Search results for: clinical quality

Authors: Gabriela-Andreea Despescu, Mădălina Mavrodin, Gheorghe Lăzăroiu, S. Nacu, R. Băstinaş

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The Monitoring of Surface Water Bodies (Rivers) from Tisa Catchment Area - Maramureş County in 2014. This study is focused on the monitoring and evaluation of river’s water bodies from Maramureş County, using the methodology associated with the EU Water Framework Directive 60/2000. Thus, in the first part are defined the theoretical terms of monitoring activities related to the water bodies’ quality and the specific features of those we can find in the studied area. There are presented the water bodies’ features, quality indicators and the monitoring frequencies for the rivers situated in the Tisa catchment area. The results have shown the actual ecological and chemical state of those water bodies, in relation with the standard values mentioned through the Water Framework Directive.

Keywords: monitoring, surveillance, water bodies, quality

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Authors: Supriyono, Sumardiyono

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Biodiesel is one of the alternative fuels that promising for substituting petrodiesel as energy source which is have advantage on sustainability and eco-friendly. Due to the raw material that tend to decompose during storage, biodiesel also have the same characteristic that tend to decompose and formed higher acid value which is the result of oxidation to double bond on a chain of ester. Decomposition of biodiesel due to oxidation reaction could prevent by introduce a small amount of antioxidant. The origin of raw materials and the process for producing biodiesel will determine the effectiveness of antioxidant. The quality degradation on biodiesel could evaluated by measuring iodine value and acid number of biodiesel. Biodiesel made from High Fatty Acid Jatropha curcas oil equality by using esterification and esterification process will stand on the quality by introduce 90 ppm pyrogallol powder on the biodiesel, which could extend the quality from 2 hours to more than 6 hours in rancimat test evaluation.

Keywords: biodiesel, antioxidant, iodine number, acid value

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Authors: Leonard Simoni, Ilir Alimehmeti, Ervina Shirka, Endri Hasimi, Ndricim Kallashi, Verona Beka, Suerta Kabili, Artan Goda

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Background: Diabetes Mellitus type 2, small vessel calibre, stented length of vessel, complex lesion morphology, and prior bypass surgery have resulted risk factors for In-Stent Restenosis (ISR). However, there are some contradictory results about body mass index (BMI) as a risk factor for ISR. Purpose: We want to identify clinical, lesional and procedural factors that can predict clinical ISR in our patients. Methods: Were enrolled 759 patients who underwent first-time elective PCI with Bare Metal Stents (BMS) from September 2011 to December 2013 in our Department of Cardiology and followed them for at least 1.5 years with a median of 862 days (2 years and 4 months). Only the patients re-admitted with ischemic heart disease underwent control coronary angiography but no routine angiographic control was performed. Patients were categorized in ISR and non-ISR groups and compared between them. Multivariate analysis - Binary Logistic Regression: Forward Conditional Method was used to identify independent predictive risk factors. P was considered statistically significant when <0.05. Results: ISR compared to non-ISR individuals had a significantly lower BMI (25.7±3.3 vs. 26.9±3.7, p=0.004), higher risk anatomy (LM + 3-vessel CAD) (23% vs. 14%, p=0.03), higher number of stents/person used (2.1±1.1 vs. 1.75±0.96, p=0.004), greater length of stents/person used (39.3±21.6 vs. 33.3±18.5, p=0.01), and a lower use of clopidogrel and ASA (together) (95% vs. 99%, p=0.012). They also had a higher, although not statistically significant, prevalence of Diabetes Mellitus (42% vs. 32%, p=0.072) and a greater number of treated vessels (1.36±0.5 vs. 1.26±0.5, p=0.08). In the multivariate analysis, Diabetes Mellitus type 2 and multiple stents used were independent predictors risk factors for In-Stent Restenosis, OR 1.66 [1.03-2.68], p=0.039, and OR 1.44 [1.16-1.78,] p=0.001, respectively. On the other side higher BMI and use of clopidogrel and ASA together resulted protective factors OR 0.88 [0.81-0.95], p=0.001 and OR 0.2 [0.06-0.72] p=0.013, respectively. Conclusion: Diabetes Mellitus and multiple stents are strong predictive risk factors, whereas the use of clopidogrel and ASA together are protective factors for clinical In-Stent Restenosis. Paradoxically High BMI is a protective factor for In-stent Restenosis, probably related to a larger diameter of vessels and consequently a larger diameter of stents implanted in these patients. Further studies are needed to clarify this finding.

