Search results for: medical errors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4141

Search results for: medical errors

3931 A Numerical Investigation of Total Temperature Probes Measurement Performance

Authors: Erdem Meriç

Abstract:

Measuring total temperature of air flow accurately is a very important requirement in the development phases of many industrial products, including gas turbines and rockets. Thermocouples are very practical devices to measure temperature in such cases, but in high speed and high temperature flows, the temperature of thermocouple junction may deviate considerably from real flow total temperature due to the effects of heat transfer mechanisms of convection, conduction, and radiation. To avoid errors in total temperature measurement, special probe designs which are experimentally characterized are used. In this study, a validation case which is an experimental characterization of a specific class of total temperature probes is selected from the literature to develop a numerical conjugate heat transfer analysis methodology to study the total temperature probe flow field and solid temperature distribution. Validated conjugate heat transfer methodology is used to investigate flow structures inside and around the probe and effects of probe design parameters like the ratio between inlet and outlet hole areas and prob tip geometry on measurement accuracy. Lastly, a thermal model is constructed to account for errors in total temperature measurement for a specific class of probes in different operating conditions. Outcomes of this work can guide experimentalists to design a very accurate total temperature probe and quantify the possible error for their specific case.

Keywords: conjugate heat transfer, recovery factor, thermocouples, total temperature probes

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3930 I Don’t Want to Have to Wait: A Study Into the Origins of Rule Violations at Rail Pedestrian Level Crossings

Authors: James Freeman, Andry Rakotonirainy

Abstract:

Train pedestrian collisions are common and are the most likely to result in severe injuries and fatalities when compared to other types of rail crossing accidents. However, there is limited research that has focused on understanding the reasons why some pedestrians’ break level crossings rules, which limits the development of effective countermeasures. As a result, this study undertook a deeper exploration into the origins of risky pedestrian behaviour through structured interviews. A total of 40 pedestrians who admitted to either intentionally breaking crossing rules or making crossing errors participated in an in-depth telephone interview. Qualitative analysis was undertaken via thematic analysis that revealed participants were more likely to report deliberately breaking rules (rather than make errors), particular after the train had passed the crossing as compared to before it arrives. Predominant reasons for such behaviours were identified to be: calculated risk taking, impatience, poor knowledge of rules and low likelihood of detection. The findings have direct implications for the development of effective countermeasures to improve crossing safety (and managing risk) such as increasing surveillance and transit officer presence, as well as installing appropriate barriers that either deter or incapacitate pedestrians from violating crossing rules. This paper will further outline the study findings in regards to the development of countermeasures as well as provide direction for future research efforts in this area.

Keywords: crossings, mistakes, risk, violations

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3929 Estimation of the Road Traffic Emissions and Dispersion in the Developing Countries Conditions

Authors: Hicham Gourgue, Ahmed Aharoune, Ahmed Ihlal

Abstract:

We present in this work our model of road traffic emissions (line sources) and dispersion of these emissions, named DISPOLSPEM (Dispersion of Poly Sources and Pollutants Emission Model). In its emission part, this model was designed to keep the consistent bottom-up and top-down approaches. It also allows to generate emission inventories from reduced input parameters being adapted to existing conditions in Morocco and in the other developing countries. While several simplifications are made, all the performance of the model results are kept. A further important advantage of the model is that it allows the uncertainty calculation and emission rate uncertainty according to each of the input parameters. In the dispersion part of the model, an improved line source model has been developed, implemented and tested against a reference solution. It provides improvement in accuracy over previous formulas of line source Gaussian plume model, without being too demanding in terms of computational resources. In the case study presented here, the biggest errors were associated with the ends of line source sections; these errors will be canceled by adjacent sections of line sources during the simulation of a road network. In cases where the wind is parallel to the source line, the use of the combination discretized source and analytical line source formulas minimizes remarkably the error. Because this combination is applied only for a small number of wind directions, it should not excessively increase the calculation time.

Keywords: air pollution, dispersion, emissions, line sources, road traffic, urban transport

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3928 Clinical Validation of an Automated Natural Language Processing Algorithm for Finding COVID-19 Symptoms and Complications in Patient Notes

Authors: Karolina Wieczorek, Sophie Wiliams

Abstract:

