Search results for: adjunct placement

Authors: Bae Yu been, Choi Sung won, Lee Ju yeon, Yang Dan Bi

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The purpose of this study is to develop a self-help therapy program for bipolar disorder (BD). Psychosocial treatment is adjunct to pharmacotherapy for BD, however, it is limited and they demand high costs. Therefore, the objective of the study is to overcome these limitations by developing the self-treatment for BD. The study was examined the efficacy of the self-treatment program for BD. A randomized controlled trial compared the self-help therapy (ST) intervention with a treatment as usual (TAU) group. ST group has conducted the program for 8 weeks (16 sessions). Mood chart, Quality of Life in Bipolar Disorder Questionnaire, Attitudes toward seeking professional help Scale, BIS, CERQ, YMRS, MADRS were used by pre, post, and follow up. The efficacy of the self-help therapy was analyzed by using mixed ANOVAs. There were significant differences in the rate of occurrence of mania or depression between the two groups. ST group reported stable moods on mood chart, and reductions in mood symptoms and improvements in quality of life and treatment adherence. This study was confirmed applicable to BD to the self-help therapy for patients with BD conducted first in Korea.

Keywords: self help therapy, bipolar disorder, self help, self therapy

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Authors: Usha Barahmand, Ali Khazaee, Goudarz Sadeghi Hashjin

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The purpose of this study is to assess the relative mediating effects of impulsivity and internalizing problems in the relationship between childhood neglect and motives for opiate use. Seventy-two adolescent opiate users were recruited for the study. Participants completed assessments of childhood abuse history, distress, impulsiveness and motives for substance use as well as a socio-demographic information sheet. Findings from bootstrap mediator analyses indicated that distress, but not impulsiveness, mediated the relationship between childhood emotional abuse and expansion and enhancement motives for substance use. The current study provides preliminary evidence that internalizing problems may function as a mechanism linking prior childhood experiences of emotional neglect to subsequent motives for substance use. Clinical implications of these findings suggest that targeting emotion dysregulation problems may be an effective adjunct in the treatment of adolescents with a history of childhood maltreatment that are at risk for substance use.

Keywords: childhood neglect, impulsiveness, internalizing problems, substance use motives

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Authors: Ahmed Shuhaiber

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The explosion of the World Wide Web and the electronic trend of university teaching have transformed the learning style to become more learner-centred, Which has popularized the digital delivery of mediated lectures as an alternative or an adjunct to traditional lectures. Despite its potential and popularity, virtual lectures have not been adopted yet in Jordanian universities. This research aimed to fill this gap by studying the factors that influence student’s willingness to accept virtual lectures in one Jordanian University. A quantitative approach was followed by obtaining 216 survey responses and statistically applying the UTAUT model with some modifications. Results revealed that performance expectancy, effort expectancy, social influences and self-efficacy could significantly influence student’s attitudes towards virtual lectures. Additionally, facilitating conditions and attitudes towards virtual lectures were found with significant influence on student’s intention to take virtual lectures. Research implications and future work were specified afterwards.

Keywords: E-learning, student willingness, UTAUT, virtual Lectures, web-based learning systems

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Authors: Amina Umulisa

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Background: Despite efforts to enhance profitability and project planning, Rwanda has experienced a decline in project success rates, notably in housing projects managed by the Rwanda Social Security Board (RSSB). This study aims to assess the impact of investment strategies and project planning practices on the performance of pension funds projects in Rwanda, focusing on housing projects by RSSB. Methods: Using descriptive and correlational research designs, this study surveyed 109 randomly selected respondents from a pool of 148 workers. Data analysis was conducted using descriptive and inferential statistics in STATA version 18. Results: Findings revealed that 54% of respondents acknowledged the importance of personnel generation. Additionally, 61% agreed with the effectiveness of training programs, and 79% supported the cost of human resource utilization. In terms of project management practices, 65.7% could determine when a project needed adjustments, 65.7% agreed with the approved budget, and 73% supported forecasted expenses. Furthermore, 68% agreed with order placement, 76.0% with using the right materials, and 64.4% with defining project scope. The study found significant associations between order placement and project quality outcomes (r=0.711, P-value <0.001), as well as with time management (Pearson was 0.701 and sing was 0.00) and cost management (r=0.885, P-value <0.001). Moreover, project time targets were found to significantly affect quality management (Pearson was 0.798, sing was 0.000), time management, and cost management (r=0.740, P-value <0.001). Conclusion: The findings highlight the positive association between the project implementation stage and quality management, indicating effective project planning practices among senior staff. However, there is a need to enhance project team collaboration and coordination to improve the performance of constructed houses.

