Search results for: ERAS protocols
596 Animal-Assisted Therapy: A Perspective From Singapore
Authors: Julia Wong, Hua Beng Lim, Petrina Goh, Johanna Foo, Caleb Ng, Nurul ‘Aqilah Bte Mohd Taufek
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Animal-assisted therapy (AAT) utilizes human-animal interaction to achieve specific therapeutic goals, and its efficacy has been demonstrated across various settings overseas. The use of AAT in Singapore, however, is still limited. Ang Mo Kio-Thye Hua Kwan (AMKH) is one of the first community hospitals in Singapore to use AAT to complement its occupational therapy services with elderly patients. This study explored the perspectives of AMKH’s occupational therapists (OTs) in relation to AAT to understand barriers and enablers in implementing and practising AAT. We also examined how OTs at-large across practice settings perceive AAT. A mixed method design was used. 64 OTs at-large participated in on online survey, and 7 AMKH OTs were interviewed individually via Zoom. Survey results were analysed with descriptive and Mann-Whitney U tests. Interviews were thematically analysed. AMKH OTs perceived various benefits of AAT articulated in overseas studies in domains such as motivation and participation, emotional, social interaction, sensory tactile stimulation, and cognition. Interestingly, this perception was also supported by 67% of OTs who had responded to the survey, even though most of the OTs who had participated in the survey had no experience in AAT. Despite the perceived benefits of AAT, both OTs from AMKH and those at-large articulated concerns on risks pertaining to AAT (e.g., allergies, unexpected animal behaviour, infections, etc). However, AMKH OTs shared several ways to mitigate these risks, demonstrating their ability to develop a safe program. For e.g., volunteers and their dogs must meet specific recruitment criteria, stringent protocols are used to screen and match dogs with patients, and there are strict exclusion criteria for patients participating in AAT. AMKH OTs’ experience suggests that additional skills and knowledge are required to implement AAT, therefore, healthcare institutions should first consider improving their staff training and risk mitigation knowledge before implementing AAT. They can also refer to AMKH’s AAT protocols and those found in overseas studies, but institutions must adapt the protocols to fit their institutional settings and patients’ profiles.Keywords: animal-assisted therapy, dog-assisted therapy, occupational therapy, complementary therapy
Procedia PDF Downloads 152595 Signal Strength Based Multipath Routing for Mobile Ad Hoc Networks
Authors: Chothmal
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In this paper, we present a route discovery process which uses the signal strength on a link as a parameter of its inclusion in the route discovery method. The proposed signal-to-interference and noise ratio (SINR) based multipath reactive routing protocol is named as SINR-MP protocol. The proposed SINR-MP routing protocols has two following two features: a) SINR-MP protocol selects routes based on the SINR of the links during the route discovery process therefore it select the routes which has long lifetime and low frame error rate for data transmission, and b) SINR-MP protocols route discovery process is multipath which discovers more than one SINR based route between a given source destination pair. The multiple routes selected by our SINR-MP protocol are node-disjoint in nature which increases their robustness against link failures, as failure of one route will not affect the other route. The secondary route is very useful in situations where the primary route is broken because we can now use the secondary route without causing a new route discovery process. Due to this, the network overhead caused by a route discovery process is avoided. This increases the network performance greatly. The proposed SINR-MP routing protocol is implemented in the trail version of network simulator called Qualnet.Keywords: ad hoc networks, quality of service, video streaming, H.264/SVC, multiple routes, video traces
Procedia PDF Downloads 249594 Genealogy of a Building: Tarikhaneh
Authors: Mohadeseh Salari Sardari
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As Muslims conquered Iran, their first impression was to show their power over others. They needed mosques for their multiple needs like prayer, tax collecting, law-making, hearing of law cases, and most important of all, as a seat of government. Sometimes they did not have time to build mosques and only began to build them after years of ruling. Many religious buildings with pre-Islamic past survived in Iran, most of the fire temples in cities were destroyed or changed radically, but some deserted temples outside of cities survived, and based on these surviving buildings, we can trace changes in fire temples inside cities and discover how they were adapted and expanded to be mosques. In addition, there are some other buildings with doubts about their date of construction. These buildings might be transitional buildings between two different historical eras or might be an old building with a slight change. One of these interesting buildings is Tarikhaneh, a small, simple yet striking building. By tracing Tarikhaneh’s roots in other buildings like fire temples and secular buildings existed before Arab invasion, it can be better understood how the original form of Tatikhaneh was.Keywords: iranian architecture, early mosques, fire temples, adaptation and reuse
Procedia PDF Downloads 137593 Performance Evaluation of Hierarchical Location-Based Services Coupled to the Greedy Perimeter Stateless Routing Protocol for Wireless Sensor Networks
Authors: Rania Khadim, Mohammed Erritali, Abdelhakim Maaden
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Nowadays Wireless Sensor Networks have attracted worldwide research and industrial interest, because they can be applied in various areas. Geographic routing protocols are very suitable to those networks because they use location information when they need to route packets. Obviously, location information is maintained by Location-Based Services provided by network nodes in a distributed way. In this paper we choose to evaluate the performance of two hierarchical rendezvous location based-services, GLS (Grid Location Service) and HLS (Hierarchical Location Service) coupled to the GPSR routing protocol (Greedy Perimeter Stateless Routing) for Wireless Sensor Network. The simulations were performed using NS2 simulator to evaluate the performance and power of the two services in term of location overhead, the request travel time (RTT) and the query Success ratio (QSR). This work presents also a new scalability performance study of both GLS and HLS, specifically, what happens if the number of nodes N increases. The study will focus on three qualitative metrics: The location maintenance cost, the location query cost and the storage cost.Keywords: location based-services, routing protocols, scalability, wireless sensor networks