Introduction: Patient data is often collected in Electronic Health Record Systems (EHR) for purposes such as providing care as well as reporting data. This information can be re-used to validate data models in clinical trials or in epidemiological studies. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. Mentioning a disease in a discharge letter does not necessarily mean that a patient suffers from this disease. Many of them discuss a diagnostic process, different tests, or discuss whether a patient has a certain disease. The COVID-19 dataset in this study used natural language processing (NLP), an automated algorithm which extracts information related to COVID-19 symptoms, complications, and medications prescribed within the hospital. Free-text patient clinical patient notes are rich sources of information which contain patient data not captured in a structured form, hence the use of named entity recognition (NER) to capture additional information. Methods: Patient data (discharge summary letters) were exported and screened by an algorithm to pick up relevant terms related to COVID-19. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. A list of 124 Systematized Nomenclature of Medicine (SNOMED) Clinical Terms has been provided in Excel with corresponding IDs. Two independent medical student researchers were provided with a dictionary of SNOMED list of terms to refer to when screening the notes. They worked on two separate datasets called "A” and "B”, respectively. Notes were screened to check if the correct term had been picked-up by the algorithm to ensure that negated terms were not picked up. Results: Its implementation in the hospital began on March 31, 2020, and the first EHR-derived extract was generated for use in an audit study on June 04, 2020. The dataset has contributed to large, priority clinical trials (including International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) by bulk upload to REDcap research databases) and local research and audit studies. Successful sharing of EHR-extracted datasets requires communicating the provenance and quality, including completeness and accuracy of this data. The results of the validation of the algorithm were the following: precision (0.907), recall (0.416), and F-score test (0.570). Percentage enhancement with NLP extracted terms compared to regular data extraction alone was low (0.3%) for relatively well-documented data such as previous medical history but higher (16.6%, 29.53%, 30.3%, 45.1%) for complications, presenting illness, chronic procedures, acute procedures respectively. Conclusions: This automated NLP algorithm is shown to be useful in facilitating patient data analysis and has the potential to be used in more large-scale clinical trials to assess potential study exclusion criteria for participants in the development of vaccines.

Keywords: automated, algorithm, NLP, COVID-19

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3927 A Review on the Re-Usage of Single-Use Medical Devices

Authors: Lucas B. Naves, Maria José Abreu

Abstract:

Reprocessing single-use device has attracted interesting on the medical environment over the last decades. The reprocessing technique was sought in order to reduce the cost of purchasing the new medical device, which can achieve almost double of the price of the reprocessed product. In this manuscript, we have done a literature review, aiming the reuse of medical device that was firstly designed for single use only, but has become, more and more, effective on its reprocessing procedure. We also show the regulation, the countries which allows this procedure, the classification of these device and also the most important issue concerning the re-utilization of medical device, how to minimizing the risk of gram positive and negative bacteria, avoid cross-contamination, hepatitis B (HBV), and C (HCV) virus, and also human immunodeficiency virus (HIV).

Keywords: reusing, reprocessing, single-use medical device, HIV, hepatitis B and C

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3926 Estimation of Normalized Glandular Doses Using a Three-Layer Mammographic Phantom

Authors: Kuan-Jen Lai, Fang-Yi Lin, Shang-Rong Huang, Yun-Zheng Zeng, Po-Chieh Hsu, Jay Wu

Abstract:

The normalized glandular dose (DgN) estimates the energy deposition of mammography in clinical practice. The Monte Carlo simulations frequently use uniformly mixed phantom for calculating the conversion factor. However, breast tissues are not uniformly distributed, leading to errors of conversion factor estimation. This study constructed a three-layer phantom to estimated more accurate of normalized glandular dose. In this study, MCNP code (Monte Carlo N-Particles code) was used to create the geometric structure. We simulated three types of target/filter combinations (Mo/Mo, Mo/Rh, Rh/Rh), six voltages (25 ~ 35 kVp), six HVL parameters and nine breast phantom thicknesses (2 ~ 10 cm) for the three-layer mammographic phantom. The conversion factor for 25%, 50% and 75% glandularity was calculated. The error of conversion factors compared with the results of the American College of Radiology (ACR) was within 6%. For Rh/Rh, the difference was within 9%. The difference between the 50% average glandularity and the uniform phantom was 7.1% ~ -6.7% for the Mo/Mo combination, voltage of 27 kVp, half value layer of 0.34 mmAl, and breast thickness of 4 cm. According to the simulation results, the regression analysis found that the three-layer mammographic phantom at 0% ~ 100% glandularity can be used to accurately calculate the conversion factors. The difference in glandular tissue distribution leads to errors of conversion factor calculation. The three-layer mammographic phantom can provide accurate estimates of glandular dose in clinical practice.

Keywords: Monte Carlo simulation, mammography, normalized glandular dose, glandularity

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3925 Neuropsychological Aspects in Adolescents Victims of Sexual Violence with Post-Traumatic Stress Disorder

Authors: Fernanda Mary R. G. Da Silva, Adriana C. F. Mozzambani, Marcelo F. Mello

Abstract:

