Search results for: clinical survey data simulation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 33585

Search results for: clinical survey data simulation

33405 Clinical Outcomes and Symptom Management in Pediatric Patients Following Eczema Action Plans: A Quality Improvement Project

Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

Abstract:

Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

Procedia PDF Downloads 139
33404 Evaluation of Tumor Microenvironment Using Molecular Imaging

Authors: Fakhrosadat Sajjadian, Ramin Ghasemi Shayan

Abstract:

The tumor microenvironment plays an fundamental part in tumor start, movement, metastasis, and treatment resistance. It varies from ordinary tissue in terms of its extracellular network, vascular and lymphatic arrange, as well as physiological conditions. The clinical application of atomic cancer imaging is regularly prevented by the tall commercialization costs of focused on imaging operators as well as the constrained clinical applications and little showcase measure of a few operators. . Since numerous cancer types share comparable characteristics of the tumor microenvironment, the capacity to target these biomarkers has the potential to supply clinically translatable atomic imaging advances for numerous types encompassing cancer and broad clinical applications. Noteworthy advance has been made in focusing on the tumor microenvironment for atomic cancer imaging. In this survey, we summarize the standards and methodologies of later progresses in atomic imaging of the tumor microenvironment, utilizing distinctive imaging modalities for early discovery and conclusion of cancer. To conclude, The tumor microenvironment (TME) encompassing tumor cells could be a profoundly energetic and heterogeneous composition of safe cells, fibroblasts, forerunner cells, endothelial cells, flagging atoms and extracellular network (ECM) components.

Keywords: molecular, imaging, TME, medicine

Procedia PDF Downloads 52
33403 The Art and Science of Trauma-Informed Psychotherapy: Guidelines for Inter-Disciplinary Clinicians

Authors: Daphne Alroy-Thiberge

Abstract:

Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

Procedia PDF Downloads 114
33402 Modelling Consistency and Change of Social Attitudes in 7 Years of Longitudinal Data

Authors: Paul Campbell, Nicholas Biddle

Abstract:

There is a complex, endogenous relationship between individual circumstances, attitudes, and behaviour. This study uses longitudinal panel data to assess changes in social and political attitudes over a 7-year period. Attitudes are captured with the question 'what is the most important issue facing Australia today', collected at multiple time points in a longitudinal survey of 2200 Australians. Consistency of attitudes, and factors predicting change over time, are assessed. The consistency of responses has methodological implications for data collection, specifically how often such questions ought to be asked of a population. When change in attitude is observed, this study assesses the extent to which individual demographic characteristics, personality traits, and broader societal events predict change.

Keywords: attitudes, longitudinal survey analysis, personality, social values

Procedia PDF Downloads 139
33401 Numerical Simulation of the Air Pollutants Dispersion Emitted by CPH Using ANSYS CFX

Authors: Oliver Mărunţălu, Gheorghe Lăzăroiu, Elena Elisabeta Manea, Dana Andreya Bondrea, Lăcrămioara Diana Robescu

Abstract:

This paper presents the results obtained by numerical simulation of the pollutants dispersion in the atmosphere coming from the evacuation of combustion gases resulting from the fuel combustion used by electric thermal power plant using the software ANSYS CFX-CFD. The model uses the Navier-Stokes equation to simulate the dispersion of pollutants in the atmosphere. We considered as important factors in elaboration of simulation the atmospheric conditions (pressure, temperature, wind speed, wind direction), the exhaust velocity of the combustion gases, chimney height and the obstacles (buildings). Using the air quality monitoring stations we have measured the concentrations of main pollutants (SO2, NOx and PM). The pollutants were monitored over a period of 3 months, after that we calculated the average concentration, which is used by the software. The concentrations are: 8.915 μg/m3 (NOx), 9.587 μg/m3 (SO2) and 42 μg/m3 (PM). A comparison of test data with simulation results demonstrated that CFX was able to describe the dispersion of the pollutant as well the concentration of this pollutants in the atmosphere.