Keywords: body mass index, diabetes mellitus, in-stent restenosis, percutaneous coronary intervention

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Authors: Varsha Hemant Patil, Swati A. Bhavsar, Abolee H. Patil

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Image quality assessment plays an important role in image evaluation. This paper aims to present an investigation of classic techniques in use for image quality assessment, especially for super-resolution imaging. Researchers have contributed a lot towards the development of super-resolution imaging techniques. However, not much attention is paid to the development of metrics for testing the performance of developed techniques. In this paper, the study report of existing image quality measures is given. The paper classifies reviewed approaches according to functionality and suitability for super-resolution imaging. Probable modifications and improvements of these to suit super-resolution imaging are presented. The prime goal of the paper is to provide a comprehensive reference source for researchers working towards super-resolution imaging and suggest a better framework for measuring the performance of super-resolution imaging techniques.

Keywords: interpolation, MSE, PSNR, SSIM, super resolution

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Authors: Nasreen Thebo, W. Shaikh, A. J. Laghari, P. Nangni

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Prunus dulcis (Almond) shell extract is demonstrated for its biomedical applications. Shell extract prepared by soxhlet method and further characterized by UV-Visible spectrophotometer, atomic absorption spectrophotometer (AAS), FTIR, GC-MS techniques. In this study, the antifungal activity of almond shell extract was observed against clinically isolated pathogenic fungi by strip method. The antioxidant potential of crude shell extract of was evaluated by using DPPH (2-2-diphenyl-1-picryhydrazyl) and radical scavenging system. The possibility of short term therapy was only 20 days. The total antioxidant activity varied from 94.38 to 95.49% and total phenolic content was found as 4.455 mg/gm in almond shell extract. Finally the results provide a great therapeutic potential against Tinea capitis infection of scalp. Included in this study of shell extract that show scientific evidence for clinical efficacy, as well as found to be more useful in the treatment of dermatologic disorders and without any doubt it can be recommended to be Patent.

Keywords: Tinea capitis, DPPH, FTIR, GC-MS therapeutic treatment

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Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero

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Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation ‬or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.

Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis

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Authors: Gustavo G. Shimamoto, Matthieu Tubino

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The characterization and the quality of biodiesel samples are checked by determining several parameters. Considering a large number of analysis to be performed, as well as the disadvantages of the use of toxic solvents and waste generation, multivariate calibration is suggested to reduce the number of tests. In this work, hydrogen nuclear magnetic resonance (1H NMR) spectra were used to build multivariate models, from partial least squares (PLS) regression, in order to determine simultaneously six important characterizing and/or quality parameters of biodiesels: density at 20 ºC, kinematic viscosity at 40 ºC, iodine value, acid number, oxidative stability, and water content. Biodiesels from twelve different oils sources were used in this study: babassu, brown flaxseed, canola, corn, cottonseed, macauba almond, microalgae, palm kernel, residual frying, sesame, soybean, and sunflower. 1H NMR reflects the structures of the compounds present in biodiesel samples and showed suitable correlations with the six parameters. The PLS models were constructed with latent variables between 5 and 7, the obtained values of r(cal) and r(val) were greater than 0.994 and 0.989, respectively. In addition, the models were considered suitable to predict all the six parameters for external samples, taking into account the analytical speed to perform it. Thus, the alliance between 1H NMR and PLS showed to be appropriate to characterize and evaluate the quality of biodiesels, reducing significantly analysis time, the consumption of reagents/solvents, and waste generation. Therefore, the proposed methods can be considered to adhere to the principles of green chemistry.

Keywords: biodiesel, multivariate calibration, nuclear magnetic resonance, quality parameters

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Authors: Hashem Dehghanniri

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Crime scripting is a simple and effective crime modeling technique that aims to improve understanding of security analysts about security and crime incidents. Low-quality scripts provide a wrong, incomplete, or sophisticated understanding of the crime commission process, which oppose the purpose of their application, e.g., identifying effective and cost-efficient situational crime prevention (SCP) measures. One important and overlooked factor in generating quality scripts is the crime scripting method. This study investigates the problems within the existing crime scripting practices and proposes a crime scripting approach that contributes to generating quality crime scripts. It was validated by experienced crime scripters. This framework helps analysts develop better crime scripts and contributes to their effective application, e.g., SCP measures identification or policy-making.