Introduction: Sexual assault against children and adolescents is a public health problem with serious consequences on their quality of life, especially for those who develop post-traumatic stress disorder (PTSD). The broad literature in this research area points to greater losses in verbal learning, explicit memory, speed of information processing, attention and executive functioning in PTSD. Objective: To compare the neuropsychological functions of adolescents from 14 to 17 years of age, victims of sexual violence with PTSD with those of healthy controls. Methodology: Application of a neuropsychological battery composed of the following subtests: WASI vocabulary and matrix reasoning; Digit subtests (WISC-IV); verbal auditory learning test RAVLT; Spatial Span subtest of the WMS - III scale; abbreviated version of the Wisconsin test; concentrated attention test - D2; prospective memory subtest of the NEUPSILIN scale; five-digit test - FDT and the Stroop test (Trenerry version) in adolescents with a history of sexual violence in the previous six months, referred to the Prove (Violence Care and Research Program of the Federal University of São Paulo), for further treatment. Results: The results showed a deficit in the word coding process in the RAVLT test, with impairment in A3 (p = 0.004) and A4 (p = 0.016) measures, which compromises the verbal learning process (p = 0.010) and the verbal recognition memory (p = 0.012), seeming to present a worse performance in the acquisition of verbal information that depends on the support of the attentional system. A worse performance was found in list B (p = 0.047), a lower priming effect p = 0.026, that is, lower evocation index of the initial words presented and less perseveration (p = 0.002), repeated words. Therefore, there seems to be a failure in the creation of strategies that help the mnemonic process of retention of the verbal information necessary for learning. Sustained attention was found to be impaired, with greater loss of setting in the Wisconsin test (p = 0.023), a lower rate of correct responses in stage C of the Stroop test (p = 0.023) and, consequently, a higher index of erroneous responses in C of the Stroop test (p = 0.023), besides more type II errors in the D2 test (p = 0.008). A higher incidence of total errors was observed in the reading stage of the FDT test p = 0.002, which suggests fatigue in the execution of the task. Performance is compromised in executive functions in the cognitive flexibility ability, suggesting a higher index of total errors in the alternating step of the FDT test (p = 0.009), as well as a greater number of persevering errors in the Wisconsin test (p = 0.004). Conclusion: The data from this study suggest that sexual violence and PTSD cause significant impairment in the neuropsychological functions of adolescents, evidencing risk to quality of life in stages that are fundamental for the development of learning and cognition.

Keywords: adolescents, neuropsychological functions, PTSD, sexual violence

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3924 Melanoma and Non-Melanoma, Skin Lesion Classification, Using a Deep Learning Model

Authors: Shaira L. Kee, Michael Aaron G. Sy, Myles Joshua T. Tan, Hezerul Abdul Karim, Nouar AlDahoul

Abstract:

Skin diseases are considered the fourth most common disease, with melanoma and non-melanoma skin cancer as the most common type of cancer in Caucasians. The alarming increase in Skin Cancer cases shows an urgent need for further research to improve diagnostic methods, as early diagnosis can significantly improve the 5-year survival rate. Machine Learning algorithms for image pattern analysis in diagnosing skin lesions can dramatically increase the accuracy rate of detection and decrease possible human errors. Several studies have shown the diagnostic performance of computer algorithms outperformed dermatologists. However, existing methods still need improvements to reduce diagnostic errors and generate efficient and accurate results. Our paper proposes an ensemble method to classify dermoscopic images into benign and malignant skin lesions. The experiments were conducted using the International Skin Imaging Collaboration (ISIC) image samples. The dataset contains 3,297 dermoscopic images with benign and malignant categories. The results show improvement in performance with an accuracy of 88% and an F1 score of 87%, outperforming other existing models such as support vector machine (SVM), Residual network (ResNet50), EfficientNetB0, EfficientNetB4, and VGG16.

Keywords: deep learning - VGG16 - efficientNet - CNN – ensemble – dermoscopic images - melanoma

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3923 Postpartum Depression and Its Association with Food Insecurity and Social Support among Women in Post-Conflict Northern Uganda

Authors: Kimton Opiyo, Elliot M. Berry, Patil Karamchand, Barnabas K. Natamba

Abstract:

Background: Postpartum depression (PPD) is a major psychiatric disorder that affects women soon after birth and in some cases, is a continuation of antenatal depression. Food insecurity (FI) and social support (SS) are known to be associated with major depressive disorder, and vice versa. This study was conducted to examine the interrelationships among FI, SS, and PPD among postpartum women in Gulu, a post-conflict region in Uganda. Methods: Cross-sectional data from postpartum women on depression symptoms, FI and SS were, respectively, obtained using the Center for Epidemiologic Studies-Depression (CES-D) scale, Individually Focused FI Access scale (IFIAS) and Duke-UNC functional social support scale. Standard regression methods were used to assess associations among FI, SS, and PPD. Results: A total of 239 women were studied, and 40% were found to have any PPD, i.e., with depressive symptom scores of ≥ 17. The mean ± standard deviation (SD) for FI score and SS scores were 6.47 ± 5.02 and 19.11 ± 4.23 respectively. In adjusted analyses, PPD symptoms were found to be positively associated with FI (unstandardized beta and standardized beta of 0.703 and 0.432 respectively, standard errors =0.093 and p-value < 0.0001) and negatively associated with SS (unstandardized beta and standardized beta of -0.263 and -0.135 respectively, standard errors = 0.111 and p-value = 0.019). Conclusions: Many women in this post-conflict region reported experiencing PPD. In addition, this data suggest that food security and psychosocial support interventions may help mitigate women’s experience of PPD or its severity.

