Search results for: clinical error

Authors: Viyango Pandian, Kumaresh Athiyappan

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Pelvic congestion Syndrome (PCS) is usually seen in multiparous women who give history of chronic dull-aching pelvic pain. We report a case of a 17 year old unmarried female, who presented with acute onset of chronic dull-aching abdominal pain in the left iliac fossa, which particularly increased during menstruation and was finally diagnosed to be pelvic congestion syndrome. On ultrasonography, multiple tortuous and dilated veins were observed in the left adnexa. Both ovaries appeared normal in size, volume and echotexture. Computed tomography (CT) angiography was performed to precisely delineate the venous pathway and to assess any associated abnormality; which showed a dilated and tortuous left ovarian vein with an anomalous course around the left kidney and draining into the left renal vein. Clinical parameters and hormonal levels were within normal limits. This is a rare case of anomalous course of left ovarian vein associated with pelvic congestion syndrome.

Keywords: anomalous course of ovarian vein, computed tomography, pelvic congestion syndrome, ultrasonography

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Authors: Clemens Bulitta, Sasan Sadrizadeh, Sebastian Buhl

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Introduction: Ventilation technology in operating theatres (OT)is internationally regulated by dif-ferent standards, which define basic specifications for technical equipment and many times also the necessary operating and performance parameters. This confronts the operators of healthcare facilities with the question of finding the best ventilation and air conditioning system for the OT in order to achieve the goal of a large and robust surgicalworkzone with appropriate air quality and climate for patient safety and occupational health. Additionally, energy consumption and the potential need for clothing that limits transmission of bacteria must be considered as well as the total life cycle cost. However, the evaluation methodology of ventilation systems regarding these matters are still a topic of discussion. To date, there are neither any uniform standardized specifications nor any common validation criteria established. Thus, this study aimed to review data in the literature and add ourown research results to compare and assess the performance of different ventilations systems regarding infection preventive effects, energy efficiency, and staff comfort. Methods: We have conducted a comprehensive literature review on OT ventilation-related topics to understand the strengths and limitations of different ventilation systems. Furthermore, data from experimental assessments on OT ventilation systems at the University of Amberg-Weidenin Germany were in-cluded to comparatively assess the performance of Laminar Airflow (LAF), Turbulent Mixing Air-flow(TMA), and Temperature-controlled Airflow (TcAF) with regards to patient and occupational safety as well as staff comfort including indoor climate.CFD simulations from the Royal Institute of Technology in Sweden (KTH) were also studied to visualize the differences between these three kinds of ventilation systems in terms of the size of the surgical workzone, resilience to obstacles in the airflow, and energy use. Results: A variety of ventilation concepts are in use in the OT today. Each has its advantages and disadvantages, and thus one may be better suited than another depend-ing on the built environment and clinical workflow. Moreover, the proper functioning of OT venti-lation is also affected by multiple external and internal interfering factors. Based on the available data TcAF and LAF seem to provide the greatest effects regarding infection control and minimizing airborne risks for surgical site infections without the need for very tight surgical clothing systems. Resilience to obstacles, staff comfort, and energy efficiency seem to be favourable with TcAF. Conclusion: Based on literature data in current publications and our studies at the Technical Uni-versity of Applied Sciences Amberg-Weidenand the Royal Institute of Technoclogy, LAF and TcAF are more suitable for minimizing the risk for surgical site infections leading to improved clin-ical outcomes. Nevertheless, regarding the best management of thermal loads, atmosphere, energy efficiency, and occupational safety, overall results and data suggest that TcAF systems could pro-vide the economically most efficient and clinically most effective solution under routine clinical conditions.

Keywords: ventilation systems, infection control, energy efficiency, operating theatre, airborne infection risks

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Authors: Karthikeyan M., Paul M. J.

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This case report discusses a 54-year-old woman from Salem, Tamilnadu, who presented with a rare case of papillary thyroid carcinoma (PTC), manifesting as a hypervascular mass in the left carotid sheath. The patient had a two-and-a-half-month history of non-progressive neck swelling, with symptoms including dysphagia and a choking sensation. Clinical examination and investigations such as FNAC and CECT revealed a large vascular mass in the left neck region, initially perplexing the diagnosis. The patient underwent total thyroidectomy and excision of the left carotid sheath mass. Histopathology confirmed PTC. Postoperatively, the patient received Iodine-131 ablation and showed good recovery with no recurrence. This case highlights the diagnostic challenge and atypical presentation of PTC as a vascular neck mass, emphasizing the importance of a comprehensive approach in evaluating thyroid and neck lesions.