Keywords: attack modelling, crime commission process, crime script, situational crime prevention

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Authors: Andrés Calvillo Téllez, Marianne Martínez Zanzarric, José Cruz Núñez Pérez

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A modular system that performs basic monitoring of both water and air quality is presented. Monitoring is essential for environmental, aquaculture, and agricultural disciplines, where this type of instrumentation is necessary for data collection. The system uses low-cost components, which allows readings close to those with high-cost probes. The probe collects readings such as the coordinates of the geographical position, as well as the time it records the target parameters of the monitored. The modules or subsystems that make up the probe are the global positioning (GPS), which shows the altitude, latitude, and longitude data of the point where the reading will be recorded, a real-time clock stage, the date marking the time, the module SD memory continuously stores data, data acquisition system, central processing unit, and energy. The system acquires parameters to measure water quality, conductivity, pressure, and temperature, and for air, three types of ammonia, dioxide, and carbon monoxide gases were censored. The information obtained allowed us to identify the schedule of modification of the parameters and the identification of the ideal conditions for the growth of microorganisms in the water.

Keywords: calibration, conductivity, datalogger, monitoring, real time clock, water quality

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Authors: Jolanta Uszko, Tomasz Wloch, Aneta Pirowska, Roman Nowobilski

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Introduction: Phantom phenomena are often reported by subjects who have undergone limb amputation. Mostly, patients feel the amputated part of the limb as if it was still attached to the body. Two types of phantom phenomena: painless (phantom sensation) and painful (phantom pain) were described. Triggers of phantom sensations and phantom pain, as well as fully effective treatment, have not been clearly described yet. Purpose: To assess the influence of psychosocial factors and some clinical conditions on the occurrence of phantom phenomena in amputee athletes. Subjects: 21 men (age: 31 years, SD = 7.5 years) after lower or upper extremity amputation, who regularly performed high-intensity sports (Amp Football Team Players) were included to the study. Method and equipment: In the research, the following method and tools were used: Questionnaire [Pirowska] adapted for athletes with disabilities, Numerical Rating Scale (NRS) - for phantom pain assessment, McGill Pain Assessment Questionnaire (short version), Beck's Depression Inventory (BDI), State Trait Anxiety Inventory (STAI): X-1 and X-2, shortened version of The World Health Organization Quality of Life (WHOQOLBREFF). Results: In the study group, the lower leg amputations with traumatic etiology were predominant. Phantom sensations were present in all subjects. Half of the respondents claimed to experience phantom sensations at least once a day, paroxysmally. There was a prevalence of phantom sensations characterized as incomplete, immobile limb. Phantom pain was reported by over 85% of respondents. The nature of phantom pain was frequently described as stabbing, squeezing, shooting, pulsing, tiring. There was a significant correlation between phantom pain intensity and anxiety, quality of life, depressive tendencies, perception of phantom pain as the obstacle in daily functioning and intensity of the limb pain before amputation. Conclusions: The etiology of phantom phenomena is complex. Psychological factors seem to have a significant influence on the intensity of the phantom pain. Particular attention should be paid to patients who complain about persistent limb pain before the amputation. These are patients with an increased risk of the phantom pain of relatively high intensity.

Keywords: amputation, phantom pain, phantom sensations, adaptive sports

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Authors: Najmeh Hamid, Vajiheh Hamedy , Zahra Rostamianasl

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Background: Cancer is one of the medical problems that have been associated with pain. Moreover, the pain is combined with negative emotions such as anxiety, depression and anger. Poor pain management causes negative effects on the quality of life, which results in negative effects that continue a long time after the painful experiences. Objectives: The aim of this research was to compare the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, depression, anger and anxiety in children with cancer. Methods: The research method of this “Randomized Controlled Clinical Trial” was a pre, post-test and follow-up with a control group. In this research, we have examined the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, anxiety, depression and anger in children with cancer in Ahvaz. Two psychological interventions (cognitive behavioral therapy for pain and the computerized version) were compared with the control group. The sample consisted of 60 children aged 8 to 12 years old with different types of cancer at Shafa hospital in Ahwaz. According to the including and excluding criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria, 60 subjects were selected. Then, randomly, 45 subjects were selected. The subjects were randomly divided into three groups of 15 (two experimental and one control group). The research instruments included Spielberger Anxiety Inventory (STAY-2) and International Pain Measurement Scale. The first experimental group received 6 sessions of cognitive-behavioral therapy for 6 weeks, and the second group was subjected to a computerized version of cognitive-behavioral therapy for 6 weeks, but the control group did not receive any interventions. For ethical considerations, a version of computerized cognitive-behavioral therapy was provided to them. After 6 weeks, all three groups were evaluated as post-test and eventually after a one-month follow-up. Results: The findings of this study indicated that both interventions could reduce the negative emotions (pain, anger, anxiety, depression) associated with cancer in children in comparison with a control group (p<0.0001). In addition, there were no significant differences between the two interventions (p<0.01). It means both interventions are useful for reducing the negative effects of pain and enhancing adjustment. Conclusion: we can use CBT in situations in which there is no access to psychologists and psychological services. In addition, it can be a useful alternative to conventional psychological interventions.

