Search results for: emergency care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4345

Search results for: emergency care

1795 Designing for Wearable Interactions: Exploring Care Design for Design Anthropology and Participatory Design

Authors: Wei-Chen Chang, Yu-Cheng Pei

Abstract:

This research examines wearable interaction design to mediate the design anthropology and participatory design found in technology and fashion. We will discuss the principles of design anthropology and participatory design using a wearable and fashion product process to transmit the ‘people-situation-reason-object’ method and analyze five sense applied examples that provide new thinking for designers engaged in future industry. Design anthropology and Participatory Design attempt to engage physiological and psychological design through technology-function, meaning-form and fashion aesthetics to achieve cognition between user and environment. The wearable interaction provides technological characteristics and semantic ideas transmitted to craft-cultural, collective, cheerful and creative performance. It is more confident and innovative attempt, that is able to achieve a joyful, fundamental interface. This study takes two directions for cultural thinking as the basis to establish a set of life-craft designs with interactive experience objects by users that assist designers in examining the sensual feelings to initiate a new lifestyle value.

Keywords: design anthropology, wearable design, design communication, participatory design

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1794 Impact of Overall Teaching Program of Anatomy in Learning: A Students Perspective

Authors: Mamatha Hosapatna, Anne D. Souza, Antony Sylvan Dsouza, Vrinda Hari Ankolekar

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Our study intends to know the effect of the overall teaching program of Anatomy on a students learning. The advancement of various teaching methodologies in the present era has led to progressive changes in education. A student should be able to correlate well between the theory and practical knowledge attained even in the early years of their education in medicine and should be able to implement the same in patient care. The present study therefore aims to assess the impact the current anatomy teaching program has on a students learning and to what extent is it successful in making the learning program effective. Specific objectives of our study to assess the impact of overall teaching program of Anatomy in a students’ learning. Description of process proposed: A questionnaire will be constructed and the students will be asked to put forth their views regarding the Anatomy teaching program and its method of assessment. Suggestions, if any will also be encouraged to be put forth. Type of study is cross sectional observations. Target population is the first year MBBS students and sample size is 250. Assessment plan is to obtaining students responses using questionnaire. Calculating percentages of the responses obtained. Tabulation of the results will be done.

Keywords: anatomy, observational study questionnaire, observational study, M.B.B.S students

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1793 A Robust Optimization Method for Service Quality Improvement in Health Care Systems under Budget Uncertainty

Authors: H. Ashrafi, S. Ebrahimi, H. Kamalzadeh

Abstract:

With the development of business competition, it is important for healthcare providers to improve their service qualities. In order to improve service quality of a clinic, four important dimensions are defined: tangibles, responsiveness, empathy, and reliability. Moreover, there are several service stages in hospitals such as financial screening and examination. One of the most challenging limitations for improving service quality is budget which impressively affects the service quality. In this paper, we present an approach to address budget uncertainty and provide guidelines for service resource allocation. In this paper, a service quality improvement approach is proposed which can be adopted to multistage service processes to improve service quality, while controlling the costs. A multi-objective function based on the importance of each area and dimension is defined to link operational variables to service quality dimensions. The results demonstrate that our approach is not ultra-conservative and it shows the actual condition very well. Moreover, it is shown that different strategies can affect the number of employees in different stages.

Keywords: allocation, budget uncertainty, healthcare resource, service quality assessment, robust optimization

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1792 Lifetime Assessment for Test Strips of POCT Device through Accelerated Degradation Test

Authors: Jinyoung Choi, Sunmook Lee

Abstract:

In general, single parameter, i.e. temperature, as an accelerating parameter is used to assess the accelerated stability of Point-of-Care Testing (POCT) diagnostic devices. However, humidity also plays an important role in deteriorating the strip performance since major components of test strips are proteins such as enzymes. 4 different Temp./Humi. Conditions were used to assess the lifetime of strips. Degradation of test strips were studied through the accelerated stability test and the lifetime was assessed using commercial POCT products. The life distribution of strips, which were obtained by monitoring the failure time of test strip under each stress condition, revealed that the weibull distribution was the most proper distribution describing the life distribution of strips used in the present study. Equal shape parameters were calculated to be 0.9395 and 0.9132 for low and high concentrations, respectively. The lifetime prediction was made by adopting Peck Eq. Model for Stress-Life relationship, and the B10 life was calculated to be 70.09 and 46.65 hrs for low and high concentrations, respectively.