Keywords: postpartum depression, food insecurity, social support, post-conflict region

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3922 Constructions of Linear and Robust Codes Based on Wavelet Decompositions

Authors: Alla Levina, Sergey Taranov

Abstract:

The classical approach to the providing noise immunity and integrity of information that process in computing devices and communication channels is to use linear codes. Linear codes have fast and efficient algorithms of encoding and decoding information, but this codes concentrate their detect and correct abilities in certain error configurations. To protect against any configuration of errors at predetermined probability can robust codes. This is accomplished by the use of perfect nonlinear and almost perfect nonlinear functions to calculate the code redundancy. The paper presents the error-correcting coding scheme using biorthogonal wavelet transform. Wavelet transform applied in various fields of science. Some of the wavelet applications are cleaning of signal from noise, data compression, spectral analysis of the signal components. The article suggests methods for constructing linear codes based on wavelet decomposition. For developed constructions we build generator and check matrix that contain the scaling function coefficients of wavelet. Based on linear wavelet codes we develop robust codes that provide uniform protection against all errors. In article we propose two constructions of robust code. The first class of robust code is based on multiplicative inverse in finite field. In the second robust code construction the redundancy part is a cube of information part. Also, this paper investigates the characteristics of proposed robust and linear codes.

Keywords: robust code, linear code, wavelet decomposition, scaling function, error masking probability

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3921 The Efficiency of the Use of Medical Bilingual Dictionary in English Language Teaching in Vocational College

Authors: Zorana Jurinjak, Christos Alexopoulos

Abstract:

The aim of this paper is to examine the effectiveness of using a medical bilingual dictionary in teaching English in a vocational college. More precisely, to what extent the use of bilingual medical dictionary in relation to the use of Standard English bilingual dictionaries influences the results on tests, and thus the acquisition of better competence of students mastering the subject terminology. Secondary interest in this paper would be to raise awareness among students and teachers about the advantages of dictionary use. The experiment was conducted at College of Applied Health Sciences in Ćuprija on a sample of 90 students. The respondents translated three medical texts with 42 target terms. Statistical analyses of the data obtained show that the differences in average time and correct answers favor the students who used medical dictionary.

Keywords: bilingual medical dictionary, standard english bilingual dictionary, medical terminology, EOS, ESP

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3920 Importance of Human Factors on Cybersecurity within Organizations: A Study of Attitudes and Behaviours

Authors: Elham Rajabian

Abstract:

The ascent of cybersecurity incidents is a rising threat to most organisations in general, while the impact of the incidents is unique to each of the organizations. It is a need for behavioural sciences to concentrate on employees’ behaviour in order to prepare key security mitigation opinions versus cybersecurity incidents. There are noticeable differences among users of a computer system in terms of complying with security behaviours. We can discuss the people's differences under several subjects such as delaying tactics on something that must be done, the tendency to act without thinking, future thinking about unexpected implications of present-day issues, and risk-taking behaviours in security policies compliance. In this article, we introduce high-profile cyber-attacks and their impacts on weakening cyber resiliency in organizations. We also give attention to human errors that influence network security. Human errors are discussed as a part of psychological matters to enhance compliance with the security policies. The organizational challenges are studied in order to shape a sustainable cyber risks management approach in the related work section. Insiders’ behaviours are viewed as a cyber security gap to draw proper cyber resiliency in section 3. We carry out the best cybersecurity practices by discussing four CIS challenges in section 4. In this regard, we provide a guideline and metrics to measure cyber resilience in organizations in section 5. In the end, we give some recommendations in order to build a cybersecurity culture based on individual behaviours.

Keywords: cyber resilience, human factors, cybersecurity behavior, attitude, usability, security culture

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3919 Evaluation of Vehicle Classification Categories: Florida Case Study

Authors: Ren Moses, Jaqueline Masaki

Abstract:

This paper addresses the need for accurate and updated vehicle classification system through a thorough evaluation of vehicle class categories to identify errors arising from the existing system and proposing modifications. The data collected from two permanent traffic monitoring sites in Florida were used to evaluate the performance of the existing vehicle classification table. The vehicle data were collected and classified by the automatic vehicle classifier (AVC), and a video camera was used to obtain ground truth data. The Federal Highway Administration (FHWA) vehicle classification definitions were used to define vehicle classes from the video and compare them to the data generated by AVC in order to identify the sources of misclassification. Six types of errors were identified. Modifications were made in the classification table to improve the classification accuracy. The results of this study include the development of updated vehicle classification table with a reduction in total error by 5.1%, a step by step procedure to use for evaluation of vehicle classification studies and recommendations to improve FHWA 13-category rule set. The recommendations for the FHWA 13-category rule set indicate the need for the vehicle classification definitions in this scheme to be updated to reflect the distribution of current traffic. The presented results will be of interest to States’ transportation departments and consultants, researchers, engineers, designers, and planners who require accurate vehicle classification information for planning, designing and maintenance of transportation infrastructures.