Procedia PDF Downloads 372592 Principles of Music Composition in Impressionism by Focusing on Claude Debussy and Maurice Ravel’s Piano Works
Authors: Parham Bakhtiari
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The essence of Musical Impressionism is best captured in the compositions of Claude Debussy and Maurice Ravel. These two important individuals represent the core of this art form, with their piano compositions remaining significant, impactful, and commonly performed in contemporary times. Their piano works reflected a revolutionary compositional style that strayed from classical romanticism and drew heavy inspiration from Symbolist poets and Asian arts. Additionally, numerous technical applications are commonly utilized to exemplify the principles of impressionism style by composers who did not frequently use them in prior eras, resulting in effectively evoking impressionistic images through diverse sonorities. The goal of this study is to showcase the range of impressionistic elements and compositional techniques, such as dissonances, pentatonic and whole-tone scales, parallel movements, and polytonality, through an examination of their piano compositions.Keywords: music, impressionism, Debussy, ravel, piano, composition
Procedia PDF Downloads 38591 Gluteal Augmentation: A Historical Perspective on Society's Fascination with Buttock Size
Authors: Shane R. Jackson
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Gluteal augmentation with fat grafting, commonly referred to as the Brazilian Butt Lift, is the fastest-growing cosmetic surgical procedure, despite the risks and controversy that surrounds it. While many commentators attribute this rise in popularity with current societal trends towards public sharing of private life, the fascination with buttock size is in fact a much older human trait. By searching beyond medical literature and delving into historical sources, from ancient civilisations, through the Renaissance and Victorian eras to the ‘Instagram generation’ of the present day, this paper examines the differences – and similarities – in society’s ideal buttock shape and size. Furthermore, the ways in which these various cultures have altered their appearance to achieve this ideal are also examined, looking at the influence of the broader historical context. A deeper understanding of the historical, cultural and psychosocial factors that influence a patient’s desire for buttock augmentation allows the clinician to formulate a well-rounded surgical plan.Keywords: augmentation, Brazilian butt lift, buttock, fat graft, gluteal
Procedia PDF Downloads 198590 Genetic Determinants of Ovarian Response to Gonadotropin Stimulation in Women Undergoing Assisted Reproductive Treatment
Authors: D. Tohlob, E. Abo Hashem, N. Ghareeb, M. Ghanem, R. Elfarahaty, S. A. Roberts, P. Pemberton, L. Mohiyiddeen, W. G. Newman
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Gonadotropin stimulation is used in females undergoing assisted reproductive treatment for ovulation induction, but ovarian response is variable and unpredictable in these women. More effective protocols and individualization of treatment are needed to increase the success rate of IVF/ICSI cycles. We genotyped seven variants reported in previous studies to be associated with ovarian response (number of ova retrieved and total gonadotropin dose) in women undergoing IVF treatment including FSHR variants Asn 680 Ser (c.2039 A > G), Thr 307 Ala (c. 919 > A), -29 G > A, HRG c.610 C > T gene, BMP15 -9 C > G, AMH Ile 49 Ser (c.146 G > T), and AMHR -489A˃G in 118 Egyptian females attending Mansoura Integrated Fertility Center in Egypt, these females were undergoing their first cycle of controlled ovarian hyper stimulation for IVF/ICSI treatment. They were analyzed by TaqMan allelic discrimination assay in Manchester Center of Genomic Medicine. We found no evidence of any significant difference (p value < 0.05) in the number of eggs retrieved or the gonadotropin dose used between individuals in all genotypes except for HRG c.610 C > T gene polymorphism where regression analysis gives a p value of 0.04 with a fewer eggs number in TT genotyped females. These results indicate that these variants do not provide sufficient clinically relevant data to individualize the treatment protocols.Keywords: controlled ovarian hyperstimulation, gene variants, ovarian response, assisted reproduction
Procedia PDF Downloads 319589 Asylum Seekers' Legal Limbo under the Migrant Protection Protocols: Implications from a US-Mexico Border Project
Authors: Tania M. Guerrero, Ileana Cortes Santiago
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Estamos Unidos Asylum Project has served more than 2,000 asylum seekers and migrants who are under the Migrant Protection Protocols (MPP) policy in Ciudad Juarez, Mexico. The U.S. policy, implemented in January 2019, has stripped asylum seekers of their rights—forcing people fleeing violence and discrimination to wait in similar or worse conditions from which they fled and navigate their entire asylum process in a different country. Several civil rights groups, including the American Civil Liberties Union (ACLU), challenged MPP in U.S. federal courts in February 2019, arguing a violation of international U.S. obligations towards refugees and asylum-seekers under the 1951 Refugee Convention and the Refugee Act of 1980 in regards to the non-refoulement principle. MPP has influenced Mexico's policies, enforcement, and prioritization of the presence of asylum seekers and migrants; it has also altered the way international non-governmental organizations work at the Mexican Northern border. Estamos Unidos is a project situated in a logistical conundrum, as it provides needed legal services to a population in a legal and humanitarian void, i.e., a liminal space. The liminal space occupied by asylum seekers living under MPP is one that, in today's world, should not be overlooked; it dilutes asylum law and U.S. commitments to international protections. This paper provides analysis of and broader implications from a project whose main goal is to uphold the protections of asylum seekers and international refugee law. The authors identified and analyzed four critical points based on field work conducted since August 2019: (1) strategic coalition building with international, local, and national organizations; (2) brokering between domestic and international contexts and critical legal constraints; (3) flexibility to sudden policy changes and the diverse needs of the multiethnic groups of migrants and asylum seekers served by the project; and (4) the complexity of providing legal assistance to asylum seekers who are survivors of trauma. The authors concur with scholarship when highlighting the erosion of protections of asylum seekers and migrants as a dangerous and unjust global phenomenon.Keywords: asylum, human rights, migrant protection protocols, refugees law
