Search results for: electronic patient portal
2862 Electronically Controlled Motorized Steering System (E-Mo Steer)
Authors: M. Prasanth, V. Nithin, R. Keerthana, S.Kalyani
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In the current scenario, the steering system in automobiles is such that the motion from the steering wheel is transferred to driving wheel by mechanical linkages. In this paper, we propose a method to design a steering mechanism using servomotors to turn the wheels instead of linkages. In this method, a steering angle sensor senses the turn angle of the steering wheel and its output is processed by an electronical control module. Then the ECM compares the angle value to that of a standard value from a look-up database. Then it gives the appropriate input power and the turning duration to the motors. Correspondingly, the motors turn the wheels by means of bevel gears welded to both the motor output shafts and the wheel hubs. Thus, the wheels are turned without the complicated framework of linkages, reducing the driver’s effort and fatigue considerably.Keywords: electronic control unit, linkage-less steering, servomotors, E-Mo Steer
Procedia PDF Downloads 2632861 Nurse-Led Codes: Practical Application in the Emergency Department during a Global Pandemic
Authors: F. DelGaudio, H. Gill
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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation
Procedia PDF Downloads 1552860 The Cost and Benefit on the Investment in Safety and Health of the Enterprises in Thailand
Authors: Charawee Butbumrung
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The purpose of this study is to evaluate the monetary worthiness of investment and the usefulness of risk estimation as a tool employed by a production section of an electronic factory. This study employed the case study of accidents occurring in production areas. Data is collected from interviews with six production of safety coordinators and collect the information from the relevant section. The study will present the ratio of benefits compared with the operation costs for investment. The result showed that it is worthwhile for investment with the safety measures. In addition, the organizations must be able to analyze the causes of accidents about the benefits of investing in protective working process. They also need to quickly provide the manual for the staff to learn how to protect themselves from accidents and how to use all of the safety equipment.Keywords: cost and benefit, enterprises in Thailand, investment in safety and health, risk estimation
Procedia PDF Downloads 2652859 Nanohybride Porphyrin and Silver as an Efficient Catalyst for Oxidation of Alcohols by Tetrabutylammonium Peroxomonosulfate
Authors: Atena Naeimi, Asghar Amiri, Zahra Ghasemi
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A stable suspension of nanocomposite simple manganese(III) meso-tetraphenylporphyrin nanoaggregates and Ag was prepared by a host–guest procedure, in which ethanol and water are used as ‘green’ solvents. The oxidation of alcohols by tetrabutylammonium Peroxomonosulfate(TP) were efficiently enhanced with excellent selectivity under the influence of simple Mn(TPP)OAc (TPP = meso-tetraphenylporphyrin) nanoparticles. Enhanced stabilities and activities were achieved with nanostructured Mn catalysts compared to those of the individual counterparts in solution according to turnover numbers and UV/Vis studies. The title nanocatalyst facilitates a greener reaction because the reaction solvent is water and TP is safe to use. The efficiency of the oxidation system depends critically upon the steric hindrances and electronic structures of both nitrogen donor ligand sand porphyrin nanoparticles.Keywords: oxidation, nanoaggregates, porphyrinoids, silver
Procedia PDF Downloads 2952858 Use of Cloud Computing and Smart Devices in Healthcare
Authors: Nikunj Agarwal, M. P. Sebastian
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Cloud computing can reduce the start-up expenses of implementing EHR (Electronic Health Records). However, many of the healthcare institutions are yet to implement cloud computing due to the associated privacy and security issues. In this paper, we analyze the challenges and opportunities of implementing cloud computing in healthcare. We also analyze data of over 5000 US hospitals that use Telemedicine applications. This analysis helps to understand the importance of smart phones over the desktop systems in different departments of the healthcare institutions. The wide usage of smartphones and cloud computing allows ubiquitous and affordable access to the health data by authorized persons, including patients and doctors. Cloud computing will prove to be beneficial to a majority of the departments in healthcare. Through this analysis, we attempt to understand the different healthcare departments that may benefit significantly from the implementation of cloud computing.Keywords: cloud computing, smart devices, healthcare, telemedicine
