Search results for: clinical codes

Authors: Syed A. Alam, Arifa Bilal

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A propagated wave of barbaric and injustice Muslims has been popularized by the International powers in the recent past to divert the winning force of Muslims in the Afghan war against Russia. It is a tactic to demolish the power of Jihaad and the religious image of Islam. The propaganda picturized that Muslims were not peaceful or trustworthy people by displaying some brutal actions of a little number of funded people. The word ‘Islam’ is titled as ‘complete codes of life’ because of the peacefulness and trustworthiness of these codes for whole lives. These codes help the whole of humanity beyond the boundaries of any religion, sect, creed, color, geography, or race to lead their lives peacefully and trustfully. The human beings who act upon these codes of life, Islam, can be called Muslims. Those people are not Muslims who do not act upon these codes of life. History is evident that the Muslims proved themselves, collectively, that they are acting upon these codes of life. In this article, an analytical study was conducted regarding popular treaties signed between Muslims and non-Muslim communities in different times and regions on different matters. The study included the treaties of Hudabiyah Treaty, Mithaq-e-Madinah, Lucknow Pact, Indus Water Pact, Air Space Violation Treaty, Gallipoli Treaty, Amity Treaty, US-Russia Peace Treaty, and Wadi Arab Peace Treaty. After critical analysis of these treaties, it can be clearly concluded that Muslims fulfilled these treatises, but non-Muslim stakeholders of these treaties broke these treaties in one aspect or many and in the start or later. It can be concluded that the history of treaties between Muslim and non-Muslim communities declared that Muslims had fulfilled these treaties and pacts, so they are more trustworthy and peaceful people.

Keywords: fulfilled treaties, Muslim and non-muslim pacts, Islam and peacefulness, Islam and treaties

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Authors: Dmitry Dikarev, Ajit Nimbalker, Alexei Davydov

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Polar coding is a novel example of error correcting codes, which can achieve Shannon limit at block length N→∞ with log-linear complexity. Active research is being carried to adopt this theoretical concept for using in practical applications such as 5th generation wireless communication systems. Cyclic redundancy check (CRC) error detection code is broadly used in conjunction with successive cancellation list (SCL) decoding algorithm to improve finite-length polar code performance. However, there are two issues: increase of code block payload overhead by CRC bits and decrease of CRC error-detection capability. This paper proposes a method to control CRC overhead and false alarm rate of polar decoding. As shown in the computer simulations results, the proposed method provides the ability to use any set of CRC polynomials with any list size while maintaining the desired level of false alarm rate. This level of flexibility allows using polar codes in 5G New Radio standard.

Keywords: 5G New Radio, channel coding, cyclic redundancy check, list decoding, polar codes

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Authors: Seyed Sadegh Naseralavi, Najmeh Bemani

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In this paper, different concrete codes including America, New Zealand, Mexico, Italy, India, Canada, Hong Kong, Euro Code and Britain are compared with the Iranian concrete design code. First, by using Adaptive Neuro Fuzzy Inference System (ANFIS), the codes having the most correlation with the Iranian ninth issue of the national regulation are determined. Consequently, two anticipated methods are used for comparing the codes: Artificial Neural Network (ANN) and Multi-variable regression. The results show that ANN performs better. Predicting is done by using only tensile steel ratio and with ignoring the compression steel ratio.

Keywords: adaptive neuro fuzzy inference system, anticipate method, artificial neural network, concrete design code, multi-variable regression

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Authors: Putul Haldar, Yogendra Singh, D. K. Paul

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Un-Reinforced Masonry (URM) infilled RC framed buildings are the most common construction practice for modern multi-storey buildings in India like many other parts of the world. Although the behavior and failure pattern of the global structure changes significantly due to infill-frame interaction, the general design practice is to treat them as non-structural elements and their stiffness, strength and interaction with frame is often ignored, as it is difficult to simulate. Indian Standard, like many other major national codes, does not provide any explicit guideline for modeling of infills. This paper takes a stock of controlling design provisions in some of the major national seismic design codes (BIS 2002; CEN 2004; NZS-4230 2004; ASCE-41 2007) to ensure the desired seismic performance of infilled frame. Most of the national codes on seismic design of buildings still lack in adequate guidelines on modeling and design of URM infilled frames results in variable assumption in analysis and design. This paper, using nonlinear pushover analysis, also presents the effect of one of such assumptions of conventional ‘simultaneous’ analysis procedure of infilled frame on the seismic performance of URM infilled RC frame buildings.