Procedia PDF Downloads 133588 Formal Implementation of Routing Information Protocol Using Event-B
Authors: Jawid Ahmad Baktash, Tadashi Shiroma, Tomokazu Nagata, Yuji Taniguchi, Morikazu Nakamura
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The goal of this paper is to explore the use of formal methods for Dynamic Routing, The purpose of network communication with dynamic routing is sending a massage from one node to others by using pacific protocols. In dynamic routing connections are possible based on protocols of Distance vector (Routing Information Protocol, Border Gateway protocol), Link State (Open Shortest Path First, Intermediate system Intermediate System), Hybrid (Enhanced Interior Gateway Routing Protocol). The responsibility for proper verification becomes crucial with Dynamic Routing. Formal methods can play an essential role in the Routing, development of Networks and testing of distributed systems. Event-B is a formal technique consists of describing rigorously the problem; introduce solutions or details in the refinement steps to obtain more concrete specification, and verifying that proposed solutions are correct. The system is modeled in terms of an abstract state space using variables with set theoretic types and the events that modify state variables. Event-B is a variant of B, was designed for developing distributed systems. In Event-B, the events consist of guarded actions occurring spontaneously rather than being invoked. The invariant state properties must be satisfied by the variables and maintained by the activation of the events.Keywords: dynamic rout RIP, formal method, event-B, pro-B
Procedia PDF Downloads 401587 Improving Functionality of Radiotherapy Department Through: Systemic Periodic Clinical Audits
Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan
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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.Keywords: audit, clinical, radiotherapy, improving functionality
Procedia PDF Downloads 88586 Satire of Victorian Mores in Charles Dickens’ Great Expectations
Authors: Nagwa Abouserie Soliman
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The Victorian era, which started with the reign of Queen Victoria from June 1837 to January 1901, could be considered as one of the most significant eras that had a crucial impact which formed contemporary British life despite the fact that with the rise of the British empire many negative aspects surfaced, namelysocial inequalities such as class differences, child labor, population increase and poverty due to the industrial revolution. Charles Dickens was one of the most prominent writers of the Victorian era who perceived the hypocrisy of the Victorian mores. The appropriate researchstyle that was chosen for this literary analysis is a qualitative research method in which the researcher used the conceptual approach to analyse theDickensian characterisation andwriting style through diction, narrative voice, and images. The aim of this paper is to argue that Charles Dickens inGreat Expectations (1861) was highly satirical of the Victorian mores, as he uses a lot of sharp irony-to satirize various Victorian traditions such as class divisions, the justice system, the poor working class, and the upper-class snobbery that he thought are inhumane and unjust.Keywords: victorian, child labour, poverty, class division, snobbery
Procedia PDF Downloads 123585 The Indo-European and Old Iranian Fire and Its Relations with the Lur Fire
Authors: Behzad Moeini Sam, Sara Mohammadi Avandi
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The rituals of fire among the Iranians go back to the general Proto-Indo-European and Indo-Iranian eras when they lived in regions known as the Pontic-Caspian (Indo-Europeans) and Kazakhstan (the Andronovo culture belonging to the Indo-Iranian tribes), and we can get to know about their vulgar heritage despite their separation from each other during several millennia. The early Aryan settlers of Iran had brought their cults to their new home and were bequeathed to them by their Indo-Iranian ancestors. Tradition speaks of several great sacred Iranian fires consecrated by the pre-Zoroastrian kings. Ātar or fire corresponds to the Vedic Agni Atar's functions are elaborately delineated in the Later Avesta. This paper aims to show the fire cults among the Iranian Lur tribes that originate in the past. Therefore, it will be searched for rituals in equally Indo-European and Indo-Iranian Periods and Old Iranian Texts and their frequency among the Lur tribes. In addition to the library books, we tried to interview the chiefs of Lur tribes. Finally, we concluded that the fire among the Lur Tribes is a sequence of beliefs of the Proto-Indo-European and Indo-Iranian Periods reflected in Old and Middle Iranian texts.Keywords: Indo-European, ancient Iran, fire, Lur, Zoroastrian
Procedia PDF Downloads 84584 Assessing the Competence of Junior Pediatric Doctors in Managing Pediatric Diabetic Ketoacidosis: An Exploration Across Pediatric Care Units
Authors: Mai Ali
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Advancing beyond the junior stage of a paediatrician’s career is a crucial step where they accumulate essential skills and knowledge. This process prepares them for the challenges they'll encounter throughout their profession, particularly in dealing with paediatric emergencies. This can be especially demanding for trainees specializing in fields like endocrinology, particularly in the management of Diabetic Ketoacidosis (DKA) in the UK. In different societal contexts, junior doctors, whether specializing in pediatrics or other medical fields, are generally expected to possess a fundamental level of knowledge and skills necessary for managing diabetic ketoacidosis (DKA) emergencies. These physicians consistently concurred in recognizing prevalent problems in the healthcare facilities they examined. Such issues include the lack of established guidelines for DKA treatment and the inadequate availability of comprehensive training opportunities. The abstract underscores the critical importance of junior paediatricians acquiring expertise in managing paediatric emergencies, with a specific focus on DKA. Commonly, issues like the lack of standardized protocols and training deficiencies are recurring themes across healthcare facilities. This research proposal aims to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom when handling DKA in various clinical contexts. The primary goal is to assess their competency and suggest effective strategies for comprehensive DKA training improvement.Keywords: junior pediatrician, DKA, standardized protocols, level of competence
