Search results for: clinical error

Authors: Wael El-Deeb

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The present study aimed to investigate the diagnostic importance of acute phase proteins in urinary tract infection (UTI) in cattle. We describe the clinical, bacteriological and biochemical findings in 99 lactating cows. Blood and urine samples from diseased (n=84) and control healthy cows (n=15) were submitted to laboratory investigations. The urine analysis revealed hematuria and pyuria in UTI group. The isolated bacteria were E.coli (43/84) Corynebacterium spp, (31/84), Proteus spp. (6/84) and Streptococcus spp (4/84). The concentrations of Haptoglobin (Hp), serum amyloid A (SAA), α1-Acid glycoprotein (AGP), fibrinogen (Fb), total protein, albumen, and globulin were higher in cows with UTI when compared to healthy ones. Fifty-one of 84 cows with UTI were successfully treated. The levels of Hp, SAA, AGP, total protein, and globulin were associated with the odds of treatment failure. Conclusively, acute phase proteins could be used as diagnostic and prognostic biomarkers in cows with UTI.

Keywords: cows, urinary, infections, haptoglobin, serum Amyloid A

Procedia PDF Downloads 724

Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

Procedia PDF Downloads 223

Authors: Ayesha Sohail, Khadija Maqbool, Anila Asif, Haroon Ahmad

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The field of tissue engineering is an active area of research. Bone tissue engineering helps to resolve the clinical problems of critical size and non-healing defects by the creation of man-made bone tissue. We will design and validate an efficient numerical model, which will simulate the effective diffusivity in bone tissue engineering. Our numerical model will be based on the finite element analysis of the diffusion-reaction equations. It will have the ability to optimize the diffusivity, even at multi-scale, with the variation of time. It will also have a special feature, with which we will not only be able to predict the oxygen, glucose and cell density dynamics, more accurately, but will also sort the issues arising due to anisotropy. We will fix these problems with the help of modifying the governing equations, by selecting appropriate spatio-temporal finite element schemes, by adaptive grid refinement strategy and by transient analysis.

Keywords: scaffolds, porosity, diffusion, transient analysis

Procedia PDF Downloads 541

Authors: Ahmad Hashim, Zarizi Ab Rahman

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Measurement of body composition via a field method has the most popular instruments which are used to estimate the percentage of body fat. Among the instruments used are the Body Mass Index, Bio Impedance Analysis and Skinfold Test. All three of these instruments do not involve high costs, do not require high technical skills, are mobile, save time, and are suitable for use in large populations. Because all three instruments can estimate the percentage of body fat, but it is important to identify the most appropriate instruments and have high reliability. Hence, this study was conducted to determine the reliability and convergent validity of the instruments. A total of 40 students, males and females aged between 13 and 14 years participated in this study. The study found that the test retest and Pearson correlation coefficient of reliability for the three instruments is very high, r = .99. While the inter class reliability also are at high level with r = .99 for Body Mass Index and Bio Impedance Analysis, r = .96 for Skin fold test. Intra class reliability coefficient for these three instruments is too high for Body Mass Index r = .99, Bio Impedance Analysis r = .97, and Skin fold Test r = .90. However, Standard Error of Measurement value for all three instruments indicates the Body Mass Index is the most appropriate instrument with a mean value of .000672 compared with other instruments. The findings show that the Body Mass Index is an instrument which is the most accurate and reliable in estimating body fat percentage for the population studied.

Keywords: reliability, validity, body mass index, bio impedance analysis and skinfold test

Procedia PDF Downloads 336

Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

Procedia PDF Downloads 134

Authors: Jia-Sin Li, Ying-Fang Wang, Cheing-Tong Yan

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In this study, an integrated approach of Google Spreadsheet and QR code which is free internet resources was used to improve the inspection procedure. The mobile phone Application（App）was also designed to combine with a web page to create an automatic checklist in order to provide a new integrated information of inspection management system. By means of client-server model, the client App is developed for Android mobile OS and the back end is a web server. It can set up App accounts including authorized data and store some checklist documents in the website. The checklist document URL could generate QR code first and then print and paste on the machine. The user can scan the QR code by the app and filled the checklist in the factory. In the meanwhile, the checklist data will send to the server, it not only save the filled data but also executes the related functions and charts. On the other hand, it also enables auditors and supervisors to facilitate the prevention and response to hazards, as well as immediate report data checks. Finally, statistics and professional analysis are performed using inspection records and other relevant data to not only improve the reliability, integrity of inspection operations and equipment loss control, but also increase plant safety and personnel performance. Therefore, it suggested that the traditional paper-based inspection method could be replaced by the APP which promotes the promotion of industrial security and reduces human error.

