Search results for: medical equipment remanufacture

Authors: Nasim Hashemi, Abbas Sheikhtaheri

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Telemedicine is the use of telecommunication and information technologies to provide health care services that would often not be consistently available in distant rural communities to people at these remote areas. Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Thus, teleophthalmology can overcome geographical barriers and improve quality, access, and affordability of eye health care services. Since teleophthalmology has been widespread applied in recent years, the aim of this study was to determine the different applications of teleophthalmology in the world. To this end, three bibliographic databases (Medline, ScienceDirect, Scopus) were comprehensively searched with these keywords: eye care, eye health care, primary eye care, diagnosis, detection, and screening of different eye diseases in conjunction with telemedicine, telehealth, teleophthalmology, e-services, and information technology. All types of papers were included in the study with no time restriction. We conducted the search strategies until 2015. Finally 70 articles were surveyed. We classified the results based on the’type of eye problems covered’ and ‘the type of telemedicine services’. Based on the review, from the ‘perspective of health care levels’, there are three level for eye health care as primary, secondary and tertiary eye care. From the ‘perspective of eye care services’, the main application of teleophthalmology in primary eye care was related to the diagnosis of different eye diseases such as diabetic retinopathy, macular edema, strabismus and aged related macular degeneration. The main application of teleophthalmology in secondary and tertiary eye care was related to the screening of eye problems i.e. diabetic retinopathy, astigmatism, glaucoma screening. Teleconsultation between health care providers and ophthalmologists and also education and training sessions for patients were other types of teleophthalmology in world. Real time, store–forward and hybrid methods were the main forms of the communication from the perspective of ‘teleophthalmology mode’ which is used based on IT infrastructure between sending and receiving centers. In aspect of specialists, early detection of serious aged-related ophthalmic disease in population, screening of eye disease processes, consultation in an emergency cases and comprehensive eye examination were the most important benefits of teleophthalmology. Cost-effectiveness of teleophthalmology projects resulted from reducing transportation and accommodation cost, access to affordable eye care services and receiving specialist opinions were also the main advantages of teleophthalmology for patients. Teleophthalmology brings valuable secondary and tertiary care to remote areas. So, applying teleophthalmology for detection, treatment and screening purposes and expanding its use in new applications such as eye surgery will be a key tool to promote public health and integrating eye care to primary health care.

Keywords: applications, telehealth, telemedicine, teleophthalmology

Procedia PDF Downloads 354

Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Lakshminarayanan, Vijayaraghavan, Krishnamurthy

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The ever-increasing demand for high efficiency in automotive and aerospace applications requires new materials to suit to high temperature applications. The Ceramic Matrix Composites nowadays find its applications for high strength and high temperature environments. In this paper, Al2O3 and Sic ceramic materials are taken in particulate form as matrix and reinforcement respectively. They are blended together in Ball Milling and compacted in Cold Compaction Machine by powder metallurgy technique. Scanning Electron Microscope images are taken for the samples in order to find out proper blending of powders. Micro harness testing is also carried out for the samples in Vickers Micro Hardness Testing Equipment. Surface grinding of the samples is also carried out in Surface Grinding Machine in order to find out grinding force estimates. The surface roughness of the grounded samples is also taken in Surface Profilometer. These are yielding promising results.

Keywords: ceramic matrix composite, cold compaction, material characterization, particulate and surface grinding

Procedia PDF Downloads 230

Authors: Magdaléna Náplavová, Tomáš Ludík, Petr Hrůza, František Božek

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The use of IT equipment has become a part of every day. However, each device that is part of cyberspace should be secured against unauthorized use. It is very important to know the basics of these security devices, but also the basics of safe conduct their owners. This information should be part of every curriculum computer science education in primary and secondary schools. Therefore, the work focuses on the education of pupils in primary and secondary schools on the Internet. Analysis of the current state describes approaches to the education of pupils in security issues on the Internet. The paper presents a questionnaire-based survey which was carried out in the Czech Republic, whose task was to ascertain the level of opinion pupils in primary and secondary schools on the issue of communication in social networks. The research showed that awareness of socio-pathological phenomena on the Internet environment is very low. Based on the results it was proposed appropriate ways of teaching to this issue and its inclusion a proposal of curriculum for primary and secondary schools.

