Search results for: healthcare architecture

Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: adverse drug reactions, drug safety, monitoring, pharmacovigilance

Procedia PDF Downloads 177

Authors: Volker Landersheim, Daria Manushyna, Thinh Pham, Dai-Duong Tran, Thomas Geury, Omar Hegazy, Steven Wilkins

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Air pollution is one of the emerging problems in our society. Targets of reduction of CO₂ emissions address low-carbon and resource-efficient transport. (Plug-in) hybrid electric propulsion concepts offer the possibility to reduce total cost of ownership (TCO) and emissions for public transport vehicles (e.g., bus application). In this context, typically, diesel engines are used to form the hybrid propulsion system of the vehicle. Though the technological development of diesel engines experience major advantages, some challenges such as the high amount of particle emissions remain relevant. Gaseous fuels (i.e., compressed natural gases (CNGs) or liquefied petroleum gases (LPGs) represent an attractive alternative to diesel because of their composition. In the framework of the research project 'Optimised Real-world Cost-Competitive Modular Hybrid Architecture' (ORCA), which was funded by the EU, two different hybrid-electric propulsion concepts have been investigated: one using a diesel engine as internal combustion engine and one using CNG as fuel. The aim of the current study is to analyze specific benefits for the aforementioned hybrid propulsion systems for predefined driving scenarios with regard to emissions and total cost of ownership in bus application. Engine models based on experimental data for diesel and CNG were developed. For the purpose of designing optimal energy management strategies for each propulsion system, maps-driven or quasi-static models for specific engine types are used in the simulation framework. An analogous modelling approach has been chosen to represent emissions. This paper compares the two concepts regarding their CO₂ and NOx emissions. This comparison is performed for relevant bus missions (urban, suburban, with and without zero-emission zone) and with different energy management strategies. In addition to the emissions, also the downsizing potential of the combustion engine has been analysed to minimize the powertrain TCO (pTCO) for plug-in hybrid electric buses. The results of the performed analyses show that the hybrid vehicle concept using the CNG engine shows advantages both with respect to emissions as well as to pTCO. The pTCO is 10% lower, CO₂ emissions are 13% lower, and the NOx emissions are more than 50% lower than with the diesel combustion engine. These results are consistent across all usage profiles under investigation.

Keywords: bus transport, emissions, hybrid propulsion, pTCO, CNG

Procedia PDF Downloads 115

Authors: Andrei Bejan, Luminita Marin, Dalila Belei

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Phenothiazine with electron-rich nitrogen and sulfur heteroatoms has a high electron-donating ability which promotes a good conjugation and therefore low band-gap with consequences upon charge carrier mobility improving and shifting of light emission in visible domain. Moreover, its non-planar butterfly conformation inhibits molecular aggregation and thus preserves quite well the fluorescence quantum yield in solid state compared to solution. Therefore phenothiazine and its derivatives are promising hole transport materials for use in organic electronic and optoelectronic devices as light emitting diodes, photovoltaic cells, integrated circuit sensors or driving circuits for large area display devices. The objective of this paper was to obtain a series of new phenothiazine derivatives by introduction of different electron withdrawing substituents as formyl, carboxyl and cyanoacryl units in order to create a push pull system which has potential to improve the electronic and optical properties. Bromine atom was used as electrono-donor moiety to extend furthermore the existing conjugation. The understudy compounds were structural characterized by FTIR and 1H-NMR spectroscopy and single crystal X-ray diffraction. Besides, the single crystal X-ray diffraction brought information regarding the supramolecular architecture of the compounds. Photophysical properties were monitored by UV-vis and photoluminescence spectroscopy, while the electrochemical behavior was established by cyclic voltammetry. The absorption maxima of the studied compounds vary in a large range (322-455 nm), reflecting the different electronic delocalization degree, depending by the substituent nature. In a similar manner, the emission spectra reveal different color of emitted light, a red shift being evident for the groups with higher electron withdrawing ability. The emitted light is pure and saturated for the compounds containing strong withdrawing formyl or cyanoacryl units and reach the highest quantum yield of 71% for the compound containing bromine and cyanoacrilic units. Electrochemical study show reversible oxidative and reduction processes for all the compounds and a close correlation of the HOMO-LUMO band gap with substituent nature. All these findings suggest the obtained compounds as promising materials for optoelectronic devices.

Keywords: electrochemical properties, phenothiazine derivatives, photoluminescence, quantum yield

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Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

Procedia PDF Downloads 143

Authors: Domenica Bona

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Colin Chant and David Goodman argue that historians of Chinese pre-industrial cities tend to underestimate revolutions and overestimate cyclic patterns: periods of peace and prosperity in the earl part of each d nast , followed b peasants’ rebellions and upheavals. Boyd described these cyclic patterns as part of the background of Chinese town planning and architecture. Thus old ideals of city planning-square plan, southward orientation and a palace along the central axis - are revived again and again in the ascendant phases of several d nastic c cles (e.g. Chang’an, Kaifen, and Beijing). Along this line of thought, m paper questions the relationship between the “magic square rule” and modern Chinese urban- planning. As a matter of fact, the classical theme of “cosmic Taoist urbanism” is still a reference for planning cities and new urban developments, whenever there is the intention to express nationalist ideals and “cultural straightforwardness.” Besides, some case studies can be related to “modern d nasties”: the first Republic under the Kuo Min Tang, the red People’s Republic and the post-Maoist open country of Deng Xiao Ping. Considering the project for the new capital of Nanjing in the Thirties, Beijing’s Tianan Men area in the ifties, and Shenzhen’s utian CBD in late 20th century, I argue that cyclic patterns are still in place, though with deformations related to westernization, private interests and lack of spirituality. How far new Chinese cities are - or simply seem to be - westernized? Symbolism, invisible frameworks, repeating features and behavioural patterns make urban China just “superficiall” western. This can be well noticed in cities previousl occupied b foreigners, like Hong Kong, or in newly founded ones, like Shenzhen, where both Asians and non-Asian people can feel the gender-shift from New-York-like landscapes to something else. Current planning in main metropolitan areas shows a blurred relationship between public policies and private investments: two levels of decisions and actions, one addressing the larger scale and infrastructures, the other concerning the micro scale and development of single plots. While zoning is instrumental in this process, master plans are often laid out over a very poor cartography, so much that any relation between the formal characters of new cities and the centuries-old structure of the related territory gets lost.