Keywords: checklist, Google spreadsheet, APP, self-inspection

Procedia PDF Downloads 118

Authors: Ismail Karaca, Ridvan Saracoglu, Omer Soner

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Fuzzy Logic, an advanced method to support decision-making, is used by various scientists in many disciplines. Fuzzy programming is a product of fuzzy logic, fuzzy rules, and implication. In marine science, fuzzy programming for ships is dramatically increasing together with autonomous ship studies. In this paper, a program to support the decision-making process for ship navigation has been designed. The program is produced in fuzzy logic and rules, by taking the marine accidents and expert opinions into account. After the program was designed, the program was tested by 46 ship accidents reported by the Transportation Safety Investigation Center of Turkey. Wind speed, sea condition, visibility, day/night ratio have been used as input data. They have been converted into a risk factor within the Fuzzy Logic Designer application and fuzzy rules set by marine experts. Finally, the expert's meteorological risk factor for each accident is compared with the program's risk factor, and the error rate was calculated. The main objective of this study is to improve the navigational safety of ships, by using the advance decision support model. According to the study result, fuzzy programming is a robust model that supports safe navigation.

Keywords: calculation of risk factor, fuzzy logic, fuzzy programming for ship, safety navigation of ships

Procedia PDF Downloads 189

Authors: Afef Dridi, Salah Mezlini

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Since experimental devices cannot calculate stress and deformation of complex structures. The Finite Element Method FEM has been widely used in several fields of research. One of these fields is orthodontics. The advantage of using such a method is the use of an accurate and non invasive method that allows us to have a sufficient data about the physiological reactions can happening in soft tissues. Most of researches done in this field were interested in the study of stresses and deformations induced by orthodontic apparatus in soft tissues (alveolar tissues). Only few studies were interested in the distribution of stress and strain in the orthodontic brackets. These studies, although they tried to be as close as possible to real conditions, their models did not reproduce the clinical cases. For this reason, the model generated by our research is the closest one to reality. In this study, a numerical model was developed to explore the stress and strain distribution under the application of real conditions. A comparison between different material properties was also done.

Keywords: visco-hyperelasticity, FEM, orthodontic treatment, inverse method

Procedia PDF Downloads 259

Authors: M. R. Ghasemi, R. Ghiasi, H. Varaee

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Surrogate model has received increasing attention for use in detecting damage of structures based on vibration modal parameters. However, uncertainties existing in the measured vibration data may lead to false or unreliable output result from such model. In this study, an efficient approach based on Monte Carlo simulation is proposed to take into account the effect of uncertainties in developing a surrogate model. The probability of damage existence (PDE) is calculated based on the probability density function of the existence of undamaged and damaged states. The kriging technique allows one to genuinely quantify the surrogate error, therefore it is chosen as metamodeling technique. Enhanced version of ideal gas molecular movement (EIGMM) algorithm is used as main algorithm for model updating. The developed approach is applied to detect simulated damage in numerical models of 72-bar space truss and 120-bar dome truss. The simulation results show the proposed method can perform well in probability-based damage detection of structures with less computational effort compared to direct finite element model.

