Search results for: surgical errors

Authors: Stephanie Ducrot, Marie Vernet, Eve Meiss, Yves Chaix

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Learning to read is a key topic of debate today, both in terms of its implications on school failure and illiteracy and regarding what are the best teaching methods to develop. It is estimated today that four to six percent of school-age children suffer from specific developmental disorders that impair learning. The findings from people with dyslexia and typically developing readers suggest that the problems children experience in learning to read are related to the preliteracy skills that they bring with them from kindergarten. Most tools available to professionals are designed for the evaluation of child language problems. In comparison, there are very few tools for assessing the relations between visual skills and the process of learning to read. Recent literature reports that visual-motor skills and visual-spatial attention in preschoolers are important predictors of reading development — the main goal of this study aimed at improving screening for future reading difficulties in preschool children. We used a prospective, longitudinal approach where oculomotor processes (assessed with the DiagLECT test) were measured in pre-readers, and the impact of these skills on future reading development was explored. The dialect test specifically measures the online time taken to name numbers arranged irregularly in horizontal rows (horizontal time, HT), and the time taken to name numbers arranged in vertical columns (vertical time, VT). A total of 131 preschoolers took part in this study. At Time 0 (kindergarten), the mean VT, HT, errors were recorded. One year later, at Time 1, the reading level of the same children was evaluated. Firstly, this study allowed us to provide normative data for a standardized evaluation of the oculomotor skills in 5- and 6-year-old children. The data also revealed that 25% of our sample of preschoolers showed oculomotor impairments (without any clinical complaints). Finally, the results of this study assessed the validity of the DiagLECT test for predicting reading outcomes; the better a child's oculomotor skills are, the better his/her reading abilities will be.

Keywords: vision, attention, oculomotor processes, reading, preschoolers

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Authors: R. Stoyanova, R. Dimova, M. Tarnovska, T. Boeva, R. Dimov, I. Doykov

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Patient safety culture (PSC) is an essential component of quality of healthcare. Improving PSC is considered a priority in many developed countries. Specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods: The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. To quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the x²-test was applied. The research hypothesis assumed that there are no significant differences between the Bulgarian, Croatian and US PSCs. Results: The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: ‘Staff worries that their mistakes are kept in their personnel file’ (RA16), ‘Things ‘fall between the cracks’ when transferring patients from one unit to another’ (RF3) and ‘Shift handovers are problematic for patients in this hospital’ (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions: Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

Keywords: patient safety culture, healthcare, HSOPSC, medical error

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Authors: U. Ali Rahoma, Nabil Esawy, Fawzia Ibrahim Moursy, A. H. Hassan, Samy A. Khalil, Ashraf S. Khamees

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The design of any solar energy conversion system requires the knowledge of solar radiation data obtained over a long period. Satellite data has been widely used to estimate solar energy where no ground observation of solar radiation is available, yet there are limitations on the temporal coverage of satellite data. Reanalysis is a “retrospective analysis” of the atmosphere parameters generated by assimilating observation data from various sources, including ground observation, satellites, ships, and aircraft observation with the output of NWP (Numerical Weather Prediction) models, to develop an exhaustive record of weather and climate parameters. The evaluation of the performance of reanalysis datasets (ERA-5) for North Africa against high-quality surface measured data was performed using statistical analysis. The estimation of global solar radiation (GSR) distribution over six different selected locations in North Africa during ten years from the period time 2011 to 2020. The root means square error (RMSE), mean bias error (MBE) and mean absolute error (MAE) of reanalysis data of solar radiation range from 0.079 to 0.222, 0.0145 to 0.198, and 0.055 to 0.178, respectively. The seasonal statistical analysis was performed to study seasonal variation of performance of datasets, which reveals the significant variation of errors in different seasons—the performance of the dataset changes by changing the temporal resolution of the data used for comparison. The monthly mean values of data show better performance, but the accuracy of data is compromised. The solar radiation data of ERA-5 is used for preliminary solar resource assessment and power estimation. The correlation coefficient (R2) varies from 0.93 to 99% for the different selected sites in North Africa in the present research. The goal of this research is to give a good representation for global solar radiation to help in solar energy application in all fields, and this can be done by using gridded data from European Centre for Medium-Range Weather Forecasts ECMWF and producing a new model to give a good result.

Keywords: solar energy, solar radiation, ERA-5, potential energy

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Authors: M. S. Nikitenko, S. A. Kizilov, D. Y. Khudonogov

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The paper considers an approach to a machine vision operating system combined with using a grid of light markers. This approach is used to solve several scientific and technical problems, such as measuring the capability of an apron feeder delivering coal from a lining return port to a conveyor in the technology of mining high coal releasing to a conveyor and prototyping an autonomous vehicle obstacle detection system. Primary verification of a method of calculating bulk material volume using three-dimensional modeling and validation in laboratory conditions with relative errors calculation were carried out. A method of calculating the capability of an apron feeder based on a machine vision system and a simplifying technology of a three-dimensional modelled examined measuring area with machine vision was offered. The proposed method allows measuring the volume of rock mass moved by an apron feeder using machine vision. This approach solves the volume control issue of coal produced by a feeder while working off high coal by lava complexes with release to a conveyor with accuracy applied for practical application. The developed mathematical apparatus for measuring feeder productivity in kg/s uses only basic mathematical functions such as addition, subtraction, multiplication, and division. Thus, this fact simplifies software development, and this fact expands the variety of microcontrollers and microcomputers suitable for performing tasks of calculating feeder capability. A feature of an obstacle detection issue is to correct distortions of the laser grid, which simplifies their detection. The paper presents algorithms for video camera image processing and autonomous vehicle model control based on obstacle detection machine vision systems. A sample fragment of obstacle detection at the moment of distortion with the laser grid is demonstrated.