Keywords: URM infills, RC frame, seismic design codes, construction sequence of infilled frame

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Authors: Mohamed Boly

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This paper investigates the link between foreign aid and environmental protection, specifically CO2 emissions, in aid recipient countries. Conflicting results exist in the literature regarding the environmental impact of foreign aid. We come to reconcile them, using Project-Level Aid Data with environment codes, over the 1980- 2010 period. The disaggregation of aid according to the environmental codes, show why the results of previous literature remain very mixed. Moreover, we find that the effect of environmental aid is conditioned by some specific characteristics of the recipient country, independently of the donor.

Keywords: foreign aid, green aid, interactive effects, pollution

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Authors: J. R. Wang, H. C. Chang, A. L. Ho, J. H. Yang, S. W. Chen, C. Shih

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The purpose of the study is to analyze the load rejection transient of ABWR by using TRACE, PARCS, and SNAP codes. This study has some steps. First, using TRACE, PARCS, and SNAP codes establish the model of ABWR. Second, the key parameters are identified to refine the TRACE/PARCS/SNAP model further in the frame of a steady state analysis. Third, the TRACE/PARCS/SNAP model is used to perform the load rejection transient analysis. Finally, the FSAR data are used to compare with the analysis results. The results of TRACE/PARCS are consistent with the FSAR data for the important parameters. It indicates that the TRACE/PARCS/SNAP model of ABWR has a good accuracy in the load rejection transient.

Keywords: ABWR, TRACE, PARCS, SNAP

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Authors: Mette Kjerholt, Thora Grothe Thomsen, Connie Bøttcher Berthelsen, Bibi Hølge Hazelton

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Academic nursing is a relatively new phenomenon in Denmark. Leadership and management training in nursing does not prepare Danish nurse leaders to become leaders for nurses with academic background, and some leaders may feel estranged with including this kind of nursing staff in clinical settings. Currently there is a debate regarding what academic nurses can contribute with in clinical practice, and some managers express concern regarding whether this will lead to less focus on clinical practice and more focus on theoretical issues that may not seem so relevant in a busy everyday clinical setting. The paper will present the experiences of integrating three advanced nurse practitioners with Ph.D. degrees (ANP) in three different clinical departments at a regional hospital in Denmark with no prior experiences with such profiles among its staff.

Keywords: leadership, advanced nurse practitioners, clinical practice, academic nursing

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Authors: Khaled M. Alhawiti

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This paper investigates the future of medicine and the use of Natural language processing. The importance of having correct clinical information available online is remarkable; improving patient care at affordable costs could be achieved using automated applications to use the online clinical information. The major challenge towards the retrieval of such vital information is to have it appropriately coded. Majority of the online patient reports are not found to be coded and not accessible as its recorded in natural language text. The use of Natural Language processing provides a feasible solution by retrieving and organizing clinical information, available in text and transforming clinical data that is available for use. Systems used in NLP are rather complex to construct, as they entail considerable knowledge, however significant development has been made. Newly formed NLP systems have been tested and have established performance that is promising and considered as practical clinical applications.

Keywords: clinical information, information retrieval, natural language processing, automated applications

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Authors: Behre O. Ozalp

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Cinema is a reflection of the society, as much as it captures the social codes. These codes are learned within the society; and through movies these practices of the gender order are reproduced as well. One of the best examples engendering these codes is a modern classic of Turkish cinema, Cholera District (1997), originally Ağır Roman in Turkish. It is a coming of age movie of a teenage boy in an old neighborhood of Istanbul, where he learns to be a 'man' through the hegemonic masculinity codes of the society. The corporal and verbal practices that are used in the representation of the male protagonist's portrayal is based on his performativity. This paper, through narrative analysis of the aforementioned movie, reviews how gender and narrative are intertwined within the context of queer theory. The methodology follows the protagonist's object of desire while evaluating his heterosexuality which requires affirmative performances. The framework of the study firstly focuses on the protagonist's own life and his interactions with the males of his kinship. Later, the focus gravitates towards his interactions with the female object of desire while evaluating how this relationship shapes his status in society. Lastly, the study focuses on the relationship between the protagonist and non-relative males of the neighborhood. The journey of a young male becoming a man by copying the other males delivers a clear representation of how heterosexuality is favored in terms of gender order.