Keywords: vehicle classification, traffic monitoring, pavement design, highway traffic

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3918 Knowledge-Attitude-Practice Survey Regarding High Alert Medication in a Teaching Hospital in Eastern India

Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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3917 Pattern of Refractive Error, Knowledge, Attitude and Practice about Eye Health among the Primary School Children in Bangladesh

Authors: Husain Rajib, K. S. Kishor, D. G. Jewel

Abstract:

Background: Uncorrected refractive error is a common cause of preventable visual impairment in pediatric age group which can be lead to blindness but early detection of visual impairment can reduce the problem that will have good effective in education and more involve in social activities. Glasses are the cheapest and commonest form of correction of refractive errors. To achieve this, patient must exhibit good compliance to spectacle wear. Patient’s attitude and perception of glasses and eye health could affect compliance. Material and method: A Prospective community based cross sectional study was designed in order to evaluate the knowledge, attitude and practices about refractive errors and eye health amongst the primary school going children. Result: Among 140 respondents, 72 were males and 68 were females. We found 50 children were myopic and out of them 26 were male and 24 were female, 27 children were hyperopic and out of them 14 were male and 13 were female. About 63 children were astigmatic and out of them 32 were male and 31 were female. The level of knowledge, attitude was satisfactory. The attitude of the students, teachers and parents was cooperative which helps to do cycloplegic refraction. Practice was not satisfactory due to social stigma and information gap. Conclusion: Knowledge of refractive error and acceptance of glasses for the correction of uncorrected refractive error. Public awareness program such as vision screening program, eye camp, and teachers training program are more beneficial for wearing and prescribing spectacle.

Keywords: refractive error, stigma, knowledge, attitude, practice

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3916 Need for a National Newborn Screening Programme in India: Pilot Study Data

Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

Abstract:

Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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3915 Enhanced Visual Sharing Method for Medical Image Security

Authors: Kalaivani Pachiappan, Sabari Annaji, Nithya Jayakumar

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In recent years, Information security has emerged as foremost challenges in many fields. Especially in medical information systems security is a major issue, in handling reports such as patients’ diagnosis and medical images. These sensitive data require confidentiality for transmission purposes. Image sharing is a secure and fault-tolerant method for protecting digital images, which can use the cryptography techniques to reduce the information loss. In this paper, visual sharing method is proposed which embeds the patient’s details into a medical image. Then the medical image can be divided into numerous shared images and protected by various users. The original patient details and medical image can be retrieved by gathering the shared images.

Keywords: information security, medical images, cryptography, visual sharing

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3914 Barriers and Opportunities for Implementing Electronic Prescription Software in Public Libyan Hospitals

Authors: Abdelbaset M. Elghriani, Abdelsalam M. Maatuk, Isam Denna, Amira Abdulla Werfalli

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Electronic prescription software (e-prescribing) benefits patients and physicians by preventing handwriting errors and giving accurate prescriptions. E-prescribing allows prescriptions to be written and sent to pharmacies electronically instead of using handwritten notes. Significant factors that may affect the adoption of e-prescription systems include lacking technical support, financial resources to operate the systems, and change resistance from some clinicians, which have been identified as barriers to the implementation of e-prescription systems. This study aims to explore the trends and opinions of physicians and pharmacists about e-prescriptions and to identify the obstacles and benefits of the application of e-prescriptions in the health care system. A cross-sectional descriptive study was conducted at three Libyan public hospitals. Data were collected through a self-constructed questionnaire to assess the opinions regarding potential constraining factors and benefits of implementing an e-prescribing system in hospitals. Data presented as mean, frequency distribution table, cross-tabulation, and bar charts. Data analysis was performed, and the results show that technical, financial, and organizational obstacles are the most important obstacles that prevent the application of e-prescribing systems in Libyan hospitals. In addition, there was awareness of the benefits of e-prescribing, especially reducing medication dispensing errors, and a desire of physicians and pharmacists to use electronic prescriptions.

Keywords: physicians, e-prescribing, health care system, pharmacists

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3913 Ghost Frequency Noise Reduction through Displacement Deviation Analysis

Authors: Paua Ketan, Bhagate Rajkumar, Adiga Ganesh, M. Kiran

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Low gear noise is an important sound quality feature in modern passenger cars. Annoying gear noise from the gearbox is influenced by the gear design, gearbox shaft layout, manufacturing deviations in the components, assembly errors and the mounting arrangement of the complete gearbox. Geometrical deviations in the form of profile and lead errors are often present on the flanks of the inspected gears. Ghost frequencies of a gear are very challenging to identify in standard gear measurement and analysis process due to small wavelengths involved. In this paper, gear whine noise occurring at non-integral multiples of gear mesh frequency of passenger car gearbox is investigated and the root cause is identified using the displacement deviation analysis (DDA) method. DDA method is applied to identify ghost frequency excitations on the flanks of gears arising out of generation grinding. Frequency identified through DDA correlated with the frequency of vibration and noise on the end-of-line machine as well as vehicle level measurements. With the application of DDA method along with standard lead profile measurement, gears with ghost frequency geometry deviations were identified on the production line to eliminate defective parts and thereby eliminate ghost frequency noise from a vehicle. Further, displacement deviation analysis can be used in conjunction with the manufacturing process simulation to arrive at suitable countermeasures for arresting the ghost frequency.