Keywords: lateral neck vascular mass, lateral aberrant thyroid, thyroid vascular swelling, smooth post op recovery

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Authors: David Parmenter, Brian Millar

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Obstructive sleep apnoea is a common condition which is generally under-diagnosed. Poorly managed obstructive sleep apnoea carries serious health risks and can greatly impact on the sufferer's quality of life. This publication covers the aetiology, symptoms, and treatment of sleep apnoea. The treatment of Obstructive Sleep Apnoea is an emerging field, and the useful role of the Dental Team is relatively unknown, therefor this paper will highlight the role of the dental team in its treatment. The concept of mandibular advancement appliances, along with the clinical and laboratory stages for constructing them, are documented. It is the hope of the author that this publication will educate healthcare professionals on the role of dental practitioners in the multidisciplinary team for treating sleep apnoea. Objective: Individuals should be more aware of the demographic of patients at risk of sleep apnoea, how it is diagnosed and which group of sleep apnoea patients are suitable to refer for mandibular appliance therapy. Individuals should also be aware of what a mandibular advancement appliance is and how it helps treat obstructive sleep apnoea.

Keywords: sleep apnoea, snoring, sleep appliances, mandibular advancement appliance

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Authors: Sanele E. Nene L., Lia M. Hewitt

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Background: Artificial intelligence (AI) has a high value in healthcare, various applications have been developed for the efficiency of clinical operations, such as appointment/surgery scheduling, diagnostic image analysis, prognosis, prediction and management of specific ailments. Purpose: The purpose of this study was to explore, describe, contrast, evaluate, and develop the various leadership strategies as a conceptual framework, applied by public health Operational Managers (OMs) to embrace AI benefits, with the aim to improve the healthcare system in a public hospital. Design and Method: A qualitative, exploratory, descriptive and contextual research design was followed and a descriptive phenomenological approach. Five phases were followed to conduct this study. Phenomenological individual interviews and focus groups were used to collect data and a phenomenological thematic data analysis method was used. Findings and conclusion: Three themes surfaced as the experiences of AI by the OMs; Positive experiences related to AI, Management and leadership processes in AI facilitation, and Challenges related to AI.

Keywords: ambivalence, embracing, Artificial intelligence, public hospital

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Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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Authors: Sneha Noble, Rahul Krishnan, Uma G., D. K. Vijaykumar

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Breast-Cancer related Lymphedema is a major problem that affects many women. Lymphedema is the swelling that generally occurs in the arms or legs caused by the removal of or damage to lymph nodes as a part of cancer treatment. Treating it at the earliest possible stage is the best way to manage the condition and prevent it from leading to pain, recurrent infection, reduced mobility, and impaired function. So, this project aims to focus on the multi-modal approaches to identify the risks of Lymphedema in post-surgical oncology patients and prevent it at the earliest. The Kinect IR Sensor is utilized to capture the images of the body and after image processing techniques, the region of interest is obtained. Then, performing the voxelization method will provide volume measurements in pre-operative and post-operative periods in patients. The formation of a mathematical model will help in the comparison of values. Clinical pathological data of patients will be investigated to assess the factors responsible for the development of lymphedema and its risks.

Keywords: Kinect IR sensor, Lymphedema, voxelization, lymph nodes

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Authors: Boyun Lee

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This study aims to discuss whether anthropomorphism some scientists tend to use in cross-species comparison can be justified epistemologically, especially in the primate mind-reading debate. Concretely, this study critically analyzes Elliott Sober’s argument about mind-reading hypothesis (MRH), an anthropomorphic hypothesis which states that nonhuman primates (e.g., chimpanzee) are mind-readers like humans. Although many scientists consider anthropomorphism as an error and choosing anthropomorphic hypothesis like MRH without any definite evidence invalid, Sober advocates that anthropomorphism is supported by cladistic parsimony that suggests choosing the simplest hypothesis postulating the minimum number of evolutionary changes, which can be justified epistemologically in the mind-reading debate. However, his argument has several problems. First, Reichenbach’s theorem which Sober uses in process of showing that MRH has the higher likelihood than its competing hypothesis, behavior-reading hypothesis (BRH), does not fit in the context of inferring the evolutionary relationship. Second, the phylogenetic tree Sober supports is one of the possible scenarios of MRH, and even without this problem, it is difficult to prove that the possibility nonhuman primate species and human share mind-reading ability is higher than the possibility of the other case, considering how evolution occurs. Consequently, it seems hard to justify anthropomorphism of MRH under Sober’s argument. Some scientists and philosophers say that anthropomorphism sometimes helps observe interesting phenomena or make hypotheses in comparative biology. Nonetheless, we cannot determine that it provides answers about why and how the interesting phenomena appear or which of the hypotheses is better, at least the mind-reading debate, under the current state.