Keywords: project success rates, investment strategies, training programs, cost management

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Authors: Kasra Afsahi, Maryam Soheilifar

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COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year- old male who presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice CT (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him in August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from15 to 18). There were no adverse effects. This case with stroke post-COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Keywords: COVID-19, stroke, virtual reality, rehabilitation

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Authors: Shaibu Baanni Azumah, William Adzawla

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Rice is an important staple crop, with current demand higher than the domestic supply in Ghana. This has led to a high and unfavourable import bill. Therefore, recent policies and interventions in the agricultural sub-sector aim at promoting various improved agricultural technologies in order to improve domestic production and reduce the importation of rice. In this study, we examined the effect of the adoption of Urea Deep Placement (UDP) technology by rice farmers on the position of the production frontier. This involved 200 farmers selected through a multi stage sampling technique in the Northern region of Ghana. A Cobb-Douglas stochastic frontier model was fitted. The result showed that the adoption of UDP technology shifts the output frontier outward and also move the farmers closer to the frontier. Farmers were also operating under diminishing returns to scale which calls for redress. Other factors that significantly influenced rice production were farm size, labour, use of certified seeds and NPK fertilizer. Although there was an opportunity for improvement, the farmers were highly efficient (92%), compared to previous studies. Farmers’ efficiency was improved through increased education, household size, experience, access to credit, and lack of extension service provision by MoFA. The study recommends the revision of Ghana’s agricultural policy to include the UDP technology. Agricultural Extension officers of the Ministry of Food and Agriculture (MoFA) should be trained on the UDP technology to support IFDC’s drive to improve adoption by rice farmers. Rice farmers are also encouraged to expand their farm lands, improve plant population, and also increase the usage of fertilizer to improve yields. Mechanisms through which credit can be made easily accessible and effectively utilised should be identified and promoted.

Keywords: efficiency, rice farmers, stochastic frontier, UDP technology

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Authors: K. A.Veselova, N. V.Gromova, I. N.Antonova, I. N. Kalakutskii

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There are many diseases and incidents that may result facial defects and deformities: cancer, trauma, burns, congenital anomalies, and autoimmune diseases. In some cases, patient may acquire atypically extensive facial defect, including more than one anatomical region or, by contrast, atypically small defect (e.g. partial auricular defect). The anaplastology gives us opportunity to help patient with facial disfigurement in cases when plastic surgery is contraindicated. Using of implant retention for facial prosthesis is strongly recommended because improves both aesthetic and functional results and makes using of the prosthesis more comfortable. Prostheticly oriented fixture position is extremely important for aesthetic and functional long-term result; however, the optimal site for fixture placement is not clear in cases with atypical configuration of facial defect. The objective of this report is to demonstrate challenges in fixture position determination we have faced with and offer the solution. In this report, four cases of implant-supported facial prosthesis are described. Extra-oral implants with four millimeter length were used in all cases. The decision regarding the quantity of surgical stages was based on anamnesis of disease. Facial prostheses were manufactured according to conventional technique. Clinical and technological difficulties and mistakes are described, and prostheticly oriented approach for determination of fixture position is demonstrated. The case with atypically large combined orbital and nasal defect resulting after arteriovenous malformation is described: the correct positioning of artificial eye was impossible due to wrong position of the fixture (with suprastructure) located in medial aspect of supraorbital rim. The suprastructure was unfixed and this fixture wasn`t used for retention in order to achieve appropriate artificial eye placement and better aesthetic result. In other case with small partial auricular defect (only helix and antihelix were absent) caused by squamoized cell carcinoma T1N0M0 surgical template was used to avoid the difficulties. To achieve the prostheticly oriented fixture position in case of extremely small defect the template was made on preliminary cast using vacuum thermoforming method. Two radiopaque markers were incorporated into template in preferable for fixture placement positions taking into account future prosthesis configuration. The template was put on remaining ear and cone-beam CT was performed to insure, that the amount of bone is enough for implant insertion in preferable position. Before the surgery radiopaque markers were extracted and template was holed for guide drill. Fabrication of implant-retained facial prostheses gives us opportunity to improve aesthetics, retention and patients’ quality of life. But every inaccuracy in planning leads to challenges on surgery and prosthetic stages. Moreover, in cases with atypically small or extended facial defects prostheticly oriented approach for determination of fixture position is strongly required. The approach including surgical template fabrication is effective, easy and cheap way to avoid mistakes and unpredictable result.

