Search results for: safety analysis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 29414

Search results for: safety analysis

27674 On Pooling Different Levels of Data in Estimating Parameters of Continuous Meta-Analysis

Authors: N. R. N. Idris, S. Baharom

Abstract:

A meta-analysis may be performed using aggregate data (AD) or an individual patient data (IPD). In practice, studies may be available at both IPD and AD level. In this situation, both the IPD and AD should be utilised in order to maximize the available information. Statistical advantages of combining the studies from different level have not been fully explored. This study aims to quantify the statistical benefits of including available IPD when conducting a conventional summary-level meta-analysis. Simulated meta-analysis were used to assess the influence of the levels of data on overall meta-analysis estimates based on IPD-only, AD-only and the combination of IPD and AD (mixed data, MD), under different study scenario. The percentage relative bias (PRB), root mean-square-error (RMSE) and coverage probability were used to assess the efficiency of the overall estimates. The results demonstrate that available IPD should always be included in a conventional meta-analysis using summary level data as they would significantly increased the accuracy of the estimates. On the other hand, if more than 80% of the available data are at IPD level, including the AD does not provide significant differences in terms of accuracy of the estimates. Additionally, combining the IPD and AD has moderating effects on the biasness of the estimates of the treatment effects as the IPD tends to overestimate the treatment effects, while the AD has the tendency to produce underestimated effect estimates. These results may provide some guide in deciding if significant benefit is gained by pooling the two levels of data when conducting meta-analysis.

Keywords: aggregate data, combined-level data, individual patient data, meta-analysis

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27673 The Safe Introduction of Tocilizumab for the Treatment of SARS-CoV-2 Pneumonia at an East London District General Hospital

Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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27672 Use of the SWEAT Analysis Approach to Determine the Effectiveness of a School's Implementation of Its Curriculum

Authors: Prakash Singh

Abstract:

The focus of this study is on the use of the SWEAT analysis approach to determine how effectively a school, as an organization, has implemented its curriculum. To gauge the feelings of the teaching staff, unstructured interviews were employed in this study, asking the participants for their ideas and opinions on each of the three identified aspects of the school: instructional materials, media and technology; teachers’ professional competencies; and the curriculum. This investigation was based on the five key components of the SWEAT model: strengths, weaknesses, expectations, abilities, and tensions. The findings of this exploratory study evoke the significance of the SWEAT achievement model as a tool for strategic analysis to be undertaken in any organization. The findings further affirm the usefulness of this analytical tool for human resource development. Employees have expectations, but competency gaps in their professional abilities may hinder them from fulfilling their tasks in terms of their job description. Also, tensions in the working environment can contribute to their experiences of tobephobia (fear of failure). The SWEAT analysis approach detects such shortcomings in any organization and can therefore culminate in the development of programmes to address such concerns. The strategic SWEAT analysis process can provide a clear distinction between success and failure, and between mediocrity and excellence in organizations. However, more research needs to be done on the effectiveness of the SWEAT analysis approach as a strategic analytical tool.

Keywords: SWEAT analysis, strategic analysis, tobephobia, competency gaps

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27671 Effect of Infill’s in Influencing the Dynamic Responses of Multistoried Structures

Authors: Rahmathulla Noufal E.

Abstract:

Investigating the dynamic responses of high rise structures under the effect of siesmic ground motion is extremely important for the proper analysis and design of multitoried structures. Since the presence of infilled walls strongly influences the behaviour of frame systems in multistoried buildings, there is an increased need for developing guidelines for the analysis and design of infilled frames under the effect of dynamic loads for safe and proper design of buildings. In this manuscript, we evaluate the natural frequencies and natural periods of single bay single storey frames considering the effect of infill walls by using the Eigen value analysis and validating with SAP 2000 (free vibration analysis). Various parameters obtained from the diagonal strut model followed for the free vibration analysis is then compared with the Finite Element model, where infill is modeled as shell elements (four noded). We also evaluated the effect of various parameters on the natural periods of vibration obtained by free vibration analysis in SAP 2000 comparing them with those obtained by the empirical expressions presented in I.S. 1893(Part I)-2002.

Keywords: infilled frame, eigen value analysis, free vibration analysis, diagonal strut model, finite element model, SAP 2000, natural period

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27670 Using a Mobile App to Foster Children Active Travel to School in Spain