Keywords: anthropomorphism, cladistic parsimony, comparative biology, mind-reading debate

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Authors: Ammal Mokhtar Metwally, Amal Elsaied, Ghada A. Abdel-Latef, Ebtissam M. Salah El-Din, Hanaa R. M. Attia

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The link between various diet therapies and autism is controversial and limited. Nutritional interventions aim to increase antioxidant levels suggesting a positive effect on the improvement of autism severity. In this study, the effectiveness of a 90-day Dates fruits consumption fruits (a non-pharmacological and risk-free option) on alleviating autism severity symptoms in individuals with ASD was investigated. The study examined also whether the baseline or improvements of some of the clinical and laboratory characteristics of the subjects affected their response to dates fruits intake on the severity of ASD symptoms. Methodology: This study involved a randomized controlled, double-blind 3-month dates fruits intake. 131 Egyptian children aged 3-12 years with confirmed ASD were enrolled in the study. cases were randomized in one of the three groups as follows; 1st regimen: Group I on 3 dates’ fruits/day (47 cases), 2nd regimen: Group II on 5 dates’ fruits/day (42 cases), and 3rd regimen: group III; nondates group (42 cases). ASD severity was assessed using both the Diagnostic and statistical manual of mental disorders, 5th ed. (DSM-V) criteria and the Childhood Autism Rating Scale (CARS) analysis. The following measures were assessed before and after the regimens: blood levels of three oxidative markers; Malondialdehyde (MDA), glutathione peroxidase (GPX1), and superoxide dismutase (SOD), nutritional, dietary assessment & anthropometric measurements Results: A significant reduction in the mean score of autism was detected based on CARS scores for those on dates’ regimens compared to those on non-dates (p < 0.01). Participants on 5 dates’ fruits/day for three months showed the highest improvement for autism severity based on both CARS and DSM5 compared to those in 3 dates’ fruits/day and non-dates groups. Responders to dates fruits intake as reflected on the Improvement of autism severity based on CARS diagnosis was detected among 78.7 % and 62.9 % based on CARS and DSM5 diagnosis, respectively. Responders had significant improvement in BMI z score and in the ratio levels of both MDA/SOD and MDA/GPX. Conclusion: The positive results of this study suggest that palm dates fruits could be recommended for children with ASD as adjuvant therapy on a daily regular basis to achieve consistent improvement of autism symptoms Objective: Investigate the effectiveness of a 90-day Dates fruits consumption fruits on alleviating autism severity symptoms in individuals with ASD and explore the clinical and laboratory characteristics of the subjects affected their response to dates fruits intake. Methodology: The study was a randomized controlled, double-blind for 3-month. 131 autistic Egyptian children aged 3-12 years were enrolled in one of the three groups; 1st: on 3 dates’ fruits/day (47 cases), 2nd: Group II on 5 dates’ fruits/day (42 cases), and 3rd: group III; nondates group (42 cases). Conclusion: The positive results of this study suggest that palm dates fruit (a non-pharmacological and risk-free option) could be recommended for children with ASD as adjuvant therapy on a daily regular basis to achieve consistent improvement of autism symptoms.

Keywords: autism spectrum disorders, palm dates fruits, CARS, DSM5, oxidative markers

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Authors: Hadi Gholizadeh, Ali Tajdin

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To have effective production planning, it is necessary to control the quality of processes. This paper aims at improving the performance of the disposable essentials process using statistical quality control and goal programming in a vague environment. That is expressed uncertainty because there is always a measurement error in the real world. Therefore, in this study, the conditions are examined in a vague environment that is a distance-based environment. The disposable essentials process in Kach Company was studied. Statistical control tools were used to characterize the existing process for four factor responses including the average of disposable glasses’ weights, heights, crater diameters, and volumes. Goal programming was then utilized to find the combination of optimal factors setting in a vague environment which is measured to apply uncertainty of the initial information when some of the parameters of the models are vague; also, the fuzzy regression model is used to predict the responses of the four described factors. Optimization results show that the process capability index values for disposable glasses’ average of weights, heights, crater diameters and volumes were improved. Such increasing the quality of the products and reducing the waste, which will reduce the cost of the finished product, and ultimately will bring customer satisfaction, and this satisfaction, will mean increased sales.

Keywords: goal programming, quality control, vague environment, disposable glasses’ optimization, fuzzy regression

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Authors: Seyed Esmail Seyedi Bariran, Khairul Salleh Mohamed Sahari

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In multi-echelon supply chain networks, optimal supplier selection significantly depends on the accuracy of suppliers’ performance prediction. Different methods of multi criteria decision making such as ANN, GA, Fuzzy, AHP, etc have been previously used to predict the supplier performance but the “black-box” characteristic of these methods is yet a major concern to be resolved. Therefore, the primary objective in this paper is to implement an artificial intelligence-based gene expression programming (GEP) model to compare the prediction accuracy with that of ANN. A full factorial design with %95 confidence interval is initially applied to determine the appropriate set of criteria for supplier performance evaluation. A test-train approach is then utilized for the ANN and GEP exclusively. The training results are used to find the optimal network architecture and the testing data will determine the prediction accuracy of each method based on measures of root mean square error (RMSE) and correlation coefficient (R2). The results of a case study conducted in Supplying Automotive Parts Co. (SAPCO) with more than 100 local and foreign supply chain members revealed that, in comparison with ANN, gene expression programming has a significant preference in predicting supplier performance by referring to the respective RMSE and R-squared values. Moreover, using GEP, a mathematical function was also derived to solve the issue of ANN black-box structure in modeling the performance prediction.