Keywords: machine vision, machine vision operating system, light markers, measuring capability, obstacle detection system, autonomous transport

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Authors: Evelyn Osehontue Uroro, Richard Bright, Jing Yang Quek, Krasimir Vasilev

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Bacterial infections have been a challenge both in the public and private sectors. The colonization of bacteria often occurs in medical devices such as catheters, heart valves, respirators, and orthopaedic implants. When biomedical devices are inserted into patients, the deposition of macromolecules such as fibrinogen and immunoglobin on their surfaces makes it easier for them to be prone to bacteria colonization leading to the formation of biofilms. The formation of biofilms on medical devices has led to a series of device-related infections which are usually difficult to eradicate and sometimes cause the death of patients. These infections require surgical replacements along with prolonged antibiotic therapy, which would incur additional health costs. It is, therefore, necessary to prevent device-related infections by inhibiting the formation of biofilms using intelligent technology. Antibiotic resistance of bacteria is also a major threat due to overuse. Different antimicrobial agents have been applied to microbial infections. They include conventional antibiotics like rifampicin. The use of conventional antibiotics like rifampicin has raised concerns as some have been found to have hepatic and nephrotoxic effects due to overuse. Hence, there is also a need for proper delivery of these antibiotics. Different techniques have been developed to encapsulate and slowly release antimicrobial agents, thus reducing host cytotoxicity. Examples of delivery systems are solid lipid nanoparticles, hydrogels, micelles, and polymeric nanoparticles. The different ways by which drugs are released from polymeric nanoparticles include diffusion-based release, elution-based release, and chemical/stimuli-responsive release. Polymeric nanoparticles have gained a lot of research interest as they are basically made from biodegradable polymers. An example of such a biodegradable polymer is polycaprolactone (PCL). PCL degrades slowly by hydrolysis but is often sensitive and responsive to stimuli like enzymes to release encapsulants for antimicrobial therapy. This study presents the synthesis of PCL nanoparticles loaded with rifampicin and the on-demand release of rifampicin for treating staphylococcus aureus infections.

Keywords: enzyme, Staphylococcus aureus, PCL, rifampicin

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Authors: Ma. Roxanne Fernandez, Josie Athens, Balsalobre-Fernandez, Masayoshi Kubo, Kim Hébert-Losier

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Objectives: The calf raise test (CRT) is used in rehabilitation and sports medicine to evaluate calf muscle function. For testing, individuals stand on one leg and go up on their toes and back down to volitional fatigue. The newly developed Calf Raise application (CRapp) for iOS uses computer-vision algorithms enabling objective measurement of CRT outcomes. We aimed to validate the CRapp by examining its concurrent validity and agreement levels against laboratory-based equipment and establishing its intra- and inter-rater reliability. Methods: CRT outcomes (i.e., repetitions, positive work, total height, peak height, fatigue index, and peak power) were assessed in thirteen healthy individuals (6 males, 7 females) on three occasions and both legs using the CRapp, 3D motion capture, and force plate technologies simultaneously. Data were extracted from two markers: one placed immediately below the lateral malleolus and another on the heel. Concurrent validity and agreement measures were determined using intraclass correlation coefficients (ICC₃,ₖ), typical errors expressed as coefficient of variations (CV), and Bland-Altman methods to assess biases and precision. Reliability was assessed using ICC3,1 and CV values. Results: Validity of CRapp outcomes was good to excellent across measures for both markers (mean ICC ≥0.878), with precision plots showing good agreement and precision. CV ranged from 0% (repetitions) to 33.3% (fatigue index) and were, on average better for the lateral malleolus marker. Additionally, inter- and intra-rater reliability were excellent (mean ICC ≥0.949, CV ≤5.6%). Conclusion: These results confirm the CRapp is valid and reliable within and between users for measuring CRT outcomes in healthy adults. The CRapp provides a tool to objectivise CRT outcomes in research and practice, aligning with recent advances in mobile technologies and their increased use in healthcare.

Keywords: calf raise test, mobile application, validity, reliability

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Authors: Rezvan Ravanfar Haghighi, V. C. Vani, Suresh Perumal, Sabyasachi Chatterjee, Pratik Kumar

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X-ray attenuation coefficient [µ(E)] of any substance, for energy (E), is a sum of the contributions from the Compton scattering [ μCom(E)] and photoelectric effect [µPh(E)]. In terms of the, electron density (ρe) and the effective atomic number (Zeff) we have µCom(E) is proportional to [(ρe)fKN(E)] while µPh(E) is proportional to [(ρeZeffx)/Ey] with fKN(E) being the Klein-Nishina formula, with x and y being the exponents for photoelectric effect. By taking the sample's HU at two different excitation voltages (V=V1, V2) of the CT machine, we can solve for X=ρe, Y=ρeZeffx from these two independent equations, as is attempted in DECT inversion. Since µCom(E) and µPh(E) are both energy dependent, the coefficients of inversion are also dependent on (a) the source spectrum S(E,V) and (b) the detector efficiency D(E) of the CT machine. In the present paper we tabulate these coefficients of inversion for different practical manifestations of S(E,V) and D(E). The HU(V) values from the CT follow: <µ(V)>=<µw(V)>[1+HU(V)/1000] where the subscript 'w' refers to water and the averaging process <….> accounts for the source spectrum S(E,V) and the detector efficiency D(E). Linearity of μ(E) with respect to X and Y implies that (a) <µ(V)> is a linear combination of X and Y and (b) for inversion, X and Y can be written as linear combinations of two independent observations <µ(V1)>, <µ(V2)> with V1≠V2. These coefficients of inversion would naturally depend upon S(E, V) and D(E). We numerically investigate this dependence for some practical cases, by taking V = 100 , 140 kVp, as are used for cardiological investigations. The S(E,V) are generated by using the Boone-Seibert source spectrum, being superposed on aluminium filters of different thickness lAl with 7mm≤lAl≤12mm and the D(E) is considered to be that of a typical Si[Li] solid state and GdOS scintilator detector. In the values of X and Y, found by using the calculated inversion coefficients, errors are below 2% for data with solutions of glycerol, sucrose and glucose. For low Zeff materials like propionic acid, Zeffx is overestimated by 20% with X being within1%. For high Zeffx materials like KOH the value of Zeffx is underestimated by 22% while the error in X is + 15%. These imply that the source may have additional filtering than the aluminium filter specified by the manufacturer. Also it is found that the difference in the values of the inversion coefficients for the two types of detectors is negligible. The type of the detector does not affect on the DECT inversion algorithm to find the unknown chemical characteristic of the scanned materials. The effect of the source should be considered as an important factor to calculate the coefficients of inversion.

