Search results for: postoperative patient rehabilitation

Authors: Djallel Bouamama, Yasser R. Haddadi

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Accurate brain tumor segmentation is crucial for diagnosis and treatment planning, yet it remains a challenging task due to the variability in tumor shapes and intensities. This paper introduces a distinct approach to brain tumor image segmentation by leveraging an advanced architecture known as Mamba-Unet. Building on the well-established U-Net framework, Mamba-Unet incorporates distinct design enhancements to improve segmentation performance. Our proposed method integrates a multi-scale attention mechanism and a hybrid loss function to effectively capture fine-grained details and contextual information in brain MRI scans. We demonstrate that Mamba-Unet significantly enhances segmentation accuracy compared to conventional U-Net models by utilizing a comprehensive dataset of annotated brain MRI scans. Quantitative evaluations reveal that Mamba-Unet surpasses traditional U-Net architectures and other contemporary segmentation models regarding Dice coefficient, sensitivity, and specificity. The improvements are attributed to the method's ability to manage class imbalance better and resolve complex tumor boundaries. This work advances the state-of-the-art in brain tumor segmentation and holds promise for improving clinical workflows and patient outcomes through more precise and reliable tumor detection.

Keywords: brain tumor classification, image segmentation, CNN, U-NET

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Authors: Claire Williams

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Randomised controlled Trials (RCTs) of efficacy are still perceived as the gold standard for the generation of evidence, and whilst advances in data collection methods are well developed, this progress has not been matched for the reporting of adverse events (AEs). Assessment and reporting of AEs in clinical trials are fraught with human error and inefficiency and are extremely time and resource intensive. Recent research conducted into the quality of reporting of AEs during clinical trials concluded it is substandard and reporting is inconsistent. Investigators commonly send reports to sponsors who are incorrectly categorised and lacking in critical information, which can complicate the detection of valid safety signals. In our presentation, we will describe an electronic data capture system, which has been designed to support clinical trial processes by reducing the resource burden on investigators, improving overall trial efficiencies, and making trials safer for patients. This proprietary technology was developed using expertise proven in the delivery of the world’s first prospective, phase 3b real-world trial, ‘The Salford Lung Study, ’ which enabled robust safety monitoring and reporting processes to be accomplished by the remote monitoring of patients’ EHRs. This technology enables safety alerts that are pre-defined by the protocol to be detected from the data extracted directly from the patients EHR. Based on study-specific criteria, which are created from the standard definition of a serious adverse event (SAE) and the safety profile of the medicinal product, the system alerts the investigator or study team to the safety alert. Each safety alert will require a clinical review by the investigator or delegate; examples of the types of alerts include hospital admission, death, hepatotoxicity, neutropenia, and acute renal failure. This is achieved in near real-time; safety alerts can be reviewed along with any additional information available to determine whether they meet the protocol-defined criteria for reporting or withdrawal. This active surveillance technology helps reduce the resource burden of the more traditional methods of AE detection for the investigators and study teams and can help eliminate reporting bias. Integration of multiple healthcare data sources enables much more complete and accurate safety data to be collected as part of a trial and can also provide an opportunity to evaluate a drug’s safety profile long-term, in post-trial follow-up. By utilising this robust and proven method for safety monitoring and reporting, a much higher risk of patient cohorts can be enrolled into trials, thus promoting inclusivity and diversity. Broadening eligibility criteria and adopting more inclusive recruitment practices in the later stages of drug development will increase the ability to understand the medicinal products risk-benefit profile across the patient population that is likely to use the product in clinical practice. Furthermore, this ground-breaking approach to AE detection not only provides sponsors with better-quality safety data for their products, but it reduces the resource burden on the investigator and study teams. With the data taken directly from the source, trial costs are reduced, with minimal data validation required and near real-time reporting enables safety concerns and signals to be detected more quickly than in a traditional RCT.

Keywords: more comprehensive and accurate safety data, near real-time safety alerts, reduced resource burden, safer trials

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Authors: Merve Aydin, Mağfiret Kara Kaşikçi

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Aim: To determine the perceptions of inpatients about care at Farabi Hospital in KTU. Material and Method: This research was conducted by using the universe known examples of formulas and probability selected by sampling method with 277 chosen patients in the hospital at least 14 days in other internal and surgical clinics except for pediatric, psychiatry, and intensive care unit services between January-March 2014 in KTU Farabi Hospital. The data was collected through the forms of nursing care perception scale of patients and defining characteristics of patients. In the evaluation of data, percentage, mean, Mann Whitney U, Student t and Kurskall Wallis tests were applied. Results: The average point the patients got in nursing care perception scale is 62.64±10.08’dir. 48.7 % of patients regard nursing care well and 36.8 % of them regard it very well. 19 % of the patients regard nursing care badly. When the age, sex, occupation, marital status, educational background, residential place, income level, hospitalization period, hospitalization clinic and having a hospital attendant were compared with nursing care perception average point, the difference among point averages was not found meaningful statistically (p > 0.05). The average point of nursing care perception was found greater in those having chronic disease (p < 0.05). Conclusion: The perception point of patients about nursing care is above the average according to the average of the lowest and highest points. The great majority of patients regard nursing care well or very well.