Keywords: Supplier Performance Prediction, ANN, GEP, Automotive, SAPCO

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Authors: Xinwen Zhu, Xingguang Li, Sun Yi

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Crack is one of the most common damages in buildings, bridges, roads and so on, which may pose safety hazards. However, cracks frequently happen in structures of various materials. Traditional methods of manual detection and measurement, which are known as subjective, time-consuming, and labor-intensive, are gradually unable to meet the needs of modern development. In addition, crack detection and measurement need be safe considering space limitations and danger. Intelligent crack detection has become necessary research. In this paper, an efficient method for crack detection and quantification using a 3D sensor, LiDAR, and depth camera is proposed. This method works even in a dark environment, which is usual in real-world applications. The LiDAR rapidly spins to scan the surrounding environment and discover cracks through lasers thousands of times per second, providing a rich, 3D point cloud in real-time. The LiDAR provides quite accurate depth information. The precision of the distance of each point can be determined within around  ±3 cm accuracy, and not only it is good for getting a precise distance, but it also allows us to see far of over 100m going with the top range models. But the accuracy is still large for some high precision structures of material. To make the depth of crack is much more accurate, the depth camera is in need. The cracks are scanned by the depth camera at the same time. Finally, all data from LiDAR and Depth cameras are analyzed, and the size of the cracks can be quantified successfully. The comparison shows that the minimum and mean absolute percentage error between measured and calculated width are about 2.22% and 6.27%, respectively. The experiments and results are presented in this paper.

Keywords: LiDAR, depth camera, real-time, detection and measurement

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Authors: Sandra So, Mohd Roslan Ismail, Safurah Jaafar

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With the rapid proliferation of data in healthcare has provided an opportune platform creation of Artificial Intelligence (AI). AI has brought a paradigm shift for healthcare professionals, promising improvement in delivery and quality. This study aims to determine the perception of healthcare personnel on perceived ease of use, perceived usefulness, and subjective norm toward attitude for artificial intelligence acceptance. A cross-sectional single institutional study of employees’ perception of adopting AI in the hospital was conducted. The survey was conducted using a questionnaire adapted from Technology Acceptance Model and a four-point Likert scale was used. There were 96 or 75.5% of the total population responded. This study has shown the significant relationship and the importance of ease of use, perceived usefulness, and subjective norm to the acceptance of AI. In the study results, it concluded that the determining factor to the strong acceptance of AI in their practices is mostly those respondents with the most interaction with the patients and clinical management.

Keywords: artificial intelligence, machine learning, perceived ease of use, perceived usefulness, subjective norm

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Authors: Weerawan Marangkun

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This study is a survey intended to investigate cost, revenue and factors affecting changes in revenue and to provide guidelines for improving factors affecting changes in revenue from tourist walking street activities in Songkhla City Municipality. Instruments used in this study were structured interviews, using Yaman table (1973) where the random sampling error was+ 10%. The sample consisting of 83 entrepreneurs were drawn from a total population of 272. The purposive sampling method was used. Data were collected during the 6-month period from December 2011 until May 2012. The findings indicate that the cost paid by an entrepreneur in connection with his/her services for tourists is mainly for travel, which stands at about 290 Baht per day. Each entrepreneur earns about 3,850 Baht per day, which means about 400,000 Baht per year. The combined total revenue from walking street tourist activities is about 108.8 million Baht per year. Such activities add economic value to tourist facilities due to expenditures by tourists and provide the entrepreneurs with considerable income. Factors affecting changes in revenue from tourist walking street activities are: the increase in the number of entrepreneurs; the holding of trade fairs, events or interesting shows in the vicinity; and weather conditions (e.g. abundant rainfall, which can contribute to a decrease in the number of tourists). Suggested measures to improve factors affecting changes in the income are: addition or creation of new activities; regulation of operations of the stalls and parking area; and generation of greater publicity through the social network.

Keywords: cost, revenue, tourist, walking street

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Authors: D.Mendes, J. Henriques, P. Carvalho, T. Rocha, S. Paredes, R. Cabiddu, R. Trimer, R. Mendes, A. Borghi-Silva, L. Kaminsky, E. Ashley, R. Arena, J. Myers

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The continued exploration of clinically relevant predictive models continues to be an important pursuit. Cardiorespiratory fitness (CRF) portends clinical vital information and as such its accurate prediction is of high importance. Therefore, the aim of the current study was to develop a data-driven model, based on computational intelligence techniques and, in particular, clustering approaches, to predict CRF. Two prediction models were implemented and compared: 1) the traditional Wasserman/Hansen Equations; and 2) an interpretable clustering approach. Data used for this analysis were from the 'FRIEND - Fitness Registry and the Importance of Exercise: The National Data Base'; in the present study a subset of 10690 apparently healthy individuals were utilized. The accuracy of the models was performed through the computation of sensitivity, specificity, and geometric mean values. The results show the superiority of the clustering approach in the accurate estimation of CRF (i.e., maximal oxygen consumption).