Keywords: attenuation coefficient, computed tomography, photoelectric effect, source spectrum

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Authors: Anusha P. Wijesundara, Dulap I. Rathnayake, Nihal D. Perera

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Bathymetric information is fundamental importance to coastal and marine planning and management, nautical navigation, and scientific studies of marine environments. Satellite-derived bathymetry data provide detailed information in areas where conventional sounding data is lacking and conventional surveys are inaccessible. The two empirical approaches of log-linear bathymetric inversion model and non-linear bathymetric inversion model are applied for deriving bathymetry from high-resolution multispectral satellite imagery. This study compares these two approaches by means of geographical error analysis for the site Kankesanturai using WorldView-2 satellite imagery. Based on the Levenberg-Marquardt method calibrated the parameters of non-linear inversion model and the multiple-linear regression model was applied to calibrate the log-linear inversion model. In order to calibrate both models, Single Beam Echo Sounding (SBES) data in this study area were used as reference points. Residuals were calculated as the difference between the derived depth values and the validation echo sounder bathymetry data and the geographical distribution of model residuals was mapped. The spatial autocorrelation was calculated by comparing the performance of the bathymetric models and the results showing the geographic errors for both models. A spatial error model was constructed from the initial bathymetry estimates and the estimates of autocorrelation. This spatial error model is used to generate more reliable estimates of bathymetry by quantifying autocorrelation of model error and incorporating this into an improved regression model. Log-linear model (R²=0.846) performs better than the non- linear model (R²=0.692). Finally, the spatial error models improved bathymetric estimates derived from linear and non-linear models up to R²=0.854 and R²=0.704 respectively. The Root Mean Square Error (RMSE) was calculated for all reference points in various depth ranges. The magnitude of the prediction error increases with depth for both the log-linear and the non-linear inversion models. Overall RMSE for log-linear and the non-linear inversion models were ±1.532 m and ±2.089 m, respectively.

Keywords: log-linear model, multi spectral, residuals, spatial error model

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Authors: Navah Z. Ratzon, Anat Keren, Shlomit Y. Greenberg

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Car accidents are a problem worldwide. Adolescents’ involvement in car accidents is higher in comparison to the overall driving population. Researchers estimate the risk of accidents among adolescents with symptoms of attention-deficit/hyperactivity disorder (ADHD) to be 1.2 to 4 times higher than that of their peers. Individuals with ADHD exhibit unique patterns of eye movements and attentional shifts that play an important role in driving. In addition, deficiencies in cognitive and executive functions among adolescents with ADHD is likely to put them at greater risk for car accidents. Fifteen adolescents with ADHD and 17 matched controls participated in the study. Individuals from both groups attended local public schools and did not have a driver’s license. Participants’ mean age was 16.1 (SD=.23). As part of the experiment, they all completed a driving simulation session, while their eye movements were monitored. Data were recorded by an eye tracker: The entire driving session was recorded, registering the tester’s exact gaze position directly on the screen. Eye movements and simulator data were analyzed using Matlab (Mathworks, USA). Participants’ cognitive and metacognitive abilities were evaluated as well. No correlation was found between saccade properties, regions of interest, and simulator performance in either group, although participants with ADHD allocated more visual scan time (25%, SD = .13%) to a smaller segment of dashboard area, whereas controls scanned the monitor more evenly (15%, SD = .05%). The visual scan pattern found among participants with ADHD indicates a distinct pattern of engagement-disengagement of spatial attention compared to that of non-ADHD participants as well as lower attention flexibility, which likely affects driving. Additionally the lower the results on the cognitive tests, the worse driving performance was. None of the participants had prior driving experience, yet participants with ADHD distinctly demonstrated difficulties in scanning their surroundings, which may impair driving. This stresses the need to consider intervention programs, before driving lessons begin, to help adolescents with ADHD acquire proper driving habits, avoid typical driving errors, and achieve safer driving.

Keywords: ADHD, attentional shifting, driving simulator, eye movements

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Authors: Yasir Memon

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The complexity and challenges in the offshore industry are increasing more than the past. The oil and gas industry is expanding every day by accomplishing these challenges. More challenging wells such as longer and deeper are being drilled in today’s environment. Blowout prevention phenomena hold a worthy importance in oil and gas biosphere. In recent, so many past years when the oil and gas industry was growing drilling operation were extremely dangerous. There was none technology to determine the pressure of reservoir and drilling hence was blind operation. A blowout arises when an uncontrolled reservoir pressure enters in wellbore. A potential of blowout in the oil industry is the danger for the both environment and the human life. Environmental damage, state/country regulators, and the capital investment causes in loss. There are many cases of blowout in the oil the gas industry caused damage to both human and the environment. A huge capital investment is being in used to stop happening of blowout through all over the biosphere to bring damage at the lowest level. The objective of this study is to promote safety and good resources to assure safety and environmental integrity in all operations during drilling. This study shows that human errors and management failure is the main cause of blowout therefore proper management with the wise use of precautions, prevention methods or controlling techniques can reduce the probability of blowout to a minimum level. It also discusses basic procedures, concepts and equipment involved in well control methods and various steps using at various conditions. Furthermore, another aim of this study work is to highlight management role in oil gas operations. Moreover, this study analyze the causes of Blowout of Macondo well occurred in the Gulf of Mexico on April 20, 2010, and deliver the recommendations and analysis of various aspect of well control methods and also provides the list of mistakes and compromises that British Petroleum and its partner were making during drilling and well completion methods and also the Macondo well disaster happened due to various safety and development rules violation. This case study concludes that Macondo well blowout disaster could be avoided with proper management of their personnel’s and communication between them and by following safety rules/laws it could be brought to minimum environmental damage.