Keywords: hegemonic masculinity, performativity, queer theory, Turkish cinema

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Authors: Marwa Ben Abdessalem, Amin Zribi, Ammar Bouallègue

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In this paper, a Joint Source Channel coding scheme based on LDPC codes is investigated. We consider two concatenated LDPC codes, one allows to compress a correlated source and the second to protect it against channel degradations. The original information can be reconstructed at the receiver by a joint decoder, where the source decoder and the channel decoder run in parallel by transferring extrinsic information. We investigate the performance of the JSC LDPC code in terms of Bit-Error Rate (BER) in the case of transmission over an Additive White Gaussian Noise (AWGN) channel, and for different source and channel rate parameters. We emphasize how JSC LDPC presents a performance tradeoff depending on the channel state and on the source correlation. We show that, the JSC LDPC is an efficient solution for a relatively low Signal-to-Noise Ratio (SNR) channel, especially with highly correlated sources. Finally, a source-channel rate optimization has to be applied to guarantee the best JSC LDPC system performance for a given channel.

Keywords: AWGN channel, belief propagation, joint source channel coding, LDPC codes

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Authors: Otman Jai, Otman Elhajjaji, Jaouad Tajmouati

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Several neutronic calculation codes must be used to solve the equation for different levels of discretization which all necessitate a specific modelisation. This chain of such models, known as a calculation scheme, leads to the knowledge of the neutron flux in a reactor from its own geometry, its isotopic compositions and a cross-section library. Being small in size, the 'Slowpoke-2' reactor is difficult to model due to the importance of the leaking neutrons. In the paper, the simulation model is presented (geometry, cross section library, assumption, etc.), and the results obtained by DRAGON4/DONJON4 codes were compared to the calculations performed with Monte Carlo code MCNP using detailed geometrical model of the reactor and the experimental data. Criticality calculations have been performed to verify and validate the model. Since created model properly describes the reactor core, it can be used for calculations of reactor core parameters and for optimization of research reactor application.

Keywords: transport equation, Dragon4, Donjon4, neutron flux, effective multiplication factor

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Authors: H. C. Chang, J. R. Wang, A. L. Ho, S. W. Chen, J. H. Yang, C. Shih, L. C. Wang

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To confirm the reactor and containment integrity of the Advanced Boiling Water Reactor (ABWR), we perform the analysis of main steamline break (MSLB) transient by using the TRACE, PARCS, and SNAP codes. The process of the research has four steps. First, the ABWR nuclear power plant (NPP) model is developed by using the above codes. Second, the steady state analysis is performed by using this model. Third, the ABWR model is used to run the analysis of MSLB transient. Fourth, the predictions of TRACE and PARCS are compared with the data of FSAR. The results of TRACE/PARCS and FSAR are similar. According to the TRACE/PARCS results, the reactor and containment integrity of ABWR can be maintained in a safe condition for MSLB.

Keywords: advanced boiling water reactor, TRACE, PARCS, SNAP

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Authors: Golyasamin Khanehzaei, Mohd. Bakri Ishak, Ahmad Makmom Hj Abdullah, Latifah Abd Manaf

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Abstract—Management of clinical waste is a critical problem worldwide. Immediate attention is required to manage the clinical waste in an appropriate way in newly developing economy country such as Malaysia. The increasing amount of clinical waste generated is resulted from rapid urbanization and growing number of private health care facilities in developing countries such as Malaysia. In order to develop a sensible clinical waste management system and improvement of the management, information on factors affecting clinical waste generation has the crucial role. This paper is the study of management characteristics of clinical waste and the level of efficiency of clinical waste management systems operating in private clinics located in Selangor, Malaysia. Are they following the proper international standards? By taking all of this in consideration the aim of this paper is to identify and discuss the current trend, current challenges and also the present opportunities among the challenges of clinical waste management in private clinics of Selangor, Malaysia. The SWOT analysis was characterized for the evaluation of strengths, weaknesses, opportunities and threats. The methodology for this study was constituted of direct observation, Informal interviews, Conducting SWOT analysis, conduction of one sustainability dimensions analysis and application. The results show that clinical waste management in private clinics is far from an ideal model.

