Search results for: hospital selection

Authors: Rahma Fitriani, Zerlita Fahdha Pusdiktasari, Herman Cahyo Diartho

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Spatial panel model is commonly used to specify more complicated behavior of economic agent distributed in space at an individual-spatial unit level. There are several spatial panel models which can be adapted based on certain assumptions. A package called splm in R has several functions, ranging from the estimation procedure, specification tests, and model selection tests. In the absence of prior assumptions, a comprehensive procedure which utilizes the available functions in splm must be formed, which is the objective of this study. In this way, the best specification and model can be fitted based on data. The implementation of the procedure works well. It specifies SARAR-FE as the best model for agricultural productivity growth of the 38 East Java’s Regencies/Municipalities.

Keywords: spatial panel, specification, splm, agricultural productivity growth

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Authors: Karima Megdouli, Bourhan tachtouch

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Ejector refrigeration cycles offer an alternative to conventional systems for producing cold from low-temperature heat. In this article, a thermodynamic model is presented. This model has the advantage of simplifying the calculation algorithm and describes the complex double-throttling mechanism that occurs in the ejector. The model assumption and calculation algorithm are presented first. The impact of each efficiency is evaluated. Validation is performed on several data sets. The ejector model is then used to simulate a RES (refrigeration ejector system), to validate its robustness and suitability for use in predicting thermodynamic cycle performance. A Taguchi and ANOVA optimization is carried out on a RES. TOPSIS analysis was applied to decide the optimum refrigerants with cost, safety, environmental and enviro economic concerns along with thermophysical properties.

Keywords: ejector, velocity distribution, shock circle, Taguchi and ANOVA optimization, TOPSIS analysis

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Authors: To Quyen Le, Oswald Devisch, Tu Anh Trinh, Els Hannes

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Urban centres worldwide are affected differently by flooding. In Vietnam this impact is increasingly negative caused by a process of rapid urbanisation. Traditional spatial planning and flood mitigation planning are not able to deal with this growing threat. This article therefore proposes to focus on increasing the participation of local communities in flood control and management. It explores, on the basis of a design studio exercise, how lay knowledge on flooding can be integrated within planning processes. The article presents a theoretical basis for the structured criterion for site selection for a flood resilient urban park from the perspective of science, then discloses the tacit and explicit knowledge of the flood-prone area and finally integrates this knowledge into the design strategies for flood resilient urban park design.

Keywords: analytic hierarchy process, AHP, design resilience, flood resilient urban park, knowledge integration

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Authors: Roberta Martino, Viviana Ventre

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Empirical evidence has, over time, confirmed that the behavior of individuals is inconsistent with the descriptions provided by the Discounted Utility Model, an essential reference for calculating the utility of intertemporal prospects. The model assumes that individuals calculate the utility of intertemporal prospectuses by adding up the values of all outcomes obtained by multiplying the cardinal utility of the outcome by the discount function estimated at the time the outcome is received. The trend of the discount function is crucial for the preferences of the decision maker because it represents the perception of the future, and its trend causes temporally consistent or temporally inconsistent preferences. In particular, because different formulations of the discount function lead to various conclusions in predicting choice, the descriptive ability of models with a hyperbolic trend is greater than linear or exponential models. Suboptimal choices from any time point of view are the consequence of this mechanism, the psychological factors of which are encapsulated in the discount rate trend. In addition, analyzing the decision-making process from a psychological perspective, there is an equivalence between the selection of dominated prospects and a degree of impatience that decreases over time. The first part of the paper describes and investigates the anomalies of the discounted utility model by relating the cognitive distortions of the decision-maker to the emotional factors that are generated during the evaluation and selection of alternatives. Specifically, by studying the degree to which impatience decreases, it’s possible to quantify how the psychological and emotional mechanisms of the decision-maker result in a lack of decision persistence. In addition, this description presents inconsistency as the consequence of an inconsistent attitude towards time-delayed choices. The second part of the paper presents an experimental phase in which we show the relationship between inconsistency and impatience in different contexts. Analysis of the degree to which impatience decreases confirms the influence of the decision maker's emotional impulses for each anomaly in the utility model discussed in the first part of the paper. This work provides an application in the field of personalized behavioral finance. Indeed, the numerous behavioral diversities, evident even in the degrees of decrease in impatience in the experimental phase, support the idea that optimal strategies may not satisfy individuals in the same way. With the aim of homogenizing the categories of investors and to provide a personalized approach to advice, the results proven in the experimental phase are used in a complementary way with the information in the field of behavioral finance to implement the Analytical Hierarchy Process model in intertemporal choices, useful for strategic personalization. In the construction of the Analytic Hierarchy Process, the degree of decrease in impatience is understood as reflecting irrationality in decision-making and is therefore used for the construction of weights between anomalies and behavioral traits.