Procedia PDF Downloads 82583 Verification Protocols for the Lightning Protection of a Large Scale Scientific Instrument in Harsh Environments: A Case Study
Authors: Clara Oliver, Oibar Martinez, Jose Miguel Miranda
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This paper is devoted to the study of the most suitable protocols to verify the lightning protection and ground resistance quality in a large-scale scientific facility located in a harsh environment. We illustrate this work by reviewing a case study: the largest telescopes of the Northern Hemisphere Cherenkov Telescope Array, CTA-N. This array hosts sensitive and high-speed optoelectronics instrumentation and sits on a clear, free from obstacle terrain at around 2400 m above sea level. The site offers a top-quality sky but also features challenging conditions for a lightning protection system: the terrain is volcanic and has resistivities well above 1 kOhm·m. In addition, the environment often exhibits humidities well below 5%. On the other hand, the high complexity of a Cherenkov telescope structure does not allow a straightforward application of lightning protection standards. CTA-N has been conceived as an array of fourteen Cherenkov Telescopes of two different sizes, which will be constructed in La Palma Island, Spain. Cherenkov Telescopes can provide valuable information on different astrophysical sources from the gamma rays reaching the Earth’s atmosphere. The largest telescopes of CTA are called LST’s, and the construction of the first one was finished in October 2018. The LST has a shape which resembles a large parabolic antenna, with a 23-meter reflective surface supported by a tubular structure made of carbon fibers and steel tubes. The reflective surface has 400 square meters and is made of an array of segmented mirrors that can be controlled individually by a subsystem of actuators. This surface collects and focuses the Cherenkov photons into the camera, where 1855 photo-sensors convert the light in electrical signals that can be processed by dedicated electronics. We describe here how the risk assessment of direct strike impacts was made and how down conductors and ground system were both tested. The verification protocols which should be applied for the commissioning and operation phases are then explained. We stress our attention on the ground resistance quality assessment.Keywords: grounding, large scale scientific instrument, lightning risk assessment, lightning standards and safety
Procedia PDF Downloads 123582 Training Volume and Myoelectric Responses of Lower Body Muscles with Differing Foam Rolling Periods
Authors: Humberto Miranda, Haroldo G. Santana, Gabriel A. Paz, Vicente P. Lima, Jeffrey M. Willardson
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Foam rolling is a practice that has increased in popularity before and after strength training. The purpose of this study was to compare the acute effects of different foam rolling periods for the lower body muscles on subsequent performance (total repetitions and training volume), myoelectric activity and rating of perceived exertion in trained men. Fourteen trained men (26.2 ± 3.2 years, 178 ± 0.04 cm height, 82.2 ± 10 kg weight and body mass index 25.9 ± 3.3kg/m2) volunteered for this study. Four repetition maximum (4-RM) loads were determined for hexagonal bar deadlift and 45º angled leg press during test and retest sessions over two nonconsecutive days. Five experimental protocols were applied in a randomized design, which included: a traditional protocol (control)—a resistance training session without prior foam rolling; or resistance training sessions performed following one (P1), two (P2), three (P3), or four (P4) sets of 30 sec. foam rolling for the lower extremity musculature. Subjects were asked to roll over the medial and lateral aspects of each muscle group with as much pressure as possible. All foam rolling was completed at a cadence of 50 bpm. These procedures were performed on both sides unilaterally as described below. Quadriceps: between the apex of the patella and the ASIS; Hamstring: between the gluteal fold and popliteal fossa; Triceps surae: between popliteal fossa and calcaneus tendon. The resistance training consisted of five sets with 4-RM loads and two-minute rest intervals between sets, and a four-minute rest interval between the hexagonal bar deadlift and the 45º angled leg press. The number of repetitions completed, the myoelectric activity of vastus lateralis (VL), vastus medialis oblique (VMO), semitendinosus (SM) and medial gastrocnemius (GM) were recorded, as well as the rating of perceived exertion for each protocol. There were no differences between the protocols in the total repetitions for the hexagonal bar deadlift (Control - 16.2 ± 5.9; P1 - 16.9 ± 5.5; P2 - 19.2 ± 5.7; P3 - 19.4 ± 5.2; P4 - 17.2 ± 8.2) (p > 0.05) and 45º angled leg press (Control - 23.3 ± 9.7; P1 - 25.9 ± 9.5; P2 - 29.1 ± 13.8; P3 - 28.0 ± 11.7; P4 - 30.2 ± 11.2) exercises. Similar results between protocols were also noted for myoelectric activity (p > 0.05) and rating of perceived exertion (p > 0.05). Therefore, the results of the present study indicated no deleterious effects on performance, myoelectric activity and rating of perceived exertion responses during lower body resistance training.Keywords: self myofascial release, foam rolling, electromyography, resistance training
Procedia PDF Downloads 226581 Enabling UDP Multicast in Cloud IaaS: An Enterprise Use Case
Authors: Patrick J. Kerpan, Ryan C. Koop, Margaret M. Walker, Chris P. Swan