Keywords: information security, cyber space, general awareness, questionnaire, socio-pathological phenomena, educational system

Procedia PDF Downloads 371

Authors: Heba Elbibas, Esra Gnijeewa, Zedan Hatush

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This paper presents research on occupational safety in construction projects, where the importance of safety management in projects was studied, including the preparation of a safety plan and program for each project and the identification of the responsibilities of each party to the contract. The research consists of two parts: 1-Field visits: which were field visits to three construction projects, including building projects, road projects, and tower installation. The safety level of these projects was evaluated through a checklist that includes the most important safety elements in terms of the application of these items in the projects. 2-Preparation of a questionnaire: which included supervisors and engineers and aimed to determine the level of awareness and commitment of different project categories to safety standards. The results showed the following: i) There is a moderate occupational safety policy. ii) The preparation and storage of maintenance reports are not fully complied with. iii) There is a moderate level of training on occupational safety for project workers. iv) The company does not impose penalties on safety violators permanently. v) There is a moderate policy for equipment and machinery safety. vi) Self-injuries occur due to (fatigue, lack of attention, deliberate error, and emotional factors), with a rate of 82.4%.

Keywords: management, safety, occupational safety, classification

Procedia PDF Downloads 83

Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

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Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

Procedia PDF Downloads 133

Authors: Gadisa Alemayehu, Muralidhar Avvari, Atkilt Mulu G.

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Since 1962 EC, the Faffa Food Share Company has been producing and supplying flour (famix) and value-added flour (baby food) in Ethiopia. It meets nearly all of the country's total flour demand, both for relief and commercial markets. However, it is incompetent in the international market due to a poor maintenance management system. The results of recorded documents and stopwatches revealed that frequent failure machines, as well as a poor maintenance management system, cause increased production downtimes, resulting in a 29.19 percent decrease in production from the planned production. As a result, the current study's goal is to recommend newly developed software for use in and as a Computerized Maintenance Management System (CMMS). As a result, the system increases machine reliability and decreases the frequency of equipment failure, reducing breakdown time and maintenance costs. The company's overall manufacturing performance improved by 4.45 percent, particularly after the implementation of the CMMS.

Keywords: CMMS, manufacturing performance, delivery, availability, flexibility, Faffa Food Share Company

Procedia PDF Downloads 112

Authors: Rajeshwari Madli, Santhosh Hebbar, Vishwanath Heddoori, G. V. Prasad

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Agriculture is the major occupation in India and forms the backbone of Indian economy in which irrigation plays a crucial role for increasing the quality and quantity of crop yield. In spite of many revolutionary advancements in agriculture, there has not been a dramatic increase in agricultural performance. Lack of irrigation infrastructure and agricultural knowledge are the critical factors influencing agricultural performance. However, by using advanced agricultural equipment, the effect of these factors can be curtailed.  The presented system aims at increasing the yield of crops by using an intelligent irrigation controller that makes use of wireless sensors. Sensors are used to monitor primary parameters such as soil moisture, soil pH, temperature and humidity. Irrigation decisions are taken based on the sensed data and the type of crop being grown. The system provides a mobile application in which farmers can remotely monitor and control the irrigation system. Also, the water pump is protected against damages due to voltage variations and dry running.

Keywords: android application, Bluetooth, wireless sensors, irrigation, temperature, soil pH

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Authors: Sushil Kumar, Mukesh Jain, Vijaya Rani, Vinod Kumar

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The prime importance of tillage is that it prepares the land where the seed easily germinate and later the plant can well establish. Using different types of equipments driven manually or by powered, machines make the soil suitable to place the seeds into the desirable depth. Moreover, tillage loosens the compacted layers. Heavy equipment and tillage implements can cause damage to the soil structure. Effect of various tillage methods on soil compaction was studied in Rabi season of 2013-14 at village Ladwa, Hisar, Haryana (India). The experiments studied the effect of six tillage treatments i.e. no tillage or zero tillage (T1), tillage with rotavator (T2), disc harrow (T3), rotavator + sub soiler (T4), disc harrow + sub soiler (T5) and power harrow (T6) on soil compaction. Soil compaction was measured before tillage and after sowing at 0, 30, 60 and 90 days after sowing. No change in soil resistance was recorded before and after no tillage treatment. Maximum soil resistance was found in zero tillage followed by disc harrow up to 150 mm soil depth. Minimum soil resistance was found in rotavator immediately after the tillage treatment. However, the soil resistance approached the same level as it had been before the tillage after the soil strata where the implement cannot reach.

