Search results for: wireless patient monitoring

Authors: Maryam Kiani

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The self-sensing capability opens up new possibilities for structural health monitoring, offering real-time information on the condition and performance of constructions. The synthesis and characterization of these functional 2D material geopolymers will be explored in this study. Various fabrication techniques, including mixing, dispersion, and coating methods, will be employed to ensure uniform distribution and integration of the 2D materials within the geopolymers. The resulting composite materials will be evaluated for their mechanical strength, electrical conductivity, and sensing capabilities through rigorous testing and analysis. The potential applications of these self-sensing geopolymers are vast. They can be used in infrastructure projects, such as bridges, tunnels, and buildings, to provide continuous monitoring and early detection of structural damage or degradation. This proactive approach to maintenance and safety can significantly improve the lifespan and efficiency of constructions, ultimately reducing maintenance costs and enhancing overall sustainability. In conclusion, the development of functional 2D material geopolymers as self-sensing materials presents an exciting advancement in the construction industry. By integrating these innovative materials into structures, we can create a new generation of intelligent, self-monitoring constructions that can adapt and respond to their environment.

Keywords: 2D materials, geopolymers, electrical properties, self-sensing

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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Authors: Behcet Al, Şener Cindoruk, Suat Zengin, Mehmet Murat Oktay, Mehmet Mustafa Sunar, Hatice Eroglu, Cuma Yildirim

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Objective: In present study we aimed to investigate the chronic drug use due to chronic diseases in patients admitted to emergency department. Materials-Methods: 144 patients who applied to emergency department (ED) of medicine school of Gaziantep University between June 2013 and September 2013 with chronic diseases and use chronic drugs were included. Information about drugs used by patients were recorded. Results: Of patients, half were male, half were female, and the mean age was 58 years. The first three common diseases were diabetes mellitus, hypertension and coronary artery diseases. Of patients, %79.2 knew their illness. Fifty patients began to use drug within three months, 36 patient began to use within the last one year. While 42 patients brought all of their drugs with themselves, 17 patients brought along a portion of drugs. While three patients stopped their medication completely, 125 patients received medication on a regular basis. Fifty-two patient described the drugs with names, 13 patients described with their colors, 3 patients described by grammes, 45 patients described with the size of the tablet and 13 patients could not describe the drugs. Ninety-two patients explained which kind of drugs were used for each diseases, 17 patient explained partly, and 35 patients had no idea. Hundred patients received medication by themselves, 44 patients medications were giving by their relatives and med carers. Of medications, 140 were written by doctors directly, three medication were given by pharmacist; and one patient bought the drug by himself. For 11 patients the drugs were not harmonious to their diseases. Fifty-one patients admitted to the ED two times within last week, and 73 admitted two times within last month. Conclusion: The majority of patients with chronic diseases and use chronic drugs know their diseases and use the drugs in order, but do not have enough information about their medication.

Keywords: chronic disease, drug use, emergency department, medication

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Authors: Nicolae Constantin, Ştefan Sorohan

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The small and medium wind turbines are running in quite different conditions as compared to the big ones. Consequently, they need also a different approach concerning the structural health monitoring (SHM) issues. There are four main differences between the above mentioned categories: (i) significantly smaller dimensions, (ii) considerably higher rotation speed, (iii) generally small distance between the turbine and the energy consumer and (iv) monitoring assumed in many situations by the owner. In such conditions, nondestructive inspections (NDI) have to be made as much as possible with affordable, yet effective techniques, requiring portable and accessible equipment. Additionally, the turbines and accessories should be easy to mount, dispose and repair. As the materials used for such unit can be metals, composites and combined, the technologies should be adapted accordingly. An example in which the two materials co-exist is the situation in which the damaged metallic skin of a blade is repaired with a composite patch. The paper presents the inspection of the bonding state of the patch, using portable ultrasonic equipment, able to put in place the Lamb wave method, which proves efficient in global and local inspections as well. The equipment is relatively easy to handle and can be borrowed from specialized laboratories or used by a community of small wind turbine users, upon the case. This evaluation is the first in a row, aimed to evaluate efficiency of NDI performed with rather accessible, less sophisticated equipment and related inspection techniques, having field inspection capabilities. The main goal is to extend such inspection procedures to other components of the wind power unit, such as the support tower, water storage tanks, etc.