Keywords: anaplastology, facial prosthesis, implant-retained facial prosthesis., maxillofacil prosthese

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Authors: Alexandra Telitsyna, Galina Semya, Elvira Garifulina

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Introduction: Starting from 2012 Russia conducts deinstitutionalization policy and now the main indicator of success is the number of children living in institutions. Active family placement process has resulted in residents of the institution now mainly consists of adolescents with behavioral and emotional problems, children with disabilities and groups of siblings. Purpose of science research: The purpose of science research is to identify factors for child’s wellbeing while temporary stay in an orphanage and the subjective assessment of children's level of well-being (psychological well-being). Methods: The data used for this project was collected by the questionnaire of 72 indicators, a tool for monitoring the behavior of children and caregivers, an additional questionnaire for children; well-being assessment questionnaire containing 10 scales for three age groups from preschool to older adolescents. In 2016-2018, the research was conducted in 1873 institution in 85 regions of Russia. In each region a team of academics, specialists from Non-profits, independent experts was created. Training was conducted for team members through a series of webinars prior to undertaking the assessment. The results: To ensure the well-being of the children, the following conditions are necessary: 1- Life of children in institution is organised according to the principles of family care (including the creation of conditions for attachment to be formed); 2- Contribution to find family-based placement for children (including reintegration into the primary family); 3- Work with parents of children, who are placed in an organization at the request of parents; 4- Children attend schools according to their needs; 5- Training of staff and volunteers; 6- Special environment and services for children with special needs and children with disabilities; 7- Cooperation with NGOs; 8 - Openness and accessibility of the organization. Conclusion: A study of the psychological well-being of children showed that the most emotionally stressful for children were questions about the presence and frequency of contact with relatives, and the level of well-being is higher in the presence of a trusted adult and respect for rights. The greatest contribution to the trouble is made by the time the child is in the orphanage, the lack of contact with parents and relatives, the uncertainty of the future.

Keywords: identifying factors, orphans, Russia, wellbeing

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Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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Authors: Ahmedou Moulaye Idriss, Tfeil Yahya, Tamas Ungi, Gabor Fichtinger

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Image-guided therapy (IGT) plays a crucial role in minimally invasive procedures for liver interventions. Accurate segmentation of the liver and precise needle placement is essential for successful interventions such as needle aspiration. In this study, we propose a deep learning-based liver 3D slicer designed to enhance segmentation accuracy and facilitate needle aspiration procedures. The developed 3D slicer leverages state-of-the-art convolutional neural networks (CNNs) for automatic liver segmentation in medical images. The CNN model is trained on a diverse dataset of liver images obtained from various imaging modalities, including computed tomography (CT) and magnetic resonance imaging (MRI). The trained model demonstrates robust performance in accurately delineating liver boundaries, even in cases with anatomical variations and pathological conditions. Furthermore, the 3D slicer integrates advanced image registration techniques to ensure accurate alignment of preoperative images with real-time interventional imaging. This alignment enhances the precision of needle placement during aspiration procedures, minimizing the risk of complications and improving overall intervention outcomes. To validate the efficacy of the proposed deep learning-based 3D slicer, a comprehensive evaluation is conducted using a dataset of clinical cases. Quantitative metrics, including the Dice similarity coefficient and Hausdorff distance, are employed to assess the accuracy of liver segmentation. Additionally, the performance of the 3D slicer in guiding needle aspiration procedures is evaluated through simulated and clinical interventions. Preliminary results demonstrate the effectiveness of the developed 3D slicer in achieving accurate liver segmentation and guiding needle aspiration procedures with high precision. The integration of deep learning techniques into the IGT workflow shows great promise for enhancing the efficiency and safety of liver interventions, ultimately contributing to improved patient outcomes.