Keywords: cardiorespiratory fitness, data-driven models, knowledge extraction, machine learning

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Authors: Yu Qin, Wanjiaman Li

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The widespread use of mobile electronic devices increases the complexities of mobile security. This thesis aims to provide a secure communication environment for smartphone users. Some research proves that the one-time pad is one of the securest encryption methods, and that the key distribution problem can be solved by using the QKD (quantum key distribution). The objective of this project is to design an Android APP (application) to exchange several random keys between mobile phones. Inspired by QKD, the developed APP uses the quick response (QR) code as a carrier to dispatch large amounts of one-time keys. After evaluating the performance of APP, it allows the mobile phone to capture and decode 1800 bytes of random data in 600ms. The continuous scanning mode of APP is designed to improve the overall transmission performance and user experience, and the maximum transmission rate of this mode is around 2200 bytes/s. The omnidirectional readability and error correction capability of QR code gives it a better real-life application, and the features of adequate storage capacity and quick response optimize overall transmission efficiency. The security of this APP is guaranteed since QR code is exchanged face-to-face, eliminating the risk of being eavesdropped. Also, the id of QR code is the only message that would be transmitted through the whole communication. The experimental results show this project can achieve superior transmission performance, and the correlation between the transmission rate of the system and several parameters, such as the QR code size, has been analyzed. In addition, some existing technologies and the main findings in the context of the project are summarized and critically compared in detail.

Keywords: one-time pad, QKD (quantum key distribution), QR code, application

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Authors: Szu-Kai Hsu, Po-Ching Lin

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As more and more multi-core processors emerge, traditional sequential programming paradigm no longer suffice. Yet only few modern dynamic programming languages can leverage such advantage. Ruby, for example, despite its wide adoption, only includes threads as a simple parallel primitive. The global virtual machine lock of official Ruby runtime makes it impossible to exploit full parallelism. Though various alternative Ruby implementations do eliminate the global virtual machine lock, they only provide developers dated locking mechanism for data synchronization. However, traditional locking mechanism error-prone by nature. Software Transactional Memory is one of the promising alternatives among others. This paper introduces a new virtual machine: GobiesVM to provide a native software transactional memory based solution for dynamic programming languages to exploit parallelism. We also proposed a simplified variation of Transactional Locking II algorithm. The empirical results of our experiments show that support of STM at virtual machine level enables developers to write straightforward code without compromising parallelism or sacrificing thread safety. Existing source code only requires minimal or even none modi cation, which allows developers to easily switch their legacy codebase to a parallel environment. The performance evaluations of GobiesVM also indicate the difference between sequential and parallel execution is significant.

Keywords: global interpreter lock, ruby, software transactional memory, virtual machine

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Authors: Tanja Salary

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This paper discusses a study conducted in a juvenile justice facility regarding medication errors. It includes an introduction to data collected about medication errors in a juvenile justice facility from 2011 - 2019 and explores contributing factors that relate to those errors. The data was obtained from electronic incident records of medication errors that were documented from the years 2011 through 2019. In addition, the presentation reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional health care facilities to juvenile justice residential facilities and acknowledges a gap in research. The theoretical/conceptual framework for the research study was Bandura and Adams’s self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory. Despite the lack of evidence in previous studies addressing medication errors in juvenile justice facilities, this presenter will share information that adds to the body of knowledge, including the potential relationship of medication errors and contributing factors of race and age. Implications for future research include the effect that education and training will have on the communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: Juvenile justice, medication errors, juveniles, error reduction strategies