Authors: P. Pérez-Martín, G. Pedrós, P. Martínez-Jiménez, M. Varo-Martínez

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In recent decades, family habits related to children’s displacements to school have changed, increasing motorized travels against active modes. This entails a major negative impact on the urban environment, road safety in cities and the physical and psychological development of children. One of the more common actions used to reverse this trend is Walking School Bus (WSB), which consists of a predefined adult-scorted pedestrian route to school with several stops along the path where schoolchildren are collected. At Tirso de Molina School in Cordoba (Spain), a new ICT-based methodology to deploy WSB has been tested. A mobile app that allows the geoposition of the group, the notification of the arrival and real-time communication between the WSB participants have been presented to the families in order to organize and register the daily participation. After an initial survey to know the travel mode and the spatial distribution of the interested families, three WSB routes have been established and the families have been trained in the app usage. During nine weeks, 33 children have joined the WSB and their parents have accompanied the groups in turns. A high recurrence in the attendance has been registered. Through a final survey, participants have valued highly the tool and the methodology designed, emphasizing as most useful features of the mobile app: notifications system, chat and real-time monitoring. It has also been found that the tool has had a major impact on the degree of confidence of parents regarding the autonomous on foot displacement of their children to school. Moreover, 37,9% of the participant families have reported a total or partial modal shift from car to walking, and the benefits more reported are an increment of the parents available time and less problems in the travel to school daily organization. As a consequence, It has been proved the effectiveness of this user-centric innovative ICT-based methodology to reduce the levels of private car drop offs, minimize barriers of time constraints, volunteer recruitment, and parents’ safety concerns, while, at the same time, increase convenience and time savings for families. This pilot study can offer guidance for community coordinated actions and local authority interventions to support sustainable school travel outcomes.

Keywords: active travel, mobile app, sustainable mobility, urban transportation planning, walking school bus

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27669 Fatigue Crack Growth Rate Measurement by Means of Classic Method and Acoustic Emission

Authors: V. Mentl, V. Koula, P. Mazal, J. Volák

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Nowadays, the acoustic emission is a widely recognized method of material damage investigation, mainly in cases of cracks initiation and growth observation and evaluation. This is highly important in structures, e.g. pressure vessels, large steam turbine rotors etc., applied both in classic and nuclear power plants. Nevertheless, the acoustic emission signals must be correlated with the real crack progress to be able to evaluate the cracks and their growth by this non-destructive technique alone in real situations and to reach reliable results when the assessment of the structures' safety and reliability is performed and also when the remaining lifetime should be evaluated. The main aim of this study was to propose a methodology for evaluation of the early manifestations of the fatigue cracks and their growth and thus to quantify the material damage by acoustic emission parameters. Specimens made of several steels used in the power producing industry were subjected to fatigue loading in the low- and high-cycle regimes. This study presents results of the crack growth rate measurement obtained by the classic compliance change method and the acoustic emission signal analysis. The experiments were realized in cooperation between laboratories of Brno University of Technology and West Bohemia University in Pilsen within the solution of the project of the Czech Ministry of Industry and Commerce: "A diagnostic complex for the detection of pressure media and material defects in pressure components of nuclear and classic power plants" and the project “New Technologies for Mechanical Engineering”.

Keywords: fatigue, crack growth rate, acoustic emission, material damage

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27668 Distinctive Features of Legal Relations in the Area of Subsoil Use, Renewal and Protection in Ukraine

Authors: N. Maksimentseva

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The issue of public administration in subsoil use, renewal and protection is of high importance for Ukraine since it is strongly linked to energy security of the state as well as it shall facilitate the people of Ukraine to efficiently implement its propitiatory rights towards natural resources and redistribution of national wealth. As it is stipulated in the Article 11 of the Subsoil Code of Ukraine (the Code) the authorities that administer the industry are limited to central executive bodies and local governments. In particular, it is stipulated in the Code that the Ukraine’s Cabinet of Ministers carries out public administration in geological exploration, production and protection of subsoil. Other state bodies of public administration include central public authority responsible for state environmental protection policies; central public authority in charge of implementation of state geological exploration and efficient subsoil use policies; central authority in charge of state health and safety control policies. There are also public authorities in the Autonomous Republic of Crimea; local executive bodies and other state authorities and local self-government authorities in compliance with laws of Ukraine. This article is devoted to the analysis of the legal relations in the area of public administration of subsoil use, renewal and protection in Ukraine. The main approaches to study the essence of legal relations in the named area as well as its tasks, functions and methods are analyzed. It is concluded in this article that legal relationship in the field of public administration of subsoil use, renewal and protection is characterized by specifics of its task (development of natural resources).

Keywords: legal relations, public administration, subsoil code of Ukraine, subsoil use, renewal and protection

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27667 Used MATLAB Code to Study the Vehicle Bridge Coupling Vibration Based On the Method of Newmark-β

Authors: Saidi Abdelkrim, Hamouine Abdelmadjid, Abdellatif Megnounif

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The study of interaction between vehicles and bridge structures has become extremely important. Large deflections and vibration induced by heavy and high-speed vehicles affect significantly the safety and efficiency of bridge. The vibration of a bridge caused by passage of vehicles is one of the most imperative considerations in the design of a bridge as a common sort of transportation structure. A major goal of this study is to create a simplified model of a vehicle bridge system in MATLAB. The model will then be used to study the influence of parameters to vehicle-bridge vibrations.

Keywords: vehicle-bridge interaction, Newmark-β, MATLAB code

Procedia PDF Downloads 598
27666 Analysis of Expression Data Using Unsupervised Techniques

Authors: M. A. I Perera, C. R. Wijesinghe, A. R. Weerasinghe

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his study was conducted to review and identify the unsupervised techniques that can be employed to analyze gene expression data in order to identify better subtypes of tumors. Identifying subtypes of cancer help in improving the efficacy and reducing the toxicity of the treatments by identifying clues to find target therapeutics. Process of gene expression data analysis described under three steps as preprocessing, clustering, and cluster validation. Feature selection is important since the genomic data are high dimensional with a large number of features compared to samples. Hierarchical clustering and K Means are often used in the analysis of gene expression data. There are several cluster validation techniques used in validating the clusters. Heatmaps are an effective external validation method that allows comparing the identified classes with clinical variables and visual analysis of the classes.