Keywords: displacement deviation analysis, gear whine, ghost frequency, sound quality

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3912 Inpatient Drug Related Problems and Pharmacist Intervention at a Tertiary Care Teaching Hospital in South India: A Retrospective Study

Authors: Bollu Mounica

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Background: Nowadays drug related problems were seen very commonly within the health care practice. These could result in the medication errors, adverse events, drug interactions and harm to patients. Pharmacist has an identified role in minimizing and preventing such type of problems. Objectives: To detect the incidence of drug related problems for the hospitalized patient, and to analyze the clinical pharmacist interventions performed during the review of prescription orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large tertiary care teaching hospital. Methods: It was a retrospective, observational and interventional study. The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. For a period starting November 2012 until December 2014, the inpatient medication charts and orders were identified and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services in a tertiary care teaching hospital on routine daily activities. Data was collected and evaluated. The causes of this problem were identified. Results: A total of 360 patients were followed. Male (71.66%) predominance was noted over females (28.33%). Drug related problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors (26.11%), improper drug selection (17.22%), followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing (26.11%), and drug change (18.05%). Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Conclusion: Our study showed that the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes needed in the prescriptions. In this context, routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of DRPs and may prevent their occurrence.

Keywords: drug related problems, clinical pharmacist, drug prescriptions, drug related problems, intervention

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3911 A Comparative Study of Various Control Methods for Rendezvous of a Satellite Couple

Authors: Hasan Basaran, Emre Unal

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Formation flying of satellites is a mission that involves a relative position keeping of different satellites in the constellation. In this study, different control algorithms are compared with one another in terms of ΔV, velocity increment, and tracking error. Various control methods, covering continuous and impulsive approaches are implemented and tested for satellites flying in low Earth orbit. Feedback linearization, sliding mode control, and model predictive control are designed and compared with an impulsive feedback law, which is based on mean orbital elements. Feedback linearization and sliding mode control approaches have identical mathematical models that include second order Earth oblateness effects. The model predictive control, on the other hand, does not include any perturbations and assumes circular chief orbit. The comparison is done with 4 different initial errors and achieved with velocity increment, root mean square error, maximum steady state error, and settling time. It was observed that impulsive law consumed the least ΔV, while produced the highest maximum error in the steady state. The continuous control laws, however, consumed higher velocity increments and produced lower amounts of tracking errors. Finally, the inversely proportional relationship between tracking error and velocity increment was established.

Keywords: chief-deputy satellites, feedback linearization, follower-leader satellites, formation flight, fuel consumption, model predictive control, rendezvous, sliding mode

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3910 A Review on Applications of Experts Systems in Medical Sciences

Authors: D. K. Sreekantha, T. M. Girish, R. H. Fattepur

Abstract:

In this article, we have given an overview of medical expert systems, which can be used for the developed of physicians in making decisions such as appropriate, prognostic, and therapeutic decisions which help to organize, store, and gives appropriate medical knowledge needed by physicians and practitioners during medical operations or further treatment. If they support the studies by using these systems, advanced tools in medicine will be developed in the future. New trends in the methodology of development of medical expert systems have also been discussed in this paper. So Authors would like to develop an innovative IT based solution to help doctors in rural areas to gain expertise in Medical Science for treating patients. This paper aims to survey the Soft Computing techniques in treating patient’s problems used throughout the world.

Keywords: expert system, fuzzy logic, knowledge base, soft computing, epilepsy

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3909 Producer’s Liability for Defective Medical Devices in Light of Council Directive 85/374/EEC

Authors: Vera Lúcia Raposo

Abstract:

Medical devices are products used for medical purposes and aimed to operate in the human body, sometimes even inside the human body. Therefore, they can become particularly risky products, and some of the injuries caused by medical devices can have serious effects on the person’s health or body, even leading to death. Because they fit in the category of 'products' as described in Article 2 of Council Directive 85/374/EEC of 25 July 1985, concerning liability for defective products, the liability of the manufacturer of medical devices follows the rules of strict liability as long as one of the defects covered by the directive is at stake. The directive is not concerned with the product’s efficiency, but instead with the product’s safety, although in what regards medical devices (the same being valid for drugs) the two concepts frequently go together, and a lack of efficiency can result in a lack of safety. In the particular case of medical devices, the most debatable defects are the ones related with erroneous or non-existing information and the so-called development defects. This paper analyses how directive 85/374/EEC applies to medical devices, which defects are covered by its regulation, and which criteria can be used to evaluate the product’s safety. Some issues are still to be clarified, even though the decisions from the European Court of Justice and from national courts are valuable tools to understand the scope of directive 85/374/EEC in what regards medical devices.