Keywords: pain, children, psychological intervention, cancer, anger, anxiety, depression

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Authors: Khaled M. Ali, Ayman A. Mostafa, Soliman M. Soliman

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Objectives: To describe the most common clinical and endoscopic findings associated with complicated corneal ulcers in cats, and to determine the short-term outcomes after surgical treatment of these cats. Animals Eighteen client-owned cats of different breeds (52 females and 28 males), ranging in age from 3 months to 6 years, with corneal ulcers. Procedures: Cats were clinically evaluated to initially determine the concurrent corneal abnormalities. Endoscopic examination was performed to determine the anterior and posterior segments abnormalities. Superficial and deep stromal ulcers were treated using conjunctival flap. Corneal sequestrum was treated by partial keratectomy and conjunctival flap. Anterior synechia was treated via peripheral iridectomy and separation of the adhesion between the iris and the inner cornea. Symblepharon was treated by removal of the adhered conjunctival membrane from the cornea. Incurable endophthalmitis was treated surgically by extirpation. Short-term outcomes after surgical managements of selected corneal abnormalities were then assessed clinically and endoscopically. Results: Deep stromal ulcer with descemetocele, endophthalmitis, symblepharon, corneal sequestration and anterior synechia with secondary glaucoma and corneal scarring were the most common complications of corneal ulcer. FHV-1 was a common etiologic factor of corneal ulceration. Persistent corneal scars of varying shape and size developed in cats with deep stromal ulcer, anterior synechia, and corneal sequestration. Conclusions: Domestic shorthaired and Persian cats were the most predisposed breeds to FHV-1 infection and subsequent corneal ulceration. Immediate management of patients with corneal ulcer would prevent serious complications. No age or sex predisposition to complicated corneal ulceration in cats.

Keywords: cats, complicated corneal ulceration, clinical, endoscopic diagnosis, FHV-1

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Authors: Z. Soleymani, M. Amirzadeh

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Quality Function Deployment (QFD) was developed in 1960 in Japan and introduced in 1983 in America and Europe. The paper presents a real application of this technique in a way that the method of applying QFD in design and production aero fuel pumps has been considered. While designing a product and in order to apply system engineering process, the first step is identification customer needs then its transition to engineering parameters. Since each change in deign after production process leads to extra human costs and also increase in products quality risk, QFD can make benefits in sale by meeting customer expectations. Since the needs identified as well, the use of QFD tool can lead to increase in communications and less deviation in design and production phases, finally it leads to produce the products with defined technical attributes.

Keywords: customer voice, engineering parameters, gear pump, QFD

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Authors: Valerie Follonier, Henrike Hamelmann, Jean-Michel Jullien

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The Distance Learning University in Switzerland (UniDistance) is offering bachelor and master courses as well as further education programs. The professors and their assistants work at traditional Swiss universities and are giving their courses at UniDistance following a blended learning and flipped classroom approach. A standardized course evaluation by the students has been established as a component of a quality improvement process. The students’ feedback enables the stakeholders to identify areas of improvement, initiate professional development for the teaching teams and thus continuously augment the quality of instruction. This paper describes the evaluation process, the tools involved and how the approach involving all stakeholders helps forming a culture of quality in teaching. Additionally, it will present the first evaluation results following the new process. Two software tools have been developed to support all stakeholders in the process of the semi-annual formative evaluation. The first tool allows to create the survey and to assign it to the relevant courses and students. The second tool presents the results of the evaluation to the stakeholders, providing specific features for the teaching teams, the dean, the directorate and EDUDL+ (Educational development unit distance learning). The survey items were selected in accordance with the e-learning strategy of the institution and are formulated to support the professional development of the teaching teams. By reviewing the results the teaching teams become aware of the opinion of the students and are asked to write a feedback for the attention of their dean. The dean reviews the results of the faculty and writes a general report about the situation of the faculty and the possible improvements intended. Finally, EDUDL+ writes a final report summarising the evaluation results. A mechanism of adjustable warnings allows it to generate quality indicators for each module. These are summarised for each faculty and globally for the whole institution in order to increase the vigilance of the responsible. The quality process involves changing the indicators regularly to focus on different areas each semester, to facilitate the professional development of the teaching teams and to progressively augment the overall teaching quality of the institution.