Keywords: cancer subtypes, gene expression data analysis, clustering, cluster validation

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27665 Botulism Clinical Experience and Update

Authors: Kevin Yeo, Christine Hall, Babinchak Tim

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BAT® [Botulism Antitoxin Heptavalent (A,B,C,D,E,F,G)-(Equine)] anti-toxin is a mixture of equine immune globulin fragments indicated for the treatment of symptomatic botulism in adult and pediatric patients. The effectiveness of BAT anti-toxin is based on efficacy studies conducted in animal models. A general explanation of the pivotal animal studies, post market surveillance and outcomes of an observational patient registry for patients treated with BAT product distributed in the USA is briefly discussed. Overall it took 20 animal studies for two well-designed and appropriately powered pivotal efficacy studies – one in which the effectiveness of BAT was assessed against all 7 serotypes in the guinea pig, and the other where efficacy is confirmed in the Rhesus macaque using Serotype A. Clinical Experience for BAT to date involves approximately 600 adult and pediatric patients with suspected botulism. In pre-licensure, patient data was recorded under the US CDC expanded access program (259 adult and pediatric patients between 10 days to 88 years of age). In post licensure, greater than 350 patients to date have received BAT and been followed up by enhanced expanded access program. The analysis of the post market surveillance data provided a unique opportunity to demonstrate clinical benefit in the field study required by the animal rule. While the animal rule is applied because human efficacy studies are not ethical or feasible, a post-marketing requirement is to conduct a study to evaluate safety and clinical benefit when circumstances arise and demonstrate the favourable benefit-risk profile that supported licensure.

Keywords: botulism, threat, clinical benefit, observational patient registry

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27664 Stress Analysis of Buried Pipes from Soil and Traffic Loads

Authors: A. Mohamed, A. El-Hamalawi, M. Frost, A. Connell

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Often design standards do not provide guidance or formulae for the calculation of stresses on buried pipelines caused by external loads. Frequently engineers rely on other methods and published sources of information to calculate such imposed stresses and a variety of methods can be used. This paper reviews three current approaches to soil pipeline interaction modelling to predict stresses on buried pipelines subjected to soil overburden and traffic loading. The traditional approach to use empirical stress formulas to calculate circumferential bending stresses on pipelines. The alternative approaches considered are the use of a finite element package to compute an estimate of circumferential bending stress and a proprietary stress analysis system (SURFLOAD) to estimate the circumferential bending stress. The results from analysis using the methods are presented and compared to experimental results in terms of predicted and measured circumferential stresses. This study shows that the approach used to assess externally generated stress is important and can lead to an over-conservative analysis. Using FE analysis either through SURFLOAD or a general FE package to predict circumferential stress is the most accurate way to undertake stress analysis due to traffic and soil loads. Although conservative, classical empirical methods will continue to be applied to the analysis of buried pipelines, an opportunity exists, therefore, in many circumstances, to use applied numerical techniques, made possible by advances in finite element analysis.

Keywords: buried pipelines, circumferential bending stress, finite element analysis, soil overburden, soil pipeline interaction analysis (SPIA), traffic loadings

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27663 Web-Based Decision Support Systems and Intelligent Decision-Making: A Systematic Analysis

Authors: Serhat Tüzün, Tufan Demirel

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Decision Support Systems (DSS) have been investigated by researchers and technologists for more than 35 years. This paper analyses the developments in the architecture and software of these systems, provides a systematic analysis for different Web-based DSS approaches and Intelligent Decision-making Technologies (IDT), with the suggestion for future studies. Decision Support Systems literature begins with building model-oriented DSS in the late 1960s, theory developments in the 1970s, and the implementation of financial planning systems and Group DSS in the early and mid-80s. Then it documents the origins of Executive Information Systems, online analytic processing (OLAP) and Business Intelligence. The implementation of Web-based DSS occurred in the mid-1990s. With the beginning of the new millennia, intelligence is the main focus on DSS studies. Web-based technologies are having a major impact on design, development and implementation processes for all types of DSS. Web technologies are being utilized for the development of DSS tools by leading developers of decision support technologies. Major companies are encouraging its customers to port their DSS applications, such as data mining, customer relationship management (CRM) and OLAP systems, to a web-based environment. Similarly, real-time data fed from manufacturing plants are now helping floor managers make decisions regarding production adjustment to ensure that high-quality products are produced and delivered. Web-based DSS are being employed by organizations as decision aids for employees as well as customers. A common usage of Web-based DSS has been to assist customers configure product and service according to their needs. These systems allow individual customers to design their own products by choosing from a menu of attributes, components, prices and delivery options. The Intelligent Decision-making Technologies (IDT) domain is a fast growing area of research that integrates various aspects of computer science and information systems. This includes intelligent systems, intelligent technology, intelligent agents, artificial intelligence, fuzzy logic, neural networks, machine learning, knowledge discovery, computational intelligence, data science, big data analytics, inference engines, recommender systems or engines, and a variety of related disciplines. Innovative applications that emerge using IDT often have a significant impact on decision-making processes in government, industry, business, and academia in general. This is particularly pronounced in finance, accounting, healthcare, computer networks, real-time safety monitoring and crisis response systems. Similarly, IDT is commonly used in military decision-making systems, security, marketing, stock market prediction, and robotics. Even though lots of research studies have been conducted on Decision Support Systems, a systematic analysis on the subject is still missing. Because of this necessity, this paper has been prepared to search recent articles about the DSS. The literature has been deeply reviewed and by classifying previous studies according to their preferences, taxonomy for DSS has been prepared. With the aid of the taxonomic review and the recent developments over the subject, this study aims to analyze the future trends in decision support systems.