Keywords: energy, environment, oil and gas industry, Macondo well accident

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Authors: Naim Izet Kajtazi

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Context: The third ventricle colloid cyst (CC) is a benign growth usually located in the third ventricle and can cause various neurological symptoms, including sudden death. Modern surgical interventions may still result in a wide range of complications and cerebral venous thrombosis (CVT) is among them. Process: A 38-year-old female with an existing diagnosis of diabetes mellitus (DM) and hypothyroidism and a six-month history of headaches, blurred vision, and vomiting presented to our clinic three days after the headaches became excessively severe. Neurological examination on admission revealed bilateral papilledema without any associated focal neurological deficits. Brain computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of a third ventricle colloid cyst and associated non-communicating hydrocephalus involving the lateral ventricles. As a result, the patient underwent emergency bilateral external ventricular drainage (EVD) insertion followed by a third ventricular CC excision under neuronavigation through a right frontal craniotomy. Twelve days post-operatively, the patient developed further headaches, followed by a generalized tonic-clonic seizure that led to no postictal neurological deficits. Nonetheless, computed tomography venography of the brain revealed extensive thrombosis of the superior sagittal sinus, inferior sagittal sinus, right sigmoid sinus, and right internal jugular vein. A newly diagnosed CVT was treated with intravenous heparin. The patient was discharged with warfarin, which was discontinued after 12 months. Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from mild chronic headaches. Outcome: Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from mild chronic headaches. Relevance: A preoperative venous study should be performed in all cases to gain a better understanding of the venous anatomy. We advocate meticulous microsurgical techniques to protect the venous system surrounding the foramen of Monro and reduce the amount of retraction during surgery.

Keywords: CVT, seizures, third ventricle colloid cyst, MRI of brain

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Authors: Jae Ni Jang, Young Uk Kim

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Background: Chat Generative Pre-training Transformer-3 (ChatGPT; San Francisco, California, Open Artificial Intelligence) is an artificial intelligence chatbot based on a large language model designed to generate human-like text. As the usage of ChatGPT is increasing among less knowledgeable patients, medical students, and anesthesia and pain medicine residents or trainees, we aimed to evaluate the accuracy of ChatGPT-3 responses to questions about the American Society of Anesthesiologists (ASA) classification based on patients’ underlying diseases and assess the quality of the generated responses. Methods: A total of 47 questions were submitted to ChatGPT using textual prompts. The questions were designed for ChatGPT-3 to provide answers regarding ASA classification in response to common underlying diseases frequently observed in adult patients. In addition, we created 18 questions regarding the ASA classification for pediatric patients and pregnant women. The accuracy of ChatGPT’s responses was evaluated by cross-referencing with Miller’s Anesthesia, Morgan & Mikhail’s Clinical Anesthesiology, and the American Society of Anesthesiologists’ ASA Physical Status Classification System (2020). Results: Out of the 47 questions pertaining to adults, ChatGPT -3 provided correct answers for only 23, resulting in an accuracy rate of 48.9%. Furthermore, the responses provided by ChatGPT-3 regarding children and pregnant women were mostly inaccurate, as indicated by a 28% accuracy rate (5 out of 18). Conclusions: ChatGPT provided correct responses to questions relevant to the daily clinical routine of anesthesiologists in approximately half of the cases, while the remaining responses contained errors. Therefore, caution is advised when using ChatGPT to retrieve anesthesia-related information. Although ChatGPT may not yet be suitable for clinical settings, we anticipate significant improvements in ChatGPT and other large language models in the near future. Regular assessments of ChatGPT's ASA classification accuracy are essential due to the evolving nature of ChatGPT as an artificial intelligence entity. This is especially important because ChatGPT has a clinically unacceptable rate of error and hallucination, particularly in pediatric patients and pregnant women. The methodology established in this study may be used to continue evaluating ChatGPT.

Keywords: American Society of Anesthesiologists, artificial intelligence, Chat Generative Pre-training Transformer-3, ChatGPT

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Authors: Daniel Alfonso Reséndiz-García, Luis Antonio García-Villanueva

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As a result of the high industrial activity, which arises from the search to satisfy the needs of products and services for society, several chemical accidents have occurred, causing serious damage to different sectors: human, economic, infrastructure and environmental losses. Historically, with the study of this chemical accidents, it has been determined that the causes are mainly due to human errors (inexperienced personnel, negligence, lack of maintenance and deficient risk analysis). The industries have the aim to increase production and reduce costs. However, it should be kept in mind that the costs involved in risk studies, implementation of barriers and safety systems is much cheaper than paying for the possible damages that could occur in the event of an accident, without forgetting that there are things that cannot be replaced, such as human lives.Therefore, it is of utmost importance to implement risk studies in all industries, which provide information for prevention and planning. The aim of this study is to compare risk methodologies by identifying the consequences of accidents related to the storage of flammable, dangerous goods for decision making and emergency response.The methodologies considered in this study are qualitative and quantitative risk analysis and consequence analysis. The latter, by means of modeling software, which provides radius of affectation and the possible scope and magnitude of damages.By using risk analysis, possible scenarios of occurrence of chemical accidents in the storage of flammable substances are identified. Once the possible risk scenarios have been identified, the characteristics of the substances, their storage and atmospheric conditions are entered into the software.The results provide information that allows the implementation of prevention, detection, control, and combat elements for emergency response, thus having the necessary tools to avoid the occurrence of accidents and, if they do occur, to significantly reduce the magnitude of the damage.This study highlights the importance of risk studies applying tools that best suited to each case study. It also proves the importance of knowing the risk exposure of industrial activities for a better prevention, planning and emergency response.

Keywords: chemical accidents, emergency response, flammable substances, risk analysis, modeling

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Authors: K. M. Damodara Gowda

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Background: Maternal health and nutrition are considered as the predominant factors influencing brain functional development. If the mother is free of illness and genetic defects, maternal nutrition would be one of the most critical factors affecting the brain development. Calorie restrictions cause significant impairment in spatial learning ability and the levels of Brain Derived Neurotrophic Factor (BDNF) in rats. But, the mechanism by which the prenatal under-nutrition leads to impairment in brain learning and memory function is still unclear. In the present study, prenatal Astaxanthin supplementation on BDNF level, spatial learning and memory performance in the offspring’s of normal, calorie restricted and Astaxanthin supplemented rats was investigated. Methodology: The rats were administered with 6mg and 12 mg of astaxanthin /kg bw for 21 days following which acquisition and retention of spatial memory was tested in a partially-baited eight arm radial maze. The BDNF level in different regions of the brain (cerebral cortex, hippocampus and cerebellum) was estimated by ELISA method. Results: Calorie restricted animals treated with astaxanthin made significantly more correct choices (P < 0.05), and fewer reference memory errors (P < 0.05) on the tenth day of training compared to offsprings of calorie restricted animals. Calorie restricted animals treated with astaxanthin also made significantly higher correct choices (P < 0.001) than untreated calorie restricted animals in a retention test 10 days after the training period. The mean BDNF level in cerebral cortex, Hippocampus and cerebellum in Calorie restricted animals treated with astaxanthin didnot show significant variation from that of control animals. Conclusion: Findings of the study indicated that memory and learning was impaired in the offspring’s of calorie restricted rats which was effectively modulated by astaxanthin at the dosage of 12 mg/kg body weight. In the same way the BDNF level at cerebral cortex, Hippocampus and Cerebellum was also declined in the offspring’s of calorie restricted animals, which was also found to be effectively normalized by astaxanthin.