Keywords: medical devices, producer’s liability, product safety, strict liability

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3908 Optical Variability of Faint Quasars

Authors: Kassa Endalamaw Rewnu

Abstract:

The variability properties of a quasar sample, spectroscopically complete to magnitude J = 22.0, are investigated on a time baseline of 2 years using three different photometric bands (U, J and F). The original sample was obtained using a combination of different selection criteria: colors, slitless spectroscopy and variability, based on a time baseline of 1 yr. The main goals of this work are two-fold: first, to derive the percentage of variable quasars on a relatively short time baseline; secondly, to search for new quasar candidates missed by the other selection criteria; and, thus, to estimate the completeness of the spectroscopic sample. In order to achieve these goals, we have extracted all the candidate variable objects from a sample of about 1800 stellar or quasi-stellar objects with limiting magnitude J = 22.50 over an area of about 0.50 deg2. We find that > 65% of all the objects selected as possible variables are either confirmed quasars or quasar candidates on the basis of their colors. This percentage increases even further if we exclude from our lists of variable candidates a number of objects equal to that expected on the basis of `contamination' induced by our photometric errors. The percentage of variable quasars in the spectroscopic sample is also high, reaching about 50%. On the basis of these results, we can estimate that the incompleteness of the original spectroscopic sample is < 12%. We conclude that variability analysis of data with small photometric errors can be successfully used as an efficient and independent (or at least auxiliary) selection method in quasar surveys, even when the time baseline is relatively short. Finally, when corrected for the different intrinsic time lags corresponding to a fixed observed time baseline, our data do not show a statistically significant correlation between variability and either absolute luminosity or redshift.

Keywords: nuclear activity, galaxies, active quasars, variability

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3907 An Effort at Improving Reliability of Laboratory Data in Titrimetric Analysis for Zinc Sulphate Tablets Using Validated Spreadsheet Calculators

Authors: M. A. Okezue, K. L. Clase, S. R. Byrn

Abstract:

The requirement for maintaining data integrity in laboratory operations is critical for regulatory compliance. Automation of procedures reduces incidence of human errors. Quality control laboratories located in low-income economies may face some barriers in attempts to automate their processes. Since data from quality control tests on pharmaceutical products are used in making regulatory decisions, it is important that laboratory reports are accurate and reliable. Zinc Sulphate (ZnSO4) tablets is used in treatment of diarrhea in pediatric population, and as an adjunct therapy for COVID-19 regimen. Unfortunately, zinc content in these formulations is determined titrimetrically; a manual analytical procedure. The assay for ZnSO4 tablets involves time-consuming steps that contain mathematical formulae prone to calculation errors. To achieve consistency, save costs, and improve data integrity, validated spreadsheets were developed to simplify the two critical steps in the analysis of ZnSO4 tablets: standardization of 0.1M Sodium Edetate (EDTA) solution, and the complexometric titration assay procedure. The assay method in the United States Pharmacopoeia was used to create a process flow for ZnSO4 tablets. For each step in the process, different formulae were input into two spreadsheets to automate calculations. Further checks were created within the automated system to ensure validity of replicate analysis in titrimetric procedures. Validations were conducted using five data sets of manually computed assay results. The acceptance criteria set for the protocol were met. Significant p-values (p < 0.05, α = 0.05, at 95% Confidence Interval) were obtained from students’ t-test evaluation of the mean values for manual-calculated and spreadsheet results at all levels of the analysis flow. Right-first-time analysis and principles of data integrity were enhanced by use of the validated spreadsheet calculators in titrimetric evaluations of ZnSO4 tablets. Human errors were minimized in calculations when procedures were automated in quality control laboratories. The assay procedure for the formulation was achieved in a time-efficient manner with greater level of accuracy. This project is expected to promote cost savings for laboratory business models.

Keywords: data integrity, spreadsheets, titrimetry, validation, zinc sulphate tablets

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3906 Proposition of an Ontology of Diseases and Their Signs from Medical Ontologies Integration

Authors: Adama Sow, Abdoulaye Guiss´e, Oumar Niang

Abstract:

To assist medical diagnosis, we propose a federation of several existing and open medical ontologies and terminologies. The goal is to merge the strengths of all these resources to provide clinicians the access to a variety of shared knowledges that can facilitate identification and association of human diseases and all of their available characteristic signs such as symptoms and clinical signs. This work results to an integration model loaded from target known ontologies of the bioportal platform such as DOID, MESH, and SNOMED for diseases selection, SYMP, and CSSO for all existing signs.