Keywords: hospital, patient, perception of nursing care, nursing care

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Authors: Ardiana Murtezani, Ilirijana Dallku, Teuta Osmani Vllasolli, Sabit Sllamniku

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Background: The use of foot orthoses are always indicated when there are alterations of the optimal biomechanics' position of the foot. Orthotics are very effective and very suitable for the majority of patients with pain due to overload which can be related to biomechanical disorders. Aim: To assess the frequency of patients requiring foot orthoses, type of orthoses and analysis of their disease leading to the use of foot orthoses. Material and Methods: Our study included 128 patients with various foot pathologies, treated at the outpatient department of the Ortho-Prosthetic Center of Kosovo (OPCK) in Prishtina. Prospective-descriptive clinical method was used during this study. Functional status of patients was examined, and the following parameters are noted: range of motion measurements for the affected joints/lower extremities, manual test for muscular strength below the knee and foot of the affected extremity, perimeter measurements of the lower extremities, measurements of lower extremities, foot length measurement, foot width measurements and size. In order to complete the measurements the following instruments are used: plantogram, pedogram, meter and cork shoe lift appliances. Results: The majority of subjects in this study are male (60.2% vs. 39.8%), and the dominant age group was 0-9 (47.7%), 61 subjects respectively. Most frequent foot disorders were: congenital disease 60.1%, trauma cases 13.3%, consequences from rheumatologic disease 12.5%, neurologic dysfunctions 11.7%, and the less frequented are the infectious cases 1.6%. Congenital anomalies were the most frequent cases, and from this group majority of cases suffered from pes planovalgus (37.5%), eqinovarus (15.6%) and discrepancies between extremities (6.3%). Furthermore, traumatic amputations (2.3%) and arthritis (0.8%). As far as neurologic disease, subjects with cerebral palsy are represented with (3.1%), peroneal nerve palsy (2.3%) and hemiparesis (1.6%). Infectious disease osteomyelitis sequels are represented with (1.6%). Conclusion: Based on our study results, we have concluded that the use of foot orthoses for patients suffering from rheumatoid arthritis and nonspecific arthropaty was effective treatment choice, leading to decrease of pain, less deformities and improves the quality of life.

Keywords: orthoses, epidemiological analysis, rheumatoid arthritis, rehabilitation

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Authors: Jenny Jin

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Background: The therapeutic use of cannabis for cancer symptom control in Australia is gaining momentum, reflecting a broader global acceptance of its medicinal potential. Objective: This overview examines the historical context, current regulations, and clinical applications of cannabis in oncology within Australia. Methods: A historical analysis outlines the ancient and 19th-century medicinal uses of cannabis, followed by its prohibition in the early 20th century and subsequent resurgence in the late 20th century. The current legal framework under the therapeutic gods administration (TGA) is discussed. Results: Research indicates that cannabinoids, particularly THC and CBD, effectively alleviate pain, reduce chemotherapy-induced nausea and vomiting, stimulate appetite, and enhance overall quality of life for cancer patients. Despite these benefits, challenges such as dosing standardization, stigma, and access barriers persist. Conclusion: Continued clinical research, policy development, and educational initiatives are essential to optimize the use of cannabis in cancer care. A patient-centred approach, emphasizing interdisciplinary collaboration and informed decision-making, is crucial for improving therapeutic outcomes in this evolving field.

Keywords: historical context of cannabis, symptom control in oncology patients, therapeutic benefits, outcome and future

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Authors: V. Argyropoulos, M. Nikolaraizi, K. Tanou

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There is little available information concerning the cognitive and communicative abilities of the people who are deaf-blind. This mainly stems from the general inadequacy of existing assessment instruments employed with deafblind individuals. Although considerable variability exists with regard to cognitive capacities of the deaf-blind, careful examination of the literature reveals that the majority of these persons suffer from significant deficits in cognitive and adaptive functioning. The few reports available primarily are case studies, narrative program descriptions, or position papers by workers in the field. Without the objective verification afforded by controlled research, specialists in psychology, education, and other rehabilitation services must rely on personal speculations or biases to guide their decisions in the planning, implementation, and evaluation of services to deaf-blind children and adults. This paper highlights the framework and discusses the results of an action research network. The aim of this study was twofold: a) to describe and analyse the different ways in which a student with deafblindness approached a number of developmental issues such as novel tasks, exploration and manipulation of objects, reactions to social stimuli, motor coordination, and quality of play and b) to map the appropriate functional approach for the specific student that could be used to develop strategies for classroom participation and socialization. The persons involved in this collaborative action research scheme were general teachers, a school counsellor, academic staff and student teachers. Rating scales and checklists were used to gather information in natural activities and settings, and additional data were also obtained through interviews with the educators of the student. The findings of this case study indicated that there is a great need to focus on the development of effective intervention strategies. The results showed that the identification of positive reinforcers for this population might represent an important and challenging aspect of behaviour programmes. Finally, the findings suggest that additional empirical work is needed to increase attention to methodological and social validity issues.

Keywords: action research, cognitive and communicative abilities, deafblindness, effective strategies

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Authors: Carolina Gouveia, José Vieira, Pedro Pinho

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The cardiopulmonary signal monitoring, without the usage of contact electrodes or any type of in-body sensors, has several applications such as sleeping monitoring and continuous monitoring of vital signals in bedridden patients. This system has also applications in the vehicular environment to monitor the driver, in order to avoid any possible accident in case of cardiac failure. Thus, the bio-radar system proposed in this paper, can measure vital signals accurately by using the Doppler effect principle that relates the received signal properties with the distance change between the radar antennas and the person’s chest-wall. Once the bio-radar aim is to monitor subjects in real-time and during long periods of time, it is impossible to guarantee the patient immobilization, hence their random motion will interfere in the acquired signals. In this paper, a mathematical model of the bio-radar is presented, as well as its simulation in MATLAB. The used algorithm for breath rate extraction is explained and a method for DC offsets removal based in a motion detection system is proposed. Furthermore, experimental tests were conducted with a view to prove that the unavoidable random motion can be used to estimate the DC offsets accurately and thus remove them successfully.