Keywords: accelerated degradation, diagnostic device, lifetime assessment, POCT

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1791 Location Uncertainty – A Probablistic Solution for Automatic Train Control

Authors: Monish Sengupta, Benjamin Heydecker, Daniel Woodland

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New train control systems rely mainly on Automatic Train Protection (ATP) and Automatic Train Operation (ATO) dynamically to control the speed and hence performance. The ATP and the ATO form the vital element within the CBTC (Communication Based Train Control) and within the ERTMS (European Rail Traffic Management System) system architectures. Reliable and accurate measurement of train location, speed and acceleration are vital to the operation of train control systems. In the past, all CBTC and ERTMS system have deployed a balise or equivalent to correct the uncertainty element of the train location. Typically a CBTC train is allowed to miss only one balise on the track, after which the Automatic Train Protection (ATP) system applies emergency brake to halt the service. This is because the location uncertainty, which grows within the train control system, cannot tolerate missing more than one balise. Balises contribute a significant amount towards wayside maintenance and studies have shown that balises on the track also forms a constraint for future track layout change and change in speed profile.This paper investigates the causes of the location uncertainty that is currently experienced and considers whether it is possible to identify an effective filter to ascertain, in conjunction with appropriate sensors, more accurate speed, distance and location for a CBTC driven train without the need of any external balises. An appropriate sensor fusion algorithm and intelligent sensor selection methodology will be deployed to ascertain the railway location and speed measurement at its highest precision. Similar techniques are already in use in aviation, satellite, submarine and other navigation systems. Developing a model for the speed control and the use of Kalman filter is a key element in this research. This paper will summarize the research undertaken and its significant findings, highlighting the potential for introducing alternative approaches to train positioning that would enable removal of all trackside location correction balises, leading to huge reduction in maintenances and more flexibility in future track design.

Keywords: ERTMS, CBTC, ATP, ATO

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1790 Synthesis and Characterization of Novel Hollow Silica Particle through DODAB Vesicle Templating

Authors: Eun Ju Park, Wendy Rusli, He Tao, Alexander M. Van Herk, Sanggu Kim

Abstract:

Hollow micro-/nano- structured materials have proven to be promising in wide range of applications, such as catalysis, drug delivery and controlled release, biotechnology, and personal and consumer care. Hollow sphere structures can be obtained through various templating approaches; colloid templates, emulsion templates, multi-surfactant templates, and single crystal templates. Vesicles are generally the self-directed assemblies of amphiphilic molecules including cationic, anionic, and cationic surfactants in aqueous solutions. The directed silica capsule formations were performed at the surface of dioctadecyldimethylammoniumbromide(DODAB) bilayer vesicles as soft template. The size of DODAB bilayer vesicles could be tuned by extrusion of a preheated dispersion of DODAB. The synthesized hollow silica particles were characterized by conventional TEM, cryo-TEM and SEM to determine the morphology and structure of particles and dynamic light scattering (DLS) method to measure the particle size and particle size distribution.

Keywords: characterization, DODAB, hollow silica particle, synthesis, vesicle

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1789 Structuring and Visualizing Healthcare Claims Data Using Systems Architecture Methodology

Authors: Inas S. Khayal, Weiping Zhou, Jonathan Skinner

Abstract:

Healthcare delivery systems around the world are in crisis. The need to improve health outcomes while decreasing healthcare costs have led to an imminent call to action to transform the healthcare delivery system. While Bioinformatics and Biomedical Engineering have primarily focused on biological level data and biomedical technology, there is clear evidence of the importance of the delivery of care on patient outcomes. Classic singular decomposition approaches from reductionist science are not capable of explaining complex systems. Approaches and methods from systems science and systems engineering are utilized to structure healthcare delivery system data. Specifically, systems architecture is used to develop a multi-scale and multi-dimensional characterization of the healthcare delivery system, defined here as the Healthcare Delivery System Knowledge Base. This paper is the first to contribute a new method of structuring and visualizing a multi-dimensional and multi-scale healthcare delivery system using systems architecture in order to better understand healthcare delivery.

Keywords: health informatics, systems thinking, systems architecture, healthcare delivery system, data analytics

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1788 Potentials for Change in the MENA Region: A Socioeconomic Perspective

Authors: Shaira Karishma Sheriff, Zarinah Hamid

Abstract:

The Arab Spring, which commenced during the end of 2010 and accelerated during 2011, was caused primarily due to poverty, unemployment and a general recession in the Middle East and North African (MENA) region. The core motivation of this revolution could be said to be the need for political, economic and social reforms that the region desires to experience. Though GDP growth has been significant in the region, the income distribution mechanism in MENA countries has been ineffective. This results in low levels of education, substandard health care facilities, unemployment, and poverty. This paper argues that MENA countries have great potential for experiencing socioeconomic development by being less dependent on oil exports and enhancing their services sector through better education which would eventually lead to job creation. Furthermore, the region can encourage better trade and political integration by forming transparent and accountable governments. The notion of Nation-State needs to be addressed and the countries in the region need to look for ways to develop effective supra-national institutions for better political and economic integration that goes beyond geographical borders.