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The User Datagram Protocol (UDP) multicast is a vital part of data center networking that is being left out of major cloud computing providers' network infrastructure. Enterprise users rely on multicast, and particularly UDP multicast to create and connect vital business operations. For example, UPD makes a variety of business functions possible from simultaneous content media updates, High-Performance Computing (HPC) grids, and video call routing for massive open online courses (MOOCs). Essentially, UDP multicast's technological slight is causing a huge effect on whether companies choose to use (or not to use) public cloud infrastructure as a service (IaaS). Allowing the ‘chatty’ UDP multicast protocol inside a cloud network could have a serious impact on the performance of the cloud as a whole. Cloud IaaS providers solve the issue by disallowing all UDP multicast. But what about enterprise use cases for multicast applications in organizations that want to move to the cloud? To re-allow multicast traffic, enterprises can build a layer 3 - 7 network over the top of a data center, private cloud, or public cloud. An overlay network simply creates a private, sealed network on top of the existing network. Overlays give complete control of the network back to enterprise cloud users the freedom to manage their network beyond the control of the cloud provider’s firewall conditions. The same logic applies if for users who wish to use IPsec or BGP network protocols inside or connected into an overlay network in cloud IaaS.Keywords: cloud computing, protocols, UDP multicast, virtualization
Procedia PDF Downloads 590580 A Holistic Analysis of the Emergency Call: From in Situ Negotiation to Policy Frameworks and Back
Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees
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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse
Procedia PDF Downloads 103579 Comparative Assessment of the Thermal Tolerance of Spotted Stemborer, Chilo partellus Swinhoe (Lepidoptera: Crambidae) and Its Larval Parasitoid, Cotesia sesamiae Cameron (Hymenoptera: Braconidae)
Authors: Reyard Mutamiswa, Frank Chidawanyika, Casper Nyamukondiwa
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Under stressful thermal environments, insects adjust their behaviour and physiology to maintain key life-history activities and improve survival. For interacting species, mutual or antagonistic, thermal stress may affect the participants in differing ways, which may then affect the outcome of the ecological relationship. In agroecosystems, this may be the fate of relationships between insect pests and their antagonistic parasitoids under acute and chronic thermal variability. Against this background, we therefore investigated the thermal tolerance of different developmental stages of Chilo partellus Swinhoe (Lepidoptera: Crambidae) and its larval parasitoid Cotesia sesamiae Cameron (Hymenoptera: Braconidae) using both dynamic and static protocols. In laboratory experiments, we determined lethal temperature assays (upper and lower lethal temperatures) using direct plunge protocols in programmable water baths (Systronix, Scientific, South Africa), effects of ramping rate on critical thermal limits following standardized protocols using insulated double-jacketed chambers (‘organ pipes’) connected to a programmable water bath (Lauda Eco Gold, Lauda DR.R. Wobser GMBH and Co. KG, Germany), supercooling points (SCPs) following dynamic protocols using a Pico logger connected to a programmable water bath, heat knock-down time (HKDT) and chill-coma recovery (CCRT) time following static protocols in climate chambers (HPP 260, Memmert GmbH + Co.KG, Germany) connected to a camera (HD Covert Network Camera, DS-2CD6412FWD-20, Hikvision Digital Technology Co., Ltd, China). When exposed for two hours to a static temperature, lower lethal temperatures ranged -9 to 6; -14 to -2 and -1 to 4ºC while upper lethal temperatures ranged from 37 to 48; 41 to 49 and 36 to 39ºC for C. partellus eggs, larvae and C. sesamiae adults respectively. Faster heating rates improved critical thermal maxima (CTmax) in C. partellus larvae and adult C. partellus and C. sesamiae. Lower cooling rates improved critical thermal minima (CTmin) in C. partellus and C. sesamiae adults while compromising CTmin in C. partellus larvae. The mean SCPs for C. partellus larvae, pupae and adults were -11.82±1.78, -10.43±1.73 and -15.75±2.47 respectively with adults having the lowest SCPs. Heat knock-down time and chill-coma recovery time varied significantly between C. partellus larvae and adults. Larvae had higher HKDT than adults, while the later recovered significantly faster following chill-coma. Current results suggest developmental stage differences in C. partellus thermal tolerance (with respect to lethal temperatures and critical thermal limits) and a compromised temperature tolerance of parasitoid C. sesamiae relative to its host, suggesting potential asynchrony between host-parasitoid population phenology and consequently biocontrol efficacy under global change. These results have broad implications to biological pest management insect-natural enemy interactions under rapidly changing thermal environments.Keywords: chill-coma recovery time, climate change, heat knock-down time, lethal temperatures, supercooling point
Procedia PDF Downloads 238578 Investigation of Cold Atmospheric Plasma Exposure Protocol on Wound Healing in Diabetic Foot Ulcer
Authors: P. Akbartehrani, M. Khaledi Pour, M. Amini, M. Khani, M. Mohajeri Tehrani, E. Ghasemi, P. Charipoor, B. Shokri
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A common problem between diabetic patients is foot ulcers which are chronic and require specialized treatment. Previous studies illustrate that Cold atmospheric plasma (CAP) has beneficial effects on wound healing and infection. Nevertheless, the comparison of different cap exposure protocols in diabetic ulcer wound healing remained to be studied. This study aims to determine the effect of two different exposure protocols on wound healing in diabetic ulcers. A prospective, randomized clinical trial was conducted at two clinics. Diabetic patients with G1 and G2 wanger classification diabetic foot ulcers were divided into two groups of study. One group was treated by the first protocol, which was treating wounds by argon-generated cold atmospheric plasma jet once a week for five weeks in a row. The other group was treated by the second protocol, which was treating wounds every three days for five weeks in a row. The wounds were treated for 40 seconds/cubic centimeter, while the nozzle tip was moved nonlocalized 1 cm above the wounds. A patient with one or more wounds could participate in different groups as wounds were separately randomized, which allow a participant to be treated several times during the study. The study's significant findings were two different reductions rate in wound size, microbial load, and two different healing speeds. This study concludes that CAP therapy by the second protocol yields more effective healing speeds, reduction in wound sizes, and microbial loads of foot ulcers in diabetic patients.Keywords: wound healing, diabetic ulcers, cold atmospheric plasma, cold argon jet
Procedia PDF Downloads 218577 Refractory Cardiac Arrest: Do We Go beyond, Do We Increase the Organ Donation Pool or Both?