Keywords: deep learning, liver segmentation, 3D slicer, image guided therapy, needle aspiration

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Authors: Mohammad Reza Esmaili

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One of the most important parts of the restoration process of a power network is the synchronizing of its subsystems. In this situation, the biggest concern of the system operators will be the reduction of the standing phase angle (SPA) between the endpoints of the two islands. In this regard, the system operators perform various actions and maneuvers so that the synchronization operation of the subsystems is successfully carried out and the system finally reaches acceptable stability. The most common of these actions include load control, generation control and, in some cases, changing the network topology. Although these maneuvers are simple and common, due to the weak network and extreme load changes, the restoration will be associated with low speed. One of the best ways to control the SPA is to use FACTS devices. By applying a soft control signal, these tools can reduce the SPA between two subsystems with more speed and accuracy, and the synchronization process can be done in less time. Meanwhile, the unified power controller (UPFC), a series-parallel compensator device with the change of transmission line power and proper adjustment of the phase angle, will be the proposed option in order to realize the subject of this research. Therefore, with the optimal placement of UPFC in a power system, in addition to improving the normal conditions of the system, it is expected to be effective in reducing the SPA during power system restoration. Therefore, the presented paper provides an optimal structure to coordinate the three problems of improving the division of subsystems, reducing the SPA and optimal power flow with the aim of determining the optimal location of UPFC and optimal subsystems. The proposed objective functions in this paper include maximizing the quality of the subsystems, reducing the SPA at the endpoints of the subsystems, and reducing the losses of the power system. Since there will be a possibility of creating contradictions in the simultaneous optimization of the proposed objective functions, the structure of the proposed optimization problem is introduced as a non-linear multi-objective problem, and the Pareto optimization method is used to solve it. The innovative technique proposed to implement the optimization process of the mentioned problem is an optimization algorithm called the water cycle (WCA). To evaluate the proposed method, the IEEE 39 bus power system will be used.

Keywords: UPFC, SPA, water cycle algorithm, multi-objective problem, pareto

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Authors: G. V. Siva Krishna Rao, B. Srinivasa Rao

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The main aim of the paper is to implement a technique using distributed generation in distribution systems to reduce the distribution system losses and to improve voltage profiles. The fuzzy logic technique is used to select the proper location of DG and an analytical method is proposed to calculate the size of DG unit at any power factor. The optimal sizes of DG units are compared with optimal sizes obtained using the genetic algorithm. The suggested method is programmed under Matlab software and is tested on IEEE 33 bus system and the results are presented.

Keywords: DG Units, sizing of DG units, analytical methods, optimum size

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Authors: Kevser Cakmak, Adrián Montesano, Lourdes Artigas, Marta Salla, Clara Mateu

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The main objective of this research is to explore the relational letter writing technique as an intervention in couple therapy for reconnecting couples with their values and ethical preferences. This is a recently developed therapeutic tool within the framework of Narrative Therapy that consists of two interviews and a letter writing task, in which a meta-conversation between the relationship itself, the couple members, and the therapists is fostered. Although this specific therapeutic technique can be used within the therapy process, in this case study, it is used as a brief stand-alone narrative intervention for a middle age heterosexual couple breast cancer survivor. Couple’s relational and personal wellbeing was monitored before, during, and after the intervention by means of the dyadic adjustment and the clinical outcomes in routine evaluation-outcome measure, respectively. The couple showed a significant improvement after the intervention in both levels. The content of the letter writing exercises was qualitatively analysed to explore the reconstruction of their ethical values. Results from both methods are integrated in order to get an in-depth perspective of the newly developed tool. The potential of the letter writing technique as stand-alone and as adjunct brief intervention is discussed.

Keywords: couple therapy, narrative therapy, psychotherapy tool, relational letter writing

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Authors: Nurten Tasdemir, Busra Baloglu, Zeynep Cingoz, Can Demirel, Zeki Gezer, Barıs Efe