Keywords: political reforms, social reforms, economic development, nation-state, economic integration

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1787 Telemedicine for Substance-Related Disorders: A Patient Satisfaction Survey among Individuals in Argentina

Authors: Badino Manuel, Farias Maria Alejandra

Abstract:

Telemedicine (TM) has the potential to develop efficient and cost-effective means for delivering quality health care services and outcomes, showing equal or, in some cases, better results than in-person treatment. To analyze patient satisfaction with the use of TM becomes relevant because this can affect the results of treatment and the adherence to it. The aim is to assess patient satisfaction with telemedicine for treating substance-related disorders in a mental health service in Córdoba, Argentina. A descriptive cross-sectional study was conducted among patients with substance-related disorders (N=115). A patient satisfaction survey was conducted from December 2021 to March 2022. For a total of 115 participants, 59,1% were male, 38,3% were female and 2,6% non-binary. In relation to educational status, 40% finished university, 39,1% high school, and 20,9 % only primary school. Regarding age, 4,3 % were young, 92,2% were adults, and 3,5% were elderly. Regarding TM treatment, 95,7% reported being satisfied. Furthermore, 85,2% of users declared that they would continueTM treatment, and 14,8% said that they would not resume TM treatment. To conclude, high levels of patient satisfaction contributes to the continuity of TM modality.

Keywords: telemedicine, mental health, substance-related disorders, patient satisfaction

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1786 The Net as a Living Experience of Distance Motherhood within Italian Culture

Authors: C. Papapicco

Abstract:

Motherhood is an existential human relationship that lasts for the whole life and is always interwoven with subjectivity and culture. As a result of the brain drain, the motherhood becomes motherhood at distance. Starting from the hypothesis that re-signification of the mother at distance practices is culturally relevant; the research aims to understand the experience of mother at a distance in order to extrapolate the strategies of management of the empty nest. Specifically, the research aims to evaluate the experience of a brain drain’s mother, who created a blog that intends to take care of other parents at a distance. Actually, the blog is the only artifact symbol of the Italian culture of motherhood at distance. In the research, a Netnographic Analysis of the blog mammedicervelliinfuga.com is offered with the aim of understanding if the online world becomes an opportunity to manage the role of mother at a distance. A narrative interview with the blog creator was conducted and then the texts were analyzed by means of a Diatextual Analysis approach. It emerged that the migration projects of talented children take on different meanings and representations for parents. Thus, it is shown that the blog becomes a new form of understanding and practicing motherhood at a distance.

Keywords: brain drain, diatextual analysis, distance motherhood blog, online and offline narrations

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1785 Hypothesis of a Holistic Treatment of Cancer: Crab Method

Authors: Devasis Ghosh

Abstract:

The main hindrance to total cure of cancer is a) the failure to control continued production of cancer cells, b) its sustenance and c) its metastasis. This review study has tried to address this issue of total cancer cure in a more innovative way. A 10-pronged “CRAB METHOD”, a novel holistic scientific approach of Cancer treatment has been hypothesized in this paper. Apart from available Chemotherapy, Radiotherapy and Oncosurgery, (which shall not be discussed here), seven other points of interference and treatment has been suggested, i.e. 1. Efficient stress management. 2. Dampening of ATF3 expression. 3. Selective inhibition of Platelet Activity. 4. Modulation of serotonin production, metabolism and 5HT receptor antagonism. 5. Auxin, its anti-proliferative potential and its modulation. 6. Melatonin supplementation because of its oncostatic properties. 7. HDAC Inhibitors especially valproic acid use due to its apoptotic role in many cancers. If all the above stated seven steps are thoroughly taken care of at the time of initial diagnosis of cancer along with the available treatment modalities of Chemotherapy, Radiotherapy and Oncosurgery, then perhaps, the morbidity and mortality rate of cancer may be greatly reduced.

Keywords: ATF3 dampening, auxin modulation, cancer, platelet activation, serotonin, stress, valproic acid

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1784 Critical Accounting Estimates and Transparency in Financial Reporting: An Observation Financial Reporting under US GAAP

Authors: Ahmed Shaik

Abstract:

Estimates are very critical in accounting and Financial Reporting cannot be complete without these estimates. There is a long list of accounting estimates that are required to be made to compute Net Income and to determine the value of assets and liabilities. To name a few, valuation of inventory, depreciation, valuation of goodwill, provision for bad debts and estimated warranties, etc. require the use of different valuation models and forecasts. Different business entities under the same industry may use different approaches to measure the value of financial items being reported in Income Statement and Balance Sheet. The disclosure notes do not provide enough details of the approach used by a business entity to arrive at the value of a financial item. Lack of details in the disclosure notes makes it difficult to compare the financial performance of one business entity with the other in the same industry. This paper is an attempt to identify the lack of enough information about accounting estimates in disclosure notes, the impact of the absence of details of accounting estimates on the comparability of financial data and financial analysis. An attempt is made to suggest the detailed disclosure while taking care of the cost and benefit of making such disclosure.