Keywords: clinical waste, SWOT analysis, Selangor, Malaysia

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Authors: Tambe Daniel Atem

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Background: Clinical Research is an organized research on human beings intended to provide adequate information on the drug use as a therapeutic agent on its safety and efficacy. The significance of the study is to educate the global health and life science graduates in Clinical Research in depth to perform better as it involves testing drugs on human beings. Objectives: to provide an overall understanding of the scientific approach to the evaluation of new and existing medical interventions and to apply ethical and regulatory principles appropriate to any individual research. Methodology: It is based on – Primary data analysis and Secondary data analysis. Primary data analysis: means the collection of data from journals, the internet, and other online sources. Secondary data analysis: a survey was conducted with a questionnaire to interview the Clinical Research Professionals to understand the need of training to perform clinical trials globally. The questionnaire consisted details of the professionals working with the expertise. It also included the areas of clinical research which needed intense training before entering into hardcore clinical research domain. Results: The Clinical Trials market worldwide worth over USD 26 billion and the industry has employed an estimated 2,10,000 people in the US and over 70,000 in the U.K, and they form one-third of the total research and development staff. There are more than 2,50,000 vacant positions globally with salary variations in the regions for a Clinical Research Coordinator. R&D cost on new drug development is estimated at US$ 70-85 billion. The cost of doing clinical trials for a new drug is US$ 200-250 million. Due to an increase trained Clinical Research Professionals India has emerged as a global hub for clinical research. The Global Clinical Trial outsourcing opportunity in India in the pharmaceutical industry increased to more than $2 billion in 2014 due to increased outsourcing from U.S and Europe to India. Conclusion: Assessment of training need is recommended for newer Clinical Research Professionals and trial sites, especially prior the conduct of larger confirmatory clinical trials.

Keywords: clinical research, clinical trials, clinical research professionals

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Authors: Cinna Soltanpur, Mohammad Ghamari, Behzad Momahed Heravi, Fatemeh Zare

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Low-density parity-check (LDPC) codes have been shown to deliver capacity approaching performance; however, problematic graphical structures (e.g. trapping sets) in the Tanner graph of some LDPC codes can cause high error floors in bit-error-ratio (BER) performance under conventional sum-product algorithm (SPA). This paper presents a serial concatenation scheme to avoid the trapping sets and to lower the error floors of LDPC code. The outer code in the proposed concatenation is the LDPC, and the inner code is a high rate array code. This approach applies an interactive hybrid process between the BCJR decoding for the array code and the SPA for the LDPC code together with bit-pinning and bit-flipping techniques. Margulis code of size (2640, 1320) has been used for the simulation and it has been shown that the proposed concatenation and decoding scheme can considerably improve the error floor performance with minimal rate loss.

Keywords: concatenated coding, low–density parity–check codes, array code, error floors

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Authors: Somaya A. Abd El Mottaleb, Ahmed Abd El Aziz, Heba A. Fayed, Moustafa H. Aly

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In this paper, we present the performance of spectral amplitude coding optical code division multiple access using different detectors at different transmission distances using single photodiode detection technique. Modified double weight codes are used as signature codes. Simulation results show that the system using avalanche photo detector can move distance longer than that using positive intrinsic negative photo detector.

Keywords: avalanche photodiode, modified double weight, multiple access technique, single photodiode.

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Authors: Sedigheh Salemi, Mahnaz Sanjari, Maryam Aalaa, Mohammad Mirzabeigi

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Clinical governance is the framework within which the health service provider is required to ongoing accountability and improvement of the quality of their services. This cross-sectional study was conducted in 661 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 24 questions in which 4 questions focused on clinical governance defining from the nurses' perspective. The reliability was evaluated by Cronbach's alpha (α=0/83). Statistical analyzes were performed, using SPSS version 16. Approximately 40% of nurses correctly answered that clinical governance is not "system of punishment and rewards for the staff". The most nurses believed that "clinical efficacy" is one of the main components of clinical governance. A few of nurses correctly responded that "Evidence Based Practice" and "management" is not part of clinical governance. The small number of nurses correctly answered that the "maintenance of patient records" and "to recognize the adverse effects" is not the role of nurse in clinical governance. Most "do not know" answer was to the "maintenance of patient records". The most nurses unanimously believed that the implementation of clinical governance led to "promoting the quality of care". About a third of nurses correctly stated that the implementation of clinical governance will not lead to "an increase in salaries and benefits of the medical team". As a member of the health team, nurses are responsible in terms of participation in quality improvement and it is necessary to create an environment in which clinical care will flourish and serve to preserve the high standards.