Keywords: China, contemporary cities, cultural heritage, shenzhen, urban planning

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Authors: Esshili Awatef, Manitz Marie-Pierre, Eßlinger Manuela, Gerhardt Alexandra, Plümper Jennifer, Wachholz Simone, Friebe Astrid, Juckel Georg

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Maternal immune activation (MIA) resulting from maternal viral infection during pregnancy is a known risk factor for schizophrenia. The neural mechanisms by which maternal infections increase the risk for schizophrenia remain unknown, although the prevailing hypothesis argues that an activation of the maternal immune system induces changes in the maternal-fetal environment that might interact with fetal brain development. It may lead to an activation of fetal microglia inducing long-lasting functional changes of these cells. Based on post-mortem analysis showing an increased number of activated microglial cells in patients with schizophrenia, it can be hypothesized that these cells contribute to disease pathogenesis and may actively be involved in gray matter loss observed in such patients. In the present study, we hypothesize that prenatal treatment with the inflammatory agent Poly(I:C) during embryogenesis at contributes to microglial activation in the offspring, which may, therefore, represent a contributing factor to the pathogenesis of schizophrenia and underlines the need for new pharmacological treatment options. Pregnant rats were treated with intraperitoneal injections a single dose of Poly(I:C) or saline on gestation day 17. Brains of control and Poly(I:C) offspring, were removed and into 20-μm-thick coronal sections were cut by using a Cryostat. Brain slices were fixed and immunostained with ba1 antibody. Subsequently, Iba1-immunoreactivity was detected using a secondary antibody, goat anti-rabbit. The sections were viewed and photographed under microscope. The immunohistochemical analysis revealed increases in microglia cell number in the prefrontal cortex, in offspring of poly(I:C) treated-rats as compared to the controls injected with NaCl. However, no significant differences were observed in microglia activation in the cerebellum among the groups. Prenatal immune challenge with Poly(I:C) was able to induce long-lasting changes in the offspring brains. This lead to a higher activation of microglia cells in the prefrontal cortex, a brain region critical for many higher brain functions, including working memory and cognitive flexibility. which might be implicated in possible changes in cortical neuropil architecture in schizophrenia. Further studies will be needed to clarify the association between microglial cells activation and schizophrenia-related behavioral alterations.

Keywords: Microglia, neuroinflammation, PolyI:C, schizophrenia

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Authors: Eiman Kattan, Hong Wei

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In using Convolutional Neural Network (CNN) for classification, there is a set of hyperparameters available for the configuration purpose. This study aims to evaluate the impact of a range of parameters in CNN architecture i.e. AlexNet on land cover classification based on four remotely sensed datasets. The evaluation tests the influence of a set of hyperparameters on the classification performance. The parameters concerned are epoch values, batch size, and convolutional filter size against input image size. Thus, a set of experiments were conducted to specify the effectiveness of the selected parameters using two implementing approaches, named pertained and fine-tuned. We first explore the number of epochs under several selected batch size values (32, 64, 128 and 200). The impact of kernel size of convolutional filters (1, 3, 5, 7, 10, 15, 20, 25 and 30) was evaluated against the image size under testing (64, 96, 128, 180 and 224), which gave us insight of the relationship between the size of convolutional filters and image size. To generalise the validation, four remote sensing datasets, AID, RSD, UCMerced and RSCCN, which have different land covers and are publicly available, were used in the experiments. These datasets have a wide diversity of input data, such as number of classes, amount of labelled data, and texture patterns. A specifically designed interactive deep learning GPU training platform for image classification (Nvidia Digit) was employed in the experiments. It has shown efficiency in both training and testing. The results have shown that increasing the number of epochs leads to a higher accuracy rate, as expected. However, the convergence state is highly related to datasets. For the batch size evaluation, it has shown that a larger batch size slightly decreases the classification accuracy compared to a small batch size. For example, selecting the value 32 as the batch size on the RSCCN dataset achieves the accuracy rate of 90.34 % at the 11th epoch while decreasing the epoch value to one makes the accuracy rate drop to 74%. On the other extreme, setting an increased value of batch size to 200 decreases the accuracy rate at the 11th epoch is 86.5%, and 63% when using one epoch only. On the other hand, selecting the kernel size is loosely related to data set. From a practical point of view, the filter size 20 produces 70.4286%. The last performed image size experiment shows a dependency in the accuracy improvement. However, an expensive performance gain had been noticed. The represented conclusion opens the opportunities toward a better classification performance in various applications such as planetary remote sensing.

Keywords: CNNs, hyperparamters, remote sensing, land cover, land use

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Authors: M. Kharrat, G. Moreau, Z. Aboura

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The latest advances in the weaving industry, combined with increasingly sophisticated means of materials processing, have made it possible to produce complex 3D composite structures. Mainly used in aeronautics, composite materials with 3D architecture offer better mechanical properties than 2D reinforced composites. Nevertheless, these materials require a good understanding of their behavior. Because of the complexity of such materials, the damage mechanisms are multiple, and the scenario of their appearance and evolution depends on the nature of the exerted solicitations. The AE technique is a well-established tool for discriminating between the damage mechanisms. Suitable sensors are used during the mechanical test to monitor the structural health of the material. Relevant AE-features are then extracted from the recorded signals, followed by a data analysis using pattern recognition techniques. In order to better understand the damage scenarios of interlock composite materials, a multi-instrumentation was set-up in this work for tracking damage initiation and development, especially in the vicinity of the first significant damage, called macro-damage. The deployed instrumentation includes video-microscopy, Digital Image Correlation, Acoustic Emission (AE) and micro-tomography. In this study, a multi-variable AE data analysis approach was developed for the discrimination between the different signal classes representing the different emission sources during testing. An unsupervised classification technique was adopted to perform AE data clustering without a priori knowledge. The multi-instrumentation and the clustered data served to label the different signal families and to build a learning database. This latter is useful to construct a supervised classifier that can be used for automatic recognition of the AE signals. Several materials with different ingredients were tested under various solicitations in order to feed and enrich the learning database. The methodology presented in this work was useful to refine the damage threshold for the new generation materials. The damage mechanisms around this threshold were highlighted. The obtained signal classes were assigned to the different mechanisms. The isolation of a 'noise' class makes it possible to discriminate between the signals emitted by damages without resorting to spatial filtering or increasing the AE detection threshold. The approach was validated on different material configurations. For the same material and the same type of solicitation, the identified classes are reproducible and little disturbed. The supervised classifier constructed based on the learning database was able to predict the labels of the classified signals.