Keywords: air pollutants, computational fluid dynamics, dispersion, simulation

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33400 A National Survey of Clinical Psychology Graduate Student Attitudes toward Psychotherapy Treatment Manuals: A Replication Study

Authors: B. Bergström, A. Ladd, A. Jones, L. Rosso, P. Michael

Abstract:

Attitudes toward treatment manuals serve as a meaningful predictor of general attitudes toward evidence-based practice. Despite demonstrating high effectiveness in treating many mental disorders, manualized treatments have been underutilized by practitioners. Thus, one can assess the state of the field regarding the adoption of evidence-based practices by surveying practitioner attitudes towards manualized treatments. This study is an adapted replication that assesses psychology graduate student attitudes towards manualized treatments, as a general marker for attitudes towards evidence-based practice. Training programs provide future clinicians with the foundation for critical skills in clinical practice. Research demonstrates that post-graduate continuing education has little to no effect on clinical practice; thus, graduate programs serve as the primary, and often final platform for all future practice. However, there are little empirical data identifying the attitudes and training of graduate students in utilizing manualized treatments. The empirical analysis of this study indicates an increase in positive attitudes among graduate student attitudes towards manualized treatments (within the United States), when compared to past surveys of professional psychologists. Findings from this study may inform graduate programs of barriers for students in developing positive attitudes toward manualized treatments and evidence-based practice. This study also serves as a preliminary predictor of the state-of-the field, in regards to professional psychologists attitudes towards evidence-based practice, if attitudes remain stable. This study indicates that the attitudes toward utilizing evidence-based practices, such as treatment manuals, has become more positive since year 2000.

Keywords: exposure therapy, evidence based practice, manualized treatments, student attitudes

Procedia PDF Downloads 165
33399 The Use of Respiratory Index of Severity in Children (RISC) for Predicting Clinical Outcomes for 3 Months-59 Months Old Patients Hospitalized with Community-Acquired Pneumonia in Visayas Community Medical Center, Cebu City from January 2013 - June 2

Authors: Karl Owen L. Suan, Juliet Marie S. Lambayan, Floramay P. Salo-Curato

Abstract:

Objective: To predict the outcome among patients admitted with community-acquired pneumonia (ages 3 months to 59 months old) admitted in Visayas Community Medical Center using the Respiratory Index of Severity in Children (RISC). Design: A cross-sectional study design was used. Setting: The study was done in Visayas Community Medical Center, which is a private tertiary level in Cebu City from January-June 2013. Patients/Participants: A total of 72 patients were initially enrolled in the study. However, 1 patient transferred to another institution, thus 71 patients were included in this study. Within 24 hours from admission, patients were assigned a RISC score. Statistical Analysis: Cohen’s kappa coefficient was used for inter-rater agreement for categorical data. This study used frequency and percentage distribution for qualitative data. Mean, standard deviation and range were used for quantitative data. To determine the relationship of each RISC score parameter and the total RISC score with the outcome, a Mann Whitney U Test and 2x2 Fischer Exact test for testing associations were used. A p value less of than 0.05 alpha was considered significant. Results: There was a statistical significance between RISC score and clinical outcome. RISC score of greater than 4 was correlated with intubation and/or mortality. Conclusion: The RISC scoring system is a simple combination of clinical parameters and a reliable tool that will help stratify patients aged 3 months to 59 months in predicting clinical outcome.

Keywords: RISC, clinical outcome, community-acquired pneumonia, patients

Procedia PDF Downloads 304
33398 Wind Power Forecast Error Simulation Model

Authors: Josip Vasilj, Petar Sarajcev, Damir Jakus

Abstract:

One of the major difficulties introduced with wind power penetration is the inherent uncertainty in production originating from uncertain wind conditions. This uncertainty impacts many different aspects of power system operation, especially the balancing power requirements. For this reason, in power system development planing, it is necessary to evaluate the potential uncertainty in future wind power generation. For this purpose, simulation models are required, reproducing the performance of wind power forecasts. This paper presents a wind power forecast error simulation models which are based on the stochastic process simulation. Proposed models capture the most important statistical parameters recognized in wind power forecast error time series. Furthermore, two distinct models are presented based on data availability. First model uses wind speed measurements on potential or existing wind power plant locations, while the seconds model uses statistical distribution of wind speeds.

Keywords: wind power, uncertainty, stochastic process, Monte Carlo simulation

Procedia PDF Downloads 487
33397 Implementation of a Web-Based Clinical Outcomes Monitoring and Reporting Platform across the Fortis Network

Authors: Narottam Puri, Bishnu Panigrahi, Narayan Pendse

Abstract:

Background: Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from the patient care. Reporting of outcomes and its continuous monitoring provides an opportunity for both assessing and improving the quality of patient care. In 2012, International Consortium Of HealthCare Outcome Measurement (ICHOM) was founded which has defined global Standard Sets for measuring the outcome of various treatments. Method: Monitoring of Clinical Outcomes was identified as a pillar of Fortis’ core value of Patient Centricity. The project was started as an in-house developed Clinical Outcomes Reporting Portal by the Fortis Medical IT team. Standard sets of Outcome measurement developed by ICHOM were used. A pilot was run at Fortis Escorts Heart Institute from Aug’13 – Dec’13.Starting Jan’14, it was implemented across 11 hospitals of the group. The scope was hospital-wide and major clinical specialties: Cardiac Sciences, Orthopedics & Joint Replacement were covered. The internally developed portal had its limitations of report generation and also capturing of Patient related outcomes was restricted. A year later, the company provisioned for an ICHOM Certified Software product which could provide a platform for data capturing and reporting to ensure compliance with all ICHOM requirements. Post a year of the launch of the software; Fortis Healthcare has become the 1st Healthcare Provider in Asia to publish Clinical Outcomes data for the Coronary Artery Disease Standard Set comprising of Coronary Artery Bypass Graft and Percutaneous Coronary Interventions) in the public domain. (Jan 2016). Results: This project has helped in firmly establishing a culture of monitoring and reporting Clinical Outcomes across Fortis Hospitals. Given the diverse nature of the healthcare delivery model at Fortis Network, which comprises of hospitals of varying size and specialty-mix and practically covering the entire span of the country, standardization of data collection and reporting methodology is a huge achievement in itself. 95% case reporting was achieved with more than 90% data completion at the end of Phase 1 (March 2016). Post implementation the group now has one year of data from its own hospitals. This has helped identify the gaps and plan towards ways to bridge them and also establish internal benchmarks for continual improvement. Besides the value created for the group includes: 1. Entire Fortis community has been sensitized on the importance of Clinical Outcomes monitoring for patient centric care. Initial skepticism and cynicism has been countered by effective stakeholder engagement and automation of processes. 2. Measuring quality is the first step in improving quality. Data analysis has helped compare clinical results with best-in-class hospitals and identify improvement opportunities. 3. Clinical fraternity is extremely pleased to be part of this initiative and has taken ownership of the project. Conclusion: Fortis Healthcare is the pioneer in the monitoring of Clinical Outcomes. Implementation of ICHOM standards has helped Fortis Clinical Excellence Program in improving patient engagement and strengthening its commitment to its core value of Patient Centricity. Validation and certification of the Clinical Outcomes data by an ICHOM Certified Supplier adds confidence to its claim of being leaders in this space.

Keywords: clinical outcomes, healthcare delivery, patient centricity, ICHOM

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33396 Architecture Design of the Robots Operability Assessment Simulation Testbed

Authors: Sang Yeong Choi, Woo Sung Park

Abstract:

This paper presents the architecture design of the robot operability assessment simulation testbed (called "ROAST") for the resolution of robot operability problems occurred during interactions between human operators and robots. The basic idea of the ROAST architecture design is to enable the easy composition of legacy or new simulation models according to its purpose. ROAST architecture is based on IEEE1516 High Level Architecture (HLA) of defense modeling and simulation. The ROAST architecture is expected to provide the foundation framework for the easy construction of a simulation testbed to order to assess the robot operability during the robotic system design. Some of ROAST implementations and its usefulness are demonstrated through a simple illustrative example.

Keywords: robotic system, modeling and simulation, simulation architecture, operability assessment

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33395 Development of Management System of the Experience of Defensive Modeling and Simulation by Data Mining Approach

Authors: D. Nam Kim, D. Jin Kim, Jeonghwan Jeon

Abstract:

Defense Defensive Modeling and Simulation (M&S) is a system which enables impracticable training for reducing constraints of time, space and financial resources. The necessity of defensive M&S has been increasing not only for education and training but also virtual fight. Soldiers who are using defensive M&S for education and training will obtain empirical knowledge and know-how. However, the obtained knowledge of individual soldiers have not been managed and utilized yet since the nature of military organizations: confidentiality and frequent change of members. Therefore, this study aims to develop a management system for the experience of defensive M&S based on data mining approach. Since individual empirical knowledge gained through using the defensive M&S is both quantitative and qualitative data, data mining approach is appropriate for dealing with individual empirical knowledge. This research is expected to be helpful for soldiers and military policy makers.

Keywords: data mining, defensive m&s, management system, knowledge management

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33394 Numerical Simulation of the Coal Spontaneous Combustion Dangerous Area in Composite Long-Wall Gobs

Authors: Changshan Zhang, Zhijin Yu, Shixing Fan

Abstract:

A comprehensive hazard evaluation for coal self-heating in composite long-wall gobs is heavily dependent on computational simulation. In this study, the spatial distributions of cracks which caused significant air leakage were simulated by universal distinct element code (UDEC) simulation. Based on the main routes of air leakage and characteristics of coal self-heating, a computational fluid dynamics (CFD) modeling was conducted to model the coal spontaneous combustion dangerous area in composite long-wall gobs. The results included the oxygen concentration distributions and temperature profiles showed that the numerical approach is validated by comparison with the test data. Furthermore, under the conditions of specific engineering, the major locations where some techniques for extinguishing and preventing long-wall gob fires need to be put into practice were also examined.