Keywords: clinical governance, nurses, salary, health team

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Authors: Bikash Kumar Malick

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Labour reform is a most celebrated theme for policy makers, at the same time it is also a most misunderstood and skeptical concept even for the educated masses in India. One of the widely focused and discussed topics which needs an in-depth examination is India’s labour laws. It may actually help to reach points to understand the exact requirements in labour reforms by making the labour laws more simple and concise in form and its implementation. It is also a requirement to guide states in India in terms of making laws on it as Indian Constitution itself is federal in form and unitary in spirit. Recently, Codes of Wages Bill has been introduced in Indian Parliament while other three codes are waiting to come in the same line and those codes actually highlight the simplified features of labour laws to enable labour reform in a succinct manner. However, it still brings more confusion in minds of people. To wipe out the confusion and to bring a note and to put it for correlation among the labour reforms of both centre and states which both generates employment and make growth sustainable in India providing clear public understanding. This time is also ripe minimizing the apprehension about all the coming labour laws simplified in different codes in India. This article attempts to highlight the need of labour reform and its possible impact. It also examines the higher rates of minimum wages and its links with its coverage agriculture and nonagricultural sectors (including mines) over the period time. It also takes into consideration of central sphere and in states sphere minimum wage which are linked with Consumer Price Index to bring into account the living standard of workers and to examine the cause and effect between minimum wage and output in both agriculture and non agricultural sector with regression analysis. Increase in minimum wage has actually strengthened the sustainable output.

Keywords: codes of wages, indian constitution, minimum wage, labour laws, labour reforms

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Authors: Hye-Kyung Kang

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Social justice is a central principle of the social work profession and education. However, scholars have long questioned the profession’s commitment to putting social justice values into practice. Clinical social work has been particularly criticized for its lack of attention to social justice and for failing to address the concerns of the oppressed. One prominent criticism of clinical social work is that it often relies on individual intervention and fails to take on system-level changes or advocacy. This concern evokes the historical macro-micro tension of the social work profession where micro (e.g., mental health counseling) and macro (e.g., policy advocacy) practices are conceptualized as separate domains, creating a false binary for social workers. One contributor to this false binary seems to be that most clinical practice models do not prepare social work students and practitioners to make a clear link between clinical practice and social justice. This paper presents a model of clinical social work practice that clearly recognizes the essential and necessary connection between social justice, advocacy, and clinical practice throughout the clinical process: engagement, assessment, intervention, and evaluation. Contemporary relational theories, critical social work frameworks, and anti-oppressive practice approaches are integrated to build a clinical social work practice model that addresses the urgent need for mental health practice that not only helps and heals the person but also challenges societal oppressions and aims to change them. The application of the model is presented through case vignettes.

Keywords: social justice, clinical social work, clinical social work model, integrative model

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Authors: Dongping Fang, Lian Duan, Xiaojing Yuan, Mike Xu, Allyn Klunder, Kevin Tan, Suiting Cao, Yeqing Ji