Keywords: analytic hierarchy process, behavioral finance, financial anomalies, impatience, time inconsistency

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Authors: Sarah Bouayyad, Ajay Nigam, Meera Beena

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Acquired benign tracheoesophageal fistula is a rare medical condition that usually results from trauma, foreign bodies, or granulomatous infections. This is an unusual presentation of a male patient with a history of laryngectomy who had had over a period of several years inappropriately and vigorously used valve cleaning brushes to clean tracheal secretions, which had led to the formation of a tracheoesophageal fistula. Due to the patient’s obsessive habit, we couldn’t manage him using conventional surgical methods. Instead, we opted for the placement of a salivary bypass tube, which yielded good results and recovery. To the best of our knowledge, no other case of similar etiology has been published. We would like to highlight the importance of appropriate patient selection and education prior to performing a tracheoesophageal puncture to avoid developing life-threatening complications as demonstrated in our case report.

Keywords: tracheoesophageal fistula, speech valve, endoscopic insertion of salivary bypass tube, head and neck malignancies

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Authors: Numra Qayyum, Samina Sarwat, Noor ul Ain

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Bilingual speakers generally can speak both languages with the same competency without mixing them intentionally and making mistakes, but sometimes errors occur in language selection. This quantitative study particularly deals with the language errors made by Urdu-English bilinguals. In this research, researchers have given special attention to the part played by bottom-up priming and top-down cognitive control in these errors. Unstable Urdu-English bilingual participants termed pictures and were prompted to shift from one language to another under the pressure of time. Different situations were given to manipulate the participants. The long and short runs trials of the same language were also given before switching to another language. The study is concluded with the findings that bilinguals made more errors when switching to the first language from their second language, and these errors are large in number, especially when a speaker is switching from L2 (second language) to L1 (first language) after a long run. When the switching is reversed, i.e., from L2 to LI, it had no effect at all. These results gave the clear responsibility of all these errors to top-down cognitive control.

Keywords: bottom up priming, language error, language switching, top down cognitive control

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Authors: Chothmal, Basant Agarwal

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Sentiment analysis means to classify a given review document into positive or negative polar document. Sentiment analysis research has been increased tremendously in recent times due to its large number of applications in the industry and academia. Sentiment analysis models can be used to determine the opinion of the user towards any entity or product. E-commerce companies can use sentiment analysis model to improve their products on the basis of users’ opinion. In this paper, we propose a new One-class Support Vector Machine (One-class SVM) based sentiment analysis model for movie review documents. In the proposed approach, we initially extract features from one class of documents, and further test the given documents with the one-class SVM model if a given new test document lies in the model or it is an outlier. Experimental results show the effectiveness of the proposed sentiment analysis model.

Keywords: feature selection methods, machine learning, NB, one-class SVM, sentiment analysis, support vector machine

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Authors: Ahmed Kayad Abdourazak, Abderafi Souad, Zejli Driss, Idriss Abdoulkader Ibrahim

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In this paper Artificial Neural Network (ANN) is used to predict the solar irradiation in Djibouti for the first Time that is useful to the integration of Concentrating Solar Power (CSP) and sites selections for new or future solar plants as part of solar energy development. An ANN algorithm was developed to establish a forward/reverse correspondence between the latitude, longitude, altitude and monthly solar irradiation. For this purpose the German Aerospace Centre (DLR) data of eight Djibouti sites were used as training and testing in a standard three layers network with the back propagation algorithm of Lavenber-Marquardt. Results have shown a very good agreement for the solar irradiation prediction in Djibouti and proves that the proposed approach can be well used as an efficient tool for prediction of solar irradiation by providing so helpful information concerning sites selection, design and planning of solar plants.