Keywords: decision support systems, intelligent decision-making, systematic analysis, taxonomic review

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27662 The Effectiveness of Communication Skills Using Transactional Analysis on the Dimensions of Marital Intimacy: An Experimental Study

Authors: Mehravar Javid, James Sexton, S. Taridashti, Joseph Dorer

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Objective: Intimacy is among the most important factors in marital relationships and includes different aspects. Communication skills can enable couples to promote their intimacy. This experimental study was conducted to measure the effectiveness of communication skills using Transactional Analysis (TA) on various dimensions of marital intimacy. Method: The participants in this study were female teachers. Analysis of covariance was recruited in the experimental group (n =15) and control group (n =15) with pre-test and post-test. Random assignment was applied. The experimental group received the Transactional Analysis training program for 9 sessions of 2 hours each week. The instrument was the Marital Intimacy Questionnaire, with 87 items and 9 subscales. Result: The findings suggest that training in Transactional Analysis significantly increased the total score of intimacy except spiritual intimacy on the post-test. Discussion: According to the obtained data, it is concluded that communication skills using Transactional Analysis (TA) training could increase intimacy and improve marital relationships. The study highlights the differential effects on emotional, rational, sexual, and psychological intimacy compared to physical, social/recreational, and relational intimacy over a 9-week period.

Keywords: communication skills, intimacy, marital relationships, transactional analysis

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27661 Childhood Trauma and Borderline Personality: An Analysis of the Root Causes and Treatment Plans

Authors: Sidika McNeil

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Borderline personality disorder (BPD) is a personality disorder that has been found to have strong origins in childhood trauma. One of the key symptoms of BPD is an association with irregular moods swings, as well as suicidal ideation (SI). Owing to the typically severe trauma patients experience during childhood, it is hard for them to control their emotions and thus makes it hard to emotionally regulate. It is then very common for those suffering from BPD to turn to unhealthy coping mechanisms, such as substance use, unhealthy relationships, and more, often unsuccessfully creating experiences that facilitate safety which leads to further negative experiences. With the high suicide rating among children, adolescents, and teens, and an ever-increasing number of children being diagnosed with BPD, it is very important that more research is done to find further treatments for patients who are currently suffering. Methods: Utilizing data found in prior studies, this paper will analyze the literature to focus on a comprehensive treatment plan for those with DBT. It is currently suggested that with the use of dialectical behavioral therapy (DBT), a therapy that focuses on changing negative thinking patterns and pushes for more positive ones is helpful for treatment for those with BPD. Though this therapy is not a cure to BPD, it does help mitigate the risk; this essay will explore other options that can further the treatment process, such as cognitive analytical therapy (CAT), which focuses on delving into the past to find the root causes of an issue to create coping strategies and harm reduction, a type of therapy used to aid patients in lowering the use of substances without complete cessation. Results: The research provides enough evidence to link between the treatment of BPD with the utilization of CAT.

Keywords: borderline personality disorder, cognitive analytical therapy, dialectical behavioral therapy, harm reduction, suicidal ideation

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27660 A Critical Discourse Analysis of President Muhammad Buhari's Speeches

Authors: Joy Aworo-Okoroh

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Politics is about trust and trust is challenged by the speaker’s ability to manipulate language before the electorate. Critical discourse analysis investigates the role of language in constructing social relationships between a political speaker and his audience. This paper explores the linguistic choices made by President Muhammad Buhari that enshrines his ideologies as well as the socio-political relations of power between him and Nigerians in his speeches. Two speeches of President Buhari –inaugural and Independence Day speeches are analyzed using Norman Fairclough’s perspective on Halliday’s Systemic functional grammar. The analysis is at two levels. The first level of analysis is the identification of transitivity and modality choices in the speeches and how they reveal the covert ideologies. The second analysis is premised on Normal Fairclough’s model, the clauses are analyzed to identify elements of power, hesistation, persuasion, threat and religious statement. It was discovered that Buhari is a dominant character who manipulates the material processes a lot.