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Student nurses are increasingly exposed to technology in the workplace after graduation with the growing numbers of electric health records (EHRs), handheld computers, barcode scanner medication dispensing systems, and automatic capture of patient data such as vital signs. Internationally, electronic health records (EHRs) systems are being implemented and evaluated. Students will inevitably encounter EHRs in the clinical learning environment and their professional practice. Nursing students must develop competency in the use of EHR. Aim: The study aimed to examine nursing students’ experiences of learning to use electronic health records (EHR) in clinical placements. Method: This study adopted a descriptive approach. The study population consisted of second and third-year nursing students at the Zonguldak School of Health in the West Black Sea Region of Turkey; the study was conducted during the 2015–2016 academic year. The sample consisted of 315 (74.1% of 425 students) nursing students who volunteered to participate. The students, who were involved in clinical practice, were invited to participate in the study Data were collected by a questionnaire designed by the researchers based on the relevant literature. Data were analyzed descriptively using the Statistical Package for Social Sciences (SPSS) for Windows version 16.0. The data are presented as means, standard deviations, and percentages. Approval for the study was obtained from the Ethical Committee of the University (Reg. Number: 29/03/2016/112) and the director of Nursing Department. Findings: A total of 315 students enrolled in this study, for a response rate of 74.1%. The mean age of the sample was 22.24 ± 1.37 (min: 19, max: 32) years, and most participants (79.7%) were female. Most of the nursing students (82.3%) stated that they use information technologies in clinical practice. Nearly half of the students (42.5%) reported that they have not accessed to EHR system. In addition, 61.6% of the students reported that insufficient computers available in clinical placement. Of the students, 84.7% reported that they prefer to have patient information from EHR system, and 63.8% of them found more effective to preparation for the clinical reporting. Conclusion: This survey indicated that nursing students experience to learn about EHR systems in clinical placements. For more effective learning environment nursing education should prepare nursing students for EHR systems in their educational life.

Keywords: electronic health record, clinical placement, nursing student, nursing education

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Authors: Sanjay Saraf

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The oral cavity can be the site for early manifestations of mucocutaneous disorders (MD) or the only site for occurrence of these disorders. It can also exhibit oral lesions with simultaneous associated skin lesions. The MD involving the oral mucosa commonly presents with signs such as ulcers, vesicles and bullae. The unique environment of the oral cavity may modify these signs of the disease, thereby making the clinical diagnosis an arduous task. In addition to the unique environment of oral cavity, the overlapping of the signs of various mucocutaneous disorders, also makes the clinical diagnosis more intricate. The aim of this review is to present the oral signs of dermatological disorders having common oral involvement and emphasize their importance in early detection of the systemic disorders. The aim is also to highlight the necessity of oral examination by a dermatologist while examining the skin lesions. Prior to the oral examination, it must be imperative for the dermatologists and the dental clinicians to have the knowledge of oral anatomy. It is also important to know the impact of various diseases on oral mucosa, and the characteristic features of various oral mucocutaneous lesions. An initial clinical oral examination is may help in the early diagnosis of the MD. Failure to identify the oral manifestations may reduce the likelihood of early treatment and lead to more serious problems. This paper reviews the oral manifestations of immune mediated dermatological disorders with common oral manifestations.

Keywords: dermatological investigations, genodermatosis, histological features, oral examination

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Authors: Yun Chan Lee

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Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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Authors: Cassandra Maffei, Effie Pomaki, Salomé Deslauriers-Brouillard, Levana Dahan, Caroline Storr, Ramasubramanian Ponnusamy, Philippe S. Archambault

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Sexual health education following spinal cord injury (SCI) remains poorly integrated into the rehabilitation process, especially in low-income countries where the topics of disability and sexuality are stigmatized. This research aimed to evaluate a sexual health manual that was created and distributed amongst males with SCI who had received rehabilitation services at Amar Seva Sangam (ASSA), a rehabilitation center located in rural South India. A service evaluation was completed to collect data from a convenience sample of 37 males with spinal cord injuries. Data were analyzed using descriptive statistics and content analysis. The service evaluation showed that the manual was well received by the sample and had positive impacts on secondary outcome measures, including relationship dynamics and quality of life. It can thus be used as an effective adjunct tool to support the improvement of sexual health knowledge, attitudes, and practices of individuals with SCI.

Keywords: spinal cord injury, sexual health, rehabilitation, India, education, service evaluation

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Authors: Aarti Agarwal, Ajmal Khan