Keywords: artificial neural network, solar irradiation, concentrated solar power, Lavenberg-Marquardt

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Authors: Lauren G. Coggins

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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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Authors: M. Fozan Ur Rab, Mahrukh, M. Alam, N. Sheikh

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The purpose of this study is to analyze various high lift low Reynolds number airfoils using two-dimensional Computational Fluid Dynamics (CFD) code in the isolated flow field and select optimum airfoil to suit the motorsports application. The airfoil is selected after comparing the stall behavior, transition location, pressure recovery, pressure distribution and boundary layer characteristics of various airfoils. The prime consideration while selecting airfoil is highest Cl while achieving the sustainable performance over a range of Reynolds numbers encountered on the race track. The increase in Cl is always accompanied by the increase in Cd but this must be compromised since the main goal is to increase an aerodynamic grip. It is always desirable to increase the down-force in Formula One (F1)/Formula Student (FS) to gain reduction in lap time. This paper establishes the criteria for selection of high lift low Reynolds number airfoil while considering various parameters which affect the performance of airfoils.

Keywords: aerodynamics, airfoil, downforce, formula student, lap time

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Authors: Gagandeep Singh Grover, Vini Mahajan, Bhagmal, Priti Thaware, Jaspreet Takkar

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Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated a review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have a longer stay in the hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be a major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

Keywords: dengue, death, morbidities, DHF, DSS

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Authors: Brayan S. Pabón, R. Ricardo Moreno, Edith Gonzalez

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Inside the wide Colombian natural fiber set is the banana stem leaf, known as Calceta de Plátano, which is a material present in several regions of the country and is a fiber extracted from the pseudo stem of the banana plant (Musa paradisiaca) as a regular maintenance process. Colombia had a production of 2.8 million tons in 2007 and 2008 corresponding to 8.2% of the international production, number that is growing. This material was selected to be studied because it is not being used by farmers due to it being perceived as a waste from the banana harvest and a propagation pest agent inside the planting. In addition, the Calceta does not have industrial applications in Colombia since there is not enough concrete knowledge that informs us about the properties of the material and the possible applications it could have. Based on this situation the industrial design is used as a link between the properties of the material and the need to transform it into industrial products for the market. Therefore, the project identifies potential design attributes that the banana stem leaf can have for product development. The methodology was divided into 2 main chapters: Methodology for the material recognition: -Data Collection, inquiring the craftsmen experience and bibliography. -Knowledge in practice, with controlled experiments and validation tests. -Creation of design attributes and material profile according to the knowledge developed. Moreover, the Design methodology: -Application fields selection, exploring the use of the attributes and the relation with product functions. -Evaluating the possible fields and selection of the optimum application. -Design Process with sketching, ideation, and product development. Different protocols were elaborated to qualitatively determine some material properties of the Calceta, and if they could be designated as design attributes. Once defined, performed and analyzed the validation protocols, 25 design attributes were identified and classified into 4 attribute categories (Environmental, Functional, Aesthetics and Technical) forming the material profile. Then, 15 application fields were defined based on the relation between functions of product and the use of the Calceta attributes. Those fields were evaluated to measure how much are being used the functional attributes. After fields evaluation, a final field was defined , influenced by traditional use of the fiber for packing food. As final result, two products were designed for this application field. The first one is the Multiple Container, which works to contain small or large-thin pieces of food, like potatoes chips or small sausages; it allows the consumption of food with sauces or dressings. The second is the Chorizo container, specifically designed for this food due to the long shape and the consumption mode. Natural fiber research allows the generation of a solider and a more complete knowledge about natural fibers. In addition, the research is a way to strengthen the identity through the investigation of the proper and autochthonous, allowing the use of national resources in a sustainable and creative way. Using divergent thinking and the design as a tool, this investigation can achieve advances in the natural fiber handling.

Keywords: banana stem leaf, Calceta de Plátano, design attributes, natural fibers, product design

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Authors: Mustapha Benssalah, Mustapha Djeddou, Karim Drouiche

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The random number generation (RNG) presents a significant importance for the security and the privacy of numerous applications, such as RFID technology and smart cards. Since, the quality of the generated bit sequences is paramount that a weak internal generator for example, can directly cause the entire application to be insecure, and thus it makes no sense to employ strong algorithms for the application. In this paper, we propose a new pseudo random number generator (PRNG), suitable for cryptosystems ECC-based, constructed by randomly selecting points from several elliptic curves randomly selected. The main contribution of this work is the increasing of the generator internal states by extending the set of its output realizations to several curves auto-selected. The quality and the statistical characteristics of the proposed PRNG are validated using the Chi-square goodness of fit test and the empirical Special Publication 800-22 statistical test suite issued by NIST.

Keywords: PRNG, security, cryptosystem, ECC

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Authors: Dinmukhamed T., Vassiliy S.