Keywords: accounting estimates, disclosure notes, financial reporting, transparency

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1783 Evaluation of Rehabilitation in Ischemic Stroke

Authors: Amirmohammad Dahouri

Abstract:

Each year, more than 795,000 individuals in the United States grieve a stroke, and by 2030, it is predictable that 4% of the U.S. people will have had a stroke. Ischemic stroke, accounting for about 80% of all strokes, is one of the main causes of disability. The goal of stroke rehabilitation is to help patients return to physical and mental functions and relearn the required aids to living everyday life. This flagging has an adverse effect on patients’ quality of life and affects their daily living activities. In recent years, the rehabilitation of ischemic stroke attractions more attention in the world. A review of the rudimentary perceptions of stroke rehabilitation that are price stressing to all specialists who delicacy patients with stroke. Ideas are made for patients on how to functionally manage daily activities after they have qualified for a stroke. It is vital for home healthcare clinicians to understand the process from acute events to medical equilibrium and rehabilitation to adaptation. Different sources such as Pub Med Google Scholar and science direct have been used and various contemporary articles in this era have been analyzed. The care plan must also foundation actual actions to protect against recurrent stroke, as stroke patients are generally at significant risk for further ischemic or hemorrhagic attacks. Here, we review evidence of rehabilitation in treating post-stroke impairment.

Keywords: rehabilitation, stroke, ischemic, hemorrhagic, brain

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1782 Disaster Response Training Simulator Based on Augmented Reality, Virtual Reality, and MPEG-DASH

Authors: Sunho Seo, Younghwan Shin, Jong-Hong Park, Sooeun Song, Junsung Kim, Jusik Yun, Yongkyun Kim, Jong-Moon Chung

Abstract:

In order to effectively cope with large and complex disasters, disaster response training is needed. Recently, disaster response training led by the ROK (Republic of Korea) government is being implemented through a 4 year R&D project, which has several similar functions as the HSEEP (Homeland Security Exercise and Evaluation Program) of the United States, but also has several different features as well. Due to the unpredictiveness and diversity of disasters, existing training methods have many limitations in providing experience in the efficient use of disaster incident response and recovery resources. Always, the challenge is to be as efficient and effective as possible using the limited human and material/physical resources available based on the given time and environmental circumstances. To enable repeated training under diverse scenarios, an AR (Augmented Reality) and VR (Virtual Reality) combined simulator is under development. Unlike existing disaster response training, simulator based training (that allows remote login simultaneous multi-user training) enables freedom from limitations in time and space constraints, and can be repeatedly trained with different combinations of functions and disaster situations. There are related systems such as ADMS (Advanced Disaster Management Simulator) developed by ETC simulation and HLS2 (Homeland Security Simulation System) developed by ELBIT system. However, the ROK government needs a simulator custom made to the country's environment and disaster types, and also combines the latest information and communication technologies, which include AR, VR, and MPEG-DASH (Moving Picture Experts Group - Dynamic Adaptive Streaming over HTTP) technology. In this paper, a new disaster response training simulator is proposed to overcome the limitation of existing training systems, and adapted to actual disaster situations in the ROK, where several technical features are described.

Keywords: augmented reality, emergency response training simulator, MPEG-DASH, virtual reality

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1781 Profit-Based Artificial Neural Network (ANN) Trained by Migrating Birds Optimization: A Case Study in Credit Card Fraud Detection

Authors: Ashkan Zakaryazad, Ekrem Duman

Abstract:

A typical classification technique ranks the instances in a data set according to the likelihood of belonging to one (positive) class. A credit card (CC) fraud detection model ranks the transactions in terms of probability of being fraud. In fact, this approach is often criticized, because firms do not care about fraud probability but about the profitability or costliness of detecting a fraudulent transaction. The key contribution in this study is to focus on the profit maximization in the model building step. The artificial neural network proposed in this study works based on profit maximization instead of minimizing the error of prediction. Moreover, some studies have shown that the back propagation algorithm, similar to other gradient–based algorithms, usually gets trapped in local optima and swarm-based algorithms are more successful in this respect. In this study, we train our profit maximization ANN using the Migrating Birds optimization (MBO) which is introduced to literature recently.

Keywords: neural network, profit-based neural network, sum of squared errors (SSE), MBO, gradient descent

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1780 Policy Analysis and Program Evaluation: Need to Designate a Navigable Spatial Identity for Slums Dwellers in India to Maximize Accessibility and Policy Impact

Authors: Resham Badri

Abstract:

Cities today are unable to justify equitable distribution of theirsocio- economic and infrastructural benefits to the marginalized urban poor, and the emergence of a pressing pandemic like COVID-19 has amplified its impact. Lack of identity, vulnerability, and inaccessibility contribute to exclusion. Owing to systemic gaps in institutional processes, urban development policiesfail to represent and cater to the urban poor. This paper aims to be a roadmap for the Indian Government to understand the significance of the designation of a navigable spatial identity to slum dwellers in the form of a digital address, which can form the fundamental basis of identification to enable accessibility to not only basic servicesbut also other utilities. Capitalizing on such a granular and technology backed approach shall allow to target and reach out to the urban poor strategically andaid effective urban governance. This paper adopts a three-pronged approach;(i) Policy analysis- understanding gaps in existing urban policies of India, such as the Pradhan Mantri Awas Yojana, Swachh Bharat Mission, and Adhaar Card policy, (ii) Program Evaluation- analyzing a case study, where slum dwellers in Kolhapur city in India have been provided with navigable addresses using Google Plus Codes and have gained access to basic services, vaccinations, and other emergency deliveries in COVID-19 times, (iii) Policy recommendation. This designation of a navigable spatial identity has tremendous potential to form the foundation on which policies can further base their data collection and service delivery processes to not only provide basic services but also other infrastructural and social welfare initiatives. Hence, a massive window of opportunity lies in addressing the unaddressed to elevate their living standards and respond to their basic needs.