Authors: Ortega Ivan, De La Plaza Edurne
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Background: Spain and other European countries have implemented Uncontrolled Donation after Cardiac Death (uDCD) programs. After 15 years of experience in Spain, many things have changed. Recent evidence and technical breakthroughs achieved in resuscitation are relevant for uDCD programs and raise some ethical concerns related to these protocols. Aim: To rethink current uDCD programs in the light of recent evidence on available therapeutic procedures applicable to victims of out-of-hospital cardiac arrest (OHCA). To address the following question: What is the current standard of treatment owed to victims of OHCA before including them in an uDCD protocol? Materials and Methods: Review of the scientific and ethical literature related to both uDCD programs and innovative resuscitation techniques. Results: 1) The standard of treatment received and the chances of survival of victims of OHCA depend on whether they are classified as Non-Heart Beating Patients (NHBP) or Non-Heart-Beating-Donors (NHBD). 2) Recent studies suggest that NHBPs are likely to survive, with good quality of life, if one or more of the following interventions are performed while ongoing CPR -guided by suspected or known cause of OHCA- is maintained: a) direct access to a Cath Lab-H24 or/and to extra-corporeal life support (ECLS); b) transfer in induced hypothermia from the Emergency Medical Service (EMS) to the ICU; c) thrombolysis treatment; d) mobile extra-corporeal membrane oxygenation (mini ECMO) instituted as a bridge to ICU ECLS devices. 3) Victims of OHCA who cannot benefit from any of these therapies should be considered as NHBDs. Conclusion: Current uDCD protocols do not take into account recent improvements in resuscitation and need to be adapted. Operational criteria to distinguish NHBDs from NHBP should seek a balance between the technical imperative (to do whatever is possible), considerations about expected survival with quality of life, and distributive justice (costs/benefits). Uncontrolled DCD protocols can be performed in a way that does not hamper the legitimate interests of patients, potential organ donors, their families, the organ recipients, and the health professionals involved in these processes. Families of NHBDs’ should receive information which conforms to the ethical principles of respect of autonomy and transparency.Keywords: uncontrolled donation after cardiac death resuscitation, refractory cardiac arrest, out of hospital cardiac, arrest ethics
Procedia PDF Downloads 238576 Moving Images and Re-Articulations of Self-Identity: Young People's Experiences of Viewing Representations Disability in Films
Authors: Alison Wilde, Stephen Millett
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The cultural value of disabled people has largely been overlooked within forms of media and cultural analysis until the 1980s, when disabled people and disability studies highlighted the cultural misrecognition of disabled people and called for improved forms of cultural recognition and representation. Despite an increase in cultural analysis of representations of disabled people, much has been assumed about how images are read, and little work has been done on the value attributed to disabled people by media audiences and the viewing interests and encounters of film audiences. In particular, there has been little work on film reception, or on the way that young people interpret images of disability. We set out to understand some of the ways that young people read disability imagery, by showing small groups of young people different types of film featuring impairments, chosen from three different eras in film. These were Freaks, Rear Window (remake), and Finding Nemo. The discussions after these films allowed them to explore their own experiences of disability alongside the evolution of cultural representations; in so doing they discussed significant themes of cultural value and reflected on their own identities, e.g. in/dependency, autonomy, and competency and the ways these intersected with self-identity, and attitudes to disabled people.Keywords: film, audience, identity, disability
Procedia PDF Downloads 420575 Comparing Effects of Supervised Exercise Therapy versus Home-Based Exercise Therapy on Low Back Pain Severity, Muscle Strength and Anthropometric Parameters in Patients with Nonspecific Chronic Low Back Pain
Authors: Haleh Dadgostar, Faramarz Akbari, Hosien Vahid Tari, Masoud Solaymani-Dodaran, Mohammad Razi
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Introduction: There are a number of exercises-protocols have been applied to improve low back pain. We compared the effect of supervised exercise therapy and home-based exercise therapy among patients with nonspecific chronic low back pain. Methods: 70 patients with nonspecific chronic low back pain were randomly (using a random number generator, excel) divided into two groups to compare the effects of two types of exercise therapy. After a common educational session to learn how to live with low back pain as well as to use core training protocols to strengthen the muscles, the subjects were randomly assigned to follow supervised exercise therapy (n = 31) or home-based exercise therapy (n = 34) for 20 weeks. Results: Although both types of exercise programs resulted in reduced pain, this factor decreased more significantly in supervised exercise program. All scores of fitness improved significantly in supervised exercise group. But only knee extensor strength score was increased in the home base exercise group. Conclusion: Comparing between two types of exercise, supervised group exercise showed more effective than the other one. Reduction in low back pain severity and improvement in muscle flexibility and strength can be more achieved by using a 20-week supervised exercise program compared to the home-based exercise program in patients with nonspecific chronic low back pain.Keywords: low back pain, anthropometric parameters, supervised exercise therapy, home-based exercise therapy
Procedia PDF Downloads 329574 The Role of Paper in the Copy Identification of Safavid Era Shahnamehs of Tabriz Doctrine
Authors: Ashrafosadat Mousavi Lar, Elahe Moravej
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To investigate and explain the history of each copy, we must refer to its past because it highlights parts of the civilization of people among which this copy has been codified. In this paper, eight Ferdowsi’s Shahnameh of Safavid era of Tabriz doctrine available in Iranian libraries and museums are studied. Undoubtedly, it can be said that Ferdowsi’s Shahnameh is one of the most important books that has been transcribed many times in different eras because it explains the Iranian champions’ prowess and it includes the history of Iran from Pishdadian to Sasanian dynasty. In addition, it has been attractive for governors and artists. The research methodology of this article is based on the analytical-descriptive arguments. The research hypothesis is based on papers used in Shahnameh writing in Safavid era of Tabriz doctrine were mostly Isfahanian papers existed. At that time, Isfahanian paper was unique in terms of quality, clarity, flatness of the sheets, volume, shape, softness and elegance, strength, and smoothness. This paper was mostly used to prepare the courtier and exquisite copies. This shows that the prepared copies in Safavid era of Tabriz doctrine were very important because the artists and people who ordered and were out of the court have ordered Isfahanian paper for writing their books.Keywords: paper, Shahnameh, Safavid era, Tabriz doctrine