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This article suggests the idea of fitting clothes and accessories based on augmented reality. A logical data model has been developed, taking into account the decision-making module (colors, style, type, material, popularity, etc.) based on personal data (age, gender, weight, height, leg size, hoist length, geolocation, photogrammetry, number of purchases of certain types of clothing, etc.) and statistical data of the purchase history (number of items, price, size, color, style, etc.). Also, in order to provide information to the user, it is planned to develop an augmented reality system using a QR code. This system of selection and fitting of clothing and accessories based on augmented reality will be used in stores to reduce the time for the buyer to make a decision on the choice of clothes.

Keywords: augmented reality, online store, decision-making module, like QR code, clothing store, queue

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Authors: Marianna De Almeida

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Greek secondary education is a highly selective system with regard to the access of students to Greek universities. Since access from elementary to lower secondary education and afterward to upper secondary education is rather liberal and almost free of selective mechanisms, the basic selection process comes after graduating from upper secondary school into play when students go through a highly selective process for university entry. This structure is responsible for the experience of extreme stress on the part of the candidates during a period of at least two years before the entrance examination leading to a radical change in students' everyday life routines. Instead of the school being an important agent for academic and psychological support, it seems that other agents, such as the informal private preparatory school and the student's families, take on the supportive role.

Keywords: stress, entrance examinations, family support, secondary education

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Authors: Malay Bhattacharyya, Saparya Suresh

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The Correlation Structure associated with a portfolio is subjected to vary across time. Studying the structural breaks in the time-dependent Correlation matrix associated with a collection had been a subject of interest for a better understanding of the market movements, portfolio selection, etc. The current paper proposes a methodology for testing the change in the time-dependent correlation structure of a portfolio in the high dimensional data using the techniques of generalized inverse, singular valued decomposition and multivariate distribution theory which has not been addressed so far. The asymptotic properties of the proposed test are derived. Also, the performance and the validity of the method is tested on a real data set. The proposed test performs well for detecting the change in the dependence of global markets in the context of high dimensional data.

Keywords: correlation structure, high dimensional data, multivariate distribution theory, singular valued decomposition

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Authors: U. P. Rathnakar, Medha Urval, K. Ashok Shenoy

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Introduction: There are many tools available for the measurement of health literacy. REALM (Rapid Estimate of Adult Literacy in Medicine) is a very commonly used tool in advanced countries. It comes in two forms-one with 66 words and shorter version (REALM-SF) with seven words. We decided to test the applicability of shorter version of the REALM test among our patients. Methodology: REALM (SF) was tested among 200 patients in a tertiary hospital. Discussion and conclusion: From the analysis of results, when the results of pronunciation indicate adequate levels of HL skills, analysis of comprehension shows that mere reading skills is likely to be misleading. So it is proposed that in Indian population who have adequate reading skills without adequate comprehension the REALM-SF test tool in its present form may not be an ideal testing tool for assessing HL.

Keywords: health literacy, REALM, short form, India

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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Authors: Mohammad Hossain Validad, Maryam Nakhaei-Moghadam, Monire Mahjoob

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Introduction: The prevalence of type 1 diabetes is increasing worldwide, and given the role of ethnicity and race in complications of diabetes, this study was designed to evaluate the ocular complications of type 1 diabetes mellitus in Zahedan. Methods: This prospective cross-sectional study was conducted on Type 1 diabetic children that referred to Alzahra Eye Hospital. All patients had a dilated binocular indirect ophthalmoscopy using a +90 D condensing lens and slit-lamp biomicroscopy. Age, gender, onset, duration of diabetes, and HbA1c level were recorded. Results: 76 type 1 diabetes patients with an age of 11.93 ± 3.76 years participated in this study. Out of 76 patients with diabetes, 19 people (25%) had ocular complications. There was a significant difference in age (P=0.01) and disease duration (P=0.07) between the two groups with and without ocular complications. Odd ratios for ocular complications with age and duration of diabetes were 1.32 and 1.32, respectively. Conclusion: Cataract was the most common ocular complication in type 1 diabetes in Zahedan, a tropical region that was significantly related to the duration of the disease and the age of the patients.