Keywords: acoustic emission, classifier, damage mechanisms, first damage threshold, interlock composite materials, pattern recognition

Procedia PDF Downloads 133

Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ülle Ernits

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Background data. This is a study in the field of health humanities. The 1930s were years of rapid cultural and economic development in Europe and in Estonia. The urban way of life the glamorous lifestyle gained popularity, although the society of Estonia in the 1930s had traditionally been agrarian. People's free time increased, which needed to be filled with activities either at home or outside the home. Therefore, the number of popular magazines aimed at housewives increased. More than 200 magazines and bulletins were published in the Republic of Estonia before the Second World War (in 1934, the population of Estonia was 1,126,000). In the 1930s, the Republic of Estonia faced several challenges in healthcare. Infectious diseases, alcoholism, prostitution and child mortality had to be dealt with. Healers without medical education operated in the villages. For the average person, medical care was quite expensive, and despite efforts, by 1940, only 20% of the population was covered by health insurance. Advice published in popular family magazines provided help in solving, understanding and preventing health problems. Aim. The aim of the study is to analyze the health counseling through magazines during the Republic of Estonia (1930-1940) in historical and cultural context. Method. In total, 420 magazine issues were processed. An extensive textual analysis, as well as an analysis of photographs and illustrations from the aspect of health advice was carried out to achieve the research objective. Results. Health counseling was written by well-known doctors of the time, leaders of the abstinence movement and others. There was advice in various areas: prevention of infectious and non-infectious diseases and their treatment with simple methods, first aid, combating sexually transmitted diseases, women's and children's health, mental health, folk medicine techniques, abstinence, healthy eating, skin care, hygiene, introducing pharmacy products. Advice was offered in both written and visual form. Photos and illustrations helped to empower the health advice. Folk heritage and health knowledge of the time were relied upon, and a scientific point of view was popularized. Aspirations towards a European lifestyle were reflected in articles and illustrations. Contribution. The article has an ethnological attitude, and its impact comes down to understanding the history of health care in its socio-cultural context. The health counseling topics of the 1930s are also applicable in today's health education and research. Health counseling builds on the legacy of the past, and it helps to understand that the past is in the future and the main principles of health counseling arise from our history and background.

Keywords: estonian republic, health counseling, lifestyle, magazines, media

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Authors: Anchal Rana

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Indian Himalayas with their diverse climatic conditions are home to many rare and endangered medicinal flora. One such species is Polygonatum verticillatum Linn., popularly known as King Solomon’s Seal or Solomon’s Seal. Its mention as an incredible medicinal herb comes from 5000 years ago in Indian Materia Medica as a component of Ashtavarga, a poly-herbal formulation comprising of eight herbs illustrated as world’s first ever revitalizing and rejuvenating nutraceutical food, which is now commercialised in the name ‘Chaywanprash’. It is an erect tall (60 to 120 cm) perennial herb with sessile, linear leaves and white pendulous flowers. The species grows well in an altitude range of 1600 to 3600 m amsl, and propagates mostly through rhizomes. The rhizomes are potential source for significant phytochemicals like flavonoids, phenolics, lectins, terpenoids, allantoin, diosgenin, β-Sitosterol and quinine. The presence of such phytochemicals makes the species an asset for antioxidant, cardiotonic, demulcent, diuretic, energizer, emollient, aphrodisiac, appetizer, glactagogue, etc. properties. Having profound concentrations of macro and micronutrients, species has fine prospects of being used as a diet supplement. However, due to unscientific and gregarious uprooting, it has been assigned a status of ‘vulnerable’ and ‘endangered’ in the Conservation Assessment and Management Plan (CAMP) process conducted by Foundation for Revitalisation of Local Health Traditions (FRLHT) during 2010, according to IUCN Red-List Criteria. Further, destructive harvesting, land use disturbances, heavy livestock grazing, climatic changes and habitat fragmentation have substantially contributed towards anomaly of the species. It, therefore, became imperative to conserve the diversity of the species and make judicious use in future research and commercial programme and schemes. A Gene Bank was therefore established at High Altitude Herbal Garden of the Forest Research Institute, Dehradun, India situated at Chakarata (30042’52.99’’N, 77051’36.77’’E, 2205 m amsl) consisting 149 accessions collected from thirty-one geographical locations spread over three Himalayan States of Jammu and Kashmir, Himachal Pradesh, and Uttarakhand. The present investigations purport towards sampling and collection of divergent germplasm followed by planting and cultivation techniques. The ultimate aim is thereby focussed on analysing genetic diversity of the species and capturing promising genotypes for carrying out further genetic improvement programme so to contribute towards sustainable development and healthcare.

Keywords: Polygonatum verticillatum Linn., phytochemicals, genetic diversity, conservation, gene bank

Procedia PDF Downloads 135

Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Donghyun Lee, Cam Nguyen

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Multi-band systems offer a great deal of benefit in modern communication and radar systems. In particular, multi-band antenna-array radar systems with their extended frequency diversity provide numerous advantages in detection, identification, locating and tracking a wide range of targets, including enhanced detection coverage, accurate target location, reduced survey time and cost, increased resolution, improved reliability and target information. An accurate calibration is a critical issue in antenna array systems. The amplitude and phase errors in multi-band and multi-polarization antenna array transceivers result in inaccurate target detection, deteriorated resolution and reduced reliability. Furthermore, the digital beam former without the RF domain phase-shifting is less immune to unfiltered interference signals, which can lead to receiver saturation in array systems. Therefore, implementing integrated front-end architecture, which can support calibration function with low insertion and filtering function from the farthest end of an array transceiver is of great interest. We report a dual K/Ka-band T/R/Calibration switch module with quasi-elliptic dual-bandpass filtering function implementing a Q-enhanced metamaterial transmission line. A unique dual-band frequency response is incorporated in the reception and calibration path of the proposed switch module utilizing the composite right/left-handed meta material transmission line coupled with a Colpitts-style negative generation circuit. The fabricated fully integrated T/R/Calibration switch module in 0.18-μm BiCMOS technology exhibits insertion loss of 4.9-12.3 dB and isolation of more than 45 dB in the reception, transmission and calibration mode of operation. In the reception and calibration mode, the dual-band frequency response centered at 24.5 and 35 GHz exhibits out-of-band rejection of more than 30 dB compared to the pass bands below 10.5 GHz and above 59.5 GHz. The rejection between the pass bands reaches more than 50 dB. In all modes of operation, the IP1-dB is between 4 and 11 dBm. Acknowledgement: This paper was made possible by NPRP grant # 6-241-2-102 from the Qatar National Research Fund (a member of Qatar Foundation). The statements made herein are solely the responsibility of the authors.

Keywords: microwaves, millimeter waves, T/R switch, wireless communications, wireless communications

Procedia PDF Downloads 138

Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

Procedia PDF Downloads 117

Authors: Kuniaki Kudo, Raviraj Solanki, Kaushal Patel, Yash Virani

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This research mainly concerns optimizing UI test automation for large-scale web applications. The test target application is the HHAexchange homecare management WEB application that seamlessly connects providers, state Medicaid programs, managed care organizations (MCOs), and caregivers through one platform with large-scale functionalities. This study focuses on user interface automation testing for the WEB application. The quality assurance team must execute many manual users interface test cases in the development process to confirm no regression bugs. The team automated 346 test cases; the UI automation test execution time was over 17 hours. The business requirement was reducing the execution time to release high-quality products quickly, and the quality assurance automation team modernized the test automation framework to optimize the execution time. The base of the WEB UI automation test environment is Selenium, and the test code is written in Python. Adopting a compilation language to write test code leads to an inefficient flow when introducing scalability into a traditional test automation environment. In order to efficiently introduce scalability into Test Automation, a scripting language was adopted. The scalability implementation is mainly implemented with AWS's serverless technology, an elastic container service. The definition of scalability here is the ability to automatically set up computers to test automation and increase or decrease the number of computers running those tests. This means the scalable mechanism can help test cases run parallelly. Then test execution time is dramatically decreased. Also, introducing scalable test automation is for more than just reducing test execution time. There is a possibility that some challenging bugs are detected by introducing scalable test automation, such as race conditions, Etc. since test cases can be executed at same timing. If API and Unit tests are implemented, the test strategies can be adopted more efficiently for this scalability testing. However, in WEB applications, as a practical matter, API and Unit testing cannot cover 100% functional testing since they do not reach front-end codes. This study applied a scalable UI automation testing strategy to the large-scale homecare management system. It confirmed the optimization of the test case execution time and the detection of a challenging bug. This study first describes the detailed architecture of the scalable test automation environment, then describes the actual performance reduction time and an example of challenging issue detection.