Keywords: bio-signals, DC component, Doppler effect, ellipse fitting, radar, SDR

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Authors: Hang T. T. Tran, Ha T. Le, Hanh T. P. Tran, Hung V. Cao, Giang T. H. Nguyen, Dien M. Tran, Tobias Alfvén, Linus Olson

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Background: Hypoxic Ischemic Encephalopathy is one of the major causes of neonatal death and those who survive with severe encephalopathy are more likely to develop adverse long-term outcomes such as neurocognitive impairment and cerebral palsy, which is a huge burden, especially in low-middle income countries. It is important to have a long-term follow-up for early detection and promote early intervention for these groups of high-risk infants. Aim: To determine the neurological outcome of cooling infants at 18 months and identify an optimized neurological examination scale for Hypoxic Ischemic Encephalopathy infants in Vietnam. Method: Descriptive study of neurodevelopmental outcomes at 18 months of HIE infants who underwent therapeutic hypothermia treatment in Vietnam. All survived cooling infants were assessed at discharge and at 6, 12, and 18 months by a pediatric physical therapist and a neurologist using two assessment tools: Ages and Stages Questionnaires and the Hammersmith Infant Neurological Examination scale to detect impairments and promote early intervention for those who require it. Results: During a 3-year period, a total of 130 neonates with moderate to severe HIE underwent therapeutic hypothermia treatment using Phase change material mattress (65% moderate, 35% severe – Sarnat). 43 (33%) died during hospitalization and infancy; among survivors, 69 (79%) completed 3 follow-ups at 18 months. At 18 months, 25 had cerebral palsy, 11 had mild delayed neurodevelopment. At each time-point, infants with a normal/mildly delayed neurodevelopment had significantly higher Ages and Stages Questionnaires and Hammersmith Infant Neurological Examination scores (p<0.05) than those with cerebral palsy. Conclusion: The study showed that the Ages and Stages Questionnaires and Hammersmith Infant Neurological Examination is a helpful tool in the process of early diagnosis of infants at low and high neurological risk and identifying those infants needing specific rehabilitation programme.

Keywords: encephalopathy, phase-change-material, neurodevelopment, cerebral palsy

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Authors: Omer Abdalla Ishag, Magdi Baker Amien

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Physicians used the stethoscope for listening patient heart sounds in order to make a diagnosis. However, the determination of heart conditions by acoustic stethoscope is a difficult task so it requires special training of medical staff. This study developed an accurate model for analyzing the phonocardiograph signal based on PC and DSP processor. The system has been realized into two phases; offline and real time phase. In offline phase, 30 cases of heart sounds files were collected from medical students and doctor's world website. For experimental phase (real time), an electronic stethoscope has been designed, implemented and recorded signals from 30 volunteers, 17 were normal cases and 13 were various pathologies cases, these acquired 30 signals were preprocessed using an adaptive filter to remove lung sounds. The background noise has been removed from both offline and real data, using wavelet transform, then graphical and statistics features vector elements were extracted, finally a look-up table was used for classification heart sounds cases. The obtained results of the implemented system showed accuracy of 90%, 80% and sensitivity of 87.5%, 82.4% for offline data, and real data respectively. The whole system has been designed on TMS320VC5509a DSP Platform.

Keywords: code composer studio, heart sounds, phonocardiograph, wavelet transform

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Authors: Ajeevan Gautam, Gulam Anwer Khan, Pratibha Pokhrel

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Introduction: Dermatoglyphics is the science which deals with the study of dermal ridge configuration on the digits, palms and soles. It is grooved by ridges and forms variety of configurations. The aim of the study was to identify dermal ridge patterns on fingertip of hypertensive patients and in normal population and to compare patterns among them. Methods: The subjects of the study were 130 hypertensives and 130 non-hypertensives cases of Kathmandu Valley aged between 40 to 80 years. Case history was recorded after consent finger prints were taken. Different parameters as whorl, loop, arch and composite patterns were studied and analysed. Result: It revealed, increased whorl pattern in hypertensive. It showed 65.69% whorl, 29.23% loop and 5.07% arch patterns in right hand of hypertensive people. In control, it was found to be 34.46% whorl, 58.15% loop and 5.38% arch patterns respectively. Similarly in left hand 63.69% whorl, 32% loop and 4.30% arch in hypertensive group. In control group it was 60.15% as loop, 35.69% as whorl and 15% as arch. Discussion: Based on findings of the result, it was concluded that the whorl, loop and arch patterns observed as 65.69%, 29.23% and 5.07% respectively in hypertensive cases in right hand. Similarly in left hand, it was found to be 4.30% as arch, 32% as loop and 63.69% as whorl patterns, but in normotensive subjects these patterns were recorded as 36.43%, 58.15%, 5.38% in right hand and 35.69%, 60.15%, 4.15% in left hand as whorl, loop and arch respectively.

Keywords: arch, dermatoglyphics, hypertension, loop, whorl

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Authors: Afolakemi Helen Olaleye, Ogunjobi A. O

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Since coronavirus disease 2019 (COVID-19) was first reported in Nigeria, the virus has spread to virtually all sub-Saharan Africa (SSA) countries. In Nigeria, government agencies came together to create a goal-driven taskforce in improving our response against the virus. As COVID-19 international spread has been curtailed, community spread became rampant locally, leading to many health authorities raising concerns over the scarcity of medical consumables and supplies. Here at Lagos university teaching Hospital (LUTH), we present data analysis of COVID-19 infections offered at our Hospital (LUTH) and the surrounding communities. In addition, the adopted innovative solution to control the spread of infection, methods used in filling shortages of consumables, personal protective equipment (PPE), and use of mobile video technology in patient’s consultation. The management style and strategy adopted has led to a decline in infection rates in our community and among our front line staff. The current COVID -19 crisis has created an opportunity to test and demonstrate our pandemic response and control of infectious disease along with the revealed unknown potential in our community.