Keywords: probability-based damage detection (PBDD), Kriging, surrogate modeling, uncertainty quantification, artificial intelligence, enhanced ideal gas molecular movement (EIGMM)

Procedia PDF Downloads 239

Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

Procedia PDF Downloads 33

Authors: Peter U. Eze, P. Udaya, Robin J. Evans

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Data hiding can be achieved by Steganography or invisible digital watermarking. For digital watermarking, both accurate retrieval of the embedded watermark and the integrity of the cover image are important. Medical image security in Teleradiology is one of the applications where the embedded patient record needs to be extracted with accuracy as well as the medical image integrity verified. In this research paper, the Constant Correlation Spread Spectrum digital watermarking for medical image tamper detection and accurate embedded watermark retrieval is introduced. In the proposed method, a watermark bit from a patient record is spread in a medical image sub-block such that the correlation of all watermarked sub-blocks with a spreading code, W, would have a constant value, p. The constant correlation p, spreading code, W and the size of the sub-blocks constitute the secret key. Tamper detection is achieved by flagging any sub-block whose correlation value deviates by more than a small value, ℇ, from p. The major features of our new scheme include: (1) Improving watermark detection accuracy for high-pixel depth medical images by reducing the Bit Error Rate (BER) to Zero and (2) block-level tamper detection in a single computational process with simultaneous watermark detection, thereby increasing utility with the same computational cost.

Keywords: Constant Correlation, Medical Image, Spread Spectrum, Tamper Detection, Watermarking

Procedia PDF Downloads 194

Authors: Haruna Modibbo Usman, Mustapha Muktar, Nasiru Inuwa

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This paper examined the long run relationship between health outcomes and economic growth in Nigeria from 1961 to 2012. Using annual time series data, Augmented Dickey-Fuller (ADF) test is conducted to check the stochastic properties of the variables. Also, the long run relationship among the variables is confirmed based on Johansen Multivariate Cointegration approach whereas the long run and short run dynamics are observed using Vector Error Correction Mechanism (VECM). In addition, VEC Granger causality test is employed to examine the direction of causality among the variables. On the whole, the results obtained revealed the existence of a long run relationship between health outcomes and economic growth in Nigeria and that both life expectancy and crude death rate as measures of health are found to have a long run negative and statistically significant impact on the economic growth over the study period. This is further buttressed by the results of Granger causality test which indicated the existence of unidirectional causality running from life expectancy and crude death rate to economic growth. The study therefore, calls for governments at various levels to create preconditions for health improvements in Nigeria in order to boost the level of health outcomes.

Keywords: cointegration, economic growth, Granger causality, health outcomes, VECM

Procedia PDF Downloads 492

Authors: Nato Kutaladze, George Mikuchadze, Giorgi Sokhadze

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Precipitation forecasts are one of the most demanding applications in numerical weather prediction (NWP). Georgia, as the whole Caucasian region, is characterized by very complex topography. The country territory is prone to flash floods and mudflows, quantitative precipitation estimation (QPE) and quantitative precipitation forecast (QPF) at any leading time are very important for Georgia. In this study, advanced research weather forecasting model’s skill in QPF is investigated over Georgia’s territory. We have analyzed several convection parameterization and microphysical scheme combinations for different rainy episodes and heavy rainy phenomena. We estimate errors and biases in accumulated 6 h precipitation using different spatial resolution during model performance verification for 12-hour and 24-hour lead time against corresponding rain gouge observations and satellite data. Various statistical parameters have been calculated for the 8-month comparison period, and some skills of model simulation have been evaluated. Our focus is on the formation and organization of convective precipitation systems in a low-mountain region. Several problems in connection with QPF have been identified for mountain regions, which include the overestimation and underestimation of precipitation on the windward and lee side of the mountains, respectively, and a phase error in the diurnal cycle of precipitation leading to the onset of convective precipitation in model forecasts several hours too early.

Keywords: extremal dependence index, false alarm, numerical weather prediction, quantitative precipitation forecasting

Procedia PDF Downloads 147

Authors: Fatemeh Behbahani, Rubiyah Yusof

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To avoid collision between following vehicles and vehicles in front, it is vital to keep appropriate, safe spacing between both vehicles over all speeds. Therefore, the following vehicle needs to have exact information regarding the speed and spacing between vehicles. This project is conducted to simulate the tuning of controller gain for a vehicle-following system through the selected control strategy, spacing control policy and fixed-time headway policy. In addition, the paper simulates and designs an adaptive gain controller for a road-vehicle-following system which uses information on the spacing, velocity and also acceleration of a preceding vehicle in the proposed one-vehicle look-ahead strategy. The mathematical model is implemented using Kirchhoff and Newton’s Laws, and stability simulated. The trial-error method was used to obtain a suitable value of controller gain. However, the adaptive-based controller system was able to optimize the gain value automatically. Model Reference Adaptive Control (MRAC) is designed and utilized and based on firstly the Gradient and secondly the Lyapunov approach. The Lyapunov approach considers stability. The Gradient approach was found to improve the best value of gain in the controller system with fixed-time headway.