Keywords: policy analysis, urban poor, navigable spatial identity, accessibility

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1779 Energy Potential of Salinity Gradient Mixing: Case Study of Mixing Energies of Rivers of Goa with the Arabian Sea

Authors: Arijit Chakraborty, Anirban Roy

Abstract:

The Indian peninsula is strategically located in the Asian subcontinent with the Himalayas to the North and Oceans surrounding the other three directions with annual monsoons which takes care of water supply to the rivers. The total river water discharge into the Bay of Bengal and the Arabian Sea is 628 km³/year and 274 km³/year, respectively. Thus huge volumes of fresh water meet saline water, and this mixing of two streams of dissimilar salinity gives rise to tremendous mixing energies which can be harvested for various purposes like energy generation using pressure retarded osmosis or reverse electrodialysis. The present paper concentrates on analyzing the energy of mixing for the rivers in Goa. Goa has 10 rivers of various sizes all which meet the Arabian Sea. In the present work, the 8 rivers and their salinity (NaCl concentrations) have been analyzed along with their seasonal fluctuations. Next, a Gibbs free energy formulation has been implemented to analyze the energy of mixing of the selected rivers. The highest and lowest energies according to the seasonal fluctuations have been evaluated, and this provides two important insights into (i) amount of energy that can be harvested and (ii) decision on the location of such systems.

Keywords: Gibbs energy, mixing energy, salinity gradient energy, thermodynamics

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1778 Prevalence of Shift Work Disorders among Mongolian Nurses

Authors: Davaakhuu Vandannyam, Amarsaikhan Dashtseren, Oyungoo Badamdorj

Abstract:

Background: Shift work and extended working hours are increasing in many industries and organization's in the world. Over a 24 hour period, the circadian clock regulates sleep/wake patterns, body temperature, hormone levels, digestion and many other functions. Depending on the time of day or night, the human body is programmed for periods of wakefulness and sleep, high and low body temperature, high and low digestive activity and so on. Shift work is highly prevalent in industrialized societies (>20%) but, when it includes night work, it has pronounced negative effects on sleep, subjective and physiological sleepiness, performance, accident risk, as well as on health outcomes such as cardiovascular disease and certain forms of cancer. Method: In this cross-sectional field study, 634 shift work and day work nurses from a plant were involved, with participation rate of 100% (634 nurses). The general health questionnaire (GHQ-28) and RLS, ESS, ISI, FSS were used to evaluate the level of insomnia, sleepiness, fatigue and restless legs syndrome, respectively. Results: As a result of research on some indicators of health risks caused from work shift, it was proven that prevalence of restless legs syndrome was at 5.5% and 25.9% are in risk of becoming sick, 42.3% are in fatigue, 3.5% in high stage of insomnia and 27.4% are sleepy on duty. Insomnia of nurses mainly affected from long-hour shift, dissatisfaction, workload, lose of focus and use of coffee. There is sleepiness lies in the workplace due to number of shifts, unsatisfactory performance and emergency calls between shifts. It has been determined that risk of sickness influenced by number of shifts in a month and long hour shift, dissatisfaction and use of coffee and divisions are causing restless legs syndrome. Conclusions: Among the nurses, it was found that the prevalence of insomnia is 31.6%, sleepiness 27.4%, fatigue 42.3%, restless legs syndrome 35% and stress 25.9%. These factors of shift work affecting health tend to go up as working hours increase and more common among shift work nurses.

Keywords: shiftwork, insomnia, sleepiness, restless

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1777 The Impact of Social Enterprises on Women Empowerment in South Asia: A Systematic Review

Authors: Saba Aziz

Abstract:

Social enterprises are playing a growing role in transforming the lives of individuals and communities around the world, providing innovative solutions to critical social and environmental issues such as education, job creation, and health care. Women are increasingly utilising services of these enterprises to overcome socio-economic constraints and increase their access to business and market. This article systematically reviews the available literature on the role of social enterprises on women's empowerment in South Asia. Twelve key terms were specified and researched on five databases. Some of the literature was excluded based on the lack of evidence on the involvement of social enterprises. Remaining literature was rated according to the quality; due to methodological inconsistency, the findings are presented in a descriptive form. The relevant studies review the impact of social enterprises on women’s economic, social, relational, health, personal and political aspects of empowerment. In discussion, we outline areas for further research on social enterprises activity that impacts women’s overall empowerment specifically in South Asia.