Keywords: aws, elastic container service, scalability, serverless, ui automation test

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Authors: Keenoo Bibi Sumera, Alsheikh Mona, Mubarak Jan Beebee Zeba Mahetaab

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Background: Due to the busy schedule of the practicing clinicians at the hospitals, students may not always be attended to, which is to their detriment. The clinicians at the hospitals are also not always acquainted with teaching and/or supervising students on their placements. Additionally, there is a high student-patient ratio. Since they are the prospective clinical doctors under training, they need to reach the competence levels in clinical decision-making skills to be able to serve the healthcare system of the country and to be safe doctors. Aims and Objectives: A reflective portfolio was used to provide a means for students to learn by reflecting on their experiences and obtaining continuous feedback. This practice is an attempt to compensate for the scarcity of lack of resources, that is, clinical placement supervisors and patients. It is also anticipated that it will provide learners with a continuous monitoring and learning gap analysis tool for their clinical skills. Methodology: A hardcopy reflective portfolio was designed and validated. The portfolio incorporated a mini clinical evaluation exercise (mini-CEX), direct observation of procedural skills and reflection sections. Workshops were organized for the stakeholders, that is the management, faculty and students, separately. The rationale of reflection was emphasized. Students were given samples of reflective writing. The portfolio was then implemented amongst the undergraduate medical students of years four, five and six during clinical clerkship. After 16 weeks of implementation of the portfolio, a survey questionnaire was introduced to explore how undergraduate students perceive the educational value of the reflective portfolio and its impact on their deep information processing. Results: The majority of the respondents are in MD Year 5. Out of 52 respondents, 57.7% were doing the internal medicine clinical placement rotation, and 42.3% were in Otorhinolaryngology clinical placement rotation. The respondents believe that the implementation of a reflective portfolio helped them identify their weaknesses, gain professional development in terms of helping them to identify areas where the knowledge is good, increase the learning value if it is used as a formative assessment, try to relate to different courses and in improving their professional skills. However, it is not necessary that the portfolio will improve the self-esteem of respondents or help in developing their critical thinking, The portfolio takes time to complete, and the supervisors are not useful. They had to chase supervisors for feedback. 53.8% of the respondents followed the Gibbs reflective model to write the reflection, whilst the others did not follow any guidelines to write the reflection 48.1% said that the feedback was helpful, 17.3% preferred the use of written feedback, whilst 11.5% preferred oral feedback. Most of them suggested more frequent feedback. 59.6% of respondents found the current portfolio user-friendly, and 28.8% thought it was too bulky. 27.5% have mentioned that for a mobile application. Conclusion: The reflective portfolio, through the reflection of their work and regular feedback from supervisors, has an overall positive impact on the learning process of undergraduate medical students during their clinical clerkship.

Keywords: Portfolio, Reflection, Feedback, Clinical Placement, Undergraduate Medical Education

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Authors: Sunidhi Sood, Drashti Narendrakumar Shah, Aakarsh Sharma, Nirali Harsh Panchal, Maria Karizhenskaia

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Cancer is a global health concern, causing a significant number of deaths, with chemotherapy being a standard treatment method. However, chemotherapy often induces side effects that profoundly impact the physical and emotional well-being of patients, lowering their overall quality of life (QoL). This research aims to investigate the potential of music and art therapy as holistic adjunctive therapy for cancer patients undergoing chemotherapy, offering non-pharmacological support. This is achieved through a comprehensive review of existing literature with a focus on the following themes, including stress and anxiety alleviation, emotional expression and coping skill development, transformative changes, and pain management with mood upliftment. A systematic search was conducted using Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 2014 to 2023. The review solely incorporated studies focusing on the impact of music and art therapy on the health and overall well-being of cancer patients undergoing chemotherapy in North America. The findings from 16 studies involving pediatric oncology patients, females affected by breast cancer, and general oncology patients show that music and art therapies significantly reduce anxiety (standardized mean difference: -1.10) and improve perceived stress (median change: -4.0) and overall quality of life in cancer patients undergoing chemotherapy. Furthermore, music therapy has demonstrated the potential to decrease anxiety, depression, and pain during infusion treatments (average changes in resilience scale: 3.4 and 4.83 for instrumental and vocal music therapy, respectively). This data calls for consideration of the integration of music and art therapy into supportive care programs for cancer patients undergoing chemotherapy. Moreover, it provides guidance to healthcare professionals and policymakers, facilitating the development of patient-centered strategies for cancer care in Canada. Further research is needed in collaboration with qualified therapists to examine its applicability and explore and evaluate patients' perceptions and expectations in order to optimize the therapeutic benefits and overall patient experience. In conclusion, integrating music and art therapy in cancer care promises to substantially enhance the well-being and psychosocial state of patients undergoing chemotherapy. However, due to the small population size considered in existing studies, further research is needed to bridge the knowledge gap and ensure a comprehensive, patient-centered approach, ultimately enhancing the quality of life (QoL) for individuals facing the challenges of cancer treatment.