Keywords: COVID-19, preparedness, response, Lagos university teaching hospital

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Authors: Bahar Ayberk

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The study was conducted to determine the relationship between physical fitness and academic performance among university students. A far-famed saying ‘Sound mind in a sound body’ referring to the potential quality of increased physical fitness in the intellectual development of individuals seems to be endorsed. There is a growing body of literature the impact of physical fitness on academic achievement, especially in elementary and middle-school aged children. Even though there are numerous positive effects related to being physically active and physical fitness, their effect on academic achievement is not very much clear for university students. The subjects for this study included 25 students (20 female and 5 male) enrolled in Yeditepe University, Physiotherapy and Rehabilitation Department of Health Science Faculty. All participants filled in a questionnaire about their socio-demographic status, general health status, and physical activity status. Health-related physical fitness testing, included several core components: 1) body composition evaluation (body mass index, waist-to-hip ratio), 2) cardiovascular endurance evaluation (queen’s college step test), 3) muscle strength and endurance evaluation (sit-up test, push-up test), 4) flexibility evaluation (sit and reach test). Academic performance evaluation was based on student’s Cumulative Grade Point Average (CGPA). The prevalence of the subjects participating physical activity was found to be 40% (n = 10). CGPA scores were significantly higher among students having regular physical activity when we compared the students having regular physical activities or not (respectively 2,71 ± 0.46, 3.02 ± 0.28 scores, p = 0.076). The result of the study also revealed that there is positive correlation relationship between sit-up, push up and academic performance points (CGPA) (r = 0.43, p ≤ 0.05 ) and negative correlation relationship between cardiovascular endurance parameter (Queen's College Step Test) and academic performance points (CGPA) (r = -0.47, p ≤ 0.05). In conclusion, the findings confirmed that physical fitness level was generally associated with academic performance in the study group. Cardiovascular endurance and muscle strength and endurance were associated with student’s CGPA, whereas body composition and flexibility were unrelated to CGPA.

Keywords: academic performance, health-related physical fitness, physical activity, physical fitness testing

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Authors: Guy Rubin, Ravit Shay, Nimrod Rozen

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The accuracy of a diagnostic test used to classify a patient as having disease or being disease-free is a valuable piece of information to be used by the physician when making treatment decisions. Finger laceration, suspected to have nerve injury is a challenging decision for the treating surgeon. The purpose of this study was to evaluate the sensitivity, specificity and predictive values of six clinical tests in the diagnosis of digital nerve injury. The six clinical tests included light touch, pin prick, static and dynamic 2-point discrimination, Semmes Weinstein monofilament and wrinkle test. Data comparing pre-surgery examination with post-surgery results of 42 patients with 52 digital nerve injury was evaluated. The subjective examinations, light touch, pin prick, static and dynamic 2-point discrimination and Semmes-Weinstein monofilament were not sensitive (57.6, 69.7, 42.4, 40 and 66.8% respectively) and specific (36.8, 36.8, 47.4, 42.1 and 31.6% respectively). Wrinkle test, the only objective examination, was the most sensitive (78.1%) and specific (55.6%). This result gives no pre-operative examination the ability to predict the result of explorative surgery.

Keywords: digital nerve, injury, nerve examination, Semmes-Weinstein monofilamen, sensitivity, specificity, two point discrimination, wrinkle test

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Authors: Chellammal Surianarayanan

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Healthcare industry is generating large amounts of data driven by various needs such as record keeping, physician’s prescription, medical imaging, sensor data, Electronic Patient Record(EPR), laboratory, pharmacy, etc. Healthcare data is so big and complex that they cannot be managed by conventional hardware and software. The complexity of healthcare big data arises from large volume of data, the velocity with which the data is accumulated and different varieties such as structured, semi-structured and unstructured nature of data. Despite the complexity of big data, if the trends and patterns that exist within the big data are uncovered and analyzed, higher quality healthcare at lower cost can be provided. Hadoop is an open source software framework for distributed processing of large data sets across clusters of commodity hardware using a simple programming model. The core components of Hadoop include Hadoop Distributed File System which offers way to store large amount of data across multiple machines and MapReduce which offers way to process large data sets with a parallel, distributed algorithm on a cluster. Hadoop ecosystem also includes various other tools such as Hive (a SQL-like query language), Pig (a higher level query language for MapReduce), Hbase(a columnar data store), etc. In this paper an analysis has been done as how healthcare big data can be processed and analyzed using Hadoop ecosystem.

Keywords: big data analytics, Hadoop, healthcare data, towards quality healthcare

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Authors: Sagarjyoti Roy

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Dengue is an arboviral infection, belonging to family flaviviridae, comprising of four serotypes; DENV1, DENV2, DENV3 and DENV4. All four serotypes are capable of causing full-spectrum of clinical features, ranging from self-limiting fever to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Complications may affect any organ system, including those involving gastrointestinal system and serositis. We report a case, of a 28 years, non-alcoholic male, presenting with a 7 day history of fever and malaise followed by abdominal pain and distension, from 4th day of fever. He was admitted in medicine department of RG KAR medical college hospital. Dengue fever was confirmed by NS1 and dengue IgM positivity. Platelet count was 30,000/cc (1.5- 4 lac/cc) and haematocrit was 52% (38- 50% for men). Clinicoradiological findings revealed bilateral pleural effusion, ascites and splenomegaly. Ascitic fluid was hemorrhagic in nature, with a high protein and RBC content. Liver function tests revealed mild transaminitis with normal coagulation profile. Patient was managed conservatively. A diagnosis of dengue fever complicated by serositis and spontaneous haemoperitoneum was made. The symptoms subsided after a hospital stay of 10 days. The case highlights haemorrhage into peritoneal cavity as a possible complication of dengue fever. Although a definite explanation requires more detailed studies, platelet or endothelial cell dysfunction might be contributory.

Keywords: ascites, dengue, haemoperitoneum, serositis

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Authors: Naser Safdarian, Nader Jafarnia Dabanloo

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In this paper we used four features i.e. Q-wave integral, QRS complex integral, T-wave integral and total integral as extracted feature from normal and patient ECG signals to detection and localization of myocardial infarction (MI) in left ventricle of heart. In our research we focused on detection and localization of MI in standard ECG. We use the Q-wave integral and T-wave integral because this feature is important impression in detection of MI. We used some pattern recognition method such as Artificial Neural Network (ANN) to detect and localize the MI. Because these methods have good accuracy for classification of normal and abnormal signals. We used one type of Radial Basis Function (RBF) that called Probabilistic Neural Network (PNN) because of its nonlinearity property, and used other classifier such as k-Nearest Neighbors (KNN), Multilayer Perceptron (MLP) and Naive Bayes Classification. We used PhysioNet database as our training and test data. We reached over 80% for accuracy in test data for localization and over 95% for detection of MI. Main advantages of our method are simplicity and its good accuracy. Also we can improve accuracy of classification by adding more features in this method. A simple method based on using only four features which extracted from standard ECG is presented which has good accuracy in MI localization.