Keywords: computational simulation, UDEC simulation, coal self-heating, CFD modeling, long-wall gobs

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33393 Simulation of a Cost Model Response Requests for Replication in Data Grid Environment

Authors: Kaddi Mohammed, A. Benatiallah, D. Benatiallah

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Data grid is a technology that has full emergence of new challenges, such as the heterogeneity and availability of various resources and geographically distributed, fast data access, minimizing latency and fault tolerance. Researchers interested in this technology address the problems of the various systems related to the industry such as task scheduling, load balancing and replication. The latter is an effective solution to achieve good performance in terms of data access and grid resources and better availability of data cost. In a system with duplication, a coherence protocol is used to impose some degree of synchronization between the various copies and impose some order on updates. In this project, we present an approach for placing replicas to minimize the cost of response of requests to read or write, and we implement our model in a simulation environment. The placement techniques are based on a cost model which depends on several factors, such as bandwidth, data size and storage nodes.

Keywords: response time, query, consistency, bandwidth, storage capacity, CERN

Procedia PDF Downloads 275
33392 The Role Of Data Gathering In NGOs

Authors: Hussaini Garba Mohammed

Abstract:

Background/Significance: The lack of data gathering is affecting NGOs world-wide in general to have good data information about educational and health related issues among communities in any country and around the world. For example, HIV/AIDS smoking (Tuberculosis diseases) and COVID-19 virus carriers is becoming a serious public health problem, especially among old men and women. But there is no full details data survey assessment from communities, villages, and rural area in some countries to show the percentage of victims and patients, especial with this world COVID-19 virus among the people. These data are essential to inform programming targets, strategies, and priorities in getting good information about data gathering in any society.

Keywords: reliable information, data assessment, data mining, data communication

Procedia PDF Downloads 183
33391 Role of Discrete Event Simulation in the Assessment and Selection of the Potential Reconfigurable Manufacturing Solutions

Authors: Mohsin Raza, Arne Bilberg, Thomas Ditlev Brunø, Ann-Louise Andersen, Filip SKärin

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Shifting from a dedicated or flexible manufacturing system to a reconfigurable manufacturing system (RMS) requires a significant amount of time, money, and effort. Therefore, it is vital to verify beforehand that the potential reconfigurable solution will be able to achieve the organizational objectives. Discrete event simulation offers the opportunity of assessing several reconfigurable alternatives against the set objectives. This study signifies the importance of using discrete-event simulation as a tool to verify several reconfiguration options. Two different industrial cases have been presented in the study to elaborate on the role of discrete event simulation in the implementation methodology of RMSs. The study concluded that discrete event simulation is one of the important tools to consider in the RMS implementation methodology.

Keywords: reconfigurable manufacturing system, discrete event simulation, Tecnomatix plant simulation, RMS

Procedia PDF Downloads 127
33390 The Effect of Outliers on the Economic and Social Survey on Income and Living Conditions

Authors: Encarnación Álvarez, Rosa M. García-Fernández, Francisco J. Blanco-Encomienda, Juan F. Muñoz

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The European Union Survey on Income and Living Conditions (EU-SILC) is a popular survey which provides information on income, poverty, social exclusion and living conditions of households and individuals in the European Union. The EUSILC contains variables which may contain outliers. The presence of outliers can have an impact on the measures and indicators used by the EU-SILC. In this paper, we used data sets from various countries to analyze the presence of outliers. In addition, we obtain some indicators after removing these outliers, and a comparison between both situations can be observed. Finally, some conclusions are obtained.

Keywords: poverty line, headcount index, risk of poverty, skewness coefficient

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33389 Visual Simulation for the Relationship of Urban Fabric

Authors: Ting-Yu Lin, Han-Liang Lin

Abstract:

This article is about the urban form of visualization by Cityengine. City is composed of different domains, and each domain has its own fabric because of arrangement. For example, a neighborhood unit contains fabrics such as schools, street networks, residential and commercial spaces. Therefore, studying urban morphology can help us understand the urban form in planning process. Streets, plots, and buildings seem as urban fabrics, and they configure urban form. Traditionally, urban morphology usually discussed single parameter, which is building type, ignoring other parameters such as streets and plots. However, urban space is three-dimensional, instead of two-dimensional. People perceive urban space by their visualization. Therefore, using visualization can fill the gap between two dimensions and three dimensions. Hence, the study of urban morphology will strengthen the understanding of whole appearance of a city. Cityengine is a software which can edit, analyze and monitor the data and visualize the result for GIS, a common tool to analyze data and display the map for urban plan and urban design. Cityengine can parameterize the data of streets, plots and building types and visualize the result in three-dimensional way. The research will reappear the real urban form by visualizing. We can know whether the urban form can be parameterized and the parameterized result can match the real urban form. Then, visualizing the result by software in three dimension to analyze the rule of urban form. There will be three stages of the research. It will start with a field survey of Tainan East District in Taiwan to conclude the relationships between urban fabrics of street networks, plots and building types. Second, to visualize the relationship, it will turn the relationship into codes which Cityengine can read. Last, Cityengine will automatically display the result by visualizing.