Keywords: continuous improvement process, course evaluation, distance learning, software tools, teaching quality

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Authors: Peng Guo

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Objective To investigate the clinical characteristics and changes of video-polysomnography (v-PSG) in Parkinson disease (PD) patients accompanied with cognitive impairment. Methods Three hundred and ninety-four patients with PD were enrolled in Beijing Tiantan Hospital, according to CI level, the patients were divided into PD without cognitive impairment (PD-NCI), PD with mild cognitive impairment (PD-MCI), and PD with dementia (PDD) group. Collect patient's demographic data, including gender, onset age, education level and duration. The cognitive function of PD patients was evaluated by Montreal cognitive assessment (MoCA) scale, and the overall cognitive function and cognitive domains of the three groups were compared.Using v-PSG to assess the sleep status of patients. Correlation analysis of MoCA Scale and v-PSG results in PD-CI group. Results 1. In 394 cases of PD, 94 cases (23.86%) in PD-NCI group , 177 cases(44.92%) in PD-MCI group , 123 cases (31.22%) in PDD group. 2.There was no significant difference in gender, age of onset, education level and duration in PD-NCI group, PD-MCI group and PDD group （P＞0.05）. 3. The total score of MoCA scale in PD-NCI group, PD-MCI group and PDD group decreased one by one. In PD-NCI group, PD-MCI group and PDD group, the scores of each cognitive domain in MoCA scale decreased significantly（P<0.05）. 4.Compared with the PD-MCI group, PDD group had lower total sleep time, lower sleep efficiency （P<0.05）. Compared with PD-NCI group, PDD group had lower total sleep time and lower sleep efficiency （P<0.05）.5. The sleep efficiency of PD-CI patients is positively correlated with the total score of MoCA scale, visual spatial function, executive function, delayed recall and attention score（P<0.05). Conclusions The incidence of CI in PD patients was high; The cognitive function and cognitive domains of PD-CI patients were significantly impaired; In patients with PD-CI, total sleep time decreased, sleep efficiency decreased, and it was related to overall cognitive function and partial cognitive impairment.

Keywords: Parkinson disease, cognitive impairment, clinical characteristics, sleep disorders, video-polysomnography

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Authors: Nalini Kaul, Barrie Drewitt, Elsie Kohoot

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Hyperpigmentation is the third most common pigmentary disorder where dermatologic treatment is sought. It affects all ages resulting in skin darkening because of melanin accumulation. An uneven skin tone because of either exposure to the sun (solar lentigos/age spots/sun spots or skin disruption following acne, or rashes (post-inflammatory hyperpigmentation -PIH) or hormonal changes (melasma) can lead to significant psychosocial impairment. Dyschromia is a result of various alterations in biochemical processes regulating melanogenesis. Treatments include the daily use of sunscreen with lightening, brightening, and exfoliating products. Depigmentation is achieved by various depigmenting agents: common examples are hydroquinone, arbutin, azelaic acid, aloesin, mulberry, licorice extracts, kojic acid, niacinamide, ellagic acid, arbutin, green tea, turmeric, soy, ascorbic acid, and tranexamic acid. These agents affect pigmentation by interfering with mechanisms before, during, and after melanin synthesis. While immediate correction is much sought after, patience and diligence are key. Our objective was to assess the effects of a facial product with pigmentation treatment and UV protection in 35 healthy F (35-65y), meeting the study criteria. Subjects with mild to moderate hyperpigmentation and fine lines with no use of skin-lightening products in the last six months or any dermatological procedures in the last twelve months before the study started were included. Efficacy parameters included expert clinical grading for hyperpigmentation, radiance, skin tone & smoothness, fine lines, and wrinkles bioinstrumentation (Corneometer®, Colorimeter®), digital photography and imaging (Visia-CR®), and self-assessment questionnaires. Safety included grading for erythema, edema, dryness & peeling and self-assessments for itching, stinging, tingling, and burning. Our results showed statistically significant improvement in clinical grading scores, bioinstrumentation, and digital photos for hyperpigmentation-brown spots, fine lines/wrinkles, skin tone, radiance, pores, skin smoothness, and overall appearance compared to baseline. The product was also well-tolerated and liked by subjects. Conclusion: Facial hyperpigmentation is of great concern, and treatment strategies are increasingly sought. Clinical trials with both subjective and objective assessments, imaging analyses, and self-perception are essential to distinguish evidence-based products. The multifunctional cosmetic product tested in this clinical study showed efficacy, tolerability, and subject satisfaction in reducing hyperpigmentation and global photoaging.