Keywords: politics, critical discourse analysis, Norman Fairclough, systemic functional grammar

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27659 Finite Element Modelling of Mechanical Connector in Steel Helical Piles

Authors: Ramon Omar Rosales-Espinoza

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Pile-to-pile mechanical connections are used if the depth of the soil layers with sufficient bearing strength exceeds the original (“leading”) pile length, with the additional pile segment being termed “extension” pile. Mechanical connectors permit a safe transmission of forces from leading to extension pile while meeting strength and serviceability requirements. Common types of connectors consist of an assembly of sleeve-type external couplers, bolts, pins, and other mechanical interlock devices that ensure the transmission of compressive, tensile, torsional and bending stresses between leading and extension pile segments. While welded connections allow for a relatively simple structural design, mechanical connections are advantageous over welded connections because they lead to shorter installation times and significant cost reductions since specialized workmanship and inspection activities are not required. However, common practices followed to design mechanical connectors neglect important aspects of the assembly response, such as stress concentration around pin/bolt holes, torsional stresses from the installation process, and interaction between the forces at the installation (torsion), service (compression/tension-bending), and removal stages (torsion). This translates into potentially unsatisfactory designs in terms of the ultimate and service limit states, exhibiting either reduced strength or excessive deformations. In this study, the experimental response under compressive forces of a type of mechanical connector is presented, in terms of strength, deformation and failure modes. The tests revealed that the type of connector used can safely transmit forces from pile to pile. Using the results from the compressive tests, an analysis model was developed using the finite element (FE) method to study the interaction of forces under installation and service stages of a typical mechanical connector. The response of the analysis model is used to identify potential areas for design optimization, including size, gap between leading and extension piles, number of pin/bolts, hole sizes, and material properties. The results show the design of mechanical connectors should take into account the interaction of forces present at every stage of their life cycle, and that the torsional stresses occurring during installation are critical for the safety of the assembly.

Keywords: piles, FEA, steel, mechanical connector

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27658 Development of Generally Applicable Intravenous to Oral Antibiotic Switch Therapy Criteria

Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

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Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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27657 Study the Effect of Tolerances for Press Tool Assembly: Computer Aided Tolerance Analysis

Authors: Subodh Kumar, Ramkisan Pawar, Gopal D. Belurkar

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This paper describes a study for simple blanking tool. In blanking or piercing operation, punch and die should be concentric for proper cutting. In this study, tolerance analysis method is used to analyze the variation in the press tool assembly. Variation results into the eccentricity in between die and punch due to cumulative tolerance of parts used in assembly. 1D variation analysis were performed by CREO parametric computer aided design (CAD) Software Powered by CETOL 6σ computer aided tolerance analysis software. Use of CAD analysis software given the opportunity to find out the cause of variation in tool assembly. Accordingly, the new specification of tolerance and process setting for die set manufacturing has determined. Tolerance allocation and tolerance analysis method were performed iteratively to conclude that position tolerance as well as size tolerance of hole in top plate for bush and size tolerance of guide pillar were more responsible for eccentricity in punch and die. This work proposes optimum tolerance for press tool assembly parts to achieve 100 % yield for specified .015mm minimum tolerance zone.

Keywords: blanking, GD&T (Geometric Dimension and Tolerancing), DPMU (defects per million unit), press tool, stackup analysis, tolerance allocation, yield percentage

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27656 Computed Tomography Guided Bone Biopsies: Experience at an Australian Metropolitan Hospital

Authors: K. Hinde, R. Bookun, P. Tran

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Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.

Keywords: bone biopsy, computed tomography, core biopsy, histopathology

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27655 Analyses of Adverse Drug Reactions Reported of Hospital in Taiwan

Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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27654 Investors' Ratio Analysis and the Profitability of Listed Firms: Evidence from Nigeria

Authors: Abisola Akinola, Akinsulere Femi

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The stock market has continually been a source of economic development in most developing countries. This study examined the relationship between investors’ ratio analysis and profitability of quoted companies in Nigeria using secondary data obtained from the annual reports of forty-two (42) companies. The study employed the multiple regression technique to analyze the relationship between investors’ ratio analysis (measured by dividend per share and earning per share) and profitability (measured by the return on equity). The results from the analysis show that investors’ ratio analysis, when measured by earnings per share, have a positive and significant impact on profitability. However, the study noted that investors’ ratio analysis, when measured by dividend per share, tend to have a positive impact on profitability but it is statistically insignificant. By implication, investors and other stakeholders that are interested in investing in stocks can predict the earning capacity of listed firms in the stock market.

Keywords: dividend per share, earnings per share, profitability, return on equity

Procedia PDF Downloads 133
27653 Statistical Analysis of Natural Images after Applying ICA and ISA

Authors: Peyman Sheikholharam Mashhadi

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Difficulties in analyzing real world images in classical image processing and machine vision framework have motivated researchers towards considering the biology-based vision. It is a common belief that mammalian visual cortex has been adapted to the statistics of the real world images through the evolution process. There are two well-known successful models of mammalian visual cortical cells: Independent Component Analysis (ICA) and Independent Subspace Analysis (ISA). In this paper, we statistically analyze the dependencies which remain in the components after applying these models to the natural images. Also, we investigate the response of feature detectors to gratings with various parameters in order to find optimal parameters of the feature detectors. Finally, the selectiveness of feature detectors to phase, in both models is considered.