Keywords: structural health monitoring, small wind turbines, non-destructive inspection, field inspection capabilities

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Authors: Jacob Wahl, Jane Zhang

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This paper describes the development and characterization of a prototype IoT network for use with agricultural imaging and monitoring applications. The sensor and gateway nodes are designed using the ESP32 SoC with integrated Bluetooth Low Energy 4.2 and Wi-Fi. A development board, the Arducam IoTai ESP32, is used for prototyping, testing, and power measurements. Google’s Firebase is used as the cloud storage site for image data collected by the sensor. The sensor node captures images using the OV2640 2MP camera module and transmits the image data to the gateway via Bluetooth Low Energy. The gateway then uploads the collected images to Firebase via a known nearby Wi-Fi network connection. This image data can then be processed and analyzed by computer vision and machine learning pipelines to assess crop growth or other needs. The sensor node achieves a wireless transmission data throughput of 220kbps while consuming 150mA of current; the sensor sleeps at 162µA. The sensor node device lifetime is estimated to be 682 days on a 6600mAh LiPo battery while acquiring five images per day based on the development board power measurements. This network can be utilized by any application that requires high data rates, low power consumption, short-range communication, and large amounts of data to be transmitted at low-frequency intervals.

Keywords: Bluetooth low energy, ESP32, firebase cloud, IoT, smart farming

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Authors: Ali H. Daraji, Ye Jianqiao

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The micro electrical devices of the wireless sensor network are continuously developed and become very small and compact with low electric power requirements using limited period life conventional batteries. The low power requirement for these devices, cost of conventional batteries and its replacement have encouraged researcher to find alternative power supply represented by energy harvesting system to provide an electric power supply with infinite period life. In the last few years, the investigation of energy harvesting for structure health monitoring has increased to powering wireless sensor network by converting waste mechanical vibration into electricity using piezoelectric sensors. Optimisation of energy harvesting is an important research topic to ensure a flowing of efficient electric power from structural vibration. The harvesting power is mainly based on the properties of piezoelectric material, dimensions of piezoelectric sensor, its position on a structure and value of an external electric load connected between sensor electrodes. Larger surface area of sensor is not granted larger power harvesting when the sensor area is covered positive and negative mechanical strain at the same time. Thus lead to reduction or cancellation of piezoelectric output power. Optimisation of energy harvesting is achieved by locating these sensors precisely and efficiently on the structure. Limited published work has investigated the energy harvesting for aircraft wing. However, most of the published studies have simplified the aircraft wing structure by a cantilever flat plate or beam. In these studies, the optimisation of energy harvesting was investigated by determination optimal value of an external electric load connected between sensor electrode terminals or by an external electric circuit or by randomly splitting piezoelectric sensor to two segments. However, the aircraft wing structures are complex than beam or flat plate and mostly constructed from flat and curved skins stiffened by stringers and ribs with more complex mechanical strain induced on the wing surfaces. This aircraft wing structure bonded with discrete macro fibre composite sensors was modelled using multiphysics finite element to optimise the energy harvesting by determination of the optimal number of sensors, location and the output resistance load. The optimal number and location of macro fibre sensors were determined based on the maximization of the open and close loop sensor output voltage using frequency response analysis. It was found different optimal distribution, locations and number of sensors bounded on the top and the bottom surfaces of the aircraft wing.

Keywords: energy harvesting, optimisation, sensor, wing

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Authors: Marzieh Ebrahimi, Vahid Changizi, Mohammad Reza Kardan, Seyed Mahdi Hosseini Pooya, Parham Geramifar

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Radiation exposure to the patient's family members is one of the major concerns during thyroid cancer radionuclide therapy. The aim of this study was to measure the total effective dose of the family members by means of thermoluminescence personal dosimeter, and compare with those calculated by analytical methods. Eighty-five adult family members of fifty-one patients volunteered to participate in this research study. Considering the minimum and maximum range of dose rate from 15 µsv/h to 120 µsv/h at patients' release time, the calculated mean and median dose values of family members were 0.45 mSv and 0.28 mSv, respectively. Moreover, almost all family members’ doses were measured to be less than the dose constraint of 5 mSv recommended by Basic Safety Standards. Considering the influence parameters such as patient dose rate and administrated activity, the total effective doses of family members were calculated by TEDE and NRC formulas and compared with those of experimental results. The results indicated that, it is fruitful to use the quantitative calculations for releasing patients treated with I-131 and correct estimation of patients' family doses.