Keywords: anxiety, cancer, chemotherapy, depression, music and art therapy, pain management, quality of life

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Authors: Mohamed Malek Khenissi, Mohamed Montassar Ben Slama, Anis Belhaj Mohamed, Moncef Saidi

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Northern Tunisia is well known by its different and complex structural and geological zones that have been the result of a geodynamic history that extends from the early Mesozoic era to the actual period. One of these zones is the salt province, where the Halokinesis process is manifested by a number of NE/SW salt structures such as Jebel Ech-Cheid which represents masses of materials characterized by a high plasticity and low density. The salt masses extrusions that have been developed due to an extension that started from the late Triassic to late Cretaceous. The evolution of salt bodies within sedimentary basins have not only contributed to modify the architecture of the basin, but it also has certain geochemical effects which touch mainly source rocks that surround it. It has been demonstrated that the presence of salt structures within sedimentary basins can influence its temperature distribution and thermal history. Moreover, it has been creating heat flux anomalies that may affect the maturity of organic matter and the timing of hydrocarbon generation. Field samples of the Bahloul source rock (Cenomanan-Tunonian) were collected from different sights from all around Ech Cheid salt structure and evaluated using Rock-eval pyrolysis and GC/MS techniques in order to assess the degree of maturity evolution and the heat flux anomalies in the different zones analyze. The Total organic Carbon (TOC) values range between 1 to 9% and the (Tmax) ranges between 424 and 445°C, also the distribution of the source rock biomarkers both saturated and aromatic changes in a regular fashions with increasing maturity and this are shown in the chromatography results such as Ts/(Ts+Tm) ratios, 22S/(22S+22R) values for C31 homohopanes, ββ/(ββ+αα)20R and 20S/(20S+20R) ratios for C29 steranes which gives a consistent maturity indications and assessment of the field samples. These analyses are carried to interpret the maturity evolution and the heat flux around Ech Cheid salt structure through the geological history. These analyses also aim to demonstrate that the salt structure can have a direct effect on the geothermal gradient of the basin and on the maturity of the Bahloul Formation source rock. The organic matter has reached different stages of thermal maturity, but delineate a general increasing maturity trend. Our study confirms that the J. Ech Cheid salt body have on the first hand: a huge influence on the local distribution of anoxic depocentre at least within Cenomanian-Turonian time. In the second hand, the thermal anomaly near the salt mass has affected the maturity of Bahloul Formation.

Keywords: Bahloul formation, depocentre, GC/MS, rock-eval

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Authors: Sima Ajami, Batool Akbari

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Background: Radio frequency identification (RFID) system has been successfully applied to the areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services. The RFID is already used to track and trace the victims in a disaster situation. Data can be collected in real time and be immediately available to emergency personnel and saves time by the RFID. Objectives: The aim of this study was, first, to identify stakeholders and customers for rescuing earthquake victims, second, to list key internal and external factors to use RFID to track earthquake victims, finally, to assess SWOT for rescuers' viewpoint. Materials and Methods: This study was an applied and analytical study. The study population included scholars, experts, planners, policy makers and rescuers in the "red crescent society of Isfahan province", "disaster management Isfahan province", "maintenance and operation department of Isfahan", "fire and safety services organization of Isfahan municipality", and "medical emergencies and disaster management center of Isfahan". After that, researchers held a workshop to teach participants about RFID and its usages in tracking earthquake victims. In the meanwhile of the workshop, participants identified, listed, and weighed key internal factors (strengths and weaknesses; SW) and external factors (opportunities and threats; OT) to use RFID in tracking earthquake victims. Therefore, participants put weigh strengths, weaknesses, opportunities, and threats (SWOT) and their weighted scales were calculated. Then, participants' opinions about this issue were assessed. Finally, according to the SWOT matrix, strategies to solve the weaknesses, problems, challenges, and threats through opportunities and strengths were proposed by participants. Results: The SWOT analysis showed that the total weighted score for internal and external factors were 3.91 (Internal Factor Evaluation) and 3.31 (External Factor Evaluation) respectively. Therefore, it was in a quadrant SO strategies cell in the SWOT analysis matrix and aggressive strategies were resulted. Organizations, scholars, experts, planners, policy makers and rescue workers should plan to use RFID technology in order to save more victims and manage their life. Conclusions: Researchers suppose to apply SO strategies and use a firm’s internal strength to take advantage of external opportunities. It is suggested, policy maker should plan to use the most developed technologies to save earthquake victims and deliver the easiest service to them. To do this, education, informing, and encouraging rescuers to use these technologies is essential. Originality/ Value: This study was a research paper that showed how RFID can be useful to track victims in earthquake.

Keywords: frequency identification system, strength, weakness, earthquake, victim

Procedia PDF Downloads 299

Authors: Mercedes Sepulveda, Saras Henderson, Dana Farrell, Gaby Heuft

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In Australia, there is a significant number of Culturally and Linguistically Diverse (CALD) Grandparent Carers who are sole carers for their grandchildren. Services in the community such as accessible healthcare, financial support, legal aid, and transport to services can assist Grandparent Carers to continue to live in their own home whilst caring for their grandchildren. Community nurses can play a major role by being aware of the needs of these grandparents and link them to services via information and referrals. The CALD Grandparent Carer experiences have only been explored marginally and may be similar to the general Grandparent Carer population, although cultural aspects may add to their difficulties. This Needs-Gap Analysis aimed to uncover ‘hidden issues’ for CALD Grandparent Carers such as service gaps and actions needed to address these issues. The stakeholders selected for this Needs-Gap Analysis were drawn from relevant service providers such as community and aged care services, child and/or grandparents support services and CALD specific services. One hundred relevant service providers were surveyed using six structured questions via face to face, phone interviews, or email correspondence. CALD Grandparents who had a significant or sole role of being a carer for grandchildren were invited to participate through their CALD community leaders. Consultative Forums asking five questions that focused on the caring role, issues encountered, and what needed to be done, were conducted with the African, Asian, Spanish-Speaking, Middle Eastern, European, Pacific Islander and Maori Grandparent Carers living in South-east Queensland, Australia. Data from the service provider survey and the CALD Grandparent Carer forums were content analysed using thematic principles. Our findings highlighted social determinants of health grouped into six themes. These were; 1) service providers and Grandparent Carer perception that there was limited research data on CALD grandparents as carers; 2) inadequate legal and financial support; 3) barriers to accessing information and advice; 4) lack of childcare options in the light of aging and health issues; 5) difficulties around transport; and 6) inadequate technological skills often leading to social isolation for both carer and grandchildren. Our Needs-Gap Analysis provides insight to service providers especially health practitioners such as doctors and community nurses, particularly on the impact of caring for grandchildren on CALD Grandparent Carers. Furthermore, factors such as cultural differences, English language difficulties, and migration experiences also impacted on the way CALD Grandparent Carers are able to cope. The findings of this Need-Gap Analysis signposts some of the ‘ hidden issues’ that CALD Grandparents Carers face and draws together recommendations for the future as put forward by the stakeholders themselves.