Keywords: tillage, no tillage, rotavator, subsoiler, compaction

Procedia PDF Downloads 299

Authors: Yu-Chuan Huang

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Introduction: There is a higher mortality rate for unplanned transfer to intensive care units. It also needs a longer length of stay and makes the intensive care unit beds cannot be effectively used. It affects the immediate medical treatment of critically ill patients, resulting in a drop in the quality of medical care. Purpose: The purpose of this study was using SOFA and APACHEII score to analyze the mortality rate of the cases transferred from ED to ICU. According to the score that should be provide an appropriate care as early as possible. Methods: This study was a descriptive experimental design. The sample size was estimated at 220 to reach a power of 0.8 for detecting a medium effect size of 0.30, with a 0.05 significance level, using G-power. Considering an estimated follow-up loss, the required sample size was estimated as 242 participants. Data were calculated by medical system of SOFA and APACHEII score that cases transferred from ED to ICU in 2016. Results: There were 233 participants meet the study. The medical records showed 33 participants’ mortality. Age and sex with QSOFA , SOFA and sex with APACHEII showed p>0.05. Age with APCHHII in ED and ICU showed r=0.150, 0,268 (p < 0.001**). The score with mortality risk showed: ED QSOFA is r=0.235 (p < 0.001**), exp(B)=1.685(p = 0.007); ICU SOFA 0.78 (p < 0.001**), exp(B)=1.205(p < 0.001). APACHII in ED and ICU showed r= 0.253, 0.286 (p < 0.001**), exp(B) = 1.041,1.073(p = 0.017,0.001). For SOFA, a cutoff score of above 15 points was identified as a predictor of the 95% mortality risk. Conclusions: The SOFA and APACHE II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hours of ICU admission. In conclusion, the SOFA and APACHII score is significantly associated with mortality and strongly predicting mortality. Early predictors of morbidity and mortality, which we can according the predicting score, and provide patients with a detail assessment and proper care, thereby reducing mortality and length of stay.

Keywords: SOFA, APACHEII, mortality, ICU

Procedia PDF Downloads 135

Authors: Shayan Rezvanigilkolaei, Shayesteh Vefaghnematollahi

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Electrical impedance tomography is a non-invasive medical imaging technique suitable for medical applications. This paper describes an electrical impedance tomography device with the ability to navigate a robotic arm to manipulate a target object. The design of the device includes various hardware and software sections to perform medical imaging and control the robotic arm. In its hardware section an image is formed by 16 electrodes which are located around a container. This image is used to navigate a 3DOF robotic arm to reach the exact location of the target object. The data set to form the impedance imaging is obtained by having repeated current injections and voltage measurements between all electrode pairs. After performing the necessary calculations to obtain the impedance, information is transmitted to the computer. This data is fed and then executed in MATLAB which is interfaced with EIDORS (Electrical Impedance Tomography Reconstruction Software) to reconstruct the image based on the acquired data. In the next step, the coordinates of the center of the target object are calculated by image processing toolbox of MATLAB (IPT). Finally, these coordinates are used to calculate the angles of each joint of the robotic arm. The robotic arm moves to the desired tissue with the user command.

Keywords: electrical impedance tomography, EIT, surgeon robot, image processing of electrical impedance tomography