Keywords: diabet mellitus type one, cataract, ocular complication, hemoglobin A1C

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Authors: Selvakuma Kumaresh, Man Young Kim

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Combustion phenomenon will be accomplished effectively by the development of low emission combustor. One of the significant factors influencing the entire Combustion process is the mixing between a swirling angular jet (Primary Air) and the non-swirling inner jet (fuel). To study this fundamental flow, the chamber had to be designed in such a manner that the combustion process to sustain itself in a continuous manner and the temperature of the products is sufficiently below the maximum working temperature in the turbine. This study is used to develop the effective combustion with low unburned combustion products by adopting the concept of high swirl flow and motility of holes in the secondary chamber. The proper selection of a swirler is needed to reduce emission which can be concluded from the emission of Nox and CO2. The capture of CO2 is necessary to mitigate CO2 emissions from natural gas. Thus the suppression of unburned gases is a meaningful objective for the development of high performance combustor without affecting turbine blade temperature.

Keywords: combustion, emission, can-type combustion chamber, CFD, motility of holes, swirl flow

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Authors: Rhaed Khiati, Muhammad Hanif

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In the past decade, smart healthcare systems have been on an ascendant drift, especially with the evolution of hospitals and their increasing reliance on bioinformatics and software specializing in healthcare. Doctors have become reliant on technology more than ever, something that in the past would have been looked down upon, as technology has become imperative in reducing overall costs and improving the quality of patient care. With patient-doctor interactions becoming more necessary and more complicated than ever, systems must be developed while taking into account costs, patient comfort, and patient data, among other things. In this work, we proposed a smart hospital bed, which mixes the complexity and big data usage of traditional healthcare systems with the comfort found in soft beds while taking certain concerns like data confidentiality, security, and maintaining SLA agreements, etc. into account. This research work potentially provides users, namely patients and doctors, with a seamless interaction with to their respective nurses, as well as faster access to up-to-date personal data, including prescriptions and severity of the condition in contrast to the previous research in the area where there is lack of consideration of such provisions.

Keywords: big data, smart healthcare, distributed systems, bioinformatics

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Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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Authors: Narong Anurak

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This study aimed to find out the hair-care purchasing behavior at hypermarkets and to investigate two factors, package design and advertising channels, that influenced hair-care purchasing behavior. The subjects of the study consisted of 100 housewives aged between 20-60 who usually shopped at Big C Tiwanon. They were selected by accidental sampling, and were asked to complete a questionnaire. The main findings of the survey were that the majority of respondents regarding their brand selection of hair-care products, they gave priority to the product quality followed by a reasonable price, and fragrance, respectively. Besides, more than half of the respondents had brand loyalty while the rest were attracted by an attractive package design and advertising promotion campaigns. The respondents who were attracted by the package design said that the information on the labels influenced their purchasing decision the most, and television was a medium that best reached them as well.

Keywords: advertising channels, consumer purchasing decisions, hair-care market, package design

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Authors: F. Noto, G. Costa, L. Celona, F. Chines, G. Ciavola, G. Cuttone, S. Gammino, O. Leonardi, S. Marletta, G. Torrisi

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At Istituto Nazionale di Fisica Nucleare – Laboratorio Nazionale del Sud (INFN-LNS), a broad experience in the design, construction and commissioning of ECR and microwave ion sources is available. The AISHa ion source has been designed by taking into account the typical requirements of hospital-based facilities, where the minimization of the mean time between failures (MTBF) is a key point together with the maintenance operations, which should be fast and easy. It is intended to be a multipurpose device, operating at 18 GHz, in order to achieve higher plasma densities. It should provide enough versatility for future needs of the hadron therapy, including the ability to run at larger microwave power to produce different species and highly charged ion beams. The source is potentially interesting for any hadron therapy facility using heavy ions. In this paper, we analyzed the dimensional test and electrical test about an innovative solution for the containment chamber that allows us to solve our isolation and structural problems.

Keywords: FEM analysis, electron cyclotron resonance ion source, dielectrical measurement, hadron therapy

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Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman

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The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.

Keywords: breast cancer, breast fellowship, breast surgery, surgical history

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Authors: Anuradha Banerjee

Abstract:

Energy aware operation is one of the visionary goals in the area of robotics because operability of robots is greatly dependent upon their residual energy. Practically, the tasks allocated to robots carry different priority and often an upper limit of time stamp is imposed within which the task needs to be completed. If a robot is unable to complete one particular task given to it the task is reallocated to some other robot. The collection of robots is controlled by a Central Monitoring Unit (CMU). Selection of the new robot is performed by a fuzzy controller called Task Reallocator (TRAC). It accepts the parameters like residual energy of robots, possibility that the task will be successfully completed by the new robot within stipulated time, distance of the new robot (where the task is reallocated) from distance of the old one (where the task was going on) etc. The proposed methodology increases the probability of completing globally assigned tasks and saves huge amount of energy as far as the collection of robots is concerned.