Keywords: CALD grandparents, carer needs, community nurses, grandparent carers

Procedia PDF Downloads 292

Authors: Kenny Chi Man Chui

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Background: In Chinese culture, the traditional equivalent term for English dementia is chi dai zheng, which, whether translated as ‘insanity’ or ‘idiocy’ carries a sharply negative connotation. In fact, even though the traditional name for dementia has evolved, from chi dai zheng to shi zhi zheng, nao tui hua zheng or ren zhi zhang ai zheng, educating the population about more respectful terms for the condition and promoting a positive understanding about people with dementia in society have proven to be time-intensive endeavors. By extension, the use of such terms promotes the perception that people with dementia undergo a ‘total loss of self’ or experience a ‘living death’ or ‘social death’. Both in Asia and elsewhere, the appropriate nomenclature for dementia remains controversial, and different medical and healthcare professionals in Hong Kong have taken various stances on how to refer to the condition there. Indeed, how this negative perception affects the interaction between people with dementia and the surrounding others? Methodology: Qualitative research with the concept of postmodernism, interpretivism, and Foucauldian theory was adopted as frameworks in applying participatory observations, in-depth interviews, and other qualitative methods. First, ten people with dementia—one man and nine women—living in two residential care homes in Hong Kong were interviewed, as were ten members of the care staff, all of whom were women. Next, to coach the staff in understanding the feelings and self-perceptions of people with dementia, two reflective training sessions were provided. Afterward, to assess the impact of the training sessions on the staff, two focus groups were held. Findings: The findings revealed that residents with dementia did not perceive themselves as being ‘demented’ and were confused by not getting responses from the others. From the understanding of care staff, they perceived the residents as being ‘demented’, desolate troublemakers. They described people with dementia as ‘naughty children’ who should be controlled and be punished while treated them as ‘psychiatric patients’ who could be ignored and be mute. “Psychosocial restraint” happened regarding the discrepancy of perception between people with dementia and the care staff. People with dementia did not think that their confusion of memory was related to dementia or, frankly speaking, they did not know what dementia was. When others treated them as ‘demented patients, the residents with mild to moderate dementia fiercely rejected that designation and reported a host of negative feelings, hence the fluctuations of mood and emotion noted by the care staff. Conclusion: As the findings revealed, the people with dementia were also discontent with the care arrangements in the care homes, felt abandoned by others and worried about bothering others. Their shifting emotional states and moods were treated as the Behavioral and Psychological symptoms of Dementia (BPSD), which nothing can do reported by the care staff in the residential care homes. People with dementia become social withdrawal or isolated in daily living, which should be alert and be changed by the social work professionals about the occurrence of “psychosocial restraint” in dementia care.

Keywords: psychosocial restraint, qualitative research, social work with dementitude, voice of people with dementia

Procedia PDF Downloads 147

Authors: Ercan Kızılay, Mustafa Demi̇rel, Selçuk Coşkun

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Railway signaling systems consist of vital products that regulate railway traffic and provide safe route arrangements and maneuvers of trains. SIL 4 signal lamps are produced by many manufacturers today. There is a need for systems that enable these signal lamps to be controlled by commands from the interlocking. These systems should act as fail-safe and give error indications to the interlocking system when an unexpected situation occurs for the safe operation of railway systems from the RAMS perspective. In the past, driving and proving the lamp in relay-based systems was typically done via signaling relays. Today, the proving of lamps is done by comparing the current values read over the return circuit, the lower and upper threshold values. The purpose is an analog electronic object controller with the possibility of easy integration with vital systems and the signal lamp itself. During the study, the EN50126 standard approach was considered, and the concept, definition, risk analysis, requirements, architecture, design, and prototyping were performed throughout this study. FMEA (Failure Modes and Effects Analysis) and FTA (Fault Tree) Analysis) have been used for safety analysis in accordance with EN 50129. Concerning these analyzes, the 1oo2D reactive fail-safe hardware design of a controller has been researched. Electromagnetic compatibility (EMC) effects on the functional safety of equipment, insulation coordination, and over-voltage protection were discussed during hardware design according to EN 50124 and EN 50122 standards. As vital equipment for railway signaling, railway signal object controllers should be developed according to EN 50126 and EN 50129 standards which identify the steps and requirements of the development in accordance with the SIL 4(Safety Integrity Level) target. In conclusion of this study, an analog railway signal object controller, which takes command from the interlocking system, is processed in driver cards. Driver cards arrange the voltage level according to desired visibility by means of semiconductors. Additionally, prover cards evaluate the current upper and lower thresholds. Evaluated values are processed via logic gates which are composed as 1oo2D by means of analog electronic technologies. This logic evaluates the voltage level of the lamp and mitigates the risks of undue dimming.

Keywords: object controller, railway electronic, analog electronic, safety, railway signal

Procedia PDF Downloads 63

Authors: Aakriti Chetan Shah, Elle Sein

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Background/purpose: Group B Streptococcus(GBS) is the leading cause of severe early onset infection in newborns, with the incidence of Early Onset Group B Streptococcus (EOGBS) in the UK and Ireland rising from 0.48 to 0.57 per 1000 births from 2000 to 2015. A WHO study conducted in 2017, has shown that 38.5% of cases can result in stillbirth and infant deaths. This is an important problem to consider as 20% of women worldwide have GBS colonisation and can suffer from these detrimental effects. Current Royal College of Obstetricians and Midwives (RCOG) guidelines do not recommend bacteriological screening for pregnant women due to its low sensitivity in antenatal screening correlating with the neonate having GBS but advise a patient information leaflet be given to pregnant women. However, a Healthcare Safety Investigation Branch (HSIB) 2019 learning report found that only 50% of trusts and health boards reported giving GBS information leaflets to all pregnant mothers. Therefore, this audit aimed to assess current practices of information dissemination about GBS at Chelsea & Westminster (C&W) Hospital. Methodology: A quantitative cross-sectional study was carried out using a questionnaire based on the RCOG GBS guidelines and the HSIB Learning report. The study was conducted in antenatal clinics at Chelsea & Westminster Hospital, from 29th January 2021 to 14th February 2021, with twenty-two practicing obstetricians and midwives participating in the survey. The main outcome measure was the proportion of obstetricians and midwives who disseminate information about GBS to pregnant women, and the reasons behind why they do or do not. Results: 22 obstetricians and midwives responded with 18 complete responses. Of which 12 were obstetricians and 6 were midwives. Only 17% of clinical staff routinely inform all pregnant women about GBS, and do so at varying timeframes of the pregnancy, with an equal split in the first, second and third trimester. The primary reason for not informing women about GBS was influenced by three key factors: Deemed relevant only for patients at high risk of GBS, lack of time in clinic appointments and no routine NHS screening available. Interestingly 58% of staff in the antenatal clinic believe it is necessary to inform all women about GBS and its importance. Conclusion: It is vital for obstetricians and midwives to inform all pregnant women about GBS due to the high prevalence of incidental carriers in the population, and the harmful effects it can cause for neonates. Even though most clinicians believe it is important to inform all pregnant women about GBS, most do not. To ensure that RCOG and HSIB recommendations are followed, we recommend that women should be given this information at 28 weeks gestation in the antenatal clinic. Proposed implementations include an information leaflet to be incorporated into the Mum and Baby app, an informative video and end-to-end digital clinic documentation to include this information sharing prompt.