Keywords: social enterprise, women empowerment, systematic review, well-being, social impact, micro finance, South Asia, Pakistan

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1776 Implementation of Enhanced Recovery after Surgery (ERAS) Protocols in Laparoscopic Sleeve Gastrectomy (LSG); A Systematic Review and Meta-analysis

Authors: Misbah Nizamani, Saira Malik

Abstract:

Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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1775 Transboundary Pollution after Natural Disasters: Scenario Analyses for Uranium at Kyrgyzstan-Uzbekistan Border

Authors: Fengqing Li, Petra Schneider

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Failure of tailings management facilities (TMF) of radioactive residues is an enormous challenge worldwide and can result in major catastrophes. Particularly in transboundary regions, such failure is most likely to lead to international conflict. This risk occurs in Kyrgyzstan and Uzbekistan, where the current major challenge is the quantification of impacts due to pollution from uranium legacy sites and especially the impact on river basins after natural hazards (i.e., landslides). By means of GoldSim, a probabilistic simulation model, the amount of tailing material that flows into the river networks of Mailuu Suu in Kyrgyzstan after pond failure was simulated for three scenarios, namely 10%, 20%, and 30% of material inputs. Based on Muskingum-Cunge flood routing procedure, the peak value of uranium flood wave along the river network was simulated. Among the 23 TMF, 19 ponds are close to the river networks. The spatiotemporal distributions of uranium along the river networks were then simulated for all the 19 ponds under three scenarios. Taking the TP7 which is 30 km far from the Kyrgyzstan-Uzbekistan border as one example, the uranium concentration decreased continuously along the longitudinal gradient of the river network, the concentration of uranium was observed at the border after 45 min of the pond failure and the highest value was detected after 69 min. The highest concentration of uranium at the border were 16.5, 33, and 47.5 mg/L under scenarios of 10%, 20%, and 30% of material inputs, respectively. In comparison to the guideline value of uranium in drinking water (i.e., 30 µg/L) provided by the World Health Organization, the observed concentrations of uranium at the border were 550‒1583 times higher. In order to mitigate the transboundary impact of a radioactive pollutant release, an integrated framework consisting of three major strategies were proposed. Among, the short-term strategy can be used in case of emergency event, the medium-term strategy allows both countries handling the TMF efficiently based on the benefit-sharing concept, and the long-term strategy intends to rehabilitate the site through the relocation of all TMF.

Keywords: Central Asia, contaminant transport modelling, radioactive residue, transboundary conflict

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1774 Drought Resilient Water Supply for Livelihood: Establishment of Groundwater Treatment Plant at Construction Sites in Taichung City

Authors: Shang-Hsin Ou, Yang-Chun Lin, Ke-Hao Cheng

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The year 2021 marked a historic drought in Taiwan, posing unprecedented challenges due to record-low rainfall and inadequate reservoir storage. The central region experienced water scarcity, leading to the implementation of "Groundwater Utilization at Construction Sites" for drought-resilient livelihood water supply. This study focuses on the establishment process of temporary groundwater treatment plants at construction sites in Taichung City, serving as a reference for future emergency response and the utilization of construction site groundwater. To identify suitable sites for groundwater reuse projects, site selection operations were carried out based on relevant water quality regulations and assessment principles. Subsequently, the planning and design of temporary water treatment plants were conducted, considering the water quality, quantity, and on-site conditions of groundwater wells associated with construction projects. The study consolidates the major water treatment facilities at each site and addresses encountered challenges during the establishment process. Practical insights gained from operating temporary groundwater treatment plants are presented, including improvements related to stable water quality, water quantity, equipment operation, and hydraulic control. In light of possible future droughts, this study provides an outlook and recommendations to expedite and improve the setup of groundwater treatment plants at construction sites. This includes considering on-site water abstraction, treatment, and distribution conditions. The study's results aim to offer practical guidelines for effectively establishing and managing such treatment plants, while offering experiences and recommendations for other regions facing similar emergencies, water shortages, and drought situations. These endeavors contribute to ensuring sustainable water supply for drought-resilient livelihoods and maintaining societal stability.

Keywords: drought resilience, groundwater treatment, construction site, water supply

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1773 Organism Profile Causing Prosthetic Joint Infection Continues to Evolve

Authors: Bahaa Eldin Kornah

Abstract:

The organism profile for peri-prosthetic joint infection caused by hematogenous seeding or direct inoculations is changing. The organisms that cause prosthetic joint infections range from normal skin colonizers to highly virulent pathogens. The pathogens continue to evolve. While Staphylococcus aureus continues to be the leading organism, gram-negative bacilli account for approximately 7% of cases and that incidence is increasing. Methicillin-resistant S. aureus(MRSA) accounts for approximately 10% of all infections occurring in the community setting and 20% of those in the health care setting. The list of organisms causing PJI has expanded in recent years. It is important to have an understanding of which organisms may be causing a periprosthetic joint infection based on where the patient contracted it and their recent medical history. Also, recent technology has expanded rapidly and new methods to detect the pathogen and why we failed in detecting it. There are a number of explanations for the latter finding, perhaps the most important reason being the liberal use of antibiotics that interferes with the isolation of the infective organism.