Keywords: energy-efficiency, fuzzy-controller, priority, reallocation, task

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Authors: Mohammed A. A. Sarhan, Issam A. Al-Khatib

Abstract:

Complying with the technical specifications of compost production is of high importance not only for environmental protection but also for increasing the productivity and promotion of compost use by farmers in agriculture. This study focuses on the compost quality of the Palestinian market and farmers’ attitudes toward agricultural use of compost. The quality is assessed through selection of 20 compost samples of different suppliers and producers and lab testing for quality parameters, while the farmers’ attitudes to compost use for agriculture are evaluated through survey questionnaire of 321 farmers in the Hebron area. The results showed that the compost in the Palestinian markets is of medium quality due to partial or non-compliance with the quality standards and guidelines. The Palestinian farmers showed a positive attitude since 91.2% of them have the desire to use compost in agriculture. The results also showed that knowledge of difference between compost and chemical fertilizers, perception of compost benefits and previously experiencing problems in compost use, are significant factors affecting the farmers’ attitude toward the use of compost as an organic fertilizer.

Keywords: attitude, compost, compost quality, organic fertilizer, manure

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Authors: Jingpeng Gao, Xinrui Mao, Zhibin Deng

Abstract:

Aiming at the low recognition rate on the composite signal modulation in low signal to noise ratio (SNR), this paper proposes a modulation recognition algorithm based on ICanny-CNN. Firstly, the radar signal is transformed into the time-frequency image by Choi-Williams Distribution (CWD). Secondly, we propose an image processing algorithm using the Guided Filter and the threshold selection method, which is combined with the hole filling and the mask operation. Finally, the shallow convolutional neural network (CNN) is combined with the idea of the depth-wise convolution (Dw Conv) and the point-wise convolution (Pw Conv). The proposed CNN is designed to complete image classification and realize modulation recognition of radar signal. The simulation results show that the proposed algorithm can reach 90.83% at 0dB and 71.52% at -8dB. Therefore, the proposed algorithm has a good classification and anti-noise performance in radar signal modulation recognition and other fields.

Keywords: modulation recognition, image processing, composite signal, improved Canny algorithm

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Authors: Doo Ki Lee, Kumaresh Selvakumar, Man Young Kim, In Jae Song

Abstract:

The widespread utilization of mixer in selective catalytic reduction (SCR) system marks a remarkable advantage in diesel engines. In the automotive selective catalytic reduction (SCR) system, the de-NOX efficiency can be improved by highly uniform flow with effective turbulent mixing. In this paper, the exhaust pipe is complemented with the swirling mixers of three different vane angles installed at the upstream of the SCR reactor. The attributes of the mixer are established by the variation in flow behavior followed by the drawback owing to the absence of mixer. In particular, the information pertaining to the selection of proper static mixer is provided based on the correlation between the uniformity index (UI) and the pressure drop. The uniform distribution of the flow at the entrance of the SCR reactor aids to determine the configuration which gives high mixing performance and comprehend the function of the mixer.

Keywords: pressure drop, selective catalytic reduction, static mixer, turbulent mixing, uniformity index

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Authors: Renjith George Pallivathukal, Preethy Mary Donald

Abstract:

Asymptomatic oral lesions are often ignored by the patients and usually will be identified only in advanced stages. Early detection of precancerous lesions is important for better prognosis. It is also important for the oral health care person to be aware of the regional prevalence of oral lesions in order to provide early care for the same. We conducted a retrospective study to assess the prevalence of oral lesions based on the information available from patient records in a teaching dental school. Dental records of patients who attended the department of Oral medicine and diagnosis between September 2014 and September 2016 were retrieved and verified for oral lesions. Results: The ages of the patients ranged from 13 to 38 years with a mean age of 21.8 years. The lesions were classified as white (40.5%), red (23%), ulcerated (10.5%), pigmented (15.2%) and soft tissue enlargements (10.8%). 52% of the patients were unaware of the oral lesions before the dental visit. Overall, the prevalence of lesions in dental patients lower to national estimates, but the prevalence of some lesions showed variations.

Keywords: oral mucosal lesion, pre-cancer, prevalence, soft tissue lesion

Procedia PDF Downloads 348