Keywords: ECG signal processing, myocardial infarction, features extraction, pattern recognition

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Authors: Freddy Patricio Moncayo-Matute, Pablo Gerardo Peña-Tapia, Vázquez-Silva Efrén, Paúl Bolívar Torres-Jara, Diana Patricia Moya-Loaiza, Gabriela Abad-Farfán

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This study describes a clinical case and the results on the application of additive manufacturing for the surgical planning in the removal of a cranial spheno-orbital meningioma. It is verified that the use of personalized anatomical models and cutting guides helps to manage the cranial anomalies approach. The application of additive manufacturing technology: Fused Deposition Modeling (FDM), as a low-cost alternative, enables the printing of the test anatomical model, which in turn favors the reduction of surgery time, as well the morbidity rate reduction too. And the printing of the personalized cutting guide, which constitutes a valuable aid to the surgeon in terms of improving the intervention precision and reducing the invasive effect during the craniotomy. As part of the results, post-surgical follow-up is included as an instrument to verify the patient's recovery and the validity of the procedure.

Keywords: surgical planning, additive manufacturing, rapid prototyping, fused deposition modeling, custom anatomical model

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Authors: Nadine Wills

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The whole life thinking of buildings (independent if these are commercial properties or residential properties) will raise if incentive systems are provided to investors, planners and users. The Use of Building Information Modelling (BIM)-Systems offers planners the possibility to plan and re-plan buildings for decades after a period of utilization without spending many capacities. The strategy-incentive should be to plan the building in a way that makes rescheduling possible by changing just parameters in the system and not re-planning the whole building. If users receive the chance to patient incentive systems, the building stock will have a long life period. Business models of tenant electricity or self-controlled operating costs are incentive systems for building –users to let fixed running costs decline without producing damages due to wrong purposes. BIM is the controlling body to ensure that users do not abuse the incentive solution and take negative influence on the building stock. The investor benefits from the planner’s and user’s incentives: the fact that the building becomes useful for the whole life without making unnecessary investments provides possibilities to make investments in different assets. Moreover, the investor gains the facility to achieve higher rents by merchandise the property with low operating costs. To execute BIM offers whole property life cycles.

Keywords: BIM, incentives, life cycle, sustainability

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Authors: Puntarikorn Rungrattanakasin

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Objectives: To develop the trigger tool to warn about the risk of bleeding as an adverse event from warfarin drug usage during admission in Medical Wards of Chumphae Hospital. Methods: A retrospective study was performed by reviewing the medical records for the patients admitted between June 1st,2020- May 31st, 2021. ADEs were evaluated by Naranjo’s algorithm. The international normalized ratio (INR) and events of bleeding during admissions were collected. Statistical analyses, including Chi-square test and Reciever Operating Characteristic (ROC) curve for optimal INR threshold, were used for the study. Results: Among the 139 admissions, the INR range was found to vary between 0.86-14.91, there was a total of 15 bleeding events, out of which 9 were mild, and 6 were severe. The occurrence of bleeding started whenever the INR was greater than 2.5 and reached the statistical significance (p <0.05), which was in concordance with the ROC curve and yielded 100 % sensitivity and 60% specificity in the detection of a bleeding event. In this regard, the INR greater than 2.5 was considered to be an optimal threshold to alert promptly for bleeding tendency. Conclusions: The INR value of greater than 2.5 (>2.5) would be an appropriate trigger tool to warn of the risk of bleeding for patients taking warfarin in Chumphae Hospital.

Keywords: trigger tool, warfarin, risk of bleeding, medical wards

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Authors: Ali Berkan Ural

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This paper presents the analysis, evaluation, and pre-diagnosis of early stage breast based diagnostic problems (breast cancer, nodulesorlumps) by Computer Aided Diagnosing (CAD) system from mammogram radiological images. According to the statistics, the time factor is crucial to discover the disease in the patient (especially in women) as possible as early and fast. In the study, a new algorithm is developed using advanced image processing and deep learning method to detect and classify the problem at earlystagewithmoreaccuracy. This system first works with image processing methods (Image acquisition, Noiseremoval, Region Growing Segmentation, Morphological Operations, Breast BorderExtraction, Advanced Segmentation, ObtainingRegion Of Interests (ROIs), etc.) and segments the area of interest of the breast and then analyzes these partly obtained area for cancer detection/lumps in order to diagnosis the disease. After segmentation, with using the Spectrogramimages, 5 different deep learning based methods (specified Convolutional Neural Network (CNN) basedAlexNet, ResNet50, VGG16, DenseNet, Xception) are applied to classify the breast based problems.

Keywords: computer aided diagnosis, breast cancer, region growing, segmentation, deep learning

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Authors: Fei Gao, Rodolfo C. Raga Jr.

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This research proposal will ascertain the major risk factors for diabetes and to design a predictive model for risk assessment. The project aims to improve diabetes early detection and management by utilizing data science techniques, which may improve patient outcomes and healthcare efficiency. The phase relation values of each attribute were used to analyze and choose the attributes that might influence the examiner's survival probability using Diabetes Health Indicators Dataset from Kaggle’s data as the research data. We compare and evaluate eight machine learning algorithms. Our investigation begins with comprehensive data preprocessing, including feature engineering and dimensionality reduction, aimed at enhancing data quality. The dataset, comprising health indicators and medical data, serves as a foundation for training and testing these algorithms. A rigorous cross-validation process is applied, and we assess their performance using five key metrics like accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC-ROC). After analyzing the data characteristics, investigate their impact on the likelihood of diabetes and develop corresponding risk indicators.