Keywords: one-vehicle look-ahead, model reference adaptive, stability, tuning gain controller, MRAC

Procedia PDF Downloads 238

Authors: Foad Nazari, Seyed Mahmood Hosseini, Mohammad Hossein Abolbashari, Mohammad Hassan Abolbashari

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The present study is concerned with the optimal design of functionally graded plates using particle swarm optimization (PSO) algorithm. In this study, meshless local Petrov-Galerkin (MLPG) method is employed to obtain the functionally graded (FG) plate’s natural frequencies. Effects of two parameters including thickness to height ratio and volume fraction index on the natural frequencies and total mass of plate are studied by using the MLPG results. Then the first natural frequency of the plate, for different conditions where MLPG data are not available, is predicted by an artificial neural network (ANN) approach which is trained by back-error propagation (BEP) technique. The ANN results show that the predicted data are in good agreement with the actual one. To maximize the first natural frequency and minimize the mass of FG plate simultaneously, the weighted sum optimization approach and PSO algorithm are used. However, the proposed optimization process of this study can provide the designers of FG plates with useful data.

Keywords: optimal design, natural frequency, FG plate, hybrid meshless method, MLPG method, ANN approach, particle swarm optimization

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Authors: Ayad Dalloo, Sulaf Dalloo

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Electrocardiogram (ECG) recording is prone to complications, on analysis by physicians, due to noise and artifacts, thus creating ambiguity leading to possible error of diagnosis. Such drawbacks may be overcome with the advent of high resolution Methods, such as Discrete Wavelet Analysis and Digital Signal Processing (DSP) techniques. This ECG signal analysis is implemented in three stages: ECG preprocessing, features extraction and classification with the aim of realizing high resolution ECG diagnosis and improved detection of abnormal conditions in the heart. The preprocessing stage involves removing spurious artifacts (noise), due to such factors as muscle contraction, motion, respiration, etc. ECG features are extracted by applying DSP and suggested sloping method techniques. These measured features represent peak amplitude values and intervals of P, Q, R, S, R’, and T waves on ECG, and other features such as ST elevation, QRS width, heart rate, electrical axis, QR and QT intervals. The classification is preformed using these extracted features and the criteria for cardiovascular diseases. The ECG diagnostic system is successfully applied to 12-lead ECG recordings for 12 cases. The system is provided with information to enable it diagnoses 15 different diseases. Physician’s and computer’s diagnoses are compared with 90% agreement, with respect to physician diagnosis, and the time taken for diagnosis is 2 seconds. All of these operations are programmed in Matlab environment.

Keywords: ECG diagnostic system, QRS detection, ECG baseline removal, cardiovascular diseases

Procedia PDF Downloads 297

Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

Procedia PDF Downloads 98

Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

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Authors: Medhin Haftom Hailu

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The advancement of information technology has significantly impacted Ethiopia's economy, driving innovation, productivity, job creation, and global connectivity. This research examined the impact of contemporary information and communication technologies on Ethiopian economic progress. The study examined eight variables, including mobile, internet, and fixed-line penetration rates, and five macroeconomic control variables. The results showed a positive and strong effect of ICT on economic growth in Ethiopia, with 1% increase in mobile, internet, and fixed line services penetration indexes resulting in an 8.03, 10.05, and 30.06% increase in real GDP. The Granger causality test showed that all ICT variables Granger caused economic growth, but economic growth Granger caused mobile penetration rate only. The study suggests that coordinated ICT infrastructure development, increased telecom service accessibility, and increased competition in the telecom market are crucial for Ethiopia's economic growth. Ethiopia is attempting to establish a digital economy through massive investment in ensuring ICT quality and accessibility. Thus, the research could enhance in understanding of the economic impact of ICT expansion for successful ICT policy interventions for future research.