Procedia PDF Downloads 289573 A Review of Protocols and Guidelines Addressing the Exposure of Occupants to Electromagnetic Field (EMF) Radiation in Buildings
Authors: Shabnam Monadizadeh, Charles Kibert, Jiaxuan Li, Janghoon Woo, Ashish Asutosh, Samira Roostaei, Maryam Kouhirostami
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A significant share of the technology that has emerged over the past several decades produces electromagnetic field (EMF) radiation. Communications devices, household appliances, industrial equipment, and medical devices all produce EMF radiation with a variety of frequencies, strengths, and ranges. Some EMF radiation, such as Extremely Low Frequency (ELF), Radio Frequency (RF), and the ionizing range have been shown to have harmful effects on human health. Depending on the frequency and strength of the radiation, EMF radiation can have health effects at the cellular level as well as at brain, nervous, and cardiovascular levels. Health authorities have enacted regulations locally and globally to set critical values to limit the adverse effects of EMF radiation. By introducing a more comprehensive field of EMF radiation study and practice, architects and designers can design for a safer electromagnetic (EM) indoor environment, and, as building and construction specialists, will be able to monitor and reduce EM radiation. This paper identifies the nature of EMF radiation in the built environment, the various EMF radiation sources, and its human health effects. It addresses European and US regulations for EMF radiation in buildings and provides a preliminary action plan. The challenges of developing measurement protocols for the various EMF radiation frequency ranges and determining the effects of EMF radiation on building occupants are discussed. This paper argues that a mature method for measuring EMF radiation in building environments and linking these measurements to human health impacts occupant health should be developed to provide adequate safeguards for human occupants of buildings for future research.Keywords: biological affection, electromagnetic field, building regulation, human health, healthy building, clean construction
Procedia PDF Downloads 183572 Cybersecurity Challenges in the Era of Open Banking
Authors: Krish Batra
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The advent of open banking has revolutionized the financial services industry by fostering innovation, enhancing customer experience, and promoting competition. However, this paradigm shift towards more open and interconnected banking ecosystems has introduced complex cybersecurity challenges. This research paper delves into the multifaceted cybersecurity landscape of open banking, highlighting the vulnerabilities and threats inherent in sharing financial data across a network of banks and third-party providers. Through a detailed analysis of recent data breaches, phishing attacks, and other cyber incidents, the paper assesses the current state of cybersecurity within the open banking framework. It examines the effectiveness of existing security measures, such as encryption, API security protocols, and authentication mechanisms, in protecting sensitive financial information. Furthermore, the paper explores the regulatory response to these challenges, including the implementation of standards such as PSD2 in Europe and similar initiatives globally. By identifying gaps in current cybersecurity practices, the research aims to propose a set of robust, forward-looking strategies that can enhance the security and resilience of open banking systems. This includes recommendations for banks, third-party providers, regulators, and consumers on how to mitigate risks and ensure a secure open banking environment. The ultimate goal is to provide stakeholders with a comprehensive understanding of the cybersecurity implications of open banking and to outline actionable steps for safeguarding the financial ecosystem in an increasingly interconnected world.Keywords: open banking, financial services industry, cybersecurity challenges, data breaches, phishing attacks, encryption, API security protocols, authentication mechanisms, regulatory response, PSD2, cybersecurity practices
Procedia PDF Downloads 60571 Virtualization and Visualization Based Driver Configuration in Operating System
Authors: Pavan Shah
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In an Embedded system, Virtualization and visualization technology can provide us an effective response and measurable work in a software development environment. In addition to work of virtualization and virtualization can be easily deserved to provide the best resource sharing between real-time hardware applications and a healthy environment. However, the virtualization is noticeable work to minimize the I/O work and utilize virtualization & virtualization technology for either a software development environment (SDE) or a runtime environment of real-time embedded systems (RTMES) or real-time operating system (RTOS) eras. In this Paper, we particularly focus on virtualization and visualization overheads data of network which generates the I/O and implementation of standardized I/O (i.e., Virto), which can work as front-end network driver in a real-time operating system (RTOS) hardware module. Even there have been several work studies are available based on the virtualization operating system environment, but for the Virto on a general-purpose OS, my implementation is on the open-source Virto for a real-time operating system (RTOS). In this paper, the measurement results show that implementation which can improve the bandwidth and latency of memory management of the real-time operating system environment (RTMES) for getting more accuracy of the trained model.Keywords: virtualization, visualization, network driver, operating system
Procedia PDF Downloads 133570 Molecular Insights into the Genetic Integrity of Long-Term Micropropagated Clones Using Start Codon Targeted (SCoT) Markers: A Case Study with Ansellia africana, an Endangered, Medicinal Orchid
Authors: Paromik Bhattacharyya, Vijay Kumar, Johannes Van Staden
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Micropropagation is an important tool for the conservation of threatened and commercially important plant species of which orchids deserve special attention. Ansellia africana is one such medicinally important orchid species having much commercial significance. Thus, development of regeneration protocols for producing clonally stable regenerates using axillary buds is of much importance. However, for large-scale micropropagation to become not only successful but also acceptable by end-users, somaclonal variations occurring in the plantlets need to be eliminated. In the light of the various factors (genotype, ploidy level, in vitro culture age, explant and culture type, etc.) that may account for the somaclonal variations of divergent genetic changes at the cellular and molecular levels, genetic analysis of micropropagated plants using a multidisciplinary approach is of utmost importance. In the present study, the clonal integrity of the long term micropropagated A. africana plants were assessed using advanced molecular marker system i.e. Start Codon Targeted Polymorphism (SCoT). Our studies recorded a clonally stable regeneration protocol for A. africana with a very high degree of clonal fidelity amongst the regenerates. The results obtained from these molecular analyses could help in modifying the regeneration protocols for obtaining clonally stable true to type plantlets for sustainable commercial use.Keywords: medicinal orchid micropropagation, start codon targeted polymorphism (SCoT), RAP), traditional African pharmacopoeia, genetic fidelity