Keywords: statistics, independent component analysis, independent subspace analysis, phase, natural images

Procedia PDF Downloads 336
27652 Determination of a Novel Artificial Sweetener Advantame in Food by Liquid Chromatography Tandem Mass Spectrometry

Authors: Fangyan Li, Lin Min Lee, Hui Zhu Peh, Shoet Harn Chan

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Advantame, a derivative of aspartame, is the latest addition to a family of low caloric and high potent dipeptide sweeteners which include aspartame, neotame and alitame. The use of advantame as a high-intensity sweetener in food was first accepted by Food Standards Australia New Zealand in 2011 and subsequently by US and EU food authorities in 2014, with the results from toxicity and exposure studies showing advantame poses no safety concern to the public at regulated levels. To our knowledge, currently there is barely any detailed information on the analytical method of advantame in food matrix, except for one report published in Japanese, stating a high performance liquid chromatography (HPLC) and liquid chromatography/ mass spectrometry (LC-MS) method with a detection limit at ppm level. However, the use of acid in sample preparation and instrumental analysis in the report raised doubt over the reliability of the method, as there is indication that stability of advantame is compromised under acidic conditions. Besides, the method may not be suitable for analyzing food matrices containing advantame at low ppm or sub-ppm level. In this presentation, a simple, specific and sensitive method for the determination of advantame in food is described. The method involved extraction with water and clean-up via solid phase extraction (SPE) followed by detection using liquid chromatography tandem mass spectrometry (LC-MS/MS) in negative electrospray ionization mode. No acid was used in the entire procedure. Single laboratory validation of the method was performed in terms of linearity, precision and accuracy. A low detection limit at ppb level was achieved. Satisfactory recoveries were obtained using spiked samples at three different concentration levels. This validated method could be used in the routine inspection of the advantame level in food.

Keywords: advantame, food, LC-MS/MS, sweetener

Procedia PDF Downloads 468
27651 Radiation Protection Assessment of the Emission of a d-t Neutron Generator: Simulations with MCNP Code and Experimental Measurements in Different Operating Conditions

Authors: G. M. Contessa, L. Lepore, G. Gandolfo, C. Poggi, N. Cherubini, R. Remetti, S. Sandri

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Practical guidelines are provided in this work for the safe use of a portable d-t Thermo Scientific MP-320 neutron generator producing pulsed 14.1 MeV neutron beams. The neutron generator’s emission was tested experimentally and reproduced by MCNPX Monte Carlo code. Simulations were particularly accurate, even generator’s internal components were reproduced on the basis of ad-hoc collected X-ray radiographic images. Measurement campaigns were conducted under different standard experimental conditions using an LB 6411 neutron detector properly calibrated at three different energies, and comparing simulated and experimental data. In order to estimate the dose to the operator vs. the operating conditions and the energy spectrum, the most appropriate value of the conversion factor between neutron fluence and ambient dose equivalent has been identified, taking into account both direct and scattered components. The results of the simulations show that, in real situations, when there is no information about the neutron spectrum at the point where the dose has to be evaluated, it is possible - and in any case conservative - to convert the measured value of the count rate by means of the conversion factor corresponding to 14 MeV energy. This outcome has a general value when using this type of generator, enabling a more accurate design of experimental activities in different setups. The increasingly widespread use of this type of device for industrial and medical applications makes the results of this work of interest in different situations, especially as a support for the definition of appropriate radiation protection procedures and, in general, for risk analysis.

Keywords: instrumentation and monitoring, management of radiological safety, measurement of individual dose, radiation protection of workers

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27650 Analysis of Network Connectivity for Ship-To-Ship Maritime Communication Using IEEE 802.11 on Maritime Environment of Tanjung Perak, Indonesia

Authors: Ahmad Fauzi Makarim, Okkie Puspitorini, Hani'ah Mahmudah, Nur Adi Siswandari, Ari Wijayanti

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As a maritime country, Indonesia needs a solution in maritime connectivity which can assist the maritime communication system which including communication from harbor to the ship or ship to ship. The needs of many application services for maritime communication, whether for safety reasons until voyage service to help the process of voyage activity needs connection with a high bandwith. To support the government efforts in handling that kind of problem, a research is conducted in maritime communication issue by applying the new developed technology in Indonesia, namely IEEE 802.11. In this research, 3 outdoor WiFi devices are used in which have a frequency of 5.8 GHz. Maritime of Tanjung Perak harbor in Surabaya until Karang Jamuang Island are used as the location of the research with defining permission of ship node spreading by Navigation District Class 1. That maritime area formed by state 1 and state 2 areas which are the narrow area with average wave height of 0.7 meter based on the data from BMKG S urabaya. After that, wave height used as one of the parameters which are used in analyzing characteristic of signal propagation at sea surface, so it can be determined on the coverage area of transmitter system. In this research has been used three samples of outdoor wifi, there is the coverage of device A can be determined about 2256 meter, device B 4000 meter, and device C 1174 meter. Then to analyze of network connectivity for the ship to ship is used AODV routing algorithm system based on the value of the power transmit was smallest of all nodes within the transmitter coverage.