Keywords: economic growth, cointegration and error correction, ICT expansion, granger causality, penetration

Procedia PDF Downloads 80

Authors: Raghunath Arnab

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The two-phase sampling which is also known as double sampling was introduced in 1938. In two-phase sampling, samples are selected in phases. In the first phase, a relatively large sample of size is selected by some suitable sampling design and only information on the auxiliary variable is collected. During the second phase, a sample of size is selected either from, the sample selected in the first phase or from the entire population by using a suitable sampling design and information regarding the study and auxiliary variable is collected. Evidently, two phase sampling is useful if the auxiliary information is relatively easy and cheaper to collect than the study variable as well as if the strength of the relationship between the variables and is high. If the sample is selected in more than two phases, the resulting sampling design is called a multi-phase sampling. In this article we will consider how one can use data collected at the first phase sampling at the stages of estimation of the parameter, stratification, selection of sample and their combinations in the second phase in a unified setup applicable to any sampling design and wider classes of estimators. The problem of the estimation of variance will also be considered. The variance of estimator is essential for estimating precision of the survey estimates, calculation of confidence intervals, determination of the optimal sample sizes and for testing of hypotheses amongst others. Although, the variance is a non-negative quantity but its estimators may not be non-negative. If the estimator of variance is negative, then it cannot be used for estimation of confidence intervals, testing of hypothesis or measure of sampling error. The non-negativity properties of the variance estimators will also be studied in details.

Keywords: auxiliary information, two-phase sampling, varying probability sampling, unbiased estimators

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Authors: Joseph Osafo, Winifred Asare-Doku, Charity Akotia

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Decriminalizing suicide is one of the major goals of suicide prevention worldwide. In Ghana, suicide is legally prescribed and there is a wide-spread societal condemnation of the act, the survivor and families share the stigma. Evidence and advocacy continue to mount towards pressuring the government, the legal fraternity and lawmakers to consider decriminalizing the act. However, within this discourse, the views of families of attempt survivors are absent. The purpose of this study was to explore from relatives of suicide attempters their reactions towards the criminality of suicide attempt in the country. A total of 10 relatives of suicide attempters were interviewed using a semi-structured interview guide. Thematic analysis was used to analyze the data. We found that there were divergent views from families on decriminalizing suicide. We generated two major themes; Out-group bias versus In-group bias. Half of the participants opined that suicide attempt should not be decriminalized and others advocated for help and mental health care for victims of the suicide attempt. It was generally observed that although all 10 participants were cognizant that suicide attempt is a crime in Ghana, they preferred their relatives were spared from prosecution. The findings indicate incongruity, especially when participants want their relatives to avoid jail term but want the law that criminalizes suicide to remain. Findings are explained using the Fundamental Attribution Error and the concept of Kin selection. Implications for public education on decriminalization and advocacy are addressed.

Keywords: decriminalization, families, Ghana suicide, suicide attempt

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Authors: Elinor Bull, Faye Horsley

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Abstract Objective: The current study investigated if there was a difference in personality factors in prisoners who had a recorded history of firesetting and who had no recorded history of firesetting. Participants: Participants were 64 male prisoners in a Category B male prison. Participants who had set a fire were identified through the prisons data base, and prisoners who had not set a fire were selected at random. Method: The study used the International Personality Item Pool-50 to measure personality factors, and prisoners who had set a fire were identified through a range of sources accessible to the prison. Analytical evaluation was done by the Multivariate Kruskal Wallis and Mann-Whitney tests. Findings: There was a significant difference between the the firesetting and non-firesetting group in the scores of the personality factor of Contentiousness. Contentiousness was significantly lower in the firesetting sample compared to the non-firesetting sample. Conclusions: Implications for clinical practice and future research are discussed.