Keywords: calorie restiction, learning, Memory, Cerebral cortex, Hippocampus, Cerebellum, BDNF, Astaxanthin

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Authors: Irfan Anjum Manarvi, Zahid Ali kaimkhani

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Predicting location of the fracture in human bones has been a keen area of research for the past few decades. A variety of tests for hardness, deformation, and strain field measurement have been conducted in the past; but considered insufficient due to various limitations. Researchers, therefore, have proposed further studies due to inaccuracies in measurement methods, testing machines, and experimental errors. Advancement and availability of hardware, measuring instrumentation, and testing machines can now provide remedies to these limitations. The human foot is a critical part of the body exposed to various forces throughout its life. A number of products are developed for using it for protection and care, which many times do not provide sufficient protection and may itself become a source of stress due to non-consideration of the delicacy of bones in the feet. A continuous strain or overloading on feet may occur resulting to discomfort and even fracture. Mechanical properties of Tarsals, Metatarsals, and phalanges are, therefore, the primary area of consideration for all such design applications. Hardness is one of the mechanical properties which are considered very important to establish the mechanical resistance behavior of a material against applied loads. Past researchers have worked in the areas of investigating mechanical properties of these bones. However, their results were based on a limited number of experiments and taking average values of hardness due to either limitation of samples or testing instruments. Therefore, they proposed further studies in this area. The present research has been carried out to develop a hardness map of the human foot by measuring micro hardness at various locations of these bones. Results are compiled in the form of distance from a reference point on a bone and the hardness values for each surface. The number of test results is far more than previous studies and are spread over a typical bone to give a complete hardness map of these bones. These results could also be used to establish other properties such as stress and strain distribution in the bones. Also, industrial engineers could use it for design and development of various accessories for human feet health care and comfort and further research in the same areas.

Keywords: tarsals, metatarsals, phalanges, hardness testing, biomechanics of human foot

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Authors: Eunjung Lee

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This study aims to analyze the sentences generated by the beginners who learn ‘e,’ a postposition in Korean and to find out the regularity of learners’ interlanguage upon investigating the usages of ‘e’ that appears by meanings and functions in their interlanguage, and conditions that ‘e’ is used. This study was conducted with mainly two assumptions; first, the learner’s language has the specific type of interlanguage; and second, there is the regularity of interlanguage when students produce ‘e’ under the specific conditions. Learners’ output has various values and can be used as the useful data to understand interlanguage. Therefore, all the sentences containing a postposition ‘e’ by English speaking learners were searched in ‘Learners’ corpus sharing center in The National Institute of Korean Language’ in Korea, and the data were collected upon limiting the levels of learners with Level 1 and 2. 789 sentences that were used with ‘e’ were selected as the final subjects of the analysis. First, to understand the environmental characteristics to be used with a postposition, ‘e’ after summarizing 13 meaning and functions of ‘e’ appeared in three books of Korean dictionary that summarized the Korean grammar, 1) meaning function of ‘e’ that were used in each sentence was classified; 2) the nouns that were combined with ‘e,’ keywords of the sentences, and the characteristics of modifiers, linkers, and predicates appeared in front of ‘e’ were analyzed; 3) the regularity by the novice learners’ meaning and functions were reviewed; and 4) the differences of the regularity by level 1 and 2 learners’ meaning and functions were found. Upon the study results, the novice learners showed 1) they used the nouns related to ‘time(시간), before(전), after(후), next(다음), the next(그다음), then(때), day of the week(요일), and season(계절)’ mainly in front of ‘e’ when they used ‘e’ as the meaning function of time; 2) they used mainly the verbs of ‘go(가다),’ ‘come(오다),’ and ‘go round(다니다)’ as the predicate to match with ‘e’ that was the meaning function of direction and destination; and 3) they used mainly the nouns related to ‘locations or countries’ in front of ‘e,’ a meaning function postposition of ‘place,’ used mainly the verbs ‘be(있다), not be(없다), live(살다), be many(많다)’ after ‘e,’ and ‘i(이) or ka(가)’ was combined mainly in the subject words in case of ‘be(있다), not be(없다)’ or ‘be many(많다),’ and ‘eun(은) or nun(는)’ was combined mainly in the subject words in front of ‘live at’ In addition, 4) they used ‘e’ which indicates ‘cause or reason’ in the form of ‘because( 때문에),’ and 5) used ‘e’ of the subjects as the predicates to match with the predicates such as ‘treat(대하다), like(들다), and catch(걸리다).’ From these results, ‘e’ usage patterns of the Korean novice learners demonstrated very differently by the meaning functions and the learners’ interlanguage regularity could be deducted. However, little difference was found in interlanguage regularity between level 1 and 2. This study has the meaning to try to understand the interlanguage system and regularity in the learners’ acquisition process of postposition ‘e’ and this can be utilized to lessen their errors.