Procedia PDF Downloads 3962857 Science School Was Burned: A Case Study of Crisis Management in Thailand
Authors: Proud Arunrangsiwed
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This study analyzes the crisis management and image repair strategies during the crisis of Mahidol Wittayanusorn School (MWIT) library burning. The library of this school was burned by a 16-year-old-male student on June 6th, 2010. This student blamed the school that the lesson was difficult, and other students were selfish. Although no one was in the building during the fire, it had caused damage to the building, books and electronic supplies around 130 million bahts (4.4 million USD). This event aroused many discourses arguing about the education system and morality. The strategies which were used during crisis were denial, shift the blame, bolstering, minimization, and uncertainty reduction. The results of using these strategies appeared after the crisis. That was the numbers of new students, who registered for the examination to get into this school in the later years, have remained the same.Keywords: school, crisis management, violence, image repair strategies, uncertainty, burn
Procedia PDF Downloads 4712856 Analysis and Design of Single Switch Mosfet Dimmer for AC Driven Lamp
Authors: S.Pandeeswari, Raju Padma
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In this paper a new solution to implement and control single-stage electronic ballast based on the integration of a buck-boost power factor correction stage and a half bridge resonant inverter is presented. The control signals are obtained using the inverter resonant current by means of a saturable transformer. Core saturation is used to control the required dead time between the control pulses on both switches. The turn-on time of one of the inverter switches is controlled to provide proper cathode preheating during the lamp ignition process. No special integrated circuits are required to control the ballast and the total number of components is minimized. Analysis and basic design of phase cut dimmer.Keywords: MOSFET dimmer, PIC 16F877A, voltage regulator, bridge rectifier
Procedia PDF Downloads 3792855 Public Health Emergency Management (PHEM) to COVID-19 Pandemic in North-Eastern Part of Thailand
Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya
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The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.Keywords: public health, emergency management, covid-19, pandemic
Procedia PDF Downloads 812854 Use of Zikani’s Ribosome Modulating Agents for Treating Recessive Dystrophic & Junctional Epidermolysis Bullosa with Nonsense Mutations
Authors: Mei Chen, Yingping Hou, Michelle Hao, Soheil Aghamohammadzadeh, Esteban Terzo, Roger Clark, Vijay Modur
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Background: Recessive Dystrophic Epidermolysis Bullosa (RDEB) is a genetic skin condition characterized by skin tearing and unremitting blistering upon minimal trauma. Repeated blistering, fibrosis, and scarring lead to aggressive squamous cell carcinoma later in life. RDEB is caused by mutations in the COL7A1 gene encoding collagen type VII (C7), the major component of anchoring fibrils mediating epidermis-dermis adherence. Nonsense mutations in the COL7A1 gene of a subset of RDEB patients leads to premature termination codons (PTC). Similarly, most Junctional Epidermolysis Bullosa (JEB) cases are caused by nonsense mutations in the LAMB3 gene encoding the β3 subunit of laminin 332. Currently, there is an unmet need for the treatment of RDEB and JEB. Zikani Therapeutics has discovered an array of macrocyclic compounds with ring structures similar to macrolide antibiotics that can facilitate readthrough activity of nonsense mutations in the COL7A1 and LAMB3 genes by acting as Ribosome Modulating Agents (RMAs). The medicinal chemistry synthetic advancements of these macrocyclic compounds have allowed targeting the human ribosome while preserving the structural elements responsible for the safety and pharmacokinetic profile of clinically used macrolide antibiotics. Methods: C7 expression was used as a measure of readthrough activity by immunoblot assays in two primary human fibroblasts from RDEB patients (R578X/R578X and R163X/R1683X-COL7A1). Similarly, immunoblot assays in C325X/c.629-12T > A-LAMB3 keratinocytes were used to measure readthrough activity for JEB. The relative readthrough activity of each compound was measured relative to Gentamicin. An imaging-based fibroblast migration assay was used as an assessment of C7 functionality in RDEB-fibroblasts over 16-20 hrs. The incubation period for the above experiments was 48 hrs for RDEB fibroblasts and 72 hours for JEB keratinocytes. Results: 9 RMAs demonstrated increased protein expression in both