Keywords: effective dose, thermoluminescence, I-131, thyroid cancer

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Authors: B. Kenny

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There is currently no literature comparing undercasts in fracture care. This study is a randomised trial comparing the 4 commonly used undercasts in Australia. These are Webril, Sofban, Goretech and Delta-dry. The ideal undercast should be comfortable for the patient and not cause itchiness. It should be durable enough to withstand daily activities. The clinician/technician should find the undercast easy to apply and remove. It should provide adequate padding without compromising cast mouldability to obtain a good cast index and air index. 18 volunteering medical students were randomly allocated to receive 4 angular casts, one over each elbow and ankle(total of 72 casts). They were blinded to cast type. After an hour their casts were stressed by pouring 20ml Normal Saline onto the skin beneath. Each student filled a questionnaire about comfort, itchiness, weight and water resistance. Subsequently they ranked each cast 1 to 4 based on preference. Our preliminary results show Delta-dry is the most preferred undercast followed by Webril, Sofban and Goretech in that order. Underlay selection is important component of patient care with long immobilsation. Webril or Deltra-dry are by far the most preferred undercasts in our study.

Keywords: casts, fracture, treatment modality, patient compliance

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Authors: Yiannis Vacanas, Kyriacos Themistocleous, Athos Agapiou, Diofantos Hadjimitsis

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Building Information Modelling (BIM) technology is considered by construction professionals as a very valuable process in modern design, procurement and project management. Construction professionals of all disciplines can use a single 3D model which BIM technology provides, to design a project accurately and furthermore monitor the progress of construction works effectively and efficiently. Unmanned Aerial Vehicles (UAVs), a technology initially developed for military applications, is now without any difficulty accessible and has already been used by commercial industries, including the construction industry. UAV technology has mainly been used for collection of images that allow visual monitoring of building and civil engineering projects conditions in various circumstances. UAVs, nevertheless, have undergone significant advances in equipment capabilities and now have the capacity to acquire high-resolution imagery from many angles in a cost effective manner, and by using photogrammetry methods, someone can determine characteristics such as distances, angles, areas, volumes and elevations of an area within overlapping images. In order to examine the potential of using a combination of BIM and UAV technologies in construction project management, this paper presents the results of a case study of a typical road construction project where the combined use of the two technologies was used in order to achieve efficient and accurate as-built data collection of the works progress, with outcomes such as volumes, and production of sections and 3D models, information necessary in project progress monitoring and efficient project management.

Keywords: BIM, project management, project monitoring, UAV

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Authors: Freda Halim

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Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

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Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

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High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education

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Authors: Yasmine Abu Adla, Racha Soubra, Milana Kasab, Mohamad O. Diab, Aly Chkeir

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Over the past several years, researchers have shown a great interest in assessing the mobility of elderly people to measure their functional status. Usually, such an assessment is done by conducting tests that require the subject to walk a certain distance, turn around, and finally sit back down. Consequently, this study aims to provide an at home monitoring system to assess the patient’s status continuously. Thus, we proposed a technique to automatically detect when a subject sits down while walking at home. In this study, we utilized a Doppler radar system to capture the motion of the subjects. More than 20 features were extracted from the radar signals, out of which 11 were chosen based on their intraclass correlation coefficient (ICC > 0.75). Accordingly, the sequential floating forward selection wrapper was applied to further narrow down the final feature vector. Finally, 5 features were introduced to the linear discriminant analysis classifier, and an accuracy of 93.75% was achieved as well as a precision and recall of 95% and 90%, respectively.