Keywords: diabetes, risk factors, predictive model, risk assessment, data science techniques, early detection, data analysis, Kaggle

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Authors: Siddhant Yadav, Rylea Ranum, Hannah Alberts, Abdul Kalaiger, Brent Bauer, Ryan Hurt, Ann Vincent, Loren Toussaint, Sanjeev Nanda

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Background and significance: Fibromyalgia (FM) is a chronic pain disorder also characterized by chronic fatigue, morning stiffness, sleep, and cognitive symptoms, psychological disturbances (anxiety, depression), and is comorbid with multiple medical and psychiatric conditions. It has an incidence of 2-4% in the general population and is reported more commonly in women. Oxidative stress and inflammation are thought to contribute to pain in patients with FM, and the adoption of an antioxidant/anti-inflammatory diet has been suggested as a modality to alleviate symptoms. The aim of this systematic review was to evaluate the efficacy of specialized diets (ketogenic, gluten free, Mediterranean, and low carbohydrate) in improving FM symptoms. Methodology: A comprehensive search of the following databases from inception to July 15th, 2021, was conducted: Ovid MEDLINE and Epub ahead of print, in-process and other non-indexed citations and daily, Ovid Embase, Ovid EBM reviews, Cochrane central register of controlled trials, EBSCO host CINAHL with full text, Elsevier Scopus, website and citation index, web of science emerging sources citation and clinicaltrials.gov. We included randomized controlled trials, non-randomized experimental studies, cross-sectional studies, cohort studies, case series, and case reports in adults with fibromyalgia. The risk of bias was assessed with the Agency for Health Care Research and Quality designed, specific recommended criteria (AHRQ). Results: Thirteen studies were eligible for inclusion. This included a total of 761 participants. Twelve out of the 13 studies reported improvement in widespread body pain, joint stiffness, sleeping pattern, mood, and gastrointestinal symptoms, and one study reported no changes in symptomatology in patients with FM on specialized diets. None of the studies showed the worsening of symptoms associated with a specific diet. Most of the patient population was female, with the mean age at which fibromyalgia was diagnosed being 48.12 years. Improvement in symptoms was reported by the patient's adhering to a gluten-free diet, raw vegan diet, tryptophan- and magnesium-enriched Mediterranean diet, aspartame- and msg- elimination diet, and specifically a Khorasan wheat diet. Risk of bias assessment noted that 6 studies had a low risk of bias (5 clinical trials and 1 case series), four studies had a moderate risk of bias, and 3 had a high risk of bias. In many of the studies, the allocation of treatment (diets) was not adequately concealed, and the researchers did not rule out any potential impact from a concurrent intervention or an unintended exposure that might have biased the results. On the other hand, there was a low risk of attrition bias in all the trials; all were conducted with an intention-to-treat, and the inclusion/exclusion criteria, exposures/interventions, and primary outcomes were valid, reliable, and implemented consistently across all study participants. Concluding statement: Patients with fibromyalgia who followed specialized diets experienced a variable degree of improvement in their widespread body pain. Improvement was also seen in stiffness, fatigue, moods, sleeping patterns, and gastrointestinal symptoms. Additionally, the majority of the patients also reported improvement in overall quality of life.

Keywords: fibromyalgia, specialized diet, vegan, gluten free, Mediterranean, systematic review

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Authors: Gulseren Kirbas, Mushap Kuru, Buket Bakir, Ebru Karadag Sari

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Capra (mountain goat) is a genus comprising nine species. The domestic goat (C. aegagrus hircus) is a subspecies of the wild goat that is domesticated. This study aimed to determine the anatomical structure of the salpinx and ovary of the Anatolian wild goat (C. aegagrus aegagrus). Animals that were taken to the Kafkas University Wildlife Rescue and Rehabilitation Center, Kars, Turkey, because of various reasons, such as traffic accidents and firearm injuries, were used in this study. The salpinges and ovaries of four wild goats of similar ages, which could not be rescued by the Center despite all interventions, were dissected. Measurements were taken from the right-left salpinx and ovary using digital calipers. The weights of each ovary and salpinx were measured using a precision scale (min: 0.0001 g − max: 220 g, code: XB220A; Precisa, Swiss). The histological structure of the tissues was examined after weighing the organs. The tissue samples were fixed in 10% formaldehyde for 24 h. Then a routine procedure was applied, and the tissues were embedded in paraffin. Mallory’s modified triple staining was used to demonstrate the general structure of the salpinx. The salpinx was found to consist of three different regions (infundibulum, ampulla, and isthmus). These regions consisted of tunica mucosa, tunica muscularis, and tunica serosa. The prismatic epithelial cells were observed in the lamina epithelialis of tunica mucosa in every region, but the prismatic fimbrae cells occurred most in the infundibulum. The ampulla was distinguished by its many mucosal folds. It was the longest region of the salpinx and was joined to the isthmus via the ampullary–isthmus junction. Isthmus was the caudal end of the salpinx joined to the uterus and had the thickest tunica muscularis compared with the other regions. The mean length of the ovary was 13.22 ± 1.27 mm, width was 8.46 ± 0.88 mm, the thickness was 5.67 ± 0.79 mm, and weight was 0.59 ± 0.17 g. The average length of the salpinx was 58.11 ± 14.02 mm, width was 0.80 ± 0.22 mm, the thickness was 0.41 ± 0.01 mm, and weight was 0.30 ± 0.08 g. In conclusion, the Anatolian wild goat, which is included in wildlife diversity in Turkey, has been disappearing due to illegal and uncontrolled hunting as well as traffic accidents in recent years. These findings are believed to contribute to the literature.