patient RDEB fibroblasts. The highest readthrough activity at tested concentrations without cytotoxicities increased protein expression up to 179% of Gentamicin (400 µg/ml), with favored readthrough activity in R163X/R1683X-COL7A1 fibroblasts. Concurrent with protein expression, fibroblast hypermotility phenotype observed in RDEB was rescued by reducing motility by ~35% to WT levels (the same level as 690 µM Gentamicin treated cells). Laminin β3 expression was also shown to be increased by 6 RMAs in keratinocytes to 33-83% of (400 µg/ml) Gentamicin. Conclusions: To date, 9 RMAs have been identified that enhance the expression of functional C7 in a mutation-dependent manner in two different RDEB patient fibroblast backgrounds (R578X/R578X and R163X/R1683X-COL7A1). A further 6 RMAs have been identified that enhance the readthrough of C325X-LAMB3 in JEB patient keratinocytes. Based on the clinical trial conducted by us with topical gentamycin in 2017, Zikani’s RMAs achieve clinically significant levels of read-through for the treatment of recessive dystrophic and Junctional Epidermolysis Bullosa.Keywords: epidermolysis bullosa, nonsense mutation, readthrough, ribosome modulation
Procedia PDF Downloads 982853 Effect of Submaximal Eccentric versus Maximal Isometric Contraction on Delayed Onset Muscle Soreness
Authors: Mohamed M. Ragab, Neveen A. Abdel Raoof, Reham H. Diab
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Background: Delayed onset muscle soreness (DOMS) is the most common symptom when ordinary individuals and athletes are exposed to unaccustomed physical activity, especially eccentric contraction which impairs athletic performance, ordinary people work ability and physical functioning. A multitude of methods have been investigated to reduce DOMS. One of the valuable method to control DOMS is repeated bout effect (RBE) as a prophylactic method. Purpose: To compare the repeated bout effect of submaximal eccentric contraction versus maximal isometric contraction on induced DOMS. Methods: Sixty normal male volunteers were assigned randomly into three groups of equal number: Group (A) “first study group”: 20 subjects received submaximal eccentric contraction on non-dominant elbow flexors as prophylactic exercise. Group (B) “second study group”: 20 subjects received maximal isometric contraction on non-dominant elbow flexors as prophylactic exercise. Group (C) “control group”: 20 subjects did not receive any prophylactic exercise. Maximal isometric contraction peak torque of elbow flexors and patient related elbow evaluation (PREE) scale were measured for each subject 3 times before, immediately after and 48 hours after induction of DOMS. Results: Post-hoc test for maximal isometric peak torque and PREE scale immediately and 48 hours after induction of DOMS revealed that group (A) and group (B) resulted in significant decrease in maximal isometric strength loss and elbow pain and disability rather than control group (C), but submaximal eccentric group (A) was more effective than maximal isometric group (B) as it showed more rapid recovery of functional strength and less degrees of elbow pain and disability. Conclusion: Both submaximal eccentric contraction and maximal isometric contraction were effective in prevention of DOMS but submaximal eccentric contraction had the greatest protective effect.Keywords: delayed onset muscle soreness, maximal isometric peak torque, patient related elbow evaluation scale, repeated bout effect
Procedia PDF Downloads 3652852 Improving Functionality of Radiotherapy Department Through: Systemic Periodic Clinical Audits
Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan
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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.Keywords: audit, clinical, radiotherapy, improving functionality
Procedia PDF Downloads 882851 Guidelines for Proper Internal Control of Internet Payment: A Case Study of Internet Payment Gateway, Thailand
Authors: Pichamon Chansuchai
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The objective of this research were to investigate electronic payment system on the internet and offer the guidelines for proper internal control of the payment system based on international standard security control (ISO/IEC 17799:2005),in a case study of payment of the internet, Thailand. The guidelines covered five important areas: (1) business requirement for access control, (2) information systems acquisition, development and maintenance, (3) information security incident management, (4) business continuity management, and (5) compliance with legal requirement. The findings from this qualitative study revealed the guidelines for proper internet control that were more reliable and allow the same line of business to implement the same system of control.Keywords: audit, best practice, internet, payment