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Authors: Husham Bayazed

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Purpose of Presentation: Obesity and overweight are among the biggest health challenges of the 21st century, according to the WHO. Obviously, obese individuals suffer different courses of disease – from infections and allergies to cancer- and even respond differently to some treatment options. Of note, obesity often seems to predispose and triggers several secondary diseases such as diabetes, arteriosclerosis, or heart attacks. Since decades it seems that immunological signals gear inflammatory processes among obese individuals with the aforementioned conditions. This review aims to shed light how obesity sparks or rewire the immune system and predisposes to such unpleasant health outcomes. Moreover, lessons from the Covid-19 pandemic ascertain that people living with pre-existing conditions such as obesity can develop severe acute respiratory syndrome (SARS), which needs to be elucidated how obesity and its adjuvant inflammatory process distortion contribute to enhancing severe COVID-19 consequences. Recent Findings: In recent clinical studies, obesity was linked to alter and sparks the immune system in different ways. Adipose tissue (AT) is considered as a secondary immune organ, which is a reservoir of tissue-resident of different immune cells with mediator release, making it a secondary immune organ. Adipocytes per se secrete several pro-inflammatory cytokines (IL-6, IL-4, MCP-1, and TNF-α ) involved in activation of macrophages resulting in chronic low-grade inflammation. The correlation between obesity and T cells dysregulation is pivotal in rewiring the immune system. Of note, autophagy occurrence in adipose tissues further rewire the immune system due to flush and outburst of leptin and adiponectin, which are cytokines and influencing pro-inflammatory immune functions. These immune alterations among obese individuals are collectively incriminated in triggering several metabolic disorders and playing role in increasing cancers incidence and susceptibility to different infections. During COVID-19 pandemic, it was verified that patients with pre-existing obesity being at greater risk of suffering severe and fatal clinical outcomes. Beside obese people suffer from increased airway resistance and reduced lung volume, ACE2 expression in adipose tissue seems to be high and even higher than that in lungs, which spike infection incidence. In essence, obesity with pre-existence of pro-inflammatory cytokines such as LI-6 is a risk factor for cytokine storm and coagulopathy among COVID-19 patients. Summary: It is well documented that obesity is associated with chronic systemic low-grade inflammation, which sparks and alter different pillars of the immune system and triggers different metabolic disorders, and increases susceptibility of infections and cancer incidence. The pre-existing chronic inflammation in obese patients with the augmented inflammatory response against the viral infection seems to increase the susceptibility of these patients to developing severe COVID-19. Although the new weight loss drugs and bariatric surgery are considered as breakthrough news for obesity treatment, but preventing is easier than treating it once it has taken hold. However, obesity and immune system link new insights dispute the role of immunotherapy and regulating immune cells treating diet-induced obesity.

Keywords: immunity, metabolic disorders, cancer, COVID-19

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Authors: Arup Dutta, Badrul Alam, Sayed M. Wazed, Taslima Newaz, Srobonti Dutta

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Background: In today's world, with modern science and contemporary technology, a lot of diseases may be quickly identified and ruled out, but children's fever of unknown origin (FUO) still presents diagnostic difficulties in clinical settings. Any fever that reaches 38 °C and lasts for more than seven days without a known cause is now classified as a fever of unknown origin (FUO). Despite tremendous progress in the medical sector, fever of unknown origin, or FOU, persists as a major health issue and a major contributor to morbidity and mortality, particularly in children, and its spectrum is sometimes unpredictable. The etiology is influenced by geographic location, age, socioeconomic level, frequency of antibiotic resistance, and genetic vulnerability. Since there are currently no known diagnostic algorithms, doctors are forced to evaluate each patient one at a time with extreme caution. A persistent fever poses difficulties for both the patient and the doctor. This prospective, observational study was carried out in a Bangladeshi tertiary care hospital from June 2018 to May 2019 with the goal of identifying the epidemiological patterns of fever of unknown origin in pediatric patients. Methods: It was a hospital-based prospective observational study carried out on 106 children (between 2 months and 12 years) with prolonged fever of >38.0 °C lasting for more than 7 days without a clear source. Children with additional chronic diseases or known immunodeficiency problems were not allowed. Clinical practices that helped determine the definitive etiology were assessed. Initial testing included a complete blood count, a routine urine examination, PBF, a chest X-ray, CRP measurement, blood cultures, serology and additional pertinent investigations. The analysis focused mostly on the etiological results. The standard program SPSS 21 was used to analyze all of the study data. Findings: A total of 106 patients identified as having FUO were assessed, with over half (57.5%) being female and the majority (40.6%) falling within the 1 to 3-year age range. The study categorized the etiological outcomes into five groups: infections, malignancies, connective tissue conditions, miscellaneous, and undiagnosed. In the group that was being studied, infections were found to be the main cause in 44.3% of cases. Undiagnosed cases came in at 31.1%, cancers at 10.4%, other causes at 8.5%, and connective tissue disorders at 4.7%. Hepato-splenomegaly was seen in people with enteric fever, malaria, acute lymphoid leukemia, lymphoma, and hepatic abscesses, either by itself or in combination with other conditions. About 53% of people who were not diagnosed also had hepato-splenomegaly at the same time. Conclusion: Infections are the primary cause of PUO (pyrexia of unknown origin) in children, with undiagnosed cases being the second most common cause. An incremental approach is beneficial in the process of diagnosing a condition. Non-invasive examinations are used to diagnose infections and connective tissue disorders, while invasive investigations are used to diagnose cancer and other ailments. According to this study, the prevalence of undiagnosed diseases is still remarkable, so extensive historical analysis and physical examinations are necessary in order to provide a precise diagnosis.