Keywords: hyperpigmentation; photoaging, clinical testing, expert visual evaluations, bio-instruments

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Authors: Sergey Kholodkevich, Tatiana Kuznetsova

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The objective assessment of ecological state of water ecosystems is impossible without the use of biological methods of the environmental monitoring capable in the integrated look to reveal negative for biota changes of quality of water as habitats. Considerable interest for the development of such methods of environmental quality control represents biomarker approach. Measuring systems, by means of which register cardiac activity characteristics, received the name of bioelectronic. Bioelectronic systems are information and measuring systems in which animals (namely, benthic invertebrates) are directly included in structure of primary converters, being an integral part of electronic system of registration of these or those physiological or behavioural biomarkers. As physiological biomarkers various characteristics of cardiac activity of selected invertebrates have been used in bioelectronic system.lChanges in cardiac activity are considered as integrative measures of the physiological condition of organisms, which reflect the state of the environment of their dwelling. Greatest successes in the development of tools of biological methods and technologies of an assessment of surface water quality in real time. Essential advantage of bioindication of water quality by such tool is a possibility of an integrated assessment of biological effects of pollution on biota and also the expressness of such method and used approaches. In the report the practical experience of authors in biomonitoring and bioindication of an ecological condition of sea, brackish- and freshwater areas is discussed. Authors note that the method of non-invasive cardiac activity monitoring of selected invertebrates can be used not only for the advancement of biomonitoring, but also is useful in decision of general problems of comparative physiology of the invertebrates.

Keywords: benthic invertebrates, physiological state, heart rate monitoring, water quality assessment

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Authors: H. K. V. Narayan

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This study was conducted at Tata Memorial Hospital (TMH), Mumbai, India. The study was to evaluate the impact of adapting Smart Card (SC) for clinical and business transactions in order to reduce Lead times and to enforce business rules of the hospital. The objective for implementing the Smart Card was to improve the patient perception of quality in terms of structures process and outcomes and also to improve the productivity of the Institution. The Smart Card was implemented in phases from 2011 and integrated with the Hospital Information System (HIS/EMR). The implementation was a learning curve for all the stake holders as software obviated the need to use hardcopies of transactions. The acceptability to the stake holders was challenge in change management. The study assessed the impact 3 years into the implementation and the observed trends have suggested that it has decreased the lead times for services and increased the no of transactions and thereby the productivity. Patients who used to complain of multiple queues and cumbersome transactions now compliment the administration for effective use of Information and Communication Technology.

Keywords: smart card, high availability of health care information, reduction in potential medical errors due to elimination of transcription errors, reduction in no of queues, increased transactions, augmentation of revenue

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Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

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Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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Authors: Miklos Taliga

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In the present case study we examined the development and testing methods of systems that contain safety-critical elements in different industrial fields. Consequentially, we observed the classical object-oriented development and testing environment, as both medical technology and automobile industry approaches the development of safety critical elements that way. Subsequently, we examined model-based development. We introduce the quality parameters that define development and testing. While taking modern agile methodology (scrum) into consideration, we examined whether and to what extent the methodologies we found fit into this environment.