Keywords: Cityengine, urban fabric, urban morphology, visual simulation

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33388 An Insite to the Probabilistic Assessment of Reserves in Conventional Reservoirs

Authors: Sai Sudarshan, Harsh Vyas, Riddhiman Sherlekar

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The oil and gas industry has been unwilling to adopt stochastic definition of reserves. Nevertheless, Monte Carlo simulation methods have gained acceptance by engineers, geoscientists and other professionals who want to evaluate prospects or otherwise analyze problems that involve uncertainty. One of the common applications of Monte Carlo simulation is the estimation of recoverable hydrocarbon from a reservoir.Monte Carlo Simulation makes use of random samples of parameters or inputs to explore the behavior of a complex system or process. It finds application whenever one needs to make an estimate, forecast or decision where there is significant uncertainty. First, the project focuses on performing Monte-Carlo Simulation on a given data set using U. S Department of Energy’s MonteCarlo Software, which is a freeware e&p tool. Further, an algorithm for simulation has been developed for MATLAB and program performs simulation by prompting user for input distributions and parameters associated with each distribution (i.e. mean, st.dev, min., max., most likely, etc.). It also prompts user for desired probability for which reserves are to be calculated. The algorithm so developed and tested in MATLAB further finds implementation in Python where existing libraries on statistics and graph plotting have been imported to generate better outcome. With PyQt designer, codes for a simple graphical user interface have also been written. The graph so plotted is then validated with already available results from U.S DOE MonteCarlo Software.

Keywords: simulation, probability, confidence interval, sensitivity analysis

Procedia PDF Downloads 387
33387 Endodontic Pretreatments, Clinical Opportunities and Challenges

Authors: Ilma Robo, Manola Kelmendi, Saimir Heta, Megi Tafa, Vera Ostreni

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Preservation of a natural tooth, even if endodontically treated, is more indicated than its replacement with an artificial tooth placed in prosthetic ways or with implant treatment. It is known how technology and endodontic treatment procedures have evolved significantly. It is also known that significant developments have been made in both dental prostheses and implant treatments, and again, in both specialties, it is emphasized that both the tooth placed with dental prostheses and the tooth placed with implant treatment cannot replace the natural tooth. The issue is whether long-term periapical tissue healing is achieved after a successful endodontic treatment, and for this, clinical data should be collected. In the cases when the apical closure or "apical filling" with the endodontic filling was carried out correctly clinically, but for various reasons, the healing of the periapical tissues did not occur, but also for those cases when the endodontic treatment did not reach the "apical filling" of the root canal. Teeth Endodontic retreatments have their clinical difficulty, but knowing the reason why endodontic treatment success has not been achieved clinically, the clinical endodontic approach is easier. In this process, it is important for the dentist to recognize the clinical and radiographic signs of persistent apical periodontitis or renewed apical periodontitis. After this initial procedure, dentists must know and evaluate the possibility of clinical endodontic retreatment by reporting, not precisely, but with very approximate values, the percentage of clinical success of endodontic retreatment. Depending on the reason for the performance, endodontic re-treatment may also need more specialized equipment or tools, for which even the professional who undertakes the re-treatment must be equipped with the relevant knowledge of their use and clinical application. Evaluating the clinical success of endodontic re-treatment is actually a more difficult process and requires more clinical responsibility since it must be considered that the initial treatment was performed by the same specialist as the specialist who undertakes the same endodontic re-treatment. Tooth So, the clinical endodontic re-treatment of a tooth should not be seen as a fund of clinical practice only of a good successful endodontist, but as part of routine endodontic treatments, nor should it be seen as a typical case where the tools and the most advanced technological devices in the endodontic field. So, the clinical picture of endodontic re-treatments offers the possibility of finding endodontic malpractice, the possibility of more accurate assessment of dental morphological anomalies, and above all, the cognitive and professional possibilities of the diagnosis of persistent apical periodontitis. This study offers the possibility of evaluating these three directions by presenting in numbers and in percentage the frequency of the reasons why the endodontic success of the root canal treatment is not always achieved.