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Accurate prediction of a medical condition with straight clinical evidence is a long-sought topic in the medical management and health insurance field. Although great progress has been made with machine learning algorithms, the medical community is still, to a certain degree, suspicious about the model's accuracy and interpretability. This paper presents an innovative hierarchical attention deep learning model to achieve good prediction and clear interpretability that can be easily understood by medical professionals. This deep learning model uses a hierarchical attention structure that matches naturally with the medical history data structure and reflects the member’s encounter (date of service) sequence. The model attention structure consists of 3 levels: (1) attention on the medical code types (diagnosis codes, procedure codes, lab test results, and prescription drugs), (2) attention on the sequential medical encounters within a type, (3) attention on the medical codes within an encounter and type. This model is applied to predict the occurrence of stage 3 chronic kidney disease (CKD3), using three years’ medical history of Medicare Advantage (MA) members from a top health insurance company. The model takes members’ medical events, both claims and electronic medical record (EMR) data, as input, makes a prediction of CKD3 and calculates the contribution from individual events to the predicted outcome. The model outcome can be easily explained with the clinical evidence identified by the model algorithm. Here are examples: Member A had 36 medical encounters in the past three years: multiple office visits, lab tests and medications. The model predicts member A has a high risk of CKD3 with the following well-contributed clinical events - multiple high ‘Creatinine in Serum or Plasma’ tests and multiple low kidneys functioning ‘Glomerular filtration rate’ tests. Among the abnormal lab tests, more recent results contributed more to the prediction. The model also indicates regular office visits, no abnormal findings of medical examinations, and taking proper medications decreased the CKD3 risk. Member B had 104 medical encounters in the past 3 years and was predicted to have a low risk of CKD3, because the model didn’t identify diagnoses, procedures, or medications related to kidney disease, and many lab test results, including ‘Glomerular filtration rate’ were within the normal range. The model accurately predicts members A and B and provides interpretable clinical evidence that is validated by clinicians. Without extra effort, the interpretation is generated directly from the model and presented together with the occurrence date. Our model uses the medical data in its most raw format without any further data aggregation, transformation, or mapping. This greatly simplifies the data preparation process, mitigates the chance for error and eliminates post-modeling work needed for traditional model explanation. To our knowledge, this is the first paper on an interpretable deep-learning model using a 3-level attention structure, sourcing both EMR and claim data, including all 4 types of medical data, on the entire Medicare population of a big insurance company, and more importantly, directly generating model interpretation to support user decision. In the future, we plan to enrich the model input by adding patients’ demographics and information from free-texted physician notes.

Keywords: deep learning, interpretability, attention, big data, medical conditions

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Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Mahmoud A. Mahmoud, Ashraf Osman

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In this study, the different approaches currently followed by design codes to assess the stability of buildings utilizing concrete moment resisting frames structural system are evaluated. For such purpose, a parametric study was performed. It involved analyzing group of concrete moment resisting frames having different slenderness ratios (height/width ratios), designed for different lateral loads to vertical loads ratios and constructed using ordinary reinforced concrete and high strength concrete for stability check and overall buckling using code approaches and computer buckling analysis. The objectives were to examine the influence of such parameters that directly linked to frames’ lateral stiffness on the buildings’ stability and evaluates the code approach in view of buckling analysis results. Based on this study, it was concluded that, the most susceptible buildings to instability and magnification of second order effects are buildings having high aspect ratios (height/width ratio), having low lateral to vertical loads ratio and utilizing construction materials of high strength. In addition, the study showed that the instability limits imposed by codes are mainly mathematical to ensure reliable analysis not a physical ones and that they are in general conservative. Also, it has been shown that the upper limit set by one of the codes that second order moment for structural elements should be limited to 1.4 the first order moment is not justified, instead, the overall story check is more reliable.

Keywords: buckling, lateral stability, p-delta, second order

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Authors: Nanyombi Lubimbi, Josette Niyokindi

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Background: As in many other developing countries in Africa, Rwanda suffers from a chronic shortage of skilled Health Care professionals including Clinical Instructors. This shortage negatively affects the clinical instruction quality therefore impacting student-learning outcomes. Due to poor clinical supervision, it is often noted that students have no structure or consistent guidance in their learning process. The Clinical Educators and the Rwandan counterparts identified the need to create a favorable environment for learning. Description: During orientation the expectations of the student learning process, collaboration of the clinical instructors with the nurses and Clinical Educators is outlined. The ward managers facilitate structured learning by helping the students identify a maximum of two patients using the school’s objectives to guide the appropriate selection of patients. Throughout the day, Clinical Educators with collaboration of Clinical Instructors when present conduct an ongoing assessment of learning and provide feedback to the students. Post-conference is provided once or twice a week to practice critical thinking skills of patient cases that they have been taking care of during the day. Lessons Learned: The students are found to be more confident with knowledge and skills gained during rotations. Clinical facility evaluations completed by students at the end of their rotations highlight the student’s satisfaction and recommendation for continuation of structured learning. Conclusion: Based on the satisfaction of both students and Clinical Instructors, we have identified need for structured learning during clinical rotations. We acknowledge that more evidence-based practice is necessary to effectively address the needs of nursing and midwifery students throughout the country.

Keywords: Rwanda, clinical rotation, structured learning, critical thinking skills, post-conference

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Authors: Mouna Hemdi, Jamel bel Hadj Tahar

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The increasing development of multimedia applications requiring the simultaneous transport of several different services contributes to the evolution of the need for very high-speed network. In this paper, we propose an effective solution to achieve the very high speed while retaining elements of the optical transmission channel. So our study focuses on error correcting codes that aim for quality improvement on duty. We present a comparison of the quality of service for single channels and integrating the code BCH, RS and LDPC in order to find the best code in the different conditions of the transmission.