Keywords: Anatolian wild goat, anatomy, ovary, salpinx

Procedia PDF Downloads 224

Authors: Daniel Hyun

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Dental implants are one of the top 3 reasons to sue a dentist for malpractice. It involves dental implant complications, usually because of the angle of the implant from the surgery. At present, surgeons usually use a 3D-printed navigator that is customized for the patient’s teeth. However, those can’t be reused for other patients as they require time. Therefore, I made a guiding device to assist the surgeon in implant operations. The surgeon can input the objective of the operation, and the device constantly checks if the surgery is heading towards the objective within the set range, telling the surgeon by manipulating the LED. We tested the prototypes’ consistency and accuracy by checking the graph, average standard deviation, and the average change of the calculated angles. The accuracy of performance was also acquired by running the device and checking the outputs. My first prototype used accelerometer and gyroscope sensors from the Arduino MPU6050 sensor, getting a changeable graph, achieving 0.0295 of standard deviations, 0.25 of average change, and 66.6% accuracy of performance. The second prototype used only the gyroscope, and it got a constant graph, achieved 0.0062 of standard deviation, 0.075 of average change, and 100% accuracy of performance, indicating that the accelerometer sensor aggravated the functionality of the device. Using the gyroscope sensor allowed it to measure the orientations of separate axes without affecting each other and also increased the stability and accuracy of the measurements.

Keywords: implant, guide, accelerometer, gyroscope, handpiece

Procedia PDF Downloads 43

Authors: Aiza G. Clanor, Lotlot B. Hernandez, Jonna Marie T. Ibuna

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This study aimed to know the coping mechanisms of Batangueño families facing cancer, specifically, those from Cancer Warriors Foundation, Inc. Batangas chapter. The researchers used purposive sampling. This study was limited to the responses provided by the Batangueño families of the cancer patients. A family member of the immediate family with a child facing cancer represents the family as a whole. A total number of forty six (46) respondents were given the questionnaires. Upon analysis, most of the respondents came from rural areas and nuclear family and have Php 5000 and below family monthly income. Most of them have their own houses, and 3 to 5 members, one of whom is a cancer patient diagnosed for more than 2 years. The two most frequently utilized coping strategies were mobilizing the family to acquire and accept help, and reframing. Passive appraisal is the least utilized one. There was a significant difference on the coping mechanisms of the family relative to passive appraisal based on the length of time since the illness was first diagnosed. Based from the study, the researchers developed modules with discussions and activities on cancer awareness, ideas on coping and how to deal with the cancer patients that may help the respondents and other Batangueño families overcome the difficulties in facing cancer. The researchers recommend the modules for they are found to be effective ways to help the families relieve stress, reduce anxiety and improve quality of life.

Keywords: coping with chronic illness, family, psychology, cancer

Procedia PDF Downloads 539

Authors: Gousilin Leandra Rocha Da Silva, Stéfani T. A. Dantas, Bruna F. Rossi, Erika R. Bonsaglia, Ivana G. Castilho, Terue Sadatsune, Ary Fernandes Júnior, Vera l. M. Rall

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Kidney failure causes decreased diuresis and accumulation of nitrogenous substances in the body. To increase patient survival, hemodialysis is used as a partial substitute for renal function. However, contamination of the water used in this treatment, causing bacteremia in patients, is a worldwide concern. The Burkholderia cepacia complex (Bcc), a group of bacteria with more than 20 species, is frequently isolated from hemodialysis water samples and comprises opportunistic bacteria, affecting immunosuppressed patients, due to its wide variety of virulence factors, in addition to innate resistance to several antimicrobial agents, contributing to the permanence in the hospital environment and to the pathogenesis in the host. The objective of the present work was to characterize molecularly and phenotypically Bcc isolates collected from the water and dialysate of the Hemodialysis Unit and from the blood of patients at a Public Hospital in Botucatu, São Paulo, Brazil, between 2019 and 2021. We used 33 Bcc isolates, previously obtained from blood cultures from patients with bacteremia undergoing hemodialysis treatment (2019-2021) and 24 isolates obtained from water and dialysate samples in a Hemodialysis Unit (same period). The recA gene was sequenced to identify the specific species among the Bcc group. All isolates were tested for the presence of some genes that encode virulence factors such as cblA, esmR, zmpA and zmpB. Considering the epidemiology of the outbreak, the Bcc isolates were molecularly characterized by Multi Locus Sequence Type (MLST) and by pulsed-field gel electrophoresis (PFGE). The verification and quantification of biofilm in a polystyrene microplate were performed by submitting the isolates to different incubation temperatures (20°C, average water temperature and 35°C, optimal temperature for group growth). The antibiogram was performed with disc diffusion tests on agar, using discs impregnated with cefepime (30µg), ceftazidime (30µg), ciprofloxacin (5µg), gentamicin (10µg), imipenem (10µg), amikacin 30µg), sulfametazol/trimethoprim (23.75/1.25µg) and ampicillin/sulbactam (10/10µg). The presence of ZmpB was identified in all isolates, while ZmpA was observed in 96.5% of the isolates, while none of them presented the cblA and esmR genes. The antibiogram of the 33 human isolates indicated that all were resistant to gentamicin, colistin, ampicillin/sulbactam and imipenem. 16 (48.5%) isolates were resistant to amikacin and lower rates of resistance were observed for meropenem, ceftazidime, cefepime, ciprofloxacin and piperacycline/tazobactam (6.1%). All isolates were sensitive to sulfametazol/trimethoprim, levofloxacin and tigecycline. As for the water isolates, resistance was observed only to gentamicin (34.8%) and imipenem (17.4%). According to PFGE results, all isolates obtained from humans and water belonged to the same pulsotype (1), which was identified by recA sequencing as B. cepacia¸, belonging to sequence type ST-767. By observing a single pulse type over three years, one can observe the persistence of this isolate in the pipeline, contaminating patients undergoing hemodialysis, despite the routine disinfection of water with peracetic acid. This persistence is probably due to the production of biofilm, which protects bacteria from disinfectants and, making this scenario more critical, several isolates proved to be multidrug-resistant (resistance to at least three groups of antimicrobials), turning the patient care even more difficult.