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Background and Objective: Breathing difficulty is most distressing symptom for the patient and their caregivers providing palliative care to individuals with advanced malignancy. It needs to be tackled effectively and sometimes preemptively to provide relief from respiratory obstruction. Interventional procedures like tracheal stenting are becoming increasingly popular as a part of palliation for respiratory symptoms. We present a case of esophageal tumor earlier stented by Gastroenterologist to maintain esophageal patency, but the tumor outgrew to produce tracheal infiltration and thereby causing airway obstruction. Method and Result: 62-year-old man presented with unresectable Carcinoma oesophagus with inability to swallow. A metallic stent was placed by the gastroenterologist, to maintain esophageal patency and enable patient to swallow. Two months later, the patient returned to hospital in emergency with respiratory distress. CT neck and thorax revealed tumor infiltration through posterior tracheal wall. Lower extent of the tumor was till 1 cm above the carina. Airway stenting with Tracheo bronchial stent with Y configuration was planned under general anaesthesia with airway blocks. Superior Laryngeal Nerve Block, Glossopharyngeal block and Trans tracheal infiltration of local anaesthetics were performed. The patient was sedated with Fentanyl, Midazolam and propofol infusion but was breathing spontaneously. Once the rigid bronchoscope was placed inside trachea, breathing was supported with oxygen and sevoflurane. Initially, the trachea was cleared of tumor by coring. After creating space, tracheal stent was positioned and deployed. After stent placement patient was awakened, suctioned and nebulized. His respiratory stridor relieved instantaneously and was shifted to recovery. Conclusion: Airway blocks help in decreasing the incidence and severity of coughing during airway instrumentation thereby help in proper stent placement. They also reduce the requirement of general anaesthetics and hasten the post stenting recovery. Airway stent provided immediate relief to patient from symptoms of respiratory difficulty. Decision for early tracheal stenting may be taken for a select group of patients with high propensity for local spread, thereby avoiding respiratory complications and providing better quality of life in patients with inoperable malignancy.

Keywords: tracheal stent, respiratory difficulty, esophageal tumor, anaesthetic management

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Authors: Dimitra Alexiou

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In an urban area the allocation placement of an emergency service mobile units, such as ambulances, police patrol must be designed so as to achieve a prompt response to demand locations. In this paper, a partition of a given urban network into distinct sub-networks is performed such that; the vertices in each component are close and simultaneously the difference of the sums of the corresponding population in the sub-networks is almost uniform. The objective here is to position appropriately in each sub-network a mobile emergency unit in order to reduce the response time to the demands. A mathematical model in the framework of graph theory is developed. In order to clarify the corresponding method a relevant numerical example is presented on a small network.

Keywords: graph partition, emergency service, distances, location

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Authors: Ahmed Belgasem, Walid Ben Hussin, Emad Krekshi, Jamal Hashad

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Waxy crude oil, characterized by its high paraffin wax content, poses significant challenges in the oil & gas industry due to its increased viscosity and semi-solid state at reduced temperatures. The wax formation process, which includes precipitation, crystallization, and deposition, becomes problematic when crude oil temperatures fall below the wax appearance temperature (WAT) or cloud point. Addressing these issues, this paper introduces a technical solution designed to mitigate the wax appearance and enhance the oil production process in Abu-Attifil Field via a 30-inch crude oil pipeline. A comprehensive flow assurance study validates the feasibility and performance of this solution across various production rates, temperatures, and operational scenarios. The study's findings indicate that maintaining the crude oil's temperature above a minimum threshold of 63°C is achievable through the strategic placement of two heating stations along the pipeline route. This approach effectively prevents wax deposition, gelling, and subsequent mobility complications, thereby bolstering the overall efficiency, reliability, safety, and economic viability of the production process. Moreover, this solution significantly curtails the environmental repercussions traditionally associated with wax deposition, which can accumulate up to 7,500kg. The research methodology involves a comprehensive flow assurance study to validate the feasibility and performance of the proposed solution. The study considers various production rates, temperatures, and operational scenarios. It includes crude oil analysis to determine the wax appearance temperature (WAT), as well as the evaluation and comparison of operating options for the heating stations. The study's findings indicate that the proposed solution effectively prevents wax deposition, gelling, and subsequent mobility complications. By maintaining the crude oil's temperature above the specified threshold, the solution improves the overall efficiency, reliability, safety, and economic viability of the oil production process. Additionally, the solution contributes to reducing environmental repercussions associated with wax deposition. The research conclusion presents a technical solution that optimizes oil production in the Abu-Attifil Field by addressing wax formation problems through the strategic placement of two heating stations. The solution effectively prevents wax deposition, improves overall operational efficiency, and contributes to environmental sustainability. Further research is suggested for field data validation and cost-benefit analysis exploration.