Procedia PDF Downloads 262

Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

Procedia PDF Downloads 157

Authors: Hasan Hüseyin Doğan, Murad Aydın Şanda

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Element contents were analyzed in twelve wild Amanita taxa [A. caesarea (Scop.) Pers., A. citrina (Schaeff.) Pers., A. excelsa (Fr.) Bertill., A. franchetii (Boud.) Fayod, A. gemmata (Fr.) Bertill., A. mairei Foley, A. muscaria (L.) Lam., A. pantherina (DC.) Krombh., A. phalloides (Fr.) Link, A. rubescens Pers., A. vaginata (Bull.) Lam., and A. verna (Bull.) Lam.] from Marmara Region of Turkey by ICP-AES equipment. The element uptake levels were observed at different amounts in each Amanita species. The highest Pb and P concentrations were determined as 15.11 and 0.861 mg.kg-1 in A. caesarea. Fe, Co, As, Sr, Ca, Mg, Al and Na concentrations were determined as 0.832, 4.56, 15.6, 18.9, 0.44, 0.253 and 0.190 mg.kg-1 in A. gemmata respectively. A. muscaria has highest Mo, Th, Sb, V, Cr, and B concentrations as 1.45, 1.17, 1.06, 44, 75, and 7 mg.kg-1 respectively, whereas A. rubescens has highest Zn, Ba, K, S, and Se as 430.6, 65.7, 5.47, 1.16, 11.5 mg.kg-1 respectively. A. muscaria has highest Hg concentrations as 5855 µg.kg-1.The highest Mn concentration were found in A. pantherina with 1176 mg.kg-1, the highest Cd were found in A. phalloides as 10.77 mg.kg-1. In contrast to A. verna has highest Ag and Au content as 77728 and 192 µg.kg-1. Although A. citrina has only the highest Ni content as 75.9 mg.kg-1and A. vaginata has Cu content as 67.04 mg.kg-1 on the other hand A. phalloides has highest Cd concentrations as 10.77 mg.kg-1.

Keywords: amanita, element, macrofungi, Turkey

Procedia PDF Downloads 396

Authors: Basitah Taif

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This study was to explore and utilize the fresh rind of mangosteen Index Colour 5 as an upcoming raw material for the production of natural dyes. Rind from the fresh mangosteen Index Colour 5 was utilized to extract the dyes. The established extracts were experimented on silk fabrics via three types of mordanting and dyeing procedures; pre-mordanting, simultaneous mordanting and post-mordanting. As a result, the applications of the freeze-drying methodology and mechanizable equipment have helped to produce excellent range of natural colours. Silk fabric treated simultaneously with mordanting and dyeing with extract dye Index Colour 5 produced a brilliant shade of the red colour and the colour from this index is also discovered sensitive to light and washing during the fastness tests. The preliminary evaluation and instrumentation analysis allowed us to examine whether the application of different mordanting and dyeing procedures with the same extract samples and concentrations affected the colours and shades of the fabric samples.

Keywords: natural dye, freeze-drying, Garcinia mangostana Linn, mordanting

Procedia PDF Downloads 446

Authors: Maya Agarwala

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Objectives: Audit the quality of clinical photographs taken for Orthodontic patients at Queen’s hospital, Romford. Design and setting: All Orthodontic photographs are taken in the Medical Photography Department at Queen’s Hospital. Retrospective audit with data collected between January - March 2023. Gold standard: Institute of Medical Illustrators (IMI) standard 12 photographs: 6 extraoral and 6 intraoral. 100% of patients to have the standard 12 photographs meeting a satisfactory diagnostic quality. Materials and methods: 30 patients randomly selected. All photographs analysed against the IMI gold standard. Results: A total of 360 photographs were analysed. 100% of the photographs had the 12 photographic views. Of which, 93.1% met the gold standard. Of the extraoral photos: 99.4% met the gold standard, 0.6% had incorrect head positioning. Of the intraoral photographs: 87.2% met the gold standard. The most common intraoral errors were: the presence of saliva pooling (7.2%), insufficient soft tissue retraction (3.3%), incomplete occlusal surface visibility (2.2%) and mirror fogging (1.1%). Conclusion: The gold standard was not met, however the overall standard of Orthodontic photographs is high. Further training of the Medical Photography team is needed to improve the quality of photographs. Following the training, the audit will be repeated. High-quality clinical photographs are an important part of clinical record keeping.

Keywords: orthodontics, paediatric, photography, audit

Procedia PDF Downloads 66

Authors: Chau-Kuang Chen, John Hughes, Jr., A. Dexter Samuels

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The prediction models for the United States Medical Licensure Examination (USMLE) Steps 1 and 2 performances were constructed by the Monte Carlo simulation modeling approach via linear regression. The purpose of this study was to build robust simulation models to accurately identify the most important predictors and yield the valid range estimations of the Steps 1 and 2 scores. The application of simulation modeling approach was deemed an effective way in predicting student performances on licensure examinations. Also, sensitivity analysis (a/k/a what-if analysis) in the simulation models was used to predict the magnitudes of Steps 1 and 2 affected by changes in the National Board of Medical Examiners (NBME) Basic Science Subject Board scores. In addition, the study results indicated that the Medical College Admission Test (MCAT) Verbal Reasoning score and Step 1 score were significant predictors of the Step 2 performance. Hence, institutions could screen qualified student applicants for interviews and document the effectiveness of basic science education program based on the simulation results.