Keywords: code error correction, high speed broadband, optical transmission, information systems security

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Authors: Elham Mansouri, Asghar Mesbahi

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Purpose: In the current study, we aimed to investigate the macroscopic and microscopic dose enhancement effect of metallic nanoparticles in interstitial brachytherapy of uterus cancer by Iodin-125 source using a nano-lattice model in MCNPX (5) and MCNP6.1 codes. Materials and methods: Based on a nano-lattice simulation model containing a radiation source and a tumor tissue with cellular compartments loaded with 7mg/g spherical nanoparticles (bismuth, gold, and gadolinium), the energy deposited by the secondary electrons in microscopic and macroscopic level was estimated. Results: The results show that the values of macroscopic DEF is higher than microscopic DEF values and the macroscopic DEF values decreases as a function of distance from the brachytherapy source surface. Also, the results revealed a remarkable discrepancy between the DEF and secondary electron spectra calculated by MCNPX (5) and MCNP6.1 codes, which could be justified by the difference in energy cut-off and electron transport algorithms of two codes. Conclusion: According to the both MCNPX (5) and MCNP6.1 outputs, it could be concluded that the presence of metallic nanoparticles in the tumor tissue of uteruscancer increases the physical effectiveness of brachytherapy by I-125 source. The results presented herein give a physical view of radiosensitization potential of different metallic nanoparticles and could be considered in design of analytical and experimental radiosensitization studies in tumor regions using various radiotherapy modalities in the presence of heavy nanomaterials.

Keywords: MCNPX, MCNP6, nanoparticle, brachytherapy

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Authors: Ragy Raafat Gaber Attaalla

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health.

Keywords: low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Azzam Alosaimi

Abstract:

Different countries attempt to reduce energy demands and Greenhouse Gas (GHG) emissions to mitigate global warming potential. They set different building codes to regulate excessive building’s energy losses. Energy losses occur due to pressure difference between the indoor and outdoor environments, and thus, heat transfers from one region to another. One major sources of energy loss is known as building airtightness. Building airtightness is the fundamental feature of the building envelope that directly impacts infiltration. Most of international building codes require minimum performance for new construction to ensure acceptable airtightness. The execution of airtightness required standards has become more challenging in recent years due to a lack of expertise and equipment, making it costly and time-consuming. Hence, researchers have developed predictive models to predict buildings infiltration rates to meet building codes and to reduce energy and cost. This research applies a theoretical modeling approach using Matlab software to predict mean infiltration rate distributions and total heat loss of Saudi Arabia’s housing stock.

Keywords: infiltration rate, energy demands, heating loss, cooling loss, carbon emissions

Procedia PDF Downloads 130

Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

Abstract:

Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation

Procedia PDF Downloads 168

Authors: Jonah Kenei, Elisha Opiyo

Abstract:

Electronic health records, as a repository of patient information, is nowadays the most commonly used technology to record, store and review patient clinical records and perform other clinical tasks. However, the accurate identification and retrieval of relevant information from clinical records is a difficult task due to the unstructured nature of clinical documents, characterized in particular by a lack of clear structure. Therefore, medical practice is facing a challenge thanks to the rapid growth of health information in electronic health records (EHRs), mostly in narrative text form. As a result, it's becoming important to effectively manage the growing amount of data for a single patient. As a result, there is currently a requirement to visualize electronic health records (EHRs) in a way that aids physicians in clinical tasks and medical decision-making. Leveraging text visualization techniques to unstructured clinical narrative texts is a new area of research that aims to provide better information extraction and retrieval to support clinical decision support in scenarios where data generated continues to grow. Clinical datasets in electronic health records (EHR) offer a lot of potential for training accurate statistical models to classify facets of information which can then be used to improve patient care and outcomes. However, in many clinical note datasets, the unstructured nature of clinical texts is a common problem. This paper examines the very issue of getting raw clinical texts and mapping them into meaningful structures that can support healthcare professionals utilizing narrative texts. Our work is the result of a collaborative design process that was aided by empirical data collected through formal usability testing.

Keywords: classification, electronic health records, narrative texts, visualization

Procedia PDF Downloads 90