Keywords: oil production, wax depositions, solar cells, heating stations

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Authors: Kathryn Norgang, Sarah Howrath, Auni Idi Muhire, Pacifique Umubyeyi

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Description : A group of nurses address the shortage of trained staff to respond to critical patients at Rwanda Military Hospital (RMH) by developing a training program and a resuscitation response team. Members of the group who received the training when it first launched are now trainer of trainers; all components of the training program are organized and delivered by RMH staff-the clinical mentor only provides adjunct support. This two day training is held quarterly at RMH; basic life support and exposure to interventions for advanced care are included in the test and skills sign off. Seventy staff members have received the training this year alone. An increased number of admission/transfer to ICU due to successful resuscitation attempts is noted. Lessons learned: -Number of staff trained 2012-2014 (to be verified). -Staff who train together practice with greater collaboration during actual resuscitation events. -Staff more likely to initiate BLS if peer support is present-more staff trained equals more support. -More access to Advanced Cardiac Life Support training is necessary now that the cadre of BLS trained staff is growing. Conclusions: Increased access to training, peer support, and collaborative practice are effective strategies to strengthening resuscitation capacity within a hospital.

Keywords: resuscitation, basic life support, capacity building, resuscitation response teams, nurse trainer of trainers

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Authors: Abdelkader Hadjoudja, Hajar Bouazza

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The PLD/CPLD devices are widely used for logic synthesis since several decades. Based on sum of product terms (PTs) architecture, the PLD/CPLD offer a high degree of flexibility to support various application requirements. They are suitable for large combinational logic, finite state machines as well as intensive I/O designs. CPLDs offer very predictable timing characteristics and are therefore ideal for critical control applications. This paper describes how the logic synthesis techniques, such as 1) XOR detection, 2) logic doubling, 3) complement of a Boolean function are combined, applied and used to optimize the CPLDs devices architecture that is based on PAL-like macrocells. Our goal is to use these techniques for minimizing the number of macrocells required to implement a circuit and minimize the delay of mapped circuit.

Keywords: CPLD, doubling, optimization, XOR

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Authors: Vahid Rashtchi, Ashkan Pirooz

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This paper applies the Imperialist Competitive Algorithm (ICA) to find the optimal place and size of Static Compensator (STATCOM) in power systems. The output of the algorithm is a two dimensional array which indicates the best bus number and STATCOM's optimal size that minimizes all bus voltage deviations from their nominal value. Simulations are performed on IEEE 5, 14, and 30 bus test systems. Also some comparisons have been done between ICA and the famous Particle Swarm Optimization (PSO) algorithm. Results show that how this method can be considered as one of the most precise evolutionary methods for the use of optimum compensator placement in electrical grids.

Keywords: evolutionary computation, imperialist competitive algorithm, power systems compensation, static compensators, voltage profile

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Authors: Sana Ansari, Sirus Mohammadi

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In distribution systems, shunt capacitors are used to reduce power losses, to improve voltage profile, and to increase the maximum flow through cables and transformers. This paper presents a new method to determine the optimal locations and economical sizing of fixed and/or switched shunt capacitors with a view to power losses reduction and voltage stability enhancement. General Algebraic Modeling System (GAMS) has been used to solve the maximization modules using the MINOS optimization software with Linear Programming (LP). The proposed method is tested on 33 node distribution system and the results show that the algorithm suitable for practical implementation on real systems with any size.

Keywords: power losses, voltage stability, radial distribution systems, capacitor

Procedia PDF Downloads 643

Authors: Catherine Omole

Abstract:

Examination malpractice includes acts that temper with collecting accurate results during the conduct of an examination, thereby giving undue advantage to a student over his colleagues. Even though examination malpractice has been a lingering problem, examinations may not be easy to do away with completely as it is an important feedback tool in the learning process with several other functions e.g for the purpose of selection, placement, certification and promotion. Examination malpractice has created a lot of problems such as a relying on a weak work force based on false assessment results. The question is why is this problem still persisting, despite measures that have been taken to curb this ugly trend over the years? This opinion paper has identified modifications that could help relieve the student of the examination stress and thus increase the student’s effort towards effective learning and discourage examination malpractice in the long run.

Keywords: assessment, examination malpractice, learning, science classroom

Procedia PDF Downloads 254

Authors: Areej R. Banjar, Abraham G. Campbell

Abstract:

The use of Mixed Reality (MR) in teaching and training is growing popular and can improve students’ ability to perform technical procedures. This short paper outlines the creation of an interactive educational MR 3D application that aims to improve the quality of instruction for dentistry students. This application is called MRImplantology and aims to teach the fundamentals and preoperative planning of dental implant placement. MRImplantology uses cone-beam computed tomography (CBCT) images as the source for 3D dental models that dentistry students will be able to freely manipulate within a 3D MR world to aid their learning process.

