic processes difficult. Our aim was to investigate detailed anatomy of most common clinically used CSVS`s structures: the coronary sinus with its ostium, great cardiac vein, posterior vein of the left ventricle, middle cardiac vein and oblique vein of the left atrium. Methodology: This is a prospective study of 70 randomly selected autopsied hearts dissected from adult humans (Caucasian) aged 50.1±17.6 years old (24.3% females) with BMI=27.6±6.7 kg/m2. The morphology of the CSVS was assessed as well as its precise measurements were performed. Results: The coronary sinus (CS) with its ostium was present in all hearts. The mean CS ostium diameter was 9.9±2.5mm. Considered ostium was covered by its valve in 87.1% with mean valve height amounted 5.1±3.1mm. The mean percentage coverage of the CS ostium by the valve was 56%. The Vieussens valve was present in 71.4% and was unicuspid in 70%, bicuspid in 26% and tricuspid in 4% of hearts. The great cardiac vein was present in all cases. The oblique vein of the left atrium was observed in 84.3% of hearts with mean length amounted 20.2±9.3mm and mean ostium diameter 1.4±0.9mm. The average length of the CS (from the CS ostium to the Vieussens valve) was 31.1±9.5mm or (from the CS ostium to the ostium of the oblique vein of the left atrium) 28.9±10.1mm and both were correlated with the heart weight (r=0.47; p=0.00 and r=0.38; p=0.006 respectively). In 90.5% the ostium of the oblique vein of the left atrium was located proximally to the Vieussens valve, in remaining cases was distally. The middle cardiac vein was present in all hearts and its valve was noticed in more than half of all the cases (52.9%). The posterior vein of the left ventricle was observed in 91.4% of cases. Conclusions: The CSVS is vastly variable and none of basic hearts parameters is a good predictor of its morphology. The Vieussens valve could be a significant obstacle during CS cannulation. Caution should be exercised in this area to avoid coronary sinus perforation. Because of the higher incidence of the presence of the oblique vein of the left atrium than the Vieussens valve, the vein orifice is more useful in determining the CS length.

Keywords: cardiac resynchronization therapy, coronary sinus, Thebesian valve, Vieussens valve

Procedia PDF Downloads 282

Authors: P. Panwalkar, K. Veravalli, M. Tofighi, A. Mofidi

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Introduction: Anterior femoral perforation or distal anterior nail position is a known complication of femoral nailing specifically in pertrochantric fractures fixed with cephalomedullary nail. This has been attributed to wrong entry point for the femoral nail, nail with large radius of curvature or malreduced fracture. Left alone anterior perforation of femur or abutment of nail on anterior femur will result in pain and risk stress riser at distal femur and periprosthetic fracture. There have been multiple techniques described to avert or correct this problem ranging from using different nail, entry point change, poller screw to deflect the nail position, use of shorter nail or use of curved guidewire or change of nail to ensure a nail with large radius of curvature Methods: We present this technique which we have used in order to centralise the femoral nail either when the nail has been put anteriorly or when the guide wire has been inserted too anteriorly prior to the insertion of the nail. This technique requires the use of femoral reduction spool from the nailing set. This technique was used by eight trainees of different level of experience under supervision. Results: This technique was easily reproducible without any learning curve without a need for opening of fracture site or change in the entry point with three different femoral nailing sets in twenty-five cases. The process took less than 10 minutes even when revising a malpositioned femoral nail. Conclusion: Our technique of using femoral reduction spool is easily reproducible and repeatable technique for avoidance of non-centralised femoral nail insertion and distal anterior perforation of femoral nail.

Keywords: femoral fracture, nailing, malposition, surgery

Procedia PDF Downloads 121