Keywords: medical decision, medical ontologies, ontologies integration, linked data, knowledge engineering, e-health system

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3905 Dual-Channel Reliable Breast Ultrasound Image Classification Based on Explainable Attribution and Uncertainty Quantification

Authors: Haonan Hu, Shuge Lei, Dasheng Sun, Huabin Zhang, Kehong Yuan, Jian Dai, Jijun Tang

Abstract:

This paper focuses on the classification task of breast ultrasound images and conducts research on the reliability measurement of classification results. A dual-channel evaluation framework was developed based on the proposed inference reliability and predictive reliability scores. For the inference reliability evaluation, human-aligned and doctor-agreed inference rationals based on the improved feature attribution algorithm SP-RISA are gracefully applied. Uncertainty quantification is used to evaluate the predictive reliability via the test time enhancement. The effectiveness of this reliability evaluation framework has been verified on the breast ultrasound clinical dataset YBUS, and its robustness is verified on the public dataset BUSI. The expected calibration errors on both datasets are significantly lower than traditional evaluation methods, which proves the effectiveness of the proposed reliability measurement.

Keywords: medical imaging, ultrasound imaging, XAI, uncertainty measurement, trustworthy AI

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3904 Analysis of the Level of Production Failures by Implementing New Assembly Line

Authors: Joanna Kochanska, Dagmara Gornicka, Anna Burduk

Abstract:

The article examines the process of implementing a new assembly line in a manufacturing enterprise of the household appliances industry area. At the initial stages of the project, a decision was made that one of its foundations should be the concept of lean management. Because of that, eliminating as many errors as possible in the first phases of its functioning was emphasized. During the start-up of the line, there were identified and documented all production losses (from serious machine failures, through any unplanned downtime, to micro-stops and quality defects). During 6 weeks (line start-up period), all errors resulting from problems in various areas were analyzed. These areas were, among the others, production, logistics, quality, and organization. The aim of the work was to analyze the occurrence of production failures during the initial phase of starting up the line and to propose a method for determining their critical level during its full functionality. There was examined the repeatability of the production losses in various areas and at different levels at such an early stage of implementation, by using the methods of statistical process control. Based on the Pareto analysis, there were identified the weakest points in order to focus improvement actions on them. The next step was to examine the effectiveness of the actions undertaken to reduce the level of recorded losses. Based on the obtained results, there was proposed a method for determining the critical failures level in the studied areas. The developed coefficient can be used as an alarm in case of imbalance of the production, which is caused by the increased failures level in production and production support processes in the period of the standardized functioning of the line.

Keywords: production failures, level of production losses, new production line implementation, assembly line, statistical process control

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3903 InSAR Times-Series Phase Unwrapping for Urban Areas

Authors: Hui Luo, Zhenhong Li, Zhen Dong

Abstract:

The analysis of multi-temporal InSAR (MTInSAR) such as persistent scatterer (PS) and small baseline subset (SBAS) techniques usually relies on temporal/spatial phase unwrapping (PU). Unfortunately, it always fails to unwrap the phase for two reasons: 1) spatial phase jump between adjacent pixels larger than π, such as layover and high discontinuous terrain; 2) temporal phase discontinuities such as time varied atmospheric delay. To overcome these limitations, a least-square based PU method is introduced in this paper, which incorporates baseline-combination interferograms and adjacent phase gradient network. Firstly, permanent scatterers (PS) are selected for study. Starting with the linear baseline-combination method, we obtain equivalent 'small baseline inteferograms' to limit the spatial phase difference. Then, phase different has been conducted between connected PSs (connected by a specific networking rule) to suppress the spatial correlated phase errors such as atmospheric artifact. After that, interval phase difference along arcs can be computed by least square method and followed by an outlier detector to remove the arcs with phase ambiguities. Then, the unwrapped phase can be obtained by spatial integration. The proposed method is tested on real data of TerraSAR-X, and the results are also compared with the ones obtained by StaMPS(a software package with 3D PU capabilities). By comparison, it shows that the proposed method can successfully unwrap the interferograms in urban areas even when high discontinuities exist, while StaMPS fails. At last, precise DEM errors can be got according to the unwrapped interferograms.

Keywords: phase unwrapping, time series, InSAR, urban areas

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3902 Fault-Detection and Self-Stabilization Protocol for Wireless Sensor Networks

Authors: Ather Saeed, Arif Khan, Jeffrey Gosper

Abstract:

Sensor devices are prone to errors and sudden node failures, which are difficult to detect in a timely manner when deployed in real-time, hazardous, large-scale harsh environments and in medical emergencies. Therefore, the loss of data can be life-threatening when the sensed phenomenon is not disseminated due to sudden node failure, battery depletion or temporary malfunctioning. We introduce a set of partial differential equations for localizing faults, similar to Green’s and Maxwell’s equations used in Electrostatics and Electromagnetism. We introduce a node organization and clustering scheme for self-stabilizing sensor networks. Green’s theorem is applied to regions where the curve is closed and continuously differentiable to ensure network connectivity. Experimental results show that the proposed GTFD (Green’s Theorem fault-detection and Self-stabilization) protocol not only detects faulty nodes but also accurately generates network stability graphs where urgent intervention is required for dynamically self-stabilizing the network.

Keywords: Green’s Theorem, self-stabilization, fault-localization, RSSI, WSN, clustering

Procedia PDF Downloads 45