Keywords: augmented reality, education, dentistry, cone-beam computed tomography CBCT, head mounted display HMD, mixed reality

Procedia PDF Downloads 183

Authors: Sifat Rahman Ahona, Rifat Tasnim, Naima Hassan

Abstract:

Data aggregation is a helpful technique for reducing the data communication overhead in wireless sensor network. One of the important tasks of data aggregation is positioning of the aggregator points. There are a lot of works done on data aggregation. But, efficient positioning of the aggregators points is not focused so much. In this paper, authors are focusing on the positioning or the placement of the aggregation points in wireless sensor network. Authors proposed an algorithm to select the aggregators positions for a scenario where aggregator nodes are more powerful than sensor nodes.

Keywords: aggregation point, data communication, data aggregation, wireless sensor network

Procedia PDF Downloads 152

Authors: Faten Khanfir, Mohamed Tlili, Ali Medeb Hamrouni, Raki Selmi, M. S. Khalfi, Faten Ben Amor

Abstract:

Introduction: dental implant failure is a major concern for the clinician and the patient. Objectives: The aim of our study is to investigate the way in which 100 Tunisian dentists carried implant treatment for their patients from the early phase of planning and selection of patients to the placement of the implant in order to look for the implant failure factors. Results: significant correlations were found between failure rates > 5 and their corresponding factors as the number of implants placed (p = 0.001<0, 05), smoking (0.046 <0.05), unbalanced diabetes (0.03<0.05), aseptic protocol (= 0.004< 0.05) and the drilling speed (0,002<0.05) Conclusion: It seems that the number of implant placed, smoking, diabetes, aseptic protocol, and the drilling speed may contribute to dental implant failure.

Keywords: failure, implants, survey, risk, osseointegration

Procedia PDF Downloads 179

Authors: Von Jerick Tenorio, Jonald Lucero, Marivic Vestal, Edwin Tiempo

Abstract:

In patients with hostile aortic neck anatomy, the risks of proximal seal complications and stent migration remain with EVAR despite improved endograft technology. This case report discusses how the technical challenges of the hostile neck anatomy, proximal penetrating atherosclerotic ulcer (PAU) and tortuous femoral access were addressed. The CT aortogram of a 63-year-old hypertensive and diabetic man with recurring abdominal discomfort revealed a fusiform infra-renal aneurysm measuring 8.8 cm in length and 5.7 cm in diameter. The proximal landing zone only has a 3 mm healthy neck with a conicity of > 10% and a thrombus of 4 mm thick. Proximal to the aneurysm is a PAU with a circumferential mural thrombus. The right femoral artery is tortuous with > 90o angulation. A 20% oversized Endurant II endograft and Aptus Heli-FX EndoAnchors were deployed as prophylaxis for type I endoleaks and endograft migration consequent to the conical neck and proximal aneurysm extension consequent to the PAU. A stiff Backup Meier guide wire facilitated the deployment of the endograft. Coil embolization of the right internal iliac artery was performed as prophylaxis for type II endoleaks. EndoAnchors can be used as an adjunct to EVAR as prophylaxis for proximal seal complications and stent migration in patients with hostile aortic aneurysm neck anatomy and concomitant proximal PAU.

Keywords: endoAnchors, endoleaks, EVAR, hostile neck

Procedia PDF Downloads 202

Authors: Ioannis Kavouras, Eftychios Protopapadakis, Emmanuel Sardis, Anastasios Doulamis

Abstract:

In this paper, we investigate the appropriateness and usability of three different free and open-source rendering tools for urban planning visualizations. The process involves the selection of a map area, the 3D rendering transformation, the addition of nature-based solution placement, and the evaluation and assessment of the suggested applied interventions. The manuscript uses a case study involved at Dilaveri Coast, Piraeus region, Greece. Research outcomes indicate that a Blender-OSM implementation is an appropriate tool capable of supporting high-fidelity urban planning, with quick and accurate visibility of related results for end users and involved in NBS transformations.

Keywords: urban planning, nature based solution, 3D gaming tools, game engine, free and open source

Procedia PDF Downloads 105