Keywords: prediction model, sensitivity analysis, simulation method, USMLE

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Authors: Zoltán Höhling, Sarah-Lu Oberschelp, Niklas Gilsdorf, Michael Wirsching, Andrea Kuhnert

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A majority of medical students at the University of Freiburg reported stress-related psychosomatic symptoms which are often associated with their studies. International research supports these findings, as medical students worldwide seem to be at special risk for mental health problems. In some countries and institutions, psychologically based interventions that assist medical students in coping with their stressors have been implemented. It turned out that anonymity is an important aspect here. Many students fear a potential damage of reputation when being associated with mental health problems, which may be due to a high level of competitiveness in classes. Therefore, we launched an online-platform where medical students could anonymously seek help and exchange their experiences with fellow students and experts. Medical students of all semesters have access to it through the university’s learning management system (called “ILIAS”). The informative part of the platform consists of exemplary videos showing medical students (actors) who act out scenes that demonstrate the antecedents of stress-related psychosomatic disorders. These videos are linked to different expert comments, describing the exhibited symptoms in an understandable and normalizing way. The (inter-)active part of the platform consists of self-help tools (such as meditation exercises or general tips for stress-coping) and an anonymous interactive forum where students can describe their stress-related problems and seek guidance from experts and/or share their experiences with fellow students. Besides creating an immediate proposal to help affected students, we expect that competitiveness between students might be diminished and bondage improved through mutual support between them. In the initial phase after the platform’s launch, it was accessed by a considerable number of medical students. On a closer look it appeared that platform sections like general information on psychosomatic-symptoms and self-treatment tools were accessed far more often than the online-forum during the first months after the platform launch. Although initial acceptance of the platform was relatively high, students showed a rather passive way of using our platform. While user statistics showed a clear demand for information on stress-related psychosomatic symptoms and its possible remedies, active engagement in the interactive online-forum was rare. We are currently advertising the platform intensively and trying to point out the assured anonymity of the platform and its interactive forum. Our plans, to assure students their anonymity through the use of an e-learning facility and promote active engagement in the online forum, did not (yet) turn out as expected. The reasons behind this may be manifold and based on either e-learning related issues or issues related to students’ individual needs. Students might, for example, question the assured anonymity due to a lack of trust in the technological functioning university’s learning management system. However, one may also conclude that reluctance to discuss stress-related psychosomatic symptoms with peer medical students may not be solely based on anonymity concerns, but could be rooted in more complex issues such as general mistrust between students.

Keywords: e-tutoring, stress-coping, student support, online forum

Procedia PDF Downloads 371

Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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Authors: Hau-Wei Lee, Yu-Chi Liu, Chien-Hung Liu

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A mathematical model is presented for a system that measures rotational errors in a shaft using a ball lens. The geometric optical characteristics of the ball lens mounted on the shaft allows the measurement of rotation axis errors in both the radial and axial directions. The equipment used includes two quadrant detectors (QD), two laser diodes and a ball lens that is mounted on the rotating shaft to be evaluated. Rotational errors in the shaft cause changes in the optical geometry of the ball lens. The resulting deflection of the laser beams is detected by the QDs and their output signals are used to determine rotational errors. The radial and the axial rotational errors can be calculated as explained by the mathematical model. Results from system calibration show that the measurement error is within ±1 m and resolution is about 20 nm. Using a direct drive motor (DD motor) as an example, experimental results show a rotational error of less than 20 m. The most important features of this system are that it does not require the use of expensive optical components, it is small, very easy to set up, and measurements are highly accurate.

Keywords: ball lens, quadrant detector, axial error, radial error

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Authors: Muhammad Husnat Khalid, Stephan Bihn, Dirk Uwe Sauer, Nisai Fuengwarodsakul

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To combat the effects of climate change, lithium-ion batteries are getting a lot of attention for energy storage. However, due to its diverse range of applications extending from small electronics equipment to energy storage systems, its output requirements, as well as limitations, vary significantly. Many efforts are underway to increase the power and energy output of the cells without any significant compromise on their size and weight. In this paper, different active materials are explored for an existing cell Kokam that initially has graphite as anode and NCO as cathode material. The Pareto front optimization tool is then utilized to pick a cell that gives the optimum results in terms of energy, power, or both. The parameter variation of the cells is done in the MATLAB application ISEA Cell and Pack Database (ICPD) created by the Institute of Power Electronics and Electrical Drives (ISEA) RWTH Aachen, University that creates the physical-chemical model of the existing cells.