Keywords: safety-critical elements, quality managent, unit verification, model base testing, agile methods, scrum, metamodel, object-oriented programming, field specific modelling, sprint, user story, UML Standard

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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Authors: Boularas El-Alia, Arbi Raja, Bachir Bouiadjra Sara, Rezk-Kallah Haciba, Rezkkallah Baghdad

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Objectives : To determine the handling practices of cytotoxic drugs and to describe clinical manifestations expressed by hospital personnel of Sidi Bel Abbes during the year 2014. Methods: Sectional descriptive study conducted in 3 center university hospital units (Hematology, Oncology and Urology) and Gynecology of EHS Sidi Bel Abbes. A questionnaire was administered to hospital workers regulary exposed to cytotoxic drugs. A work-place visit was performed to have an overview about working conditions. The Cytotoxic Contact Index (CCI) was calculated for each nurse on a period of 15 working days. Treatment of the results was done using SPSS software. Results: The survey reveals that 22 men and 58 women are exposed to cytotoxic drugs for an average of 7 years. Many symptoms such as ocular irritation (38,75%), throat irritation (56,25%), headache (68,75%), dizziness (43,75%), nausea (37,5%), metallic taste (30%), were reported with high frequency. Are noted in the offspring, 3 congenital anomalies,2 diaphragmatic hernia and a cleft palate. The Cytotoxic Contact Index (CCI) was higher than 3 among Oncology nurses and higher than 1 for most of the nurses of Hematology and Gynecology service. The wearing of personal protective clothing was not respected by all workers: (22/23) wear gloves and (20/23) wear a mask,(5/23) wear a cap, (2/23) wear glasses. Only 3 nurses have benefited from continuous training on handling cytotoxic drugs. Conclusion: This study shows a high occupational exposure risk to cytotoxic drugs among persons handling these drugs and the necessity to apply rigorously all measures related to personal protection awareness and training of personnel to minimize these exposure.

Keywords: cytotoxic drugs, handling, clinical manifestations, hospital staff

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Authors: Somchai Buaroong

Abstract:

This research attempted to study information system success in dimensions of the user satisfaction level and to find the association between the independent factors of the user experiences, user knowledge, and user attitude. The study sample was selected using simple random sampling that comprised of 190 users who had used the Bangkok HIS. The data were reported from 165 questionnaires. The results found that the user satisfaction was at a moderate level, user satisfaction on the information quality and system quality was at a moderate level, while satisfaction on service quality was at a high level. The computer knowledge of the user was at a moderate level, and the user attitude was at a positive level. The participation of the user was at a low level and the participation in decision and in evaluation was at a low level; however participation in implementation and in benefit was at a moderate.

Keywords: information system success, hospital information system, user attitude, user satisfaction

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Authors: Dana Weimann-Saks, Inbal Peleg-Koriat

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The perception of relative power within a couple relies on the resources (emotional-social, materialistic) each partner perceives to have. The present study examines a model in which the perceived power of the couple predicts the spouses’ conflict management. In addition, we examined whether this relationship is mediated by the perceived quality of the relationship. It was found that the perception of social-emotional power predicts cooperative conflict management styles of the couple. It was also found that this correlation is mediated by the perceived quality of the relationship. Contrary to the hypothesis, perception of social-emotional power did not predict the use of non-cooperative conflict management styles.

Keywords: spouses’ conflict management, conflict management, perceived quality of the relationship, social-emotional power

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Authors: A. Somaya Madkour, B. Abeer sheta, C. Fatma Badr El Dine, D. Yasser Elwakeel, E. Nermine AbdAllah

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Criminal offenders have a fundamental goal not to leave any traces at the crime scene. Some may suppose that items recovered underwater will have no forensic value, therefore, they try to destroy the traces by throwing items in water. These traces are subjected to the destructive environmental effects. This can represent a challenge for Forensic experts investigating finger marks. Accordingly, the present study was conducted to determine the optimal method for latent fingerprints development on non-porous surfaces submerged in aquatic environments at different time interval. The two factors analyzed in this study were the nature of aquatic environment and length of submerged time. In addition, the quality of developed finger marks depending on the used method was also assessed. Therefore, latent fingerprints were deposited on metallic, plastic and glass objects and submerged in fresh or sea water for one, two, and ten days. After recovery, the items were subjected to cyanoacrylate fuming, black powder and small particle reagent processing and the prints were examined. Each print was evaluated according to fingerprint quality assessment scale. The present study demonstrated that the duration of submersion affects the quality of finger marks; the longer the duration, the worse the quality.The best results of visualization were achieved using cyanoacrylate either in fresh or sea water. This study has also revealed that the exposure to sea water had more destructive influence on the quality of detected finger marks.