Procedia PDF Downloads 426569 Comparison of Efficacy between Low-Residue Diet and Clear-Liquid Diet in Colonoscopic Bowel Preparation at a Surgical Clinic: A Randomized Controlled Trial
Authors: Sopana Wongtawee
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Purpose: Adequate bowel cleansing is essential for a high quality, effective and safe colonoscopy. The aims of this study were to compare the efficacy of bowel preparation based on a low-residue diet before 8:00 followed by a clear-liquid diet, and a low-residue diet until 16:00 one day before colonoscopy using sodium phosphate solution (Xubil ®), the side effects of the two protocols and the patient satisfaction with them. Method: This was an endoscopist-blinded, prospective, randomized, controlled trial. A total of 224 patients (112 in each group) scheduled for outpatient colonoscopy met the criteria.They were randomized to either a low-residue diet consisting of white rice porridge with either fish, chicken or eggs before 8:00 followed by a clear-liquid diet (Group 1) or a low-residue diet consisting of the same food and drink, until 16:00 the day before colonoscopy(Group 2). All of them received 45 ml of sodium phosphate solution (Xubil ®) and three glasses of water (300 ml/glass) the evening before and the morning of the procedure. The cleansing efficacy of bowel preparation was rated according to the modified Rajawithi hospital bowel preparation score scale, patient satisfaction with bowel preparation was rated using Likert scale, and side effects of the 2 protocols was assessed using a patient questionnaire. Results: The cleansing efficacy between the two groups was significantly different (p=0.02). Satisfaction with bowel preparation and side effects were not different, except for the feeling of hunger in the first group (p=0.001). Conclusion: The low-residue diet consisting of white rice porridge with fish, chicken or eggs until 16:00 one day before colonoscopy achieved a better bowel-cleansing efficacy than the protocol consisting of clear liquid all day and rice porridge only before 8:00 one day before colonoscopy.Keywords: bowel preparation, colonoscopy, sodium phosphate solution, nursing management
Procedia PDF Downloads 393568 MRI Quality Control Using Texture Analysis and Spatial Metrics
Authors: Kumar Kanudkuri, A. Sandhya
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Typically, in a MRI clinical setting, there are several protocols run, each indicated for a specific anatomy and disease condition. However, these protocols or parameters within them can change over time due to changes to the recommendations by the physician groups or updates in the software or by the availability of new technologies. Most of the time, the changes are performed by the MRI technologist to account for either time, coverage, physiological, or Specific Absorbtion Rate (SAR ) reasons. However, giving properly guidelines to MRI technologist is important so that they do not change the parameters that negatively impact the image quality. Typically a standard American College of Radiology (ACR) MRI phantom is used for Quality Control (QC) in order to guarantee that the primary objectives of MRI are met. The visual evaluation of quality depends on the operator/reviewer and might change amongst operators as well as for the same operator at various times. Therefore, overcoming these constraints is essential for a more impartial evaluation of quality. This makes quantitative estimation of image quality (IQ) metrics for MRI quality control is very important. So in order to solve this problem, we proposed that there is a need for a robust, open-source, and automated MRI image control tool. The Designed and developed an automatic analysis tool for measuring MRI image quality (IQ) metrics like Signal to Noise Ratio (SNR), Signal to Noise Ratio Uniformity (SNRU), Visual Information Fidelity (VIF), Feature Similarity (FSIM), Gray level co-occurrence matrix (GLCM), slice thickness accuracy, slice position accuracy, High contrast spatial resolution) provided good accuracy assessment. A standardized quality report has generated that incorporates metrics that impact diagnostic quality.Keywords: ACR MRI phantom, MRI image quality metrics, SNRU, VIF, FSIM, GLCM, slice thickness accuracy, slice position accuracy
Procedia PDF Downloads 171567 Comparison of Blockchain Ecosystem for Identity Management
Authors: K. S. Suganya, R. Nedunchezhian
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In recent years, blockchain technology has been found to be the most significant discovery in this digital era, after the discovery of the Internet and Cloud Computing. Blockchain is a simple, distributed public ledger that contains all the user’s transaction details in a block. The global copy of the block is then shared among all its peer-peer network users after validation by the Blockchain miners. Once a block is validated and accepted, it cannot be altered by any users making it a trust-free transaction. It also resolves the problem of double-spending by using traditional cryptographic methods. Since the advent of bitcoin, blockchain has been the backbone for all its transactions. But in recent years, it has found its roots and uses in many fields like Smart Contracts, Smart City management, healthcare, etc. Identity management against digital identity theft has become a major concern among financial and other organizations. To solve this digital identity theft, blockchain technology can be employed with existing identity management systems, which maintain a distributed public ledger containing details of an individual’s identity containing information such as Digital birth certificates, Citizenship number, Bank details, voter details, driving license in the form of blocks verified on the blockchain becomes time-stamped, unforgeable and publicly visible for any legitimate users. The main challenge in using blockchain technology to prevent digital identity theft is ensuring the pseudo-anonymity and privacy of the users. This survey paper will exert to study the blockchain concepts, consensus protocols, and various blockchain-based Digital Identity Management systems with their research scope. This paper also discusses the role of Blockchain in COVID-19 pandemic management by self-sovereign identity and supply chain management.Keywords: blockchain, consensus protocols, bitcoin, identity theft, digital identity management, pandemic, COVID-19, self-sovereign identity
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