Keywords: battery storage system, lithium-ion battery, active material variation, cell design optimization

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Authors: Sonam Sandal, Susan Verghese P.

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The phrase "environmental tobacco smoke" (ETS) refers to exposure to tobacco smoke that isn't from your own smoking but instead is caused by being in close proximity to someone else's cigar, cigarette, or pipe smoke. Environmental cigarette smoke is one of the main contributors to indoor air pollution (IAP), which is exceedingly harmful to human health and results in millions of deaths each year, according to the World Health Organization. Sidestream smoke (SS), which is discharged from a cigarette's burning end in between puffs, is the primary cause of ETS. The bulk of the ETS residue is composed of gases that are produced while smoking through the cigarette paper, mainstream smoke (MS) ingested, and side stream smoke emitted while inhaling a puff from the burning end. Each of these mixtures—SS, ETS, and MS—is an aerosol composed of an IAP-causing vapor phase and a particle phase. Therefore, indoor air-cleaning equipment designed to remove particles will not significantly alter nicotine exposure but will alter the concentrations of other dangerous substances, including particulate matter (PM), PM 2.5, and PM 10. In conclusion, indoor airborne contaminants pose serious risks to human health. ETS degrades the air quality, and when someone breathes this bad air, it weakens their lungs and makes them more susceptible to COVID-19.

Keywords: pm 10, covid-19, indoor air pollution, cigarette smoke., pm 2.5

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Authors: Supattra Pranee

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The purposes of this research are to study the current business of health spa and to study the customers’ level of expectation as well as level of satisfaction of the health spa business in Ranong, Thailand. This paper drew upon data collected from health spa customers by using questionnaire. In addition, an in-depth interview was utilized to collect data from health spa entrepreneurs. The findings revealed that the health spa business is growing very fast and the coming ASEAN Economic Community (AEC) will ameliorate the business growth and increase the customer base. There is a need to improve staff’s ability to communicate in English. However, the economic size of Ranong province is still small which has resulted in the hesitation of investors to increase their investment in this business. The findings also revealed four categories of level of expectation and satisfaction as follows: (1) Service: overall, customers had a high expectation with a mean of 3.80 and 0.873 SD and a high level of satisfaction with a mean of 3.66 and 0.704 SD. (2) Staff: overall, customers had a high expectation with a mean of 3.95 and 0.865 SD and a high level of satisfaction with a mean of 3.84 and 0.783 SD. (3) Product, Equipment, and Tools: overall, customers had a high expectation with a mean of 4.02 and 0.913 SD and a high level of satisfaction with a mean of 3.88 and 0.772 SD. (4) Place, Atmosphere, and Environment: overall, customers had a high expectation with a mean of 3.95 and 0.906 SD and a high level of satisfaction with a mean of 3.86 and 0.785 SD.

Keywords: expectation, health spa business, satisfaction, ranong province

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Authors: Mohammad Saleem, Neeta Kumar, Anita Sharma, Sazina Muzammil

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It is observed that some of the dental students in our setting take less interest in medical subjects. Various teaching methods are focus of research interest currently and being tried to generate interest among students. An approach of interactive integrated tutorial was used to assess its feasibility in teaching medical subjects to dental undergraduates. The aim was to generate interest and promote active self-learning among students. The objectives were to (1) introduce the integrated interactive learning method through two departments, (2) get feedback from the students and faculty on feasibility and effectiveness of this method. Second-year students in Bachelor of Dental Surgery course were divided into two groups. Each group was asked to study physiology and pathology of a common and important condition (anemia and hypertension) in a week’s time. During the tutorial, students asked questions on physiology and pathology of that condition from each other in the presence of teachers of both physiology and pathology departments. The teachers acted only as facilitators. After the session, the feedback from students and faculty on this alternative learning method was obtained. Results: Majority of the students felt that this method of learning is enjoyable, helped to develop reasoning skills and ability to correlate and integrate the knowledge from two related fields. Majority of the students felt that this kind of learning led to better understanding of the topic and motivated them towards deep learning. Teachers observed that the study promoted interdepartmental cross-discipline collaboration and better students’ linkages. Conclusion: Interactive integrated tutorial is effective in motivating dental students for better and deep learning of medical subjects.