Keywords: infection, periprosthetic, hip, organism profile, joint infection, joint infection

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1772 A Survey on Speech Emotion-Based Music Recommendation System

Authors: Chirag Kothawade, Gourie Jagtap, PreetKaur Relusinghani, Vedang Chavan, Smitha S. Bhosale

Abstract:

Psychological research has proven that music relieves stress, elevates mood, and is responsible for the release of “feel-good” chemicals like oxytocin, serotonin, and dopamine. It comes as no surprise that music has been a popular tool in rehabilitation centers and therapy for various disorders, thus with the interminably rising numbers of people facing mental health-related issues across the globe, addressing mental health concerns is more crucial than ever. Despite the existing music recommendation systems, there is a dearth of holistically curated algorithms that take care of the needs of users. Given that, an undeniable majority of people turn to music on a regular basis and that music has been proven to increase cognition, memory, and sleep quality while reducing anxiety, pain, and blood pressure, it is the need of the hour to fashion a product that extracts all the benefits of music in the most extensive and deployable method possible. Our project aims to ameliorate our users’ mental state by building a comprehensive mood-based music recommendation system called “Viby”.

Keywords: language, communication, speech recognition, interaction

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1771 Medical Knowledge Management since the Integration of Heterogeneous Data until the Knowledge Exploitation in a Decision-Making System

Authors: Nadjat Zerf Boudjettou, Fahima Nader, Rachid Chalal

Abstract:

Knowledge management is to acquire and represent knowledge relevant to a domain, a task or a specific organization in order to facilitate access, reuse and evolution. This usually means building, maintaining and evolving an explicit representation of knowledge. The next step is to provide access to that knowledge, that is to say, the spread in order to enable effective use. Knowledge management in the medical field aims to improve the performance of the medical organization by allowing individuals in the care facility (doctors, nurses, paramedics, etc.) to capture, share and apply collective knowledge in order to make optimal decisions in real time. In this paper, we propose a knowledge management approach based on integration technique of heterogeneous data in the medical field by creating a data warehouse, a technique of extracting knowledge from medical data by choosing a technique of data mining, and finally an exploitation technique of that knowledge in a case-based reasoning system.

Keywords: data warehouse, data mining, knowledge discovery in database, KDD, medical knowledge management, Bayesian networks

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1770 Securing Healthcare IoT Devices and Enabling SIEM Integration: Addressing

Authors: Mubarak Saadu Nabunkari, Abdullahi Abdu Ibrahim, Muhammad Ilyas

Abstract:

This study looks at how Internet of Things (IoT) devices are used in healthcare to monitor and treat patients better. However, using these devices in healthcare comes with security problems. The research explores using Security Information and Event Management (SIEM) systems with healthcare IoT devices to solve these security challenges. Reviewing existing literature shows the current state of IoT security and emphasizes the need for better protection. The main worry is that healthcare IoT devices can be easily hacked, putting patient data and device functionality at risk. To address this, the research suggests a detailed security framework designed for these devices. This framework, based on literature and best practices, includes important security measures like authentication, data encryption, access controls, and anomaly detection. Adding SIEM systems to this framework helps detect threats in real time and respond quickly to incidents, making healthcare IoT devices more secure. The study highlights the importance of this integration and offers guidance for implementing healthcare IoT securely, efficiently, and effectively.

Keywords: cyber security, threat intelligence, forensics, heath care

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1769 Stress and Distress among Physician Trainees: A Wellbeing Workshop

Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

Abstract:

Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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1768 Quality of Life Among People with Mental Illness Attending a Psychiatric Outpatient Clinic in Ethiopia: A Structural Equation Model

Authors: Wondale Getinet Alemu, Lillian Mwanri, Clemence Due, Telake Azale, Anna Ziersch

Abstract:

Background: Mental illness is one of the most severe, chronic, and disabling public health problems that affect patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods: A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total number of study participants who had a follow-up appointment during the data collection period (2400) by the total sample size of 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the QoL of people with mental illness. The domains and Health-Related Quality of Life (HRQoL) were identified. The indirect and direct effects of variables were calculated using structural equation modeling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results: A total of 636 (99.7%) participants responded and completed the WHOQOL-BREF questionnaire. The mean score of overall HRQoL of people with mental illness in the outpatient clinic was (49.6 ± 10 Sd). The highest QoL was found in the physical health domain (50.67 ±9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41±10 Sd). Rural residents, drug nonadherence, suicidal ideation, not getting counseling, moderate or severe subjective severity, the family does not participate in patient care, and a family history of mental illness had an indirect negative effect on HRQoL. Alcohol use and psychological health domain had a direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having a history of mental illness in the family had both direct and indirect effects on QoL. Furthermore, sociodemographic factors (residence, educational status, marital status), social support-related factors (self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use,) and clinical factors (objective and subjective severity of illness, not getting counseling, suicidal ideation, number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions: In this study, the QoL of people with mental illness was poor, with the psychological health domain being the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors directly and indirectly, affect QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the scourge of mental health, including the development of policy and practice drivers that address the above-identified factors.