Keywords: firesetting, personality, arson, prison, prisoners

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Palash Dey, Sudip Talukdar

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In this work, a cross-breed approach is presented for obtaining both the amount of the damage intensity and location of damage existing in thin-walled members. This cross-breed approach is developed based on response surface methodology (RSM) and genetic algorithm (GA). Theoretical finite element (FE) model of cracked angle section thin walled curved beam has been linked to the developed approach to carry out trial experiments to generate response surface functions (RSFs) of free, forced and heterogeneous dynamic response data. Subsequently, the error between the computed response surface functions and measured dynamic response data has been minimized using GA to find out the optimum damage parameters (amount of the damage intensity and location). A single crack of varying location and depth has been considered in this study. The presented approach has been found to reveal good accuracy in prediction of crack parameters and possess great potential in crack detection as it requires only the current response of a cracked beam.

Keywords: damage parameters, finite element, genetic algorithm, response surface methodology, thin walled curved beam

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Authors: Mina Beheshti, Vida Shams, Mojtaba Esfandiari, Farzaneh Abdollahi, Abdolreza Ohadi

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Most of the people who survive a stroke need rehabilitation tools to regain their mobility. The core function of these devices is a brake actuator. The goal of this study is to design and control a magnetorheological brake which can be used as a rehabilitation tool. In fact, the fluid used in this brake is called magnetorheological fluid or MR that properties can change by variation of the magnetic field. The braking properties can be set as control by using this feature of the fluid. In this research, different MR brake designs are first introduced in each design, and the dimensions of the brake have been determined based on the required torque for foot movement. To calculate the brake dimensions, it is assumed that the shear stress distribution in the fluid is uniform and the fluid is in its saturated state. After designing the rehabilitation brake, the mathematical model of the healthy movement of a healthy person is extracted. Due to the nonlinear nature of the system and its variability, various adaptive controllers, neural networks, and robust have been implemented to estimate the parameters and control the system. After calculating torque and control current, the best type of controller in terms of error and control current has been selected. Finally, this controller is implemented on the experimental data of the patient's movements, and the control current is calculated to achieve the desired torque and motion.

Keywords: rehabilitation, magnetorheological fluid, knee, brake, adaptive control, robust control, neural network control, torque control

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Authors: Amanda Rithieli Pereira Dos Santos, Rute Quelvia De Faria, Álvaro De Oliveira Cardoso, Anderson Rodrigo Da Silva, Érica Leão Fernandes Araújo

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The study of the kinetics of drying has great importance for the mathematical modeling, allowing to know about the processes of transference of heat and mass between the products and to adjust dryers managing new technologies for these processes. The present work had the objective of studying the kinetics of drying of soybean seeds and adjusting different statistical models to the experimental data varying cultivar and temperature. Soybean seeds were pre-dried in a natural environment in order to reduce and homogenize the water content to the level of 14% (b.s.). Then, drying was carried out in a forced air circulation oven at controlled temperatures of 38, 43, 48, 53 and 58 ± 1 ° C, using two soybean cultivars, BRS 8780 and Sambaíba, until reaching a hygroscopic equilibrium. The experimental design was completely randomized in factorial 5 x 2 (temperature x cultivar) with 3 replicates. To the experimental data were adjusted eleven statistical models used to explain the drying process of agricultural products. Regression analysis was performed using the least squares Gauss-Newton algorithm to estimate the parameters. The degree of adjustment was evaluated from the analysis of the coefficient of determination (R²), the adjusted coefficient of determination (R² Aj.) And the standard error (S.E). The models that best represent the drying kinetics of soybean seeds are those of Midilli and Logarítmico.

Keywords: curve of drying seeds, Glycine max L., moisture ratio, statistical models

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Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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Authors: Christy M. Moen, Richard B. Townsley

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Introduction: Metastasis to the frontal bone in thyroid cancer is extremely rare. A literature review found only six cases of thyroid cancer that metastasised to the frontal bone, with two of those involving further bone sites. Case Report: The patient was originally referred to the Oral and Maxillofacial Surgery team with an isolated mass on her forehead. Biopsies were performed, which showed this was likely a metastatic deposit from thyroid cancer. CT-PET scan showed this was an isolated lesion. The patient had a total thyroidectomy, and the forehead lesion was managed with radiotherapy. On interval scanning, the patient’s bony lesion had increased in size and had new lung nodules, which likely represented further metastasis. Conclusion: Isolated bony metastases to the frontal bone are rare. An important clinical principle to remember is that a bony metastasis from an unknown primary is more likely than primary bone cancer.