Keywords: interlanguage, interlagnage anaylsis, postposition ‘e’, Korean acquisition

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Authors: Niloofar Zebarjad

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This research aims at finding a tool to provide basketball players with real-time audio feedback on their shooting form in free throw shots. Free throws played a pivotal role in taking the lead in fierce competitions. The major problem in performing an accurate free throw seems to be improper training. Since the arm movement during the free throw shot is complex, the coach or the athlete might miss the movement details during practice. Hence, there is a necessity to create a system that measures arm movements' critical characteristics and control for improper kinematics. The proposed setup in this study quantifies arm kinematics and provides real-time feedback as an audio signal consisting of a gyroscope sensor. Spatial shoulder angle data are transmitted in a mobile application in real-time and can be saved and processed for statistical and analysis purposes. The proposed system is easy to use, inexpensive, portable, and real-time applicable. Objectives: This research aims to modify and control the free throw using audio feedback and determine if and to what extent the new setup reduces errors in arm formations during throws and finally assesses the successful throw rate. Methods: One group of elite basketball athletes and two novice athletes (control and study group) participated in this study. Each group contains 5 participants being studied in three separate sessions over a week. Results: Empirical results showed enhancements in the free throw shooting style, shot pocket (SP), and locked position (LP). The mean values of shoulder angle were controlled on 25° and 45° for SP and LP, respectively, recommended by valid FIBA references. Conclusion: Throughout the experiments, the system helped correct and control the shoulder angles toward the targeted pattern of shot pocket (SP) and locked position (LP). According to the desired results for arm motion, adding another sensor to measure and control the elbow angle is recommended.

Keywords: audio-feedback, basketball, free-throw, locked-position, motor-control, shot-pocket

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Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Youtao Gao, Bingyu Jin, Tanran Zhao, Bo Xu

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The history of satellite navigation can be dated back to the 1960s. From the U.S. Transit system and the Russian Tsikada system to the modern Global Positioning System (GPS) and the Globalnaya Navigatsionnaya Sputnikovaya Sistema (GLONASS), performance of satellite navigation has been greatly improved. Nowadays, the navigation accuracy and coverage of these existing systems have already fully fulfilled the requirement of near-Earth users, but these systems are still beyond the reach of deep space targets. Due to the renewed interest in space exploration, a novel high-precision satellite navigation system is becoming even more important. The increasing demand for such a deep space navigation system has contributed to the emergence of a variety of new constellation architectures, such as the Lunar Global Positioning System. Apart from a Walker constellation which is similar to the one adopted by GPS on Earth, a novel constellation architecture which consists of libration point satellites in the Earth-Moon system is also available to construct the lunar navigation system, which can be called accordingly, the libration point satellite navigation system. The concept of using Earth-Moon libration point satellites for lunar navigation was first proposed by Farquhar and then followed by many other researchers. Moreover, due to the special characteristics of Libration point orbits, an autonomous orbit determination technique, which is called ‘Liaison navigation’, can be adopted by the libration point satellites. Using only scalar satellite-to-satellite tracking data, both the orbits of the user and libration point satellites can be determined autonomously. In this way, the extensive Earth-based tracking measurement can be eliminated, and an autonomous satellite navigation system can be developed for future space exploration missions. The method of state estimate is an unnegligible factor which impacts on the orbit determination accuracy besides type of orbit, initial state accuracy and measurement accuracy. We apply the extended Kalman filter(EKF) and the unscented Kalman filter(UKF) to determinate the orbits of Lagrangian navigation satellites. The autonomous orbit determination errors are compared. The simulation results illustrate that UKF can improve the accuracy and z-axis convergence to some extent.

Keywords: extended Kalman filter, autonomous orbit determination, unscented Kalman filter, navigation constellation

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Authors: Mylene T. Caytap-Milan

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This study was materialized with the purpose of determining the anxieties of students towards spoken English, sources of the specified anxiety, coping mechanisms to counter the apprehensions, and teacher management to reduce the anxiety within the classroom. Being qualitative in nature, interview as the data gathering tool was utilized with an audio-recorder. Participants of the study included thirteen teachers and students of speech classes in a state university in Region I, Philippines. Data elicited were transcribed in verbatim, confirmed by the participants, coded and categorized, and themed accordingly. A triangulation method was applied to establish the stronger validity of the data. Findings confirmed teachers’ and students’ awareness of the existence of Anxiety in speaking English (ASE). Based on the data gathered from the teachers, the following themes on students’ ASE were identified: (1) No Brain and Mouth Coordination, (2) Center of Attention, and (3) Acting Out Loud. However, the following themes were formulated based on the responses made by the students themselves: (1) The Common Feeling, (2) The Incompetent Me, and (3) The Limelight. With regard the sources of students’ ASE according to teachers are the following: (1) It Began at Home, (2) It Continued in School, (3) It’s not for me at all. On the other hand, the sources of students’ ASE according to students themselves are: (1) It Comes from Within, (2) It wasn’t Nursed Well, and (3) They’re Looking for Errors. In terms of coping with ASE, students identified the following mechanisms, which were themed into: (1) Acceptance, (2) Application, and (3) Apathy. Moreover, to reduce the ASE phenomenon within the classroom, the teachers demonstrate the following roles according to themes: (1) The Compass, (2) The Counselor, (3) The Referee, (4) The Polyglot, and (5) The English Nazi. Based on the findings, the following conclusions were drawn: (1) ASE can both serve positive and negative influences to the English speaking skills of students, (2) ASE can be reduced with teachers’ provision of more English speaking opportunities and with students’ initiative of personal training, (3) ASE can be reduced when English is introduced and practiced by children at an early age, and (4) ASE is inevitable in the affective domain thus teachers are encouraged to apply psychological positivism in the classroom. Studies related to the present undertaking may refer to the succeeding recommendations: (1) experiment on activities that will reduce anxiety ASE, (2) involve a psychologist for more critical but reliable results and recommendations, and (3) conduct the study among high school and primary students.

Keywords: coping mechanisms, sources, speaking anxiety, teacher management

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Authors: Floriane Shala, Evangeline Wagner, Yichun Zhao

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Background: Proper educational training and support are proven to be major components of EHR (Electronic Health Record) implementation and use. However, the majority of health providers are not sufficiently trained in EHR use, leading to adverse events, errors, and decreased quality of care. In response to this, students studying Health Information Science, Public Health, Nursing, and Medicine should all gain a thorough understanding of EHR use at different levels for different purposes. The design of a usable and safe EHR system that accommodates the needs and workflows of different users, user groups, and disciplines is required for EHR learning to be efficient and effective. Objectives: This project builds several artifacts which seek to address both the educational and usability aspects of an educational EHR. The artifacts proposed are models for and examples of such an EHR with a configurable UI to be learned by students who need a background in EHR use during their degrees. Methods: Review literature and gather professional opinions from domain experts on usability, the use of workflow patterns, UI configurability and design, and the educational aspect of EHR use. Conduct interviews in a semi-casual virtual setting with open discussion in order to gain a deeper understanding of the principal aspects of EHR use in educational settings. Select a specific task and user group to illustrate how the proposed solution will function based on the current research. Develop three artifacts based on the available research, professional opinions, and prior knowledge of the topic. The artifacts capture the user task and user’s interactions with the EHR for learning. The first generic model provides a general understanding of the EHR system process. The second model is a specific example of performing the task of MRI ordering with a configurable UI. The third artifact includes UI mock-ups showcasing the models in a practical and visual way. Significance: Due to the lack of educational EHRs, medical professionals do not receive sufficient EHR training. Implementing an educational EHR with a usable and configurable interface to suit the needs of different user groups and disciplines will help facilitate EHR learning and training and ultimately improve the quality of patient care.