Keywords: group B Streptococcus, early onset sepsis, Antenatal care, Neonatal morbidity, GBS

Procedia PDF Downloads 156

Authors: S. Arias

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New housing developments and the technological changes that this implies, adapt the styles of living of its residents, as well as new family structures and forms of work due to the particular needs of a specific group of people which involves different techniques of dealing with, organize, equip and use a particular territory. Currently, own their own space is increasingly important and the cities are faced with the challenge of providing the opportunity for such demands, as well as energy, water and waste removal necessary in the process of construction and occupation of new human settlements. Until the day of today, not has failed to give full response to these demands and needs, resulting in cities that grow without control, badly used land, avenues and congested streets. Buildings and dwellings have an important impact on the environment and on the health of the people, therefore environmental quality associated with the comfort of humans to the sustainable development of natural resources. Applied to architecture, this concept involves the incorporation of new technologies in all the constructive process of a dwelling, changing customs of developers and users, what must be a greater effort in planning energy savings and thus reducing the emissions Greenhouse Gases (GHG) depending on the geographical location where it is planned to develop. Since the techniques of occupation of the territory are not the same everywhere, must take into account that these depend on the geographical, social, political, economic and climatic-environmental circumstances of place, which in modified according to the degree of development reached. In the analysis that must be undertaken to check the degree of sustainability of the place, it is necessary to make estimates of the energy used in artificial air conditioning and lighting. In the same way is required to diagnose the availability and distribution of the water resources used for hygiene and for the cooling of artificially air-conditioned spaces, as well as the waste resulting from these technological processes. Based on the results obtained through the different stages of the analysis, it is possible to perform an energy audit in the process of proposing recommendations of sustainability in architectural spaces in search of energy saving, rational use of water and natural resources optimization. The above can be carried out through the development of a sustainable building code in develop technical recommendations to the regional characteristics of each study site. These codes would seek to build bases to promote a building regulations applicable to new human settlements looking for is generated at the same time quality, protection and safety in them. This building regulation must be consistent with other regulations both national and municipal and State, such as the laws of human settlements, urban development and zoning regulations.

Keywords: building regulations, housing, sustainability, technology

Procedia PDF Downloads 326

Authors: Syed Asif Hassan, Tabrej Khan

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Tuberculosis (TB) caused by bacillus Mycobacterium tuberculosis (Mtb) continues to take a disturbing toll on human life and healthcare facility worldwide. The global burden of TB remains enormous. The alarming rise of multi-drug resistant strains of Mycobacterium tuberculosis calls for an increase in research efforts towards the development of new target specific therapeutics against diverse strains of M. tuberculosis. Therefore, the discovery of new molecular scaffolds targeting new drug sites should be a priority for a workable plan for fighting resistance in Mycobacterium tuberculosis (Mtb). Mtb non-acylated lipoprotein LprG (Rv1411c) has a Toll-like receptor 2 (TLR2) agonist actions that depend on its association with triacylated glycolipids binding specifically with the hydrophobic pocket of Mtb LprG lipoprotein. The detection of a glycolipid carrier function has important implications for the role of LprG in Mycobacterial physiology and virulence. Therefore, considering the pivotal role of glycolipids in mycobacterial physiology and host-pathogen interactions, designing competitive antagonist (chemotherapeutics) ligands that competitively bind to glycolipid binding domain in LprG lipoprotein, will lead to inhibition of tuberculosis infection in humans. In this study, a unified approach involving ligand-based virtual screening protocol USRCAT (Ultra Shape Recognition) software and molecular docking studies using Auto Dock Vina 1.1.2 using the X-ray crystal structure of Mtb LprG protein was implemented. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the Ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has the higher hypothetical affinity, also has greater negative value. Based on the USRCAT, Lipinski’s values and molecular docking results, [(2R)-2,3-di(hexadecanoyl oxy)propyl][(2S,3S,5S,6R)-3,4,5-trihydroxy-2,6-bis[[(2R,3S,4S,5R,6S)-3,4,5-trihydroxy-6 (hydroxymethyl)tetrahydropyran-2-yl]oxy]cyclohexyl] phosphate (XPX) was confirmed as a promising drug-like lead compound (antagonist) binding specifically to the hydrophobic domain of LprG protein with affinity greater than that of PIM2 (agonist of LprG protein) with a free binding energy of -9.98e+006 Kcal/mol and binding affinity of -132 Kcal/mol, respectively. A further, in vitro assay of this compound is required to establish its potency in inhibiting molecular evasion mechanism of MTB within the infected host macrophages. These results will certainly be helpful in future anti-TB drug discovery efforts against Multidrug-Resistance Tuberculosis (MDR-TB).

Keywords: antagonist, agonist, binding affinity, chemotherapeutics, drug-like, multi drug resistance tuberculosis (MDR-TB), RV1411c protein, toll-like receptor (TLR2)

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Authors: Gilberto Goracci, Fabio Curti

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This work presents a robust, light, and inexpensive algorithm to perform autonomous orbit determination using onboard magnetometer data in real-time. Magnetometers are low-cost and reliable sensors typically available on a spacecraft for attitude determination purposes, thus representing an interesting choice to perform real-time orbit determination without the need to add additional sensors to the spacecraft itself. Magnetic field measurements can be exploited by Extended/Unscented Kalman Filters (EKF/UKF) for orbit determination purposes to make up for GPS outages, yielding errors of a few kilometers and tens of meters per second in the position and velocity of a spacecraft, respectively. While this level of accuracy shows that Kalman filtering represents a solid baseline for autonomous orbit determination, it is not enough to provide a reliable state estimation in the absence of GPS signals. This work combines the solidity and reliability of the EKF with the versatility of a Recurrent Neural Network (RNN) architecture to further increase the precision of the state estimation. Deep learning models, in fact, can grasp nonlinear relations between the inputs, in this case, the magnetometer data and the EKF state estimations, and the targets, namely the true position, and velocity of the spacecraft. The model has been pre-trained on Sun-Synchronous orbits (SSO) up to 2126 kilometers of altitude with different initial conditions and levels of noise to cover a wide range of possible real-case scenarios. The orbits have been propagated considering J2-level dynamics, and the geomagnetic field has been modeled using the International Geomagnetic Reference Field (IGRF) coefficients up to the 13th order. The training of the module can be completed offline using the expected orbit of the spacecraft to heavily reduce the onboard computational burden. Once the spacecraft is launched, the model can use the GPS signal, if available, to fine-tune the parameters on the actual orbit onboard in real-time and work autonomously during GPS outages. In this way, the provided module shows versatility, as it can be applied to any mission operating in SSO, but at the same time, the training is completed and eventually fine-tuned, on the specific orbit, increasing performances and reliability. The results provided by this study show an increase of one order of magnitude in the precision of state estimate with respect to the use of the EKF alone. Tests on simulated and real data will be shown.