Keywords: cancer, thyroid, head and neck, surgery

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Authors: Leo Nnamdi Ozurumba-Dwight

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Single-cell genomic analytical systems have proved to be a platform to isolate bulk cells into selected single cells for genomic, proteomic, and related metabolomic studies. This is enabling systematic investigations of the level of heterogeneity in a diverse and wide pool of cell populations. Single cell technologies, embracing techniques such as high parameter flow cytometry, single-cell sequencing, and high-resolution images are playing vital roles in these investigations on messenger ribonucleic acid (mRNA) molecules and related gene expressions in tracking the nature and course of disease conditions. This entails targeted molecular investigations on unit cells that help us understand cell behavoiur and expressions, which can be examined for their health implications on the health state of patients. One of the vital good sides of single-cell RNA sequencing (scRNA seq) is its probing capacity to detect deranged or abnormal cell populations present within homogenously perceived pooled cells, which would have evaded cursory screening on the pooled cell populations of biological samples obtained as part of diagnostic procedures. Despite conduction of just single-cell transcriptome analysis, scRNAseq now permits comparison of the transcriptome of the individual cells, which can be evaluated for gene expressional patterns that depict areas of heterogeneity with pharmaceutical drug discovery and clinical treatment applications. It is vital to strictly work through the tools of investigations from wet lab to bioinformatics and computational tooled analyses. In the precise steps for scRNAseq, it is critical to do thorough and effective isolation of viable single cells from the tissues of interest using dependable techniques (such as FACS) before proceeding to lysis, as this enhances the appropriate picking of quality mRNA molecules for subsequent sequencing (such as by the use of Polymerase Chain Reaction machine). Interestingly, scRNAseq can be deployed to analyze various types of biological samples such as embryos, nervous systems, tumour cells, stem cells, lymphocytes, and haematopoietic cells. In haematopoietic cells, it can be used to stratify acute myeloid leukemia patterns in patients, sorting them out into cohorts that enable re-modeling of treatment regimens based on stratified presentations. In immunotherapy, it can furnish specialist clinician-immunologist with tools to re-model treatment for each patient, an attribute of precision medicine. Finally, the good predictive attribute of scRNAseq can help reduce the cost of treatment for patients, thus attracting more patients who would have otherwise been discouraged from seeking quality clinical consultation help due to perceived high cost. This is a positive paradigm shift for patients’ attitudes primed towards seeking treatment.

Keywords: immunotherapy, transcriptome, re-modeling, mRNA, scRNA-seq

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Authors: Victor Breux, Jérôme Boutet, Alain Goret, Viviane Cattin

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Early detection of anomalies in data centers is important to reduce downtimes and the costs of periodic maintenance. However, there is little research on this topic and even fewer on the fusion of sensor data for the detection of abnormal events. The goal of this paper is to propose a method for anomaly detection in data centers by combining sensor data (temperature, humidity, power) and deep learning models. The model described in the paper uses one autoencoder per sensor to reconstruct the inputs. The auto-encoders contain Long-Short Term Memory (LSTM) layers and are trained using the normal samples of the relevant sensors selected by correlation analysis. The difference signal between the input and its reconstruction is then used to classify the samples using feature extraction and a random forest classifier. The data measured by the sensors of a data center between January 2019 and May 2020 are used to train the model, while the data between June 2020 and May 2021 are used to assess it. Performances of the model are assessed a posteriori through F1-score by comparing detected anomalies with the data center’s history. The proposed model outperforms the state-of-the-art reconstruction method, which uses only one autoencoder taking multivariate sequences and detects an anomaly with a threshold on the reconstruction error, with an F1-score of 83.60% compared to 24.16%.

Keywords: anomaly detection, autoencoder, data centers, deep learning

Procedia PDF Downloads 194