Procedia PDF Downloads 5002850 Culturally Adapting Videos to Involve Nigerian Patients with Cancer in Clinical Trials
Authors: Abiola Falilat Ibraheem, Akinyimika Sowunmi, Valerie Otti
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Background: Introduction of innovative cancer clinical trials to Nigeria is a critical step in addressing global inequities of cancer burden. Low health and clinical trial literacy among Nigerian patients have been sighted as a significant barrier to ensuring that patients enrolled in clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. In the US, video interventions have been successful at improving education about cancer clinical trials among minority patients. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. Methods: A hospital-based representative mixed-method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020, comprising of cancer patients aged 18 and above. Patients were randomly selected during every clinic day, of which 63 patients volunteered to participate in this study. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (attitudes and intention to enroll in therapeutic clinical trials (AIET)) to improve patients’ knowledge, perception, and attitudes towards clinical trials was played, and then ended by administering a post-intervention test to the patients. For patients who had no prior knowledge, the AIET video was played for them, followed by the post-intervention test. Results: Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understand their cancer diagnosis and treatment very well. 84.1% of patients had never heard about cancer clinical trials, and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions in order to address trust in local clinical trialists. Conclusion: Due to the small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.Keywords: clinical trials, culturally targeted intervention, patient education, video intervention
Procedia PDF Downloads 1382849 Vancomycin Resistance Enterococcus and Implications to Trauma and Orthopaedic Care
Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi
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Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance
Procedia PDF Downloads 1492848 Early Outcomes and Lessons from the Implementation of a Geriatric Hip Fracture Protocol at a Level 1 Trauma Center
Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson
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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization
Procedia PDF Downloads 782847 Role of F18-FDG PET in Management of Differentiated Thyroid Cancers (TENIS) Patients
Authors: Seemab Safdar, Shazia Fatima, Ahmad Qureshy, M. Adnan Saeed, M. Faheem
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Background: Thyroid cancer has 586,000 cases per year worldwide, and this translates to 3% of all tumor diagnoses. 90% of the cases fall under differentiated thyroid carcinoma (DTC), which includes follicular thyroid cancer (FTC) and papillary thyroid cancer (PTC). During their illness, 10% of patients develop distant metastases, and two-thirds of them develop resistance to radioactive iodine (RAI) treatment. It has been shown that in some circumstances, like DTC with high TG levels and negative 131I whole-body scintigraphy (TENIS), [18F] FDG-PET-CT is an effective imaging technique. This study determines the role of [18F] FDG-PET-CT in the treatment of TENIS patients. Methods: 16 patients (n = 12 female; 4 males, age 45 ± 15 years) with histologically proven thyroid cancer (Differentiated and poorly differentiated) and high TG with negative iodine scans were included in this prospective study from January 2024 to June 2024. They underwent scanning in state-of-the-art (GE Discovery MI) [18F] FDG-PET-CT for re-staging or diagnostics of recurrent disease using a standardized protocol. All DTC subtypes and PDTC were included. The referring physicians completed standardized questionnaires both before and after PET-CT to prospectively determine the examination's effect on clinical decision-making. Patient outcomes were measured by analysis of medical records. Moreover, after PET-CT, a change in the pre-PET-CT planned therapies was documented in 32% of cases and additional invasive diagnostic procedures could be waived in 37.5 % of cases. TG levels under TSH stimulation were significantly higher in patients showing PET-CT metastases compared to patients without such findings (68.75%). Results: Without PET-CT, physicians referring to the doctors had not established a complete treatment plan for 45% of patients with thyroid carcinoma. 12/16 patients showed FDG avidity in cervical lymph nodes that were not Iodine avid previously, 2 patients had FDG avid disease in the lungs. In the process, PET-CT helped plan patient management and created a clear plan for treatment in 68.75% of patients. Conclusions: This study confirms that [18F] FDG-PET-CT used in a routine clinical setting has a very important impact on the management of patients with thyroid cancer when TG levels are persistently high in the presence of negative Iodine Scans by initiating treatments and replacing additional imaging and invasive tests.Keywords: PET-CT, TENIS, role, FDG