Keywords: children, diagnostic challenges, fever of unknown origin, pediatric fever, undiagnosed diseases

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Authors: Mohammad U. A. Khan, Md. D. Hossain

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Background: Department of Physiology finds difficulty in managing ‘subjects’ in practical procedure. To avoid this difficulty fellow examinees of other group may be used as subjects. Objective: To find out the merits and demerits of using fellow examinees as subjects in the practical procedure. Method: This cross-sectional descriptive study was conducted in the Department of Physiology, Noakhali Medical College, Bangladesh during May-June’14. Forty-two 1st year undergraduate medical students from a selected public medical college of Bangladesh were enrolled for the study purposively. Consent of students and authority was taken. Eighteen of them were selected as subjects and designated as subject-examinees. Other fellow examinees (non-subject) examined their blood pressure and pulse as part of ‘observed structured practical examination’ (OSPE). The opinion of all examinees regarding the merits and demerits of using fellow examinee as subjects in the practical procedure was recorded. Result: Examinees stated that they could perform their practical procedure without nervousness (24/42, 57.14%), accurately and comfortably (14/42, 33.33%) and subjects were made available without wasting time (2/42, 4.76%). Nineteen students (45.24%) found no disadvantage and 2 (4.76%) felt embracing when the subject was of opposite sex. The subject-examinees narrated that they could learn from the errors done by their fellow examinee (11/18, 61.1%). 75% non-subject examinees expressed their willingness to be subject so that they can learn from their fellows’ error. Conclusion: Using fellow examinees as subjects is beneficial for both the non-subject and subject examinees. Funding sources: Navana, Beximco, Unihealth, Square & Acme Pharma, Bangladesh Ltd.

Keywords: physiology, teaching, practical, OSPE

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Authors: Messaoud Eljamai, Sami Hidouri

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Massive multiple-input multiple-output (MIMO) is an emerging technology for new cellular networks such as 5G systems. Its principle is to use many antennas per cell in order to maximize the network's spectral efficiency. Inter-cellular interference remains a fundamental problem. The use of massive MIMO will not derogate from the rule. It improves performances only when the number of antennas is significantly greater than the number of users. This, considerably, limits the networks spectral efficiency. In this paper, a coordinated detector for an uplink massive MIMO system is proposed in order to mitigate the inter-cellular interference. The proposed scheme combines the coordinated multipoint technique with an interference-cancelling algorithm. It requires the serving cell to send their received symbols, after processing, decision and error detection, to the interfered cells via a backhaul link. Each interfered cell is capable of eliminating intercellular interferences by generating and subtracting the user’s contribution from the received signal. The resulting signal is more reliable than the original received signal. This allows the uplink massive MIMO system to improve their performances dramatically. Simulation results show that the proposed detector improves system spectral efficiency compared to classical linear detectors.

Keywords: massive MIMO, COMP, interference canceling algorithm, spectral efficiency

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Authors: Ren Moses, Jaqueline Masaki

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

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

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Authors: Veniamin Boiarkin, Bruno Bogaz Zarpelão, Muttukrishnan Rajarajan

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The manufacturing sector is a vital component of most economies, which leads to a large number of cyberattacks on organisations, whereas disruption in operation may lead to significant economic consequences. Adversaries aim to disrupt the production processes of manufacturing companies, gain financial advantages, and steal intellectual property by getting unauthorised access to sensitive data. Access to sensitive data helps organisations to enhance the production and management processes. However, the majority of the existing data-sharing mechanisms are either susceptible to different cyber attacks or heavy in terms of computation overhead. In this paper, a privacy-preserving data-sharing scheme for smart utilities is proposed. First, a customer’s privacy adjustment mechanism is proposed to make sure that end-users have control over their privacy, which is required by the latest government regulations, such as the General Data Protection Regulation. Secondly, a local differential privacy-based mechanism is proposed to ensure the privacy of the end-users by hiding real data based on the end-user preferences. The proposed scheme may be applied to different industrial control systems, whereas in this study, it is validated for energy utility use cases consisting of smart, intelligent devices. The results show that the proposed scheme may guarantee the required level of privacy with an expected relative error in utility.

Keywords: data-sharing, local differential privacy, manufacturing, privacy-preserving mechanism, smart utility

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Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

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Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

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Authors: Ozge Yilmaz Kusbeci, Ipek Inci

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Aim: Musculoskeletal problems are very common in Parkinson’s disease (PD). They affect quality of life and cause disabilities. However they are under-evaluated, and under-treated. The aim of this study is to evaluate the prevalence and clinical features of musculoskeletal problems in patients with Parkinson disease (PD) compared to controls. Methods: 50 PD patients and 50 age and sex matched controls were interviewed by physicians about their musculoskeletal problems. Results: The prevalence of musculoskeletal problems was significantly higher in the PD group than in the control group (p < 0.05). Commonly involved body sites were the shoulder, low back, and knee. The shoulder and low back was more frequently involved in the PD group than in the control group. However, the knee was similarly involved in both groups. Among the past diagnoses associated with musculoskeletal problems, frozen shoulder, low back pain and osteoporosis more common in the PD group than in the control group (p < 0.05). Furthermore, musculoskeletal problems in the PD group tended to receive less treatment than that of the control group. Conclusion: Musculoskeletal problems were more common in the PD group than in the controls. Therefore assessment and treatment of musculoskeletal problems could improve quality of life in PD patients.