Keywords: education, EHR, usability, configurable

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Authors: Amulya P. Rao, Prathima S., Sreedevi N.

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Speech sound disorders (SSD) encompass the major concern in younger population of India with highest prevalence rate among the speech disorders. Children with SSD if not identified and rehabilitated at the earliest, are at risk for academic difficulties. This necessitates early identification using screening tools assessing the frequently misarticulated speech sounds. The literature on frequently misarticulated speech sounds is ample in English and other western languages targeting individuals with various communication disorders. Articulation is language specific, and there are limited studies reporting the same in Kannada, a Dravidian Language. Hence, the present study aimed to identify the frequently misarticulated consonants in Kannada and also to examine the error type. A retrospective, descriptive study was carried out using secondary data analysis of 41 participants (34-phonetic type and 7-phonemic type) with SSD in the age range 3-to 12-years. All the consonants of Kannada were analyzed by considering three words for each speech sound from the Kannada Diagnostic Photo Articulation test (KDPAT). Picture naming task was carried out, and responses were audio recorded. The recorded data were transcribed using IPA 2018 broad transcription. A criterion of 2/3 or 3/3 error productions was set to consider the speech sound to be an error. Number of error productions was calculated for each consonant in each participant. Then, the percentage of participants meeting the criteria were documented for each consonant to identify the frequently misarticulated speech sound. Overall results indicated that velar /k/ (48.78%) and /g/ (43.90%) were frequently misarticulated followed by voiced retroflex /ɖ/ (36.58%) and trill /r/ (36.58%). The lateral retroflex /ɭ/ was misarticulated by 31.70% of the children with SSD. Dentals (/t/, /n/), bilabials (/p/, /b/, /m/) and labiodental /v/ were produced correctly by all the participants. The highly misarticulated velars /k/ and /g/ were frequently substituted by dentals /t/ and /d/ respectively or omitted. Participants with SSD-phonemic type had multiple substitutions for one speech sound whereas, SSD-phonetic type had consistent single sound substitutions. Intra- and inter-judge reliability for 10% of the data using Cronbach’s Alpha revealed good reliability (0.8 ≤ α < 0.9). Analyzing a larger sample by replicating such studies will validate the present study results.

Keywords: consonant, frequently misarticulated, Kannada, SSD

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Authors: A. Soria-Salinas, M.-P. Zorzano, J. Martín-Torres, J. Sánchez-García-Casarrubios, J.-L. Pérez-Díaz, A. Vakkada-Ramachandran

Abstract:

The current state-of-the-art methods of mass gauging of Electric Propulsion (EP) propellants in microgravity conditions rely on external measurements that are taken at the surface of the tank. The tanks are operated under a constant thermal duty cycle to store the propellant within a pre-defined temperature and pressure range. We demonstrate using computational fluid dynamics (CFD) simulations that the heat-transfer within the pressurized propellant generates temperature and density anisotropies. This challenges the standard mass gauging methods that rely on the use of time changing skin-temperatures and pressures. We observe that the domes of the tanks are prone to be overheated, and that a long time after the heaters of the thermal cycle are switched off, the system reaches a quasi-equilibrium state with a more uniform density. We propose a new gauging method, which we call the Improved PVT method, based on universal physics and thermodynamics principles, existing TRL-9 technology and telemetry data. This method only uses as inputs the temperature and pressure readings of sensors externally attached to the tank. These sensors can operate during the nominal thermal duty cycle. The improved PVT method shows little sensitivity to the pressure sensor drifts which are critical towards the end-of-life of the missions, as well as little sensitivity to systematic temperature errors. The retrieval method has been validated experimentally with CO₂ in gas and fluid state in a chamber that operates up to 82 bar within a nominal thermal cycle of 38 °C to 42 °C. The mass gauging error is shown to be lower than 1% the mass at the beginning of life, assuming an initial tank load at 100 bar. In particular, for a pressure of about 70 bar, just below the critical pressure of CO₂, the error of the mass gauging in gas phase goes down to 0.1% and for 77 bar, just above the critical point, the error of the mass gauging of the liquid phase is 0.6% of initial tank load. This gauging method improves by a factor of 8 the accuracy of the standard PVT retrievals using look-up tables with tabulated data from the National Institute of Standards and Technology.

Keywords: electric propulsion, mass gauging, propellant, PVT, xenon

Procedia PDF Downloads 323

Authors: O. O. Aiyelokun, O. A. Agbede

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Numerical modelling of groundwater flow can be susceptible to calibration errors due to lack of adequate ground-based hydro-metrological stations in river basins. Groundwater resources management in Southwest Nigeria is currently challenged by overexploitation, lack of planning and monitoring, urbanization and climate change; hence to adopt models as decision support tools for sustainable management of groundwater; they must be adequately calibrated. Since river basins in Southwest Nigeria are characterized by missing data, and lack of adequate ground-based hydro-meteorological stations; the need for adopting satellite-based data for constructing distributed models is crucial. This study seeks to evaluate the suitability of satellite-based data as substitute for ground-based, for computing boundary conditions; by determining if ground and satellite based meteorological data fit well in Ogun and Oshun River basins. The Climate Forecast System Reanalysis (CFSR) global meteorological dataset was firstly obtained in daily form and converted to monthly form for the period of 432 months (January 1979 to June, 2014). Afterwards, ground-based meteorological data for Ikeja (1981-2010), Abeokuta (1983-2010), and Oshogbo (1981-2010) were compared with CFSR data using Goodness of Fit (GOF) statistics. The study revealed that based on mean absolute error (MEA), coefficient of correlation, (r) and coefficient of determination (R²); all meteorological variables except wind speed fit well. It was further revealed that maximum and minimum temperature, relative humidity and rainfall had high range of index of agreement (d) and ratio of standard deviation (rSD), implying that CFSR dataset could be used to compute boundary conditions such as groundwater recharge and potential evapotranspiration. The study concluded that satellite-based data such as the CFSR should be used as input when constructing groundwater flow models in river basins in Southwest Nigeria, where majority of the river basins are partially gaged and characterized with long missing hydro-metrological data.