Keywords: quality of life, mental wellbeing, mental illness, mental disorder, Ethiopia

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1767 Early Initiation of Breastfeeding and Its Determinants among Non-Caesarean Deliveries at Primary and Secondary Health Facilities: A Case Observational Study

Authors: Farhana Karim, Abdullah N. S. Khan, Mohiuddin A. K. Chowdhury, Nabila Zaka, Alexander Manu, Shams El Arifeen, Sk Masum Billah

Abstract:

Breastfeeding, an integral part of newborn care, can reduce 55-87% of all-cause neonatal mortality and morbidity. Early initiation of breastfeeding within 1 hour of birth can avert 22% of newborn mortality. Only 45% of world’s newborns and 42% of newborns in South-Asia are put to the breast within one hour of birth. In Bangladesh, only a half of the mothers practice early initiation of breastfeeding which is less likely to be practiced if the baby is born in a health facility. This study aims to generate strong evidence for early initiation of breastfeeding practices in the government health facilities and to explore the associated factors influencing the practice. The study was conducted in selected health facilities in three neighbouring districts of Northern Bangladesh. Total 249 normal vaginal delivery cases were observed for 24 hours since the time of birth. The outcome variable was initiation of breastfeeding within 1 hour while the explanatory variables included type of health facility, privacy, presence of support person, stage of labour at admission, need for augmentation of labour, complications during delivery, need for episiotomy, spontaneous cry of the newborn, skin-to-skin contact with mother, post-natal contact with the service provider, receiving a post-natal examination and counselling on breastfeeding during postnatal contact. The simple descriptive statistics were employed to see the distribution of samples according to socio-demographic characteristics. Kruskal-Wallis test was carried out for testing the equality of medians among two or more categories of each variable and P-value is reported. A series of simple logistic regressions were conducted with all the potential explanatory variables to identify the determining factors for breastfeeding within 1 hour in a health facility. Finally, multiple logistic regression was conducted including the variables found significant at bi-variate analyses. Almost 90% participants initiated breastfeeding at the health facility and median time to initiate breastfeeding was 38 minutes. However, delivering in a sub-district hospital significantly delayed the breastfeeding initiation in comparison to delivering in a district hospital. Maintenance of adequate privacy and presence of separate staff for taking care of newborn significantly reduced the time in early breastfeeding initiation. Initiation time was found longer if the mother had an augmented labour, obstetric complications, and the newborn needed resuscitation. However, the initiation time was significantly early if the baby was put skin-to-skin on mother’s abdomen and received a postnatal examination by a provider. After controlling for the potential confounders, the odds of initiating breastfeeding within one hour of birth is higher if mother gives birth in a district hospital (AOR 3.0: 95% CI 1.5, 6.2), privacy is well-maintained (AOR 2.3: 95% CI 1.1, 4.5), babies cry spontaneously (AOR 7.7: 95% CI 3.3, 17.8), babies are put to skin-to-skin contact with mother (AOR 4.6: 95% CI 1.9, 11.2) and if the baby is examined by a provider in the facility (AOR 4.4: 95% CI 1.4, 14.2). The evidence generated by this study will hopefully direct the policymakers to identify and prioritize the scopes for creating and supporting early initiation of breastfeeding in the health facilities.

Keywords: Bangladesh, early initiation of breastfeeding, health facility, normal vaginal delivery, skin to skin contact

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1766 Predicting COVID-19 Severity Using a Simple Parameters in Resource-Limited Settings

Authors: Sireethorn Nimitvilai, Ussanee Poolvivatchaikarn, Nuchanart Tomeun

Abstract:

Objective: To determine the simple laboratory parameters to predict disease severity among COVID-19 patients in resource-limited settings. Material and methods: A retrospective cohort study was conducted at Nakhonpathom Hospital, a 722-bed tertiary care hospital, with an average of 50,000 admissions per year, during April 15 and May 15, 2021. Eligible patients were adults aged ≥ 15 years who were hospitalized with COVID-19. Baseline characteristics, comorbid conditions ad laboratory findings at admission were collected. Predictive factors for severe COVID-19 infection were analyzed. Result: There were 207 patients (79 male and 128 female) and the mean age was 46.7 (16.8) years. Of these, 39 cases (18.8%) were severe and 168 (81.2%) cases were non-severe. Factors associated with severe COVID-19 were neutrophil to lymphocyte ratio ≥ 4 (OR 8.1, 95%CI 2.3-20.3, P < 0.001) and C-reactive protein to albumin ratio ≥ 10 (OR 3.49, 95%CI 1.3-9.1, p 0.01). Conclusions: Complete blood counts, C-reactive protein and albumin are simple, inexpensive, widely available tests and can be used to predict severe COVID-19 in resource-limited settings.

Keywords: COVID-19, predictor of severity, resource-limiting settings, simple laboratory parameters

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