Keywords: parkinson disease, musculoskeletal problems, quality of life, PD disease

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Authors: Monir Ahmed

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The main purpose of this literature review was to investigate the existing quantitative clinical studies on the relationship between transcendence and psychological well-being. The primary objective of the literature review is to determine whether the existing studies adequately demonstrate the relationship between transcendence and psychological well-being, including spiritual well-being. A further objective of this literature review is to see if the ‘creatio ex nihilo’ doctrine is necessary to understand transcendence and its relationship with psychological well-being. Systematic literature review methods including studies identified from search engines, extracting data from the studies and assessing their quality for the planned review were used. The outcome of this literature review indicates that self-transcendence (STa), spiritual transcendence (STb) are positively related to psychological well-being. However, such positive relationships present limited scope for understanding transcendence and its relationship with well-being. The findings of this review support the need for further research in the area of transcendence and well-being. This literature review reveals the importance of developing a new transcendence tool for determining an individual’s ability to transcend and the relationship between his/her ability for transcendence and psychological well-being. The author of this paper proposes that the inclusion of the theological doctrine (‘creatio ex nihilo’) in understanding transcendence and psychological well-being is crucial, necessary and unavoidable.

Keywords: transcendence, psychological well-being, self-transcendence, spiritual transcendence, ‘creatio ex nihilo’

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Authors: Rajesh Kumar, Puneet Aggarwal

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In context of understanding problems faced by undergraduate students while carrying out laboratory experiments dealing with high voltages, it was found that most of the students are hesitant to work directly on machine. The reason is that error in the circuitry might lead to deterioration of machine and laboratory instruments. So, it has become inevitable to include modern pedagogic techniques for undergraduate students, which would help them to first carry out experiment in virtual system and then to work on live circuit. Further advantages include that students can try out their intuitive ideas and perform in virtual environment, hence leading to new research and innovations. In this paper, virtual environment used is of MATLAB/Simulink for three-phase induction machines. The performance analysis of three-phase induction machine is carried out using virtual environment which includes Direct Current (DC) Test, No-Load Test, and Block Rotor Test along with speed torque characteristics for different rotor resistances and input voltage, respectively. Further, this paper carries out computer aided teaching of basic Voltage Source Inverter (VSI) drive circuitry. Hence, this paper gave undergraduates a clearer view of experiments performed on virtual machine (No-Load test, Block Rotor test and DC test, respectively). After successful implementation of basic tests, VSI circuitry is implemented, and related harmonic distortion (THD) and Fast Fourier Transform (FFT) of current and voltage waveform are studied.

Keywords: block rotor test, DC test, no load test, virtual environment, voltage source inverter

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Authors: Mahboobeh Sadeghi, Zahra Izadi Khah, Mansour Hakim Javadi, Masoud Gholamali Lavasani

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Background: Since there is a relation between psychological and physiological factors, the aim of this study was to examine the effect of Emotion Regulation training on cognitive emotion regulation problem in patients with Multiple Sclerosis(MS) Method: In a randomized clinical trial thirty patients diagnosed with Multiple Sclerosis referred to state welfare organization were selected. The sample group was randomized into either an experimental group or a nonintervention control group. The subjects participated in 75-minute treatment sessions held three times a week for 4weeks (12 sessions). All 30 individuals were administered with Cognitive Emotion Regulation questionnaire (CERQ). Participants completed the questionnaire in pretest and post-test. Data obtained from the questionnaire was analyzed using Mancova. Results: Emotion Regulation significantly decreased the Cognitive Emotion Regulation problems patients with Multiple sclerosis (p < 0.001). Conclusions: Emotion Regulation can be used for the treatment of cognitive-emotion regulation problem in Multiple sclerosis.

Keywords: Multiple Sclerosis, cognitive-emotion regulation, emotion regulation, MS

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Authors: Salma Krafessi

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The financial markets have a multifaceted, intricate environment, and enormous volumes of data are produced every day. To find investment possibilities, possible fraudulent activity, and market oddities, accurate anomaly identification in this data is essential. Conventional methods for detecting anomalies frequently fail to capture the complex organization of financial data. In order to improve the identification of abnormalities in financial time series data, this study presents Tucker Decomposition as a reliable multi-way analysis approach. We start by gathering closing prices for the S&P 500 index across a number of decades. The information is converted to a three-dimensional tensor format, which contains internal characteristics and temporal sequences in a sliding window structure. The tensor is then broken down using Tucker Decomposition into a core tensor and matching factor matrices, allowing latent patterns and relationships in the data to be captured. A possible sign of abnormalities is the reconstruction error from Tucker's Decomposition. We are able to identify large deviations that indicate unusual behavior by setting a statistical threshold. A thorough examination that contrasts the Tucker-based method with traditional anomaly detection approaches validates our methodology. The outcomes demonstrate the superiority of Tucker's Decomposition in identifying intricate and subtle abnormalities that are otherwise missed. This work opens the door for more research into multi-way data analysis approaches across a range of disciplines and emphasizes the value of tensor-based methods in financial analysis.

Keywords: tucker decomposition, financial markets, financial engineering, artificial intelligence, decomposition models

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