Keywords: active learning, education, integrated, interactive, self-learning, tutorials

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Authors: Shuja Alharbi

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Oil and Gas industry has many applications considered as toxic or hazardous, where process fluid leakage is not permitted and leads to health, safety, and environmental impacts. Caustic/Acidic applications, High Benzene Concentrations, Hydrogen sulfide rich oil/gas as well as liquids operating above their auto-ignition temperatures are examples of such liquids that pose as a risk to the industry operation, and for those, special arrangements are in place to allow for the safe operation environment. Pumps in the industry requires special attention, specifically in the interface between the fluid and the environment, where the potential of leakages are foreseen. Mechanical Seals are used to contain the fluid within the equipment, but the prices are ever increasing for such seals, along with maintenance, design, and operating requirements. Several alternatives to seals are being employed nowadays, such as Sealless systems, which is hermitically sealed from the atmosphere and does not require sealing. This technology is considered relatively new and requires more studies to understand the limitations and factors associated from an owner and design perspective. Things like financial factors, maintenance factors, and design limitation should be studies further in order to have a mature and reliable technical solution available to end users.

Keywords: pump, sealless, selection, failure

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Authors: Thomas Ejobowah Boye, Philip Oghenetega Ekpon

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The paper examines the availability and the utilization of recreational facilities for prison inmate’s rehabilitation in Nigeria. In order to carry out the study the researchers visited sampled prisons in the six geo-political zones in Nigeria. Instant assessment of available recreational facilities was carried out. Inmates were asked to tick a self-design questionnaire that was validated by experts in the Departments of Physical and Health Education, Delta State University and the College of Physical Education, Mosogar on available recreational facilities and activities engaged in by them. The data collected was subjected to percentage analysis. The study revealed that there is little or no standard recreational facilities in all the prisons visited. Considering the role physical activities play in the overall development of individuals physically, mentally, emotionally, morally, and socially it was recommended that the authorities of the Nigerian prisons should as a matter of urgency include recreational activities as a means of reforming and rehabilitating prison inmates. To achieve the desire to rehabilitate prison inmates the researchers also recommended that facilities and equipment should be made available in all prisons in Nigeria.

Keywords: facility, prison, recreation, rehabilitation

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Authors: Sanjay Adhikesaven

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Workplace accidents are a critical problem that causes many deaths, injuries, and financial losses. Climate change has a severe impact on industrial workers, partially caused by global warming. To reduce such casualties, it is important to proactively find unsafe environments where injuries could occur by detecting the use of personal protective equipment (PPE) and identifying unsafe activities. Thus, we propose an industrial workplace alerting and monitoring platform to detect PPE use and classify unsafe activity in group settings involving multiple humans and objects over a long period of time. Our proposed method is the first to analyze prolonged actions involving multiple people or objects. It benefits from combining pose estimation with PPE detection in one platform. Additionally, we propose the first open-source annotated data set with video data from industrial workplaces annotated with the action classifications and detected PPE. The proposed system can be implemented within the surveillance cameras already present in industrial settings, making it a practical and effective solution.

Keywords: computer vision, deep learning, workplace safety, automation

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Authors: Magdalena Chrabąszcz, Teresa Wolniewicz, Cezary Maciejewski, Joanna Czuwara

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BACKGROUND: Dermoscopy is a clinical tool known to improve the early detection of melanoma and other malignancies of the skin. Over the past few years melanoma has grown into a disease of socio-economic importance due to the increasing incidence and persistently high mortality rates. Early diagnosis remains the best method to reduce melanoma and non-melanoma skin cancer– related mortality and morbidity. Dermoscopy is a noninvasive technique that consists of viewing pigmented skin lesions through a hand-held lens. This simple procedure increases melanoma diagnostic accuracy by up to 35%. Dermoscopy is currently the standard for clinical differential diagnosis of cutaneous melanoma and for qualifying lesion for the excision biopsy. Like any clinical tool, training is required for effective use. The introduction of small and handy dermoscopes contributed significantly to the switch of dermatoscopy toward a first-level useful tool. Non-dermatologist physicians are well positioned for opportunistic melanoma detection; however, education in the skin cancer examination is limited during medical school and traditionally lecture-based. AIM: The aim of this randomized study was to determine whether the adjunct of dermoscopy to the standard fourth year medical curriculum improves the ability of medical students to distinguish between benign and malignant lesions and assess acceptability and satisfaction with the intervention. METHODS: We performed a prospective study in 2 cohorts of fourth-year medical students at Medical University of Warsaw. Groups having dermatology course, were randomly assigned to:  cohort A: with limited access to dermatoscopy from their teacher only – 1 dermatoscope for 15 people  Cohort B: with a full access to use dermatoscopy during their clinical classes:1 dermatoscope for 4 people available constantly plus 15-minute dermoscopy tutorial. Students in both study arms got an image-based test of 10 lesions to assess ability to differentiate benign from malignant lesions and postintervention survey collecting minimal background information, attitudes about the skin cancer examination and course satisfaction. RESULTS: The cohort B had higher scores than the cohort A in recognition of nonmelanocytic (P < 0.05) and melanocytic (P <0.05) lesions. Medical students who have a possibility to use dermatoscope by themselves have also a higher satisfaction rates after the dermatology course than the group with limited access to this diagnostic tool. Moreover according to our results they were more motivated to learn dermatoscopy and use it in their future everyday clinical practice. LIMITATIONS: There were limited participants. Further study of the application on clinical practice is still needed. CONCLUSION: Although the use of dermatoscope in dermatology as a specialty is widely accepted, sufficiently validated clinical tools for the examination of potentially malignant skin lesions are lacking in general practice. Introducing medical students to dermoscopy in their fourth year curricula of medical school may improve their ability to differentiate benign from malignant lesions. It can can also encourage students to use dermatoscopy in their future practice which can significantly improve early recognition of malignant lesions and thus decrease melanoma mortality.

Keywords: dermatoscopy, early detection of melanoma, medical education, skin cancer

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Authors: Dimitar Karastoyanov, Todor Penchev

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The paper presents the research of a kind of autonomous mobile robots, intended for work and adaptive perception in unknown and unstructured environment. The objective are robots, dedicated for multi-sensory environment perception and exploration, like measurements and samples taking, discovering and putting a mark on the objects as well as environment interactions–transportation, carrying in and out of equipment and objects. At that ground classification of the different types mobile robots in accordance with the way of locomotion (wheel- or chain-driven, walking, etc.), used drive mechanisms, kind of sensors, end effectors, area of application, etc. is made. Modular system for the mechanical construction of the mobile robots is proposed. Special PLC on the base of AtMega128 processor for robot control is developed. Electronic modules for the wireless communication on the base of Jennic processor as well as the specific software are developed. The methods, means and algorithms for adaptive environment behaviour and tasks realization are examined. The methods of group control of mobile robots and for suspicious objects detecting and handling are discussed too.

Keywords: mobile robots, wireless communications, environment investigations, group control, suspicious objects

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Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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Authors: Sudhir K. Gupta

Abstract:

Introduction: When a forensic doctor determines that a suspicious death is a suicide, homicide, or accident, the decision virtually becomes incontestable by the investigating police officer, and it becomes an issue whether the medical opinion was created with necessary checks and balances on the other probabilities of the case. It is suggested that the opinion of Forensic Medical experts is conventional, mutable, and shifting from one expert to another. The determination of suicide, accident, or homicide is mandatorily required, which is the Gold Standard for conducting death investigations. Forensic investigations serve many audiences, but the court is by far the most critical. The likely questions on direct and cross-examination determine how forensic doctors gather and handle evidence and what conclusions they reach. Methodology: The author interacted with the investigative authority, and a crime scene visit was also done along with the perusal of the Postmortem report, subsequent opinion, and crime scene photographs and statements of the witness and accused. Further analysis of all relevant scientific documents and opinions of other forensic doctors, forensic scientists, and ballistic experts involved in these cases was done to arrive at an opinion with scientific justification. Findings: The opinions arrived at by the author and how they helped the judiciary in delivering justice in these cases have been discussed in this article. This can help the readers to understand the process involved in formulating a credible forensic medical expert opinion for investigators and the judiciary. Conclusion: A criminal case might be won or lost over doubt cast on the chain of custody. Medically trained forensic doctors, therefore, learn to practice their profession in legally appropriate ways, and opinions must be based on medical justifications with credible references.

Keywords: forensic doctor, professional credibility, investigation, expert opinion

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