Keywords: artificial intelligence, extended Kalman filter, orbit determination, magnetic field

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Authors: Reham Algheshairy, Khaled Tayeb, Christopher Smith, Rebecca Gregg, Haruna Musa

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Background: Diabetes is a medical condition that refers to the pancreas’ inability to secrete sufficient insulin levels, a hormone responsible for controlling glucose levels in the body. Any surplus glucose in the blood stream is excreted through the urinary system. Insulin resistance in blood cells can also cause this condition despite the fact that the pancreas is producing the required amount of insulin A number of researchers claim that the prevalence of diabetes in Saudi Arabia has reached epidemic proportions, although one study did observe one positive in the rise in the awareness of diabetes, possibly indicative of Saudi Arabia’s improving healthcare system. While a number of factors can cause diabetes, the ever-increasing incidence of the disease in Saudi Arabia has been blamed primarily on low levels of physical activity and high levels of obesity. Objectives: The project has two aims. The first aim of the project is to investigate the regulatory effects of consumption of Nigella seeds and Ajwah dates on blood glucose levels in diabetic patients with type 2 diabetes. The second aim of the project is to investigate whether these dietary factors may have potentially beneficial effects in controlling the complications that associated with type 2 diabetes. Methods: This use a random-cross intervention trail of 75 Saudi male and female with type 2 diabetes in Al-Noor hospital in Makkah ( KSA) aged between 18 and 70 years were divided into 3 groups. Group 1 will consume 2g of Nigella Sativa seeds daily along with a modified diet for 12 weeks, group 2 will be given Ajwah dates daily with a modified diet for 12 weeks and group 3 will follow a modified diet for 12 weeks. Anthropometric measurements were taken at baseline, along with bloods for HbA1c, fasting blood sugar and at the end of 12 weeks. Results: This study found significant decrease in blood level (FBG & 2PPBG) and HbA1c in the groups with diet and Nigella seeds) compared to Ajwa date. However, there is no significant change were found in HbA1c, FBG and 2hrpp regarding Ajwa group. Conclusion: This study illustrated a significant improvement in some markers of glycaemia following 2 g of Ns and diet for 12 weeks. The dose of 2g/day of consumed Nigella seeds was found to be more effective in controlling BGL and HbA1c than control and Ajwa groups. This suggests that Nigella seeds and following a diet may have a potential effect (a role in controlling outcomes for type 2 diabetes and controlling the disease). Further research is needed on a large scale to determine the optimum dose and duration of Nigella and Ajwa in order to achieve the desired results.

Keywords: type 2 diabetes, Nigella seeds, Ajwa dates, fasting blood glucose, control

Procedia PDF Downloads 273

Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

Abstract:

Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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Authors: Luisa Windhagen, Atsumi Hirose, Alex Bottle

Abstract:

Global urbanization has resulted in the expansion of slums, leaving over 10 million Tanzanians in urban poverty and at risk of poor health. Whilst rural residence has historically been associated with an increased risk of adverse pregnancy outcomes, recent studies found higher perinatal mortality rates in urban Tanzania. This study aims to understand to what extent slum neighborhoods may account for the spatial disparities seen in Tanzania. We generated a slum indicator based on UN-HABITAT criteria to identify slum clusters within the 2015-2016 Tanzania Demographic and Health Survey. Descriptive statistics, disaggregated by urban slum, urban non-slum, and rural areas, were produced. Simple and multivariable logistic regression examined the association between cluster residence type and neonatal mortality and stillbirth. For neonatal mortality, we additionally built a multilevel logistic regression model, adjusting for confounding and clustering. The neonatal mortality ratio was highest in slums (38.3 deaths per 1000 live births); the stillbirth rate was three times higher in slums (32.4 deaths per 1000 births) than in urban non-slums. Neonatal death was more likely to occur in slums than in urban non-slums (aOR=2.15, 95% CI=1.02-4.56) and rural areas (aOR=1.78, 95% CI=1.15-2.77). Odds of stillbirth were over five times higher among rural than urban non-slum residents (aOR=5.25, 95% CI=1.31-20.96). The results suggest that slums contribute to the urban disadvantage in Tanzanian neonatal health. Higher neonatal mortality in slums may be attributable to lack of education, lower socioeconomic status, poor healthcare access, and environmental factors, including indoor and outdoor air pollution and unsanitary conditions from inadequate housing. However, further research is required to ascertain specific causalities as well as significant associations between residence type and other pregnancy outcomes. The high neonatal mortality, stillbirth, and slum formation rates in Tanzania signify that considerable change is necessary to achieve international goals for health and human settlements. Disparities in access to adequate housing, safe water and sanitation, high standard antenatal, intrapartum, and neonatal care, and maternal education need to urgently be addressed. This study highlights the spatial neonatal mortality shift from rural settings to urban informal settlements in Tanzania. Importantly, other low- and middle-income countries experiencing overwhelming urbanization and slum expansion may also be at risk of a reversing trend in residential neonatal health differences.

Keywords: urban health, slum residence, neonatal mortality, stillbirth, global urbanisation

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Authors: Zhijie Li, Wenhui Peng, Zelong Yuan, Jianchun Wang

Abstract:

Turbulence is a complex phenomenon that plays a crucial role in various fields, such as engineering, atmospheric science, and fluid dynamics. Predicting and understanding its behavior over long time scales have been challenging tasks. Traditional methods, such as large-eddy simulation (LES), have provided valuable insights but are computationally expensive. In the past few years, machine learning methods have experienced rapid development, leading to significant improvements in computational speed. However, ensuring stable and accurate long-term predictions remains a challenging task for these methods. In this study, we introduce the implicit U-net enhanced Fourier neural operator (IU-FNO) as a solution for stable and efficient long-term predictions of the nonlinear dynamics in three-dimensional (3D) turbulence. The IU-FNO model combines implicit re-current Fourier layers to deepen the network and incorporates the U-Net architecture to accurately capture small-scale flow structures. We evaluate the performance of the IU-FNO model through extensive large-eddy simulations of three types of 3D turbulence: forced homogeneous isotropic turbulence (HIT), temporally evolving turbulent mixing layer, and decaying homogeneous isotropic turbulence. The results demonstrate that the IU-FNO model outperforms other FNO-based models, including vanilla FNO, implicit FNO (IFNO), and U-net enhanced FNO (U-FNO), as well as the dynamic Smagorinsky model (DSM), in predicting various turbulence statistics. Specifically, the IU-FNO model exhibits improved accuracy in predicting the velocity spectrum, probability density functions (PDFs) of vorticity and velocity increments, and instantaneous spatial structures of the flow field. Furthermore, the IU-FNO model addresses the stability issues encountered in long-term predictions, which were limitations of previous FNO models. In addition to its superior performance, the IU-FNO model offers faster computational speed compared to traditional large-eddy simulations using the DSM model. It also demonstrates generalization capabilities to higher Taylor-Reynolds numbers and unseen flow regimes, such as decaying turbulence. Overall, the IU-FNO model presents a promising approach for long-term dynamics prediction in 3D turbulence, providing improved accuracy, stability, and computational efficiency compared to existing methods.

Keywords: data-driven, Fourier neural operator, large eddy simulation, fluid dynamics

Procedia PDF Downloads 46