Keywords: hemodialysis, burkholderia cepacia, PFGE, MLST, multi drug resistance

Procedia PDF Downloads 99

Authors: S. Ishak, M. G. Nasuruddin

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Traditional Malay performances are carried out for both entertainment and curing purposes. In curing rituals, the men and women serving as shamans, communicates with the spirits and beings from the nether world to facilitate the curing process. The dependency on engaging with these other-worldly beings however, have raised religious issues of being syirik, namely practicing in rituals which are religiously forbidden. This study aims to observe how ritual leaders attempt to negotiate the fine balance between what has been religiously forbidden and the psychological and sociological needs of the patient. Two curing rituals, the main peteri and the malibobou were chosen to exemplify the communication between the physical and spiritual realities. In both rituals, the healers engaged in procedures of curing as they attempted to diagnose sicknesses and proffer cures with the help of the spirits. The main peteri was conducted by a male shaman, the tuk teri whereas the malibobou was conducted by a female ritual specialist, the bobohizan. Main peteri and the malibobou both ended with ritually thanking and sending off the spirits back to their nether, invisible domains. These curing rituals heal not only the sick individual, but by extension, the village community. Therefore, there is a need to reconcile these rituals with religious tenets, beliefs and sociological-political-cultural dimensions.

Keywords: traditional healing, trance, spirits, main peteri, bobohizan

Procedia PDF Downloads 359

Authors: Hasan Taştan, Ayşen Ciravoğlu

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The rapid growth of the human population and the environmental degradation associated with increased consumption of resources raises concerns on sustainability. Social sustainability constitutes one of the three dimensions of sustainability together with environmental and economic dimensions. Even though there is not an agreement on what social sustainability consists of, it is a well known fact that it necessitates user participation. The fore, this study aims to observe and analyze the role of user participation on social sustainability. In this paper, the links between user participation and indicators of social sustainability have been searched. In order to achieve this, first of all a literature review on social sustainability has been done; accordingly, the information obtained from researches has been used in the evaluation of the projects conducted in the developing countries considering user participation. These examples are taken as role models with pros and cons for the development of the checklist for the evaluation of the case studies. Furthermore, a case study over the post earthquake residential settlements in Turkey have been conducted. The case study projects are selected considering different building scales (differing number of residential units), scale of the problem (post-earthquake settlements, rehabilitation of shanty dwellings) and the variety of users (differing socio-economic dimensions). Decisionmaking, design, building and usage processes of the selected projects and actors of these processes have been investigated in the context of social sustainability. The cases include: New Gourna Village by Hassan Fathy, Quinta Monroy dwelling units conducted in Chile by Alejandro Aravena and Beyköy and Beriköy projects in Turkey aiming to solve the problem of housing which have appeared after the earthquake happened in 1999 have been investigated. Results of the study possible links between social sustainability indicators and user participation and links between user participation and the peculiarities of place. Results are compared and discussed in order to find possible solutions to form social sustainability through user participation. Results show that social sustainability issues depend on communities' characteristics, socio-economic conditions and user profile but user participation has positive effects on some social sustainability indicators like user satisfaction, a sense of belonging and social stability.

Keywords: housing projects, residential areas, social sustainability, user participation

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Authors: Manar Ahmed Elbadawy

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Background: Empirical evidence suggested that improving nursing teamwork (NTW) may be the key to reducing medical error. The functioning nursing teams require open communication, mutual respect, and shared mental models to activate quality patient care. The complexity and the high demands for specialized nursing knowledge and skill also require nursing staff to consult with one another and work in teams regularly. The current study aimed to evaluate the effect of the nursing teamwork training program on nursing teamwork effectiveness. Design: A quasi-experimental (one group pretest-posttest) design was utilized. Three medical intensive care units at a teaching hospital affiliated to Cairo University Hospital, Egypt. Subjects: A convenient sample of 48 nursing staff worked at the selected units. The Nursing Teamwork Observational Checklist was used. Results: Total (NTW) mean scores exhibited quite elevation post-program implementation compared to preprogram and showed little decrease 3 months later ( = 2.52, SD = ± 0.27, mean % =51.98, = 2.72, SD = ± 0.20, mean %=72.45, = 2.67, SD = ± 0.11, mean %= 67.48 respectively). Conclusion: Implementation of (NTW) training program had a positive effect on increasing (NTW) effectiveness. Regular and frequent short-term teamwork training is important to be introduced as well as sustainable monitoring is required to ensure nursing attitudes, knowledge and skills’ change about teamwork effectiveness.

Keywords: effectiveness, nursing, teamwork, training

Procedia PDF Downloads 123

Authors: Ghada E. Esheba, Ghufran Kheshaifaty, Kholoud Al-Harbi, Wafa'a Al-Harbi, Ala'a Al-Orabi, Moayad Turkistani

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Krukenberg tumor is a rare metastatic ovarian carcinoma that usually occurs in female between 30 - 40 year old and rarely seen after menopause. Stomach is the most common primary site. Histopathological features of krukenberg tumors appear as diffuse stromal proliferation, mucus-production, and numerous signet-cells and these tumors spread mostly by lymphatic route. Treatment and prognostic factors are not well established. This study describes a 34 year old female with a unilateral ovarian mass discovered accidentally during cesarean section delivery and it was misdiagnosed as luteoma of pregnancy, but histopathological examination showed a diffuse infiltration of the ovary and omentum by signet ring cells. These findings were not correlated with luteoma of pregnancy or any other types of primary ovarian tumors like surface epithelial tumor, sex cord stromal tumor or germ cell tumor. However, after the analysis of immunohistochemical results (negative CK7, positive CK20 and CDX-2), the finding was the diagnostic of metastatic krukenberg tumor. Two weeks later, the patient was evaluated and a large gastric tumor was found in her stomach and she underwent gastrectomy.

Keywords: CK7, CK20, CDX-2, Krukenburg tumor, metastatic ovarian tumor

Procedia PDF Downloads 315