Keywords: Doppler radar system, stand-to-sit phase, TUG test, machine learning, classification

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Authors: Danika Tynes

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Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory (Rogers, 1962). System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of telehealth (teleradiology, teledermatology, telepathology, telepsychology, and remote monitoring) using multiple logistic regression. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption, remote monitoring in particular. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available foster innovation.

Keywords: adoption, diffusion of innovation theory, remote monitoring, system-level indicators

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Authors: Christian Gabriel Mariveles, Darelle Jay Gallardo, Leslie Dayaoen, Laurenz Paul Diaz

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True experimental research with descriptive analysis was conducted. Utilizing Quicklime (Calcium Oxide) for self-healing properties of coconut husk fibre concrete brick. There are 2 setups established: the first one has the 1:1:2 ratio of calcium oxide, cement and sand, and the second one has a 2:1:2 ratio of the same variables. The bricks are made from the residences along Barangay Greater Lagro. The mixture of sand and cement is mixed with coconut husk fibers and then molded with different ratios in the molder. After the drying of cement, the researchers tested the bricks in the laboratory for compressive strength. The brick with the highest PSI is picked by the researchers to drop into freefall testing, and it makes remarkable remarks as it is deformed after dropping to different heights with a maximum of 20 feet. Unfortunately, the self-healing capabilities were not observed during the 12 weeks of monitoring. However, the brick was weighed after 12 weeks of monitoring, and it increased in weight by 0.030 kg. from 1.833 kg. to 1.863 kg. meaning that this ratio 2 has the potential to self-heal, but 12 weeks of monitoring by the researchers is not enough to conclude that it has a significant difference.

Keywords: self healing, coconut husk bricks, research, calcium oxide, utilizing quicklime

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Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: Evangelia Kotrotsiou, Mairy Gouva, Theodosios Paralikas, Maria Fiaka, Styliani Kotrotsiou, Maria Malliarou

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The purpose of this research is to investigate the way nurses perceive the care provided in comparison to the way patients perceive it, taking into account existing literature. As far as the sample of research is concerned, it has come from the population of nurses working in the General Hospital of Thessaloniki, St. Paul and the patients of its surgical clinic. In the present study, the sample consists of 100 nurses and 88 patients. The questionnaire used was the Caring Nurse-Patient Interactions Scale: 23-Item Version, created by Cossette et al. (2006). In the case of both patients and nurses, a high score was observed in relational care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of providing nursing care. Overall, patients rated higher clinical care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of the clinical care they were given. On the other hand, nurses rated higher comfort care in the case of the frequency of nursing care in everyday practice, as well as relational care in the area of the importance of nursing care in everyday practice.

Keywords: nursing care, patient needs, patient satisfaction, care giving

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Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

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Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality

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Authors: Dalvin D. Hill, Hector M. Castro Garcia

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A growing number of individuals utilize wearable devices on a daily basis. The usage and functionality of these wearable devices vary from user to user. One popular usage of said devices is to track health-related activities that are typically stored on a device’s memory or uploaded to an account in the cloud; based on the current trend, the data accumulated from the wearable device are stored in a standalone location. In many of these cases, this health related datum is not a factor when considering the holistic view of a user’s health lifestyle or record. This health-related data generated from wearable and Internet of Things (IoT) devices can serve as empirical information to a medical provider, as the standalone data can add value to the holistic health record of a patient. This paper proposes a solution to incorporate the data gathered from these wearable and IoT devices, with that a patient’s Personal Health Record (PHR) stored within the confines of a Health Information Exchange (HIE).

Keywords: electronic health record, health information exchanges, internet of things, personal health records, wearable devices, wearables

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Authors: Bernabeo R. Alberto

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Unmanned aerial vehicles (UAV) platforms or remotely piloted aircraft system (Rpas) - with dedicated sensors - are fundamental support to the planning, running, and control of the territory in which public safety is or may be at risk for post-disaster assessments such as flooding or landslides, for searching lost people, for crime and accident scene photography, for assisting traffic control at major events, for teaching geography, history, natural science and all those subjects that require a continuous cyclical process of observation, evaluation and interpretation. Through the use of proximal remote sensing information related to anthropic landscape and nature integration, there is an opportunity to improve knowledge and management decision-making for the safeguarding of the environment, for farming, wildlife management, land management, mapping, glacier monitoring, atmospheric monitoring, for the conservation of archeological, historical, artistic and architectural sites, allowing an exact delimitation of the site in the territory. This paper will go over many different mission types. Within each mission type, it will give a broad overview to familiarize the reader but not make them an expert. It will also give detailed information on the payloads and other testing parameters the Unmanned Aerial Vehicles (UAV) use to complete a mission. The project's goal is to improve satellite maps about the stress of the plants, air quality monitoring, and related health issues.