Keywords: apical periodontitis, clinical susccess, endodontics, E.faecalis

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33386 The Impact of ChatGPT on the Healthcare Domain: Perspectives from Healthcare Majors

Authors: Su Yen Chen

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ChatGPT has shown both strengths and limitations in clinical, educational, and research settings, raising important concerns about accuracy, transparency, and ethical use. Despite an improved understanding of user acceptance and satisfaction, there is still a gap in how general AI perceptions translate into practical applications within healthcare. This study focuses on examining the perceptions of ChatGPT's impact among 266 healthcare majors in Taiwan, exploring its implications for their career development, as well as its utility in clinical practice, medical education, and research. By employing a structured survey with precisely defined subscales, this research aims to probe the breadth of ChatGPT's applications within healthcare, assessing both the perceived benefits and the challenges it presents. Additionally, to further enhance the comprehensiveness of our methodology, we have incorporated qualitative data collection methods, which provide complementary insights to the quantitative findings. The findings from the survey reveal that perceptions and usage of ChatGPT among healthcare majors vary significantly, influenced by factors such as its perceived utility, risk, novelty, and trustworthiness. Graduate students and those who perceive ChatGPT as more beneficial and less risky are particularly inclined to use it more frequently. This increased usage is closely linked to significant impacts on personal career development. Furthermore, ChatGPT's perceived usefulness and novelty contribute to its broader impact within the healthcare domain, suggesting that both innovation and practical utility are key drivers of acceptance and perceived effectiveness in professional healthcare settings. Trust emerges as an important factor, especially in clinical settings where the stakes are high. The trust that healthcare professionals place in ChatGPT significantly affects its integration into clinical practice and influences outcomes in medical education and research. The reliability and practical value of ChatGPT are thus critical for its successful adoption in these areas. However, an interesting paradox arises with regard to the ease of use. While making ChatGPT more user-friendly is generally seen as beneficial, it also raises concerns among users who have lower levels of trust and perceive higher risks associated with its use. This complex interplay between ease of use and safety concerns necessitates a careful balance, highlighting the need for robust security measures and clear, transparent communication about how AI systems work and their limitations. The study suggests several strategic approaches to enhance the adoption and integration of AI in healthcare. These include targeted training programs for healthcare professionals to increase familiarity with AI technologies, reduce perceived risks, and build trust. Ensuring transparency and conducting rigorous testing are also vital to foster trust and reliability. Moreover, comprehensive policy frameworks are needed to guide the implementation of AI technologies, ensuring high standards of patient safety, privacy, and ethical use. These measures are crucial for fostering broader acceptance of AI in healthcare, as the study contributes to enriching the discourse on AI's role by detailing how various factors affect its adoption and impact.

Keywords: ChatGPT, healthcare, survey study, IT adoption, behaviour, applcation, concerns

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33385 An Agent-Based Modeling and Simulation of Human Muscle

Authors: Sina Saadati, Mohammadreza Razzazi

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In this article, we have tried to present an agent-based model of human muscle. A suitable model of muscle is necessary for the analysis of mankind's movements. It can be used by clinical researchers who study the influence of motion sicknesses, like Parkinson's disease. It is also useful in the development of a prosthesis that receives the electromyography signals and generates force as a reaction. Since we have focused on computational efficiency in this research, the model can compute the calculations very fast. As far as it concerns prostheses, the model can be known as a charge-efficient method. In this paper, we are about to illustrate an agent-based model. Then, we will use it to simulate the human gait cycle. This method can also be done reversely in the analysis of gait in motion sicknesses.

Keywords: agent-based modeling and simulation, human muscle, gait cycle, motion sickness

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33384 Capability of Intelligent Techniques for Friction Factor Simulation in Water Channels

Authors: Kiyoumars Roushangar, Shabnam Mirheidarian

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This study proposes metamodel approaches as a new intelligent technique for the explicit formulation of friction factors of water conveyance structures. For this purpose, experimental data of a movable bed flume with dune bed form were used. Analyzing the result clears the high capability of metamodel approaches (MNE= 0.05, R= 0.92) as a powerful tool for optimizing and explicit simulation of Manning's roughness coefficients of water conveyance structures compared to other nonlinear approaches.

Keywords: intelligent techniques, explicit simulation, roughness coefficient, water conveyance structure

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33383 M-Number of Aortic Cannulas Applied During Hypothermic Cardiopulmonary Bypass

Authors: Won-Gon Kim

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A standardized system to describe the pressure-flow characteristics of a given cannula has recently been proposed and has been termed ‘the M-number’. Using three different sizes of aortic cannulas in 50 pediatric cardiac patients on hypothermic cardiopulmonary bypass, we analyzed the correlation between experimentally and clinically derived M-numbers, and found this was positive. Clinical M-numbers were typically 0.35 to 0.55 greater than experimental M-numbers, and correlated inversely with a patient's temperature change; this was most probably due to increased blood viscosity, arising from hypothermia. This inverse relationship was more marked in higher M-number cannulas. The clinical data obtained in this study suggest that experimentally derived M-numbers correlate strongly with clinical performance of the cannula, and that the influence of temperature is significant.