Keywords: fingerprints, fresh water, sea, non-porous

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Authors: Faranak Omidian

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The aim of this research was to examine the quality of education service at master's level in the Islamic Azad University of Dezful. In terms of objective, this is an applied research and in regard to methodology, it is a descriptive analytical research. The statistical population included all students of master's degree in the Islamic Azad University of Dezful. The sample size was determined using stratified random sampling method in different fields of study. The research questionnaire is the translated version of standardized Abdullah's HEdPERF 41-item scale which is based on a 5-point Likert scale. In order to determine the validity, the translated questionnaire was given to the professors of educational sciences. The correlation among all questions has been regarded at a value of 0.644. The results showed that the quality of educational service at master's level in this university, based on chi-square goodness of fit test, was equal to 73.36 and its degree of freedom was 2 at a significant level of 0.001, indicating the low desirability of the services. According to Friedman test, academic responsiveness has been reported to be in a higher status than other dimensions with an average rank of 3.94 while accessibility, with an average rank of 2.15, has been in the lowest status from master's students' viewpoint.

Keywords: educational service quality, master's level, Iranian university

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Authors: Walid Mousa, Mohamed Nayel, Ahmed Zaghawa, Akram Salama, Ahmed El-Sify, Hesham Rashad, Dina El-Shafey

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Mycoplasmosis in small ruminants constitutes a serious contagious problem in smallholders causing severe economic losses worldwide. This study was conducted to determine the clinical, Minimum Inhibitory Concentration (MIC) and molecular characterization of Mycoplasma species associated in sheep breeding herds in Menoufiya governorate, Egypt. Out of the examination of 400 sheep, 104 (26%) showed respiratory manifestations, nasal discharges, cough and conjunctivitis with systemic body reaction. Meanwhile, out of these examined sheep, only 56 (14%) were positive for mycoplasma isolation onto PPLO(Pleuropneumonia-like organisms) specific medium. The MIC for evaluating the efficacy of sensitivity of Mycoplasma isolates against different antibiotics groups revealed that both the Linospectin and Tylosin with 2ug, 0.25ug/ml concentration were the most effective antibiotics for Mycoplasma isolates. The application of PCR was the rapid, specific and sensitive molecular approach for detection of M. ovipneumoniae, and M. arginine at 390 and 326 bp, respectively, in all tested isolates. In conclusion, the diagnosis of Mycoplsamosis in sheep is important to achieve effective control measures and minimizing the disease dissemination among sheep herds.

Keywords: MIC, mycoplasmosis, PCR, sheep

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Authors: Prince Amartey

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Water is critical to public health, quality of life, environmental preservation, economic activity, and long-term growth. In this environment, it is critical to ensure the ongoing improvement of all processes and practices that contribute to the quality and safety of water. Water safety plans (WSPs) developed by water companies are an essential public policy instrument for achieving these objectives. This manuscript examines international evidence of water safety planning adoption and implementation and reports on the current situation in Portugal as part of the necessary adaptation of the national legal framework to the publication of the Directive on water quality for human consumption. The goal is to take lessons from various successful WSP projects throughout the world while writing new legislation in Ghana and elsewhere. According to the findings, four crucial aspects and key factors of success in establishing and implementing WSPs exist commitment from leadership, technical proficiency, administration, and cooperation among agencies.

Keywords: safe drinking, risk, policy, implementation

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Authors: Bennasser Samira

Abstract:

Meningitis, especially the meningococcal one, is a serious problem of public health. A system of vigilanceand surveillance is in place to allow effective actions to be taken on actual or potential health problems caused by all forms of meningitis. Objectives: 1. Describe the epidemiological surveillance system for meningitis in the province of Taza. 2. Evaluate the quality and responsiveness of the epidemiological surveillance system for meningitis in the province of Taza. 3. Propose measures to improve this system at the provincial level. Methods: This was a descriptive study with a purely quantitative approach by evaluating the quality and responsiveness of the system during 5 years between January 2016 and December 2020. We usedfor that the investigation files of meningitis cases and the provincial database of meningitis. We calculated some quality indicators of surveillance system already defined by the National Program for the Prevention and Control of Meningitis. Results: The notification is passive, the completeness of the data is quite good (94%), and the timeliness don’t exceed 71%. The quality of the data is acceptable (91% agreement). The systematic and rapid performance of lumbar punctures increases the diagnostic capabilities of the system. The local response actions are effected in 100%. Conclusion: The improvement of this surveillance system depends on strengthening the staff skills in diagnostic, reviewing surveillance tools, and encouraging judicious use of the data.

Keywords: evaluation, meningitis, system, taza, morocco

Procedia PDF Downloads 160