Keywords: proximal remote sensing, remotely piloted aircraft system, risk, safety, unmanned aerial vehicle

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Authors: Veruska C. Dutra, Afonso R. Aquino

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Since the 1980s, global tourism activity has consolidated worldwide to become an important economic contributor, and consequently, the sociocultural and environmental impacts are starting to become evidenced. This raises the need of discussing about actions for sustainable tourism that should be linked not only to the economy, but also to the environment and social aspects. The work that is going to be presented is part of a doctoral research project in Sciences undertaken at the Sao Paulo University, Brazil. It aims to analyze whether the monitoring of the tourism sector with a focus on sustainability is applicable or not, through those indicators, put in a case study in the Jalapão State Park (JSP) conservation unit, in the state of Tocantins, Brazil. This is a study of an interdisciplinary nature that had the deductive method as its guide. We concluded that the key points of the sustainable tourism, when analyzed with the focal point in environmental indicators, are an important evaluation and quantification tool of that activity in the study locus. It displayed itself as an adequate tool for monitoring, thus decoding, the main environmental impacts that occur in tourism regions and their intensity, which is made possible through analysis, and has the objective to trace ways to prevent and correct the presented impacts.

Keywords: indicators, tourism, sustainability, Jalapão

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Authors: Emma Carr, Bilal Aslam-Pervez, David Laraway

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Litigation against surgeons and hospitals continues to increase in Western countries. While verbal consent is all that is required legally, it has for a long time been considered that written consent offers proof of discussion and interaction between the surgeon and the patient. Inadequate consenting of patients continues in the United Kingdom leaving surgeons and Health Trusts open to litigation. We present a standardised consent form which improves patient autonomy and engagement. The General Medical Council recommends that all material risks relevant to the patient are discussed and recorded prior to undergoing surgery, regardless of how likely they are to occur. Current literature was reviewed to evaluate complications associated with surgical management of mandible fractures. Analysis of risks on 52 consent forms were analysed within the Glasgow OMFS department, leading to a procedure-specific form being designed and implemented. This audit showed that the documentation of risks on consent forms was extremely variable- with uncommon risks not being recorded. Interestingly, not a single consent form was found which highlighted all the risks associated with mandible fractures. Our re-audit data confirms 100% of risks being discussed when a procedure specific form is utilised. Our hope, is to introduce further forms for inclusion on the BAOMS website and peripheral distribution. The forms are quick and easy to print and leave more time for consultation with the patient. Whilst we are under no illusion that the forms may not decrease the incidence of intended litigation, we feel confident that they will decrease the chances of it being successful.

Keywords: consent, litigation, mandible fracture, surgery

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Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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Authors: Mohamed R. Mhereeg

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The paper discusses the implementation of the MultiAgent classification System (MACS) and utilizing it to provide an automated and accurate classification of end users developing applications in the spreadsheet domain. However, different technologies have been brought together to build MACS. The strength of the system is the integration of the agent technology with the FIPA specifications together with other technologies, which are the .NET widows service based agents, the Windows Communication Foundation (WCF) services, the Service Oriented Architecture (SOA), and Oracle Data Mining (ODM). Microsoft's .NET windows service based agents were utilized to develop the monitoring agents of MACS, the .NET WCF services together with SOA approach allowed the distribution and communication between agents over the WWW. The Monitoring Agents (MAs) were configured to execute automatically to monitor excel spreadsheets development activities by content. Data gathered by the Monitoring Agents from various resources over a period of time was collected and filtered by a Database Updater Agent (DUA) residing in the .NET client application of the system. This agent then transfers and stores the data in Oracle server database via Oracle stored procedures for further processing that leads to the classification of the end user developers.