Keywords: cardiopulmonary bypass, M-number, aortic cannula, pressure-flow characteristics

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33382 Botulism Clinical Experience and Update

Authors: Kevin Yeo, Christine Hall, Babinchak Tim

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

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

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33381 Implementation of an Accessible State-Wide Trauma Education Program

Authors: Christine Lassen, Elizabeth Leonard, Matthew Oliver

Abstract:

The management of trauma is often complex and outcomes dependent on clinical expertise, effective teamwork, and a supported trauma system. The implementation of a statewide trauma education program should be accessible to all clinicians who manage trauma, but this can be challenging due to diverse individual needs, trauma service needs and geography. The NSW Institute of Trauma and Injury Management (ITIM) is a government funded body, responsible for coordinating and supporting the NSW Trauma System. The aim of this presentation is to describe how education initiatives have been implemented across the state. Simulation: In 2006, ITIM developed a Trauma Team Training Course - aimed to educate clinicians on the technical and non-technical skills required to manage trauma. The course is now independently coordinated by trauma services across the state at major trauma centres as well as in regional and rural hospitals. ITIM is currently in the process of re-evaluating and updating the Trauma Team Training Course to allow for the development of new resources and simulation scenarios. Trauma Education Evenings: In 2013, ITIM supported major trauma services to develop trauma education evenings which allowed the provision of free education to staff within the area health service and local area. The success of these local events expanded to regional hospitals. A total of 75 trauma education evenings have been conducted within NSW, with over 10,000 attendees. Wed-Based Resources: Recently, ITIM commenced free live streaming of the trauma education evenings which have now had over 3000 live views. The Trauma App developed in 2015 provides trauma clinicians with a centralised portal for trauma information and works on smartphones and tablets that integrate with the ITIM website. This supports pre-hospital and bedside clinical decisions and allows for trauma care to be more standardised, evidence-based, timely, and appropriate. Online e-Learning modules have been developed to assist clinicians, reduce unwarranted clinical variation and provide up to date evidence based education. The modules incorporate clinically focused education content with summative and formative assessments. Conclusion: Since 2005, ITIM has helped to facilitate the development of trauma education programs for doctors, nurses, pre-hospital and allied health clinicians. ITIM has been actively involved in more than 100 specialized trauma education programs, seminars and clinical workshops - attended by over 12,000 staff. The provision of state-wide trauma education is a challenging task requiring collaboration amongst numerous agencies working towards a common goal – to provide easily accessible trauma education.

Keywords: education, simulation, team-training, trauma

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33380 Effect of Implementing a Teaching Module about Diet and Exercises on Clinical Outcomes of Patients with Gout

Authors: Wafaa M. El- Kotb, Soheir Mohamed Weheida, Manal E. Fareed

Abstract:

The aim of this study was to determine the effect of implementing a teaching module about diet and exercises on clinical outcomes of patients with gout. Subjects: A purposive sample of 60 adult gouty patients was selected and randomly and alternatively divided into two equal groups 30 patients in each. Setting: The study was conducted in orthopedic out patient's clinic of Menoufia University. Tools of the study: Three tools were utilized for data collection: Knowledge assessment structured interview questionnaire, Clinical manifestation assessment tools and Nutritional assessment sheet. Results: All patients of both groups (100 %) had poor total knowledge score pre teaching, while 90 % of the study group had good total knowledge score post teaching by three months compared to 3.3 % of the control group. Moreover the recovery outcomes were significantly improved among study group compared to control group post teaching. Conclusion: Teaching study group about diet and exercises significantly improved their clinical outcomes. Recommendation: Patient's education about diet and exercises should be ongoing process for patients with gout.