Procedia PDF Downloads 142846 Designing an Automatic Mechanical System to Prevent Cancers Caused by Drinks
Authors: Ghasem Yazadani, Hamidreza Ahmadi, Masoud Ahmadi, Sajad Rezazadeh
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In this paper with designing and proposing a compound of a heating and cooling system has been tried to show effect of this system on preventing esophagus cancer that can be caused by hot and cold drinks such as tea, coffee and ice water. This system has been simulated mechanically by fluent software and also has been validated by experimental way and a comprehensive result has been presented. Both of solution ways show that this system can reduce or increase temperature of drink to safe very dramatically and it can be a huge step toward consuming drinks safely and also it can be efficient about time issues. The system consists of a temperature sensor and an electronic controller that has a computer program to act automatically this task. Also this system has been presented after many different simulations and has been tried to find the best one in the point view of velocity of heating and cooling.Keywords: fluent, heat transfer, controller, esophagus cancer
Procedia PDF Downloads 3852845 Simultech - Innovative Country-Wide Ultrasound Training Center
Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper
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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.Keywords: medical training, simulations, ultrasound, Simultech
Procedia PDF Downloads 2802844 First Principle Calculation of The Magnetic Properties of Mn-doped 6H-SiC
Authors: M. Al Azri, M. Elzain, K. Bouziane, S. M. Chérif
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The electronic and magnetic properties of 6H-SiC with Mn impurities have been calculated using ab-initio calculations. Various configurations of Mn sites and Si and C vacancies were considered. The magnetic coupling between the two Mn atoms at substitutional and interstitials sites with and without vacancies is studied as a function of Mn atoms interatomic distance. It was found that the magnetic interaction energy decreases with increasing distance between the magnetic atoms. The energy levels appearing in the band gap due to vacancies and due to Mn impurities are determined. The calculated DOS’s are used to analyze the nature of the exchange interaction between the impurities. The band coupling model based on the p-d and d-d level repulsions between Mn and SiC has been used to describe the magnetism observed in each configuration. Furthermore, the impacts of applying U to Mn-d orbital on the magnetic moment have also been investigated. The results are used to understand the experimental data obtained on Mn- 6H-SiC (as-implanted and as –annealed) for various Mn concentration (CMn = 0.7%, 1.6%, 7%).Keywords: ab-initio calculations, diluted magnetic semiconductors, magnetic properties, silicon carbide
Procedia PDF Downloads 2912843 The Design Process of an Interactive Seat for Improving Workplace Productivity
Authors: Carlos Ferreira, Paulo Freitas, Valentim Freitas
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Creative industries’ workers are becoming more prominent as countries move towards intellectual-based economies. Consequently, the nature and essence of the workplace needs to be reconfigured so that creativity and productivity can be better promoted at these spaces. Using a multidisciplinary approach and a user-centered methodology, combining product design, electronic engineering, software and human-computer interaction, we have designed and developed a new seat that uses embedded sensors and actuators to increase the overall well-being of its users, their productivity and their creativity. Our contribution focuses on the parameters that most affect the user’s work on these kinds of spaces, which are, according to our study, noise and temperature. We describe the design process for a new interactive seat targeted at improving workspace productivity.Keywords: human-computer interaction, usability, user interface, creativity, ergonomics
Procedia PDF Downloads 2212842 Parametric Analysis of Lumped Devices Modeling Using Finite-Difference Time-Domain
Authors: Felipe M. de Freitas, Icaro V. Soares, Lucas L. L. Fortes, Sandro T. M. Gonçalves, Úrsula D. C. Resende
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The SPICE-based simulators are quite robust and widely used for simulation of electronic circuits, their algorithms support linear and non-linear lumped components and they can manipulate an expressive amount of encapsulated elements. Despite the great potential of these simulators based on SPICE in the analysis of quasi-static electromagnetic field interaction, that is, at low frequency, these simulators are limited when applied to microwave hybrid circuits in which there are both lumped and distributed elements. Usually the spatial discretization of the FDTD (Finite-Difference Time-Domain) method is done according to the actual size of the element under analysis. After spatial discretization, the Courant Stability Criterion calculates the maximum temporal discretization accepted for such spatial discretization and for the propagation velocity of the wave. This criterion guarantees the stability conditions for the leapfrogging of the Yee algorithm; however, it is known that for the field update, the stability of the complete FDTD procedure depends on factors other than just the stability of the Yee algorithm, because the FDTD program needs other algorithms in order to be useful in engineering problems. Examples of these algorithms are Absorbent Boundary Conditions (ABCs), excitation sources, subcellular techniques, grouped elements, and non-uniform or non-orthogonal meshes. In this work, the influence of the stability of the FDTD method in the modeling of concentrated elements such as resistive sources, resistors, capacitors, inductors and diode will be evaluated. In this paper is proposed, therefore, the electromagnetic modeling of electronic components in order to create models that satisfy the needs for simulations of circuits in ultra-wide frequencies. The models of the resistive source, the resistor, the capacitor, the inductor, and the diode will be evaluated, among the mathematical models for lumped components in the LE-FDTD method (Lumped-Element Finite-Difference Time-Domain), through the parametric analysis of Yee cells size which discretizes the lumped components. In this way, it is sought to find an ideal cell size so that the analysis in FDTD environment is in greater agreement with the expected circuit behavior, maintaining the stability conditions of this method. Based on the mathematical models and the theoretical basis of the required extensions of the FDTD method, the computational implementation of the models in Matlab® environment is carried out. The boundary condition Mur is used as the absorbing boundary of the FDTD method. The validation of the model is done through the comparison between the obtained results by the FDTD method through the electric field values and the currents in the components, and the analytical results using circuit parameters.Keywords: hybrid circuits, LE-FDTD, lumped element, parametric analysis
Procedia PDF Downloads 1532841 Ultrasonic Irradiation Synthesis of High-Performance Pd@Copper Nanowires/MultiWalled Carbon Nanotubes-Chitosan Electrocatalyst by Galvanic Replacement toward Ethanol Oxidation in Alkaline Media
Authors: Majid Farsadrouh Rashti, Amir Shafiee Kisomi, Parisa Jahani
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The direct ethanol fuel cells (DEFCs) are contemplated as a promising energy source because, In addition to being used in portable electronic devices, it is also used for electric vehicles. The synthesis of bimetallic nanostructures due to their novel optical, catalytic and electronic characteristic which is precisely in contrast to their monometallic counterparts is attracting extensive attention. Galvanic replacement (sometimes is named to as cementation or immersion plating) is an uncomplicated and effective technique for making nanostructures (such as core-shell) of different metals, semiconductors, and their application in DEFCs. The replacement of galvanic does not need any external power supply compared to electrodeposition. In addition, it is different from electroless deposition because there is no need for a reducing agent to replace galvanizing. In this paper, a fast method for the palladium (Pd) wire nanostructures synthesis with the great surface area through galvanic replacement reaction utilizing copper nanowires (CuNWS) as a template by the assistance of ultrasound under room temperature condition is proposed. To evaluate the morphology and composition of Pd@ Copper nanowires/MultiWalled Carbon nanotubes-Chitosan, emission scanning electron microscopy, energy dispersive X-ray spectroscopy were applied. In order to measure the phase structure of the electrocatalysts were performed via room temperature X-ray powder diffraction (XRD) applying an X-ray diffractometer. Various electrochemical techniques including chronoamperometry and cyclic voltammetry were utilized for the electrocatalytic activity of ethanol electrooxidation and durability in basic solution. Pd@ Copper nanowires/MultiWalled Carbon nanotubes-Chitosan catalyst demonstrated substantially enhanced performance and long-term stability for ethanol electrooxidation in the basic solution in comparison to commercial Pd/C that demonstrated the potential in utilizing Pd@ Copper nanowires/MultiWalled Carbon nanotubes-Chitosan as efficient catalysts towards ethanol oxidation. Noticeably, the Pd@ Copper nanowires/MultiWalled Carbon nanotubes-Chitosan presented excellent catalytic activities with a peak current density of 320.73 mAcm² which was 9.5 times more than in comparison to Pd/C (34.2133 mAcm²). Additionally, activation energy thermodynamic and kinetic evaluations revealed that the Pd@ Copper nanowires/MultiWalled Carbon nanotubes-Chitosan catalyst has lower compared to Pd/C which leads to a lower energy barrier and an excellent charge transfer rate towards ethanol oxidation.Keywords: core-shell structure, electrocatalyst, ethanol oxidation, galvanic replacement reaction
Procedia PDF Downloads 1472840 An Automated Sensor System for Cochlear Implants Electrode Array Insertion
Authors: Lei Hou, Xinli Du, Nikolaos Boulgouris
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A cochlear implant, referred to as a CI, is a small electronic device that can provide direct electrical stimulation to the auditory nerve. During cochlear implant surgery, atraumatic electrode array insertion is considered to be a crucial step. However, during implantation, the mechanical behaviour of an electrode array inside the cochlea is not known. The behaviour of an electrode array inside of the cochlea is hardly identified by regular methods. In this study, a CI electrode array capacitive sensor system is proposed. It is able to automatically determine the array state as a result of the capacitance variations. Instead of applying sensors to the electrode array, the capacitance information from the electrodes will be gathered and analysed. Results reveal that this sensing method is capable of recognising different states when fed into a pre-shaped model.Keywords: cochlear implant, electrode, hearing preservation, insertion force, capacitive sensing
Procedia PDF Downloads 2382839 Effect of III-V Nitrides on Performance of Graphene-Gold SPR Biosensor
Authors: Bijaya Kumar Sahoo
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The effect of III-V nitride semiconductors on performance of a graphene-on-gold surface plasmon resonance (SPR) biosensor has been investigated theoretically. III-V nitrides (AlN, GaN and InN) have been grown between gold (Au) and graphene layers. The sensitivity and performance of the biosensor have been computed for with and without semiconductors. Due to superior electronic and optical properties, III-V nitrides demonstrate high sensitivity and performance over Si and Ge. The enhancement of evanescent electric field due to III-V nitrides have been computed and found highest for InN. The analysis shows that for a high-sensitive imaging biosensor the required optimal thickness of gold, InN and graphene are respectively 49 nm, 11 nm and 0.34 nm for the light of wavelength =633 nm (red He-Ne laser). This study suggests that InN would be a better choice for fabrication of new imaging SPR biosensors.Keywords: SPR biosensor, optical properties, III-V nitrides, sensitivity, enhancement of electric field, performance of graphene gold SPR biosensor
Procedia PDF Downloads 5502838 A Novel Design Methodology for a 1.5 KW DC/DC Converter in EV and Hybrid EV Applications
Authors: Farhan Beg
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This paper presents a method for the efficient implementation of a unidirectional or bidirectional DC/DC converter. The DC/DC converter is used essentially for energy exchange between the low voltage service battery and a high voltage battery commonly found in Electric Vehicle applications. In these applications, apart from cost, efficiency of design is an important characteristic. A useful way to reduce the size of electronic equipment in the electric vehicles is proposed in this paper. The technique simplifies the mechanical complexity and maximizes the energy usage using the latest converter control techniques. Moreover a bidirectional battery charger for hybrid electric vehicles is also implemented in this paper. Several simulations on the test system have been carried out in Matlab/Simulink environment. The results exemplify the robustness of the proposed design methodology in case of a 1.5 KW DC-DC converter.Keywords: DC-DC converters, electric vehicles, power electronics, direct current control
Procedia PDF Downloads 7272837 Stratafix Barbed Suture Versus Polydioxanone Suture on the Rate of Pancreatic Fistula After Pancreaticoduodenectomy
Authors: Saniya Ablatt, Matthew Jacobsson, Jamie Whisler, Austin Forbes
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Postoperative pancreatic fistula (POPF) is a complication that occurs in up to 41% of patients after pancreaticoduodenectomy. Although certain characteristics such as individual patient anatomy are known risk factors for POPF, the effect of barbed suture techniques remains underexplored. This study examines whether the use of Stratafix barbed suture versus PDS impacts the risk of developing POPF. After obtaining IRB exemption, a retrospective chart review was initiated involving patients who underwent pancreaticoduodenectomy for the treatment of malignant or premalignant lesions of the pancreas at our institution between April 1st 2020 and April 30th 2022. Patients were stratified into 2 groups respective to the technique used to suture the pancreatico-jejunal anastomosis: Group 1 was composed to patients in which 4.0 Stratafix® suture was used n=41. Group 1 was composed to patients in which 4.0 PDS suture was used n=42. Data regarding patient age, sex, BMI, presence or absence of biochemical leak, presence or absence of grade B & C postoperative pancreatic fistulas, rate and type of in hospital complication, rate of reoperation, 30 day readmission rate, 90 day mortality, and total mortality were compared between groups. 83 patients were included in our study with 42 receiving Stratafix and 41 receiving PDS (50.6% vs 49.4%). Stratafix patients had less biochemical leaks (0.0% vs 4.8%, p=0.19) and higher rates of POPF but this was not statistically significant (7.2% vs 2.4%, p=0.26). Additionally, there was no difference between the use of stratafix versus PDS on the risk of clinically relevant grade B or C POPF (p=0.26, OR=3.25 [CI= 0.74-16.43]). Of the independent variables including age, race, sex, BMI, and ASA class, BMI greater than 25 increased the risk of clinically relevant POPF by 7.7 times compared to patients with BMI less than 25 (p=0.03, OR=7.79 [1.04-88.51]). Despite no significant difference in primary outcomes, the Stratafix group had lower rates of secondary outcomes including 90-day mortality; bleeding, cardiac, and infectious complications; reoperation; and 30-day readmission. On statistical analysis, Stratafix decreased the risk of 30-day readmission (p=0.04, OR=0.21, CI=0.04-0.97) and had a marginally significant effect on the risk of reoperation (p=0.08, OR=0.24, CI=0.04-1.26). There was no difference between the use of Stratafix versus PDS on the risk of POPF (p=0.26). However, Stratafix decreased the risk of 30-day readmission (p=0.04) and BMI greater than 25 increased the risk of clinically relevant POPF (p=0.03).Keywords: pancreas, hepatobiliary surgery, hepatobiliary, pancreatic leak, biochemical leak, fistula, pancreatic fistula
Procedia PDF Downloads 1292836 Risk of Occupational Exposure to Cytotoxic Drugs: The Role of Handling Procedures of Hospital Workers
Authors: J. Silva, P. Arezes, R. Schierl, N. Costa
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In order to study environmental contamination by cytostatic drugs in Portugal hospitals, sampling campaigns were conducted in three hospitals in 2015 (112 samples). Platinum containing drugs and fluorouracil were chosen because both were administered in high amounts. The detection limit was 0.01 pg/cm² for platinum and 0.1 pg/cm² for fluorouracil. The results show that spills occur mainly on the patient`s chair, while the most referenced occurrence is due to an inadequately closed wrapper. Day hospitals facilities were detected as having the largest number of contaminated samples and with higher levels of contamination.Keywords: cytostatic, contamination, hospital, procedures, handling
Procedia PDF Downloads 2952835 Split Health System for Diabetes Care in Urban Area: Experience from an Action Research Project in an Urban Poor Neighborhood in Bengaluru
Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna
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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.Keywords: diabetes care, disintegrated health system, quality of care, urban health
Procedia PDF Downloads 1602834 Self-Care and Risk Behaviors in Primary Caregiver of Cancer Patients
Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García
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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.Keywords: cancer, primary caregiver, risk behaviors, self-care
Procedia PDF Downloads 4042833 Clinico-Microbiological Study of S. aureus from Various Clinical Samples with Reference to Methicillin Resistant S. aureus (MRSA)
Authors: T. G. Pathrikar, A. D. Urhekar, M. P. Bansal
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To find out S. aureus from patient samples on the basis of coagulase test. We have evaluated slide coagulase (n=46 positive), tube coagulase (n=48 positive) and DNase test (n=44, positive) , We have isolated and identified MRSA from various clinical samples and specimens by disc diffusion method determined the incidence of MRSA 50% in patients. Found out the in vitro antimicrobial susceptibility pattern of MRSA isolates and also the MIC of MRSA of oxacillin by E-Test.Keywords: cefoxitin disc diffusion MRSA detection, e – test, S. aureus devastating pathogen, tube coagulase confirmation
Procedia PDF Downloads 491