Keywords: maritime of Indonesia, maritime communications, outdoor wifi, coverage, AODV

Procedia PDF Downloads 346
27649 Effects of Using a Recurrent Adverse Drug Reaction Prevention Program on Safe Use of Medicine among Patients Receiving Services at the Accident and Emergency Department of Songkhla Hospital Thailand

Authors: Thippharat Wongsilarat, Parichat tuntilanon, Chonlakan Prataksitorn

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Recurrent adverse drug reactions are harmful to patients with mild to fatal illnesses, and affect not only patients but also their relatives, and organizations. To compare safe use of medicine among patients before and after using the recurrent adverse drug reaction prevention program . Quasi-experimental research with the target population of 598 patients with drug allergy history. Data were collected through an observation form tested for its validity by three experts (IOC = 0.87), and analyzed with a descriptive statistic (percentage). The research was conducted jointly with a multidisciplinary team to analyze and determine the weak points and strong points in the recurrent adverse drug reaction prevention system during the past three years, and 546, 329, and 498 incidences, respectively, were found. Of these, 379, 279, and 302 incidences, or 69.4; 84.80; and 60.64 percent of the patients with drug allergy history, respectively, were found to have caused by incomplete warning system. In addition, differences in practice in caring for patients with drug allergy history were found that did not cover all the steps of the patient care process, especially a lack of repeated checking, and a lack of communication between the multidisciplinary team members. Therefore, the recurrent adverse drug reaction prevention program was developed with complete warning points in the information technology system, the repeated checking step, and communication among related multidisciplinary team members starting from the hospital identity card room, patient history recording officers, nurses, physicians who prescribe the drugs, and pharmacists. Including in the system were surveillance, nursing, recording, and linking the data to referring units. There were also training concerning adverse drug reactions by pharmacists, monthly meetings to explain the process to practice personnel, creating safety culture, random checking of practice, motivational encouragement, supervising, controlling, following up, and evaluating the practice. The rate of prescribing drugs to which patients were allergic per 1,000 prescriptions was 0.08, and the incidence rate of recurrent drug reaction per 1,000 prescriptions was 0. Surveillance of recurrent adverse drug reactions covering all service providing points can ensure safe use of medicine for patients.

Keywords: recurrent drug, adverse reaction, safety, use of medicine

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27648 Central Line Stock and Use Audit in Adult Patients: A Quality Improvement Project on Central Venous Catheter Standardisation Across Hospital Departments

Authors: Gregor Moncrieff, Ursula Bahlmann

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A number of incident reports were filed from the intensive care unit with regards to adult patients admitted following operations who had a central venous catheter inserted of the incorrect length for the relevant anatomical site and catheters not compatible with pressurised injection inserted whilst in theatre. Incorrect catheter length can lead to a variety of complications and pressurised injection is a requirement for contrast enhanced computerised tomography scans. This led to several patients having a repeat procedure to insert a catheter of the correct length and also compatible with pressurised injection. This project aimed to identify the types of central venous catheters used in theatres and ensure the correct equipment would be stocked and used in future cases in accordance the existing Association of Anaesthetics of Great Britain and Northern Ireland guidelines. A questionnaire was sent out to all of the anaesthetic department in our hospital aiming to determine what types of central venous catheters were preferably used by anaesthetists and why these had been chosen. We also explored any concerns regarding introduction of standardised, pressure injectable central venous catheters to the theatre department which were already in use in other parts of the hospital and in keeping with national guidance. A total of 56 responses were collected. 64% of respondents routinely used a central venous catheter which was significantly shorter than the national recommended guidance with a further 4 different types of central venous catheters used which were different to other areas of the hospital and not pressure injectable. 75% of respondents were in agreement to standardised introduction of the pressure injectable catheters of the recommended length in accordance with national guidance. Reasons why 25% respondents were opposed to introduction of these catheters were explored and discussed. We were successfully able to introduce the standardised central catheters to the theatre department following presentation at the local anaesthetic quality and safety meeting. Reasons against introduction of the catheters were discussed and a compromise was reached that the existing catheters would continue to be stocked but would only be available on request, with a focus on encouraging use of the standardised catheters. Additional changes achieved included removing redundant catheters from the theatre stock. Ongoing data is being collected to analyse positive and negative feedback from use of the introduced catheters.

Keywords: central venous catheter, medical equipment, medical safety, quality improvement

Procedia PDF Downloads 108
27647 Cyber Bullying, Online Risks and Parental Mediation: A Comparison between Adolescent Reports and Parent Perceptions in South Africa