Keywords: clinical outcomes, diet, exercises, teaching module

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33379 Three Dimensional Large Eddy Simulation of Blood Flow and Deformation in an Elastic Constricted Artery

Authors: Xi Gu, Guan Heng Yeoh, Victoria Timchenko

Abstract:

In the current work, a three-dimensional geometry of a 75% stenosed blood vessel is analysed. Large eddy simulation (LES) with the help of a dynamic subgrid scale Smagorinsky model is applied to model the turbulent pulsatile flow. The geometry, the transmural pressure and the properties of the blood and the elastic boundary were based on clinical measurement data. For the flexible wall model, a thin solid region is constructed around the 75% stenosed blood vessel. The deformation of this solid region was modelled as a deforming boundary to reduce the computational cost of the solid model. Fluid-structure interaction is realised via a two-way coupling between the blood flow modelled via LES and the deforming vessel. The information of the flow pressure and the wall motion was exchanged continually during the cycle by an arbitrary lagrangian-eulerian method. The boundary condition of current time step depended on previous solutions. The fluctuation of the velocity in the post-stenotic region was analysed in the study. The axial velocity at normalised position Z=0.5 shows a negative value near the vessel wall. The displacement of the elastic boundary was concerned in this study. In particular, the wall displacement at the systole and the diastole were compared. The negative displacement at the stenosis indicates a collapse at the maximum velocity and the deceleration phase.

Keywords: Large Eddy Simulation, Fluid Structural Interaction, constricted artery, Computational Fluid Dynamics

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33378 Clinical and Laboratory Diagnosis of Malaria in Surat Thani, Southern Thailand

Authors: Manas Kotepui, Chatree Ratcha, Kwuntida Uthaisar

Abstract:

Malaria infection is still to be considered a major public health problem in Thailand. This study, a retrospective data of patients in Surat Thani Province, Southern Thailand during 2012-2015 was retrieved and analyzed. These data include demographic data, clinical characteristics and laboratory diagnosis. Statistical analyses were performed to demonstrate the frequency, proportion, data tendency, and group comparisons. Total of 395 malaria patients were found. Most of patients were male (253 cases, 64.1%). Most of patients (262 cases, 66.3%) were admitted at 6 am-11.59 am of the day. Three hundred and fifty-five patients (97.5%) were positive with P. falciparum. Hemoglobin, hematocrit, and MCHC between P. falciparum and P. vivax were significant different (P value<0.05).During 2012-2015, prevalence of malaria was highest in 2013. Neutrophils, lymphocytes, and monocytes were significantly changed among patients with fever ≤ 3 days compared with patients with fever >3 days. This information will guide to understanding pathogenesis and characteristic of malaria infection in Sothern Thailand.

Keywords: prevalence, malaria, Surat Thani, Thailand

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33377 Counseling Ethics in Turkish Counseling Programs

Authors: Umut Arslan, John Sommers Flanagan

Abstract:

The purpose of this study was to investigate qualifications of ethics training in counselor education programs in Turkey. The survey data were collected from 251 Turkish counseling students to examine differences in ethical judgments between freshmen and seniors. Chi-square analysis was used to analyze the data from an ethical practice and belief survey. This survey was used to assess counselor candidates’ ethical judgments regarding Turkish counseling ethical codes and sources of ethics information. Statistically significant differences were found between university seniors and freshmen on items that are related to confidentiality, dual relationships, and professional relationships. Furthermore, patterns based on demographic information showed significant differences as a result of gender, economic status, and parents’ educational level. Participants gave the highest rating of information sources to Turkish counseling ethical codes.

Keywords: ethics, training, Turkey, counselor, education

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33376 VISSIM Modeling of Driver Behavior at Connecticut Roundabouts

Authors: F. Clara Fang, Hernan Castaneda

Abstract:

The Connecticut Department of Transportation (ConnDOT) has constructed four roundabouts in the State of Connecticut within the past ten years. VISSIM traffic simulation software was utilized to analyze these roundabouts during their design phase. The queue length and level of service observed in the field appear to be better than predicted by the VISSIM model. The objectives of this project are to: identify VISSIM input variables most critical to accurate modeling; recommend VISSIM calibration factors; and, provide other recommendations for roundabout traffic operations modeling. Traffic data were collected at these roundabouts using Miovision Technologies. Cameras were set up to capture vehicle circulating activity and entry behavior for two weekdays. A large sample size of filed data was analyzed to achieve accurate and statistically significant results. The data extracted from the videos include: vehicle circulating speed; critical gap estimated by Maximum Likelihood Method; peak hour volume; follow-up headway; travel time; and, vehicle queue length. A VISSIM simulation of existing roundabouts was built to compare both queue length and travel time predicted from simulation with measured in the field. The research investigated a variety of simulation parameters as calibration factors for describing driver behaviors at roundabouts. Among them, critical gap is the most effective calibration variable in roundabout simulation. It has a significant impact to queue length, particularly when the volume is higher. The results will improve the design of future roundabouts in Connecticut and provide decision makers with insights on the relationship between various choices and future performance.

Keywords: driver critical gap, roundabout analysis, simulation, VISSIM modeling

Procedia PDF Downloads 293