Keywords: boundary condition, goodness of fit, groundwater, satellite-based data

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Authors: Aschalew C. Workneh, K. S. Hari Prasad, C. S. P. Ojha

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The crop water stress index (CWSI) is a cost-effective, non-destructive, and simple technique for tracking the start of crop water stress. This study investigated the feasibility of CWSI derived from canopy temperature to detect the water status of wheat crops. Artificial intelligence (AI) techniques have become increasingly popular in recent years for determining CWSI. In this study, the performance of two AI techniques, adaptive neuro-fuzzy inference system (ANFIS) and self-organizing maps (SOM), are compared while determining the CWSI of paddy crops. Field experiments were conducted for varying irrigation water applications during two seasons in 2022 and 2023 at the irrigation field laboratory at the Civil Engineering Department, Indian Institute of Technology Roorkee, India. The ANFIS and SOM-simulated CWSI values were compared with the experimentally calculated CWSI (EP-CWSI). Multiple regression analysis was used to determine the upper and lower CWSI baselines. The upper CWSI baseline was found to be a function of crop height and wind speed, while the lower CWSI baseline was a function of crop height, air vapor pressure deficit, and wind speed. The performance of ANFIS and SOM were compared based on mean absolute error (MAE), mean bias error (MBE), root mean squared error (RMSE), index of agreement (d), Nash-Sutcliffe efficiency (NSE), and coefficient of correlation (R²). Both models successfully estimated the CWSI of the paddy crop with higher correlation coefficients and lower statistical errors. However, the ANFIS (R²=0.81, NSE=0.73, d=0.94, RMSE=0.04, MAE= 0.00-1.76 and MBE=-2.13-1.32) outperformed the SOM model (R²=0.77, NSE=0.68, d=0.90, RMSE=0.05, MAE= 0.00-2.13 and MBE=-2.29-1.45). Overall, the results suggest that ANFIS is a reliable tool for accurately determining CWSI in wheat crops compared to SOM.

Keywords: adaptive neuro-fuzzy inference system, canopy temperature, crop water stress index, self-organizing map, wheat

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Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

Procedia PDF Downloads 131

Authors: T. Almutairi, K. Naudi, N. Nairn, X. Ju, B. Eng, J. Whitters, A. Ayoub

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Purpose: At present Cone Beam Computed Tomography (CBCT) imaging does not record dental morphology accurately due to the scattering produced by metallic restorations and the reported magnification. The aim of this pilot study is the development and validation of a new method for the replacement of the distorted dentition of CBCT scans with the dental image captured by the digital intraoral camera. Materials and Method: Six dried skulls with orthodontics brackets on the teeth were used in this study. Three intra-oral markers made of dental stone were constructed which were attached to orthodontics brackets. The skulls were CBCT scanned, and occlusal surface was captured using TRIOS® 3D intraoral scanner. Marker based and surface based registrations were performed to fuse the digital intra-oral scan(IOS) into the CBCT models. This produced a new composite digital model of the skull and dentition. The skulls were scanned again using the commercially accurate Laser Faro® arm to produce the 'gold standard' model for the assessment of the accuracy of the developed method. The accuracy of the method was assessed by measuring the distance between the occlusal surfaces of the new composite model and the 'gold standard' 3D model of the skull and teeth. The procedure was repeated a week apart to measure the reproducibility of the method. Results: The results showed no statistically significant difference between the measurements on the first and second occasions. The absolute mean distance between the new composite model and the laser model ranged between 0.11 mm to 0.20 mm. Conclusion: The dentition of the CBCT can be accurately replaced with the dental image captured by the intra-oral scanner to create a composite model. This method will improve the accuracy of orthognathic surgical prediction planning, with the final goal of the fabrication of a physical occlusal wafer without to guide orthognathic surgery and eliminate the need for dental impression.

Keywords: orthognathic surgery, superimposition, models, cone beam computed tomography

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Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

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Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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Authors: Freddy Rodriguez Saza, Erika Sanabria, Jair Tibana

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Currently, the important role of neurosciences in the professional training of the physical educator is known, highlighting in the teaching-learning process aspects such as the nervous structures involved in the adjustment of posture and movement, the neurophysiology of locomotion, the process of nerve impulse transmission, and the relationship between physical activity, learning, and cognition. The teaching-learning process of neurosciences is complex, due to the breadth of the contents, the diversity of teaching contexts required, and the demanding ability to relate concepts from different disciplines, necessary for the correct understanding of the function of the nervous system. This text presents the results of the application of a didactic environment based on the Allosteric Learning Model in morphophysiology students of the Faculty of Military Physical Education, Military School of Cadets of the Colombian Army (Bogotá, Colombia). The research focused then, on analyzing the change in the cognitive structure of the students on neurosciences. Methodology. [1] The predominant learning styles were identified. [2] Students' cognitive structure, core concepts, and threshold concepts were analyzed through the construction of Pathfinder Associative Networks. [3] Didactic Units in Neuroscience were designed to favor metacognition, the development of Executive Functions (working memory, cognitive flexibility, and inhibitory control) that led students to recognize their errors and conceptual distortions and to overcome them. [4] The Teacher's Professional Knowledge and the role of the assessment strategies applied were taken into account, taking into account the perspective of the Dynamizer, Obstacle, and Questioning axes. In conclusion, the study found that physical education students achieved significant learning in neuroscience, favored by the development of executive functions and by didactic environments oriented with the predominant learning styles and focused on increasing cognitive networks and overcoming difficulties, neuromyths and neurophobia.

Keywords: allosteric learning model, military physical education, neurosciences, pathfinder associative networks, teacher professional knowledge

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Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

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