Authors: Masa Popovac, Philip Fine

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Information and Communication Technologies (ICTs) have altered our social environments, and young people in particular have immersed themselves in the digital age. Despite countless benefits, younger ICT users are being exposed to various online risks such as contact with strangers, viewing of risky content, sending or receiving sexually themed images or comments (i.e. ‘sexting’) as well as cyber bullying. Parents may not be fully aware of the online spaces their children inhabit and often struggle to implement effective mediation strategies. This quantitative study explored (i) three types of online risks (contact risks, content risks and conduct risks), (ii) cyber bullying victimization and perpetration, and (iii) parental mediation among a sample of 689 South African adolescents aged between 12-17 years. Survey data was also collected for 227 of their parents relating to their perceptions of their child’s online experiences. A comparison between adolescent behaviors and parental perceptions was examined on the three variables in the study. Findings reveal various online risk taking behaviors. In terms of contact risks, 56% of adolescents reported having contact with at least one online stranger, with many meeting these strangers in person. Content risks included exposure to harmful information such as websites promoting extreme diets or self-harm as well as inappropriate content: 84% of adolescents had seen violent content and 75% had seen sexual content online. Almost 60% of adolescents engaged in conduct risks such as sexting. Eight online victimization behaviors were examined in the study and 79% of adolescents had at least one of these negative experiences, with a third (34%) defining this experience as cyber bullying. A strong connection between victimization and perpetration was found, with 63% of adolescents being both a victim and perpetrator. Very little parental mediation of ICT use was reported. Inferential statistics revealed that parents consistently underestimated their child’s online risk taking behaviors as well as their cyber bullying victimization and perpetration. Parents also overestimated mediation strategies in the home. The generational gap in the knowledge and use of ICTs is a barrier to effective parental mediation and online safety, since many negative online experiences by adolescents go undetected and can continue for extended periods of time thereby exacerbating the potential psychological and emotional distress. The study highlights the importance of including parents in online safety efforts.

Keywords: cyber bullying, online risk behaviors, parental mediation, South Africa

Procedia PDF Downloads 477
27646 An Analysis of Laboratory Management Practices and Laid down Standard in Some Colleges of Education in Kano State, Nigeria

Authors: Joseph Abiodun Ayo

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The main purpose of this study was to investigate the science laboratory management practices employed in some colleges of education in Kano State, Nigeria. Four specific objectives were stated to guide the study, four research questions were investigated, four null hypothesis were tested at 0.05 level of significance. A survey design was used and science laboratory management questionnaires which solicit responses that was used in answering the research questions and testing of hypotheses. These questionnaires were distributed to the respective respondents in the sampled colleges. The respondents for the study comprised biology chemistry, physics, integrated science teacher trainers and the paraprofessionals. Data were analyzed using mean and standard deviation to answer the questions. Chi-square statistical technique was used to test the hypothesis. The findings of the study revealed that all procedures on control of laboratory activities were rarely observed. Safety procedures were occasionally practiced. On provision and procurement of laboratory equipment and materials it was observed that both academic and the paraprofessional were not fully involved. While maintenance measures were occasionally observed, furthermore science laboratory management procedures are not frequently practiced. Hence making the acquisition of science process skills by students becoming difficult. To arrest these anomalies, it is recommended that direct labor in the maintenance of laboratory equipment and other apparatus by paraprofessional is crucial. Training of academic and paraprofessional through workshops to acquire technical skills in maintenance of science laboratory equipment be instituted to increase professionalism. Periodic supervision of activities in the science laboratories should be done promptly.

Keywords: laboratory, management, standard, facility

Procedia PDF Downloads 429
27645 Using Structured Analysis and Design Technique Method for Unmanned Aerial Vehicle Components

Authors: Najeh Lakhoua

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Introduction: Scientific developments and techniques for the systemic approach generate several names to the systemic approach: systems analysis, systems analysis, structural analysis. The main purpose of these reflections is to find a multi-disciplinary approach which organizes knowledge, creates universal language design and controls complex sets. In fact, system analysis is structured sequentially by steps: the observation of the system by various observers in various aspects, the analysis of interactions and regulatory chains, the modeling that takes into account the evolution of the system, the simulation and the real tests in order to obtain the consensus. Thus the system approach allows two types of analysis according to the structure and the function of the system. The purpose of this paper is to present an application of system analysis of Unmanned Aerial Vehicle (UAV) components in order to represent the architecture of this system. Method: There are various analysis methods which are proposed, in the literature, in to carry out actions of global analysis and different points of view as SADT method (Structured Analysis and Design Technique), Petri Network. The methodology adopted in order to contribute to the system analysis of an Unmanned Aerial Vehicle has been proposed in this paper and it is based on the use of SADT. In fact, we present a functional analysis based on the SADT method of UAV components Body, power supply and platform, computing, sensors, actuators, software, loop principles, flight controls and communications). Results: In this part, we present the application of SADT method for the functional analysis of the UAV components. This SADT model will be composed exclusively of actigrams. It starts with the main function ‘To analysis of the UAV components’. Then, this function is broken into sub-functions and this process is developed until the last decomposition level has been reached (levels A1, A2, A3 and A4). Recall that SADT techniques are semi-formal; however, for the same subject, different correct models can be built without having to know with certitude which model is the good or, at least, the best. In fact, this kind of model allows users a sufficient freedom in its construction and so the subjective factor introduces a supplementary dimension for its validation. That is why the validation step on the whole necessitates the confrontation of different points of views. Conclusion: In this paper, we presented an application of system analysis of Unmanned Aerial Vehicle components. In fact, this application of system analysis is based on SADT method (Structured Analysis Design Technique). This functional analysis proved the useful use of SADT method and its ability of describing complex dynamic systems.

Keywords: system analysis, unmanned aerial vehicle, functional analysis, architecture

Procedia PDF Downloads 193