Keywords: MACS, implementation, multi-agent, SOA, autonomous, WCF

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

Abstract:

Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

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Authors: Poonam Goswami

Abstract:

Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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Authors: Andrey V. Timofeev

Abstract:

An adaptive nonparametric method is proposed for stable real-time detection of seismoacoustic sources in multichannel C-OTDR systems with a significant number of channels. This method guarantees given upper boundaries for probabilities of Type I and Type II errors. Properties of the proposed method are rigorously proved. The results of practical applications of the proposed method in a real C-OTDR-system are presented in this report.

Keywords: guaranteed detection, multichannel monitoring systems, change point, interval estimation, adaptive detection

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Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

Abstract:

Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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Authors: Matheesha Herath, Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore

Abstract:

Background: Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. It is unknown whether the acute surgical unit (ASU) model affects the management and disclosure of these findings. Methods: An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings and communication of the findings to the patient and to their general practitioner (GP). Results: 1,214 patients underwent emergency appendicectomy; 465 in the traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the traditional and ASU group with regards to communication of the findings to the patient (p=0.44) and their GP (p=0.27), and there was no difference in the rates of appropriate management (p=0.21). Conclusions: The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during an appendectomy.

Keywords: acute care surgery, appendicitis, appendicectomy, incidental

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Authors: Guru Prakash, Revanth Dugalam

Abstract:

A road’s condition often deteriorates due to harsh loading such as overload due to trucks, and severe environmental conditions such as heavy rain, snow load, and cyclic loading. In absence of proper maintenance planning, this results in potholes, wide cracks, bumps, and increased roughness of roads. In this paper, a data-driven model will be developed to detect these damages using vibration and image signals. The key idea of the proposed methodology is that the road anomaly manifests in these signals, which can be detected by training a machine learning algorithm. The use of various machine learning techniques such as the support vector machine and Radom Forest method will be investigated. The proposed model will first be trained and tested with artificially simulated data, and the model architecture will be finalized by comparing the accuracies of various models. Once a model is fixed, the field study will be performed, and data will be collected. The field data will be used to validate the proposed model and to predict the future road’s health condition. The proposed will help to automate the road condition monitoring process, repair cost estimation, and maintenance planning process.

Keywords: SVM, data-driven, road health monitoring, pot-hole

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Authors: Ivan Gunass Govender, Andrea Giampiccoli

Abstract:

A developmental state should use community engagement to facilitate socio-economic development for disadvantaged groups and individual members of society through empowerment, social justice, sustainability, and self-reliance. In this regard, community-based tourism (CBT) as a growing market should be an indigenous effort aided by external facilitation. Since this form of tourism presents its own preconditions, characteristics, and challenges, it could be guided by higher education institutions engagement. In particular, the facilitation should not only serve to assist the community members to reach their own goals; but rather also focus on learning through knowledge creation and sharing with the engagement of higher education institutions. While the increased relevance of CBT has produced various CBT manuals (or handbooks/guidelines) documents aimed to ‘teach’ and assist various entities in CBT development, this research aims to analyse the current monitoring & evaluation (M&E) manuals and thereafter, propose an M&E model for CBT. It is important to mention that all too often effective monitoring is seldom carried out thus risking the long-term sustainability and improvement of the CBT ventures. Therefore, the proposed model will also consider some inputs external to the tourism field, but in relation to local economic development (LED) matters from the previously proposed development monitoring and evaluation system framework. M&E should be seen as fundamental components of any CBT initiative, and the whole CBT intervention should be evaluated. In this context, M&E in CBT should go beyond strict ‘numerical’ economic matters and should be understood in a holistic development. In addition, M&E in CBT should not consider issues in various ‘compartments’ such as tourists, tourism attractions, CBT owners/participants, and stakeholder engagement but as interdependent components of a macro-ecosystem. Finally, the external facilitation process should be structured in a way to promote community self-reliance in both the intervention and the M&E process. The research will attempt to propose an M&E model for CBT so as to enhance the CBT possibilities of long-term growth and success through effective collaborations with key stakeholders.

Keywords: community-based tourism, community-engagement